Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Cumulative Trauma Disorders”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,639 records · Page 91Linked to original sources
PubMed1992

Overuse injuries in adolescent athletes.

As sports participation increases so too does the incidence of injuries, both acute and overuse. The growing skeleton is particularly susceptible due to the presence of growth cartilage at 3 locations; the epiphyseal plate, the joint surface and the apophysis. The risk of injury is most pronounced during the rapid growth spurt of adolescence when other factors, such as muscle tightness across joints, also become important in the aetiology of sporting injury. Overuse injuries seen in this age group may reflect the growth characteristics of the immature skeleton or may be of the type seen in adult athletes undergoing rigorous training schedules. Recent developments in organised competitive sport have seen growing individuals undertake prolonged and intensive training programmes when they are particularly at risk of sustaining an overuse injury. The training programme is one of a number of risk factors important in the generation of injury, many of which can be modified or controlled to an extent. Other factors such as growth deformities or malalignments are peculiar to the individual and preparticipation evaluation of the young athlete helps to identify those at risk. Whilst long term disability rarely eventuates, the loss of enjoyment and temporary incapacity resulting from this type of injury is significant. It is apparent that many of these injuries are preventable, and given the information available concerning the factors involved in their aetiology, it is the responsibility of coaches and health professionals alike to become involved in their early diagnosis, treatment and prevention.

Adolescent↗
PubMed1992

Atraumatic osteolysis of the distal clavicle. A review.

Atraumatic osteolysis of the distal clavicle (AODC) in athletes is a stress failure syndrome of the distal clavicle. It is related to intolerable exercise doses. For some athletes, the acromioclavicular joint is the weak link in the musculoskeletal system. There is never a history of a major injury to the acromioclavicular joint. It occurs principally in young athletes who have a long history of training and performance. It is further characterised by athletes who generally have an associated intense strength training programme. The condition will inexorably progress to decrease the level of performance and later interfere with activities of daily living. If the athlete is unwilling to alter his or her exercise training and performance regimen, she or he will eventually become surgical candidates. The results of excision of the distal clavicle for AODC are good or excellent in virtually all cases. The diagnosis of AODC is confirmed by the history of accumulative exercise doses and the key historical feature of intensive participation in strength training. Local tenderness will be found at the acromioclavicular joint, plain radiographs will show degenerative changes in the vast majority of cases and joint scintigraphy must be positive to confirm the diagnosis.

Acromioclavicular Joint↗
PubMed1992

Gymnastic injuries.

In the past 15 to 20 years gymnastics has become very popular. The increased participation exposes a greater number of athletes to potential injury. The risk of gymnastic injuries seems to be proportional to the level of the athletes; the higher the level of gymnastics, the more hours are spent in practice, with a greater exposure time. With the increased risk in gymnastics, the incidence of acute injuries will also increase, and as the skill level increases, the load during the workout will also increase, providing more opportunity for chronic injuries. As in many sports, the ankle is the most injured body part. Some injuries, however, seem to be specific to gymnastics. In gymnastics the upper extremities are used as weightbearing limbs, so high impact loads are distributed through the elbow and wrist joint. Back problems appear to result not only from single episodes of macrotrauma, but also from repeated microtrauma caused by specific impact loads during vaults and hyperextension. Early detection is the key to treating elbow, wrist and back pain in the gymnast. Reinjury following an acute injury may be reduced by allowing for complete rehabilitation before returning to full practice. Some studies indicate that maturation rate could play a potential role in injury predisposition. The combination of periods of rapid growth and intense training could provide for conditions where the gymnast is more injury prone.

Athletic Injuries↗
PubMed1992

Energy expenditure, aerodynamics and medical problems in cycling. An update.

The cyclist's ability to maintain an extremely high rate of energy expenditure for long durations at a high economy of effort is dependent upon such factors as the individual's anaerobic threshold, muscle fibre type, muscle myoglobin concentration, muscle capillary density and certain anthropometric dimensions. Although laboratory tests have had some success predicting cycling potential, their validity has yet to be established for trained cyclists. Even in analysing the forces producing propulsive torque, cycling effectiveness cannot be based solely on the orientation of applied forces. Innovations of shoe and pedal design continue to have a positive influence on the biomechanics of pedalling. Although muscle involvement during a complete pedal revolution may be similar, economical pedalling rate appears to differ significantly between the novice and racing cyclist. This difference emanates, perhaps, from long term adaptation. Air resistance is by far the greatest retarding force affecting cycling. The aerodynamics of the rider and the bicycle and its components are major contributors to cycling economy. Correct body posture and spacing between riders can significantly enhance speed and efficiency. Acute and chronic responses to cycling and training are complex. To protect the safety and health of the cyclist there must be close monitoring and cooperation between the cyclist, coach, exercise scientist and physician.

Bicycling↗
PubMed1992

Iliotibial band syndrome.

The iliotibial band syndrome is most often diagnosed in runners but can be found in athletes who participate in other sports. From our experience most patients are high mileage runners with shoes either worn out or with insufficient cushioning. A total of 19 athletes with this condition have been seen in the past 3 years. Treatment consisted of rest or decreased distance, shoe changes, modification in exercise technique, anti-inflammatory medication, steroid injections and stretching. Surgery was not required.

Adolescent↗
PubMed1993

Patellofemoral stress syndrome. Current concepts.

Patellofemoral stress syndrome is a condition of peripatellar pain without anatomic malalignment, history of trauma, patellar instability or clinical evidence of patellofemoral crepitus. These patients demonstrate lateral retinacular and iliotibial band tightness. Frequently, the patient's pain occurs when sitting for prolonged periods of time with the knee flexed, and most commonly with sporting events. A complete history and physical evaluation is necessary for an accurate diagnosis. This evaluation should include the following radiographs: anterior-posterior, lateral, and most importantly, the tangential views. Once diagnosed, patellofemoral stress syndrome is usually treated conservatively. Studies indicate that 60 to 80% of knees will respond favourably to conservative treatment. The exercise programme should include iliotibial band stretching, hamstring stretching, gastrocnemius stretching, progressive resistance straight leg raising and hip adduction strengthening. These exercises should be performed 2 times/day until symptoms subside and then 3 times/week as long as the patient is active in sports. If the conservative programme fails, surgical management may be considered. A lateral retinacular release or possibly lateral retinacular lengthening are surgical procedures recommended as reliable solutions in the majority of patients. These procedures require continuation of the exercise programme to be successful.

Athletic Injuries↗
PubMed1994

Biomechanical factors associated with shoe/pedal interfaces. Implications for injury.

The principal demand on the body during cycling is on the lower extremities as they are responsible for producing a majority of the energy imparted to the bike. As a result the legs, due to high reactive forces between the foot and pedal, experience high loads on the joints. These loads may adversely affect joint tissues and contribute to overuse injuries, e.g. knee pain. The mechanical link between the leg and the bike is the shoe/pedal interface. This transmission site, by design, can either create smooth transfer of energy or abnormally high repetitive loads which are potentially injurious to the body. Incidence of lower extremity injury in cycling is high, and historically biomechanical analyses of this activity have focused their attention on either the rider or the bike, but not the link between the two. Recently, pedal designs have changed in response to complaints of sore knees with the development of pedals allowing varying degrees of float. This form of transmission is intended to enhance power transfer from rider to bike as well as minimise trauma to the legs by permitting the foot to rotate during the pedalling cycle in a toe-in/heel-out or heel-in/toe-out movement pattern. Recent evidence suggests this type of pedal design does reduce trauma and maintains power output. This article reviews common lower extremity overuse injuries and biomechanical factors during the pedalling cycle with the primary focus on the shoe/pedal interface. We will summarise information available on lower extremity kinematics and kinetics as well as recent data specifically related to shoe/pedal interface kinetics, evaluation of different pedal types-specifically comparison between clipless 'fixed' and clipless 'float' systems-and discuss their resultant effect on lower extremity dynamics and their implications for injury.

Bicycling↗
PubMed1994

Wrist injuries in sport.

The wrist is a complex joint that biomechanically transmits forces generated at the hand through to the forearm. The radial side of the wrist carries 80% of the axial load and the ulnar side the remaining 20% of the load. The incidence of wrist (and hand) injuries in the sporting population is approximately 25%. This tends to be higher in those sports using the hand and wrist, and when the potential for trauma is present. The injuries are divided into 4 categories: overuse, nerve (and vascular), traumatic, and weight-bearing injuries. Overuse injuries are common in sports involving the hand and wrist, such as racquet sports, netball, basketball and volleyball. Nerve injuries are more commonly compressive neuropathies, and are seen with cyclists who may compress the ulnar nerve in Guyon's canal. Vascular injuries are uncommon and usually result from a high velocity impact from balls. Traumatic injuries are the most common and are due to either a fall on to the wrist, a direct blow, or combination of a rotatory and torsional force. The weight-bearing injuries are more specific to gymnastics, and result from repetitive excessive compressive and rotational forces across the wrist. The pommel horse event is associated with a high incidence of wrist pain in male competitors. Arthroscopy of the wrist provides direct inspection of intra-articular structures and diagnosis of conditions that may be unclear with other investigations. As techniques advance, more conditions may be treated arthroscopically and potentially facilitate an earlier return to sport.

Athletic Injuries↗
PubMed1995

Overuse injuries in classical ballet.

Successful management of classical ballet dancers with overuse injuries requires an understanding of the art form, precise knowledge of anatomy and awareness of certain conditions. Turnout is the single most fundamental physical attribute in classical ballet and 'forcing turnout' frequently contributes to overuse injuries. Common presenting conditions arising from the foot and ankle include problems at the first metatarsophalangeal joint, second metatarsal stress fractures, flexor hallucis longus tendinitis and anterior and posterior ankle impingement syndromes. Persistent shin pain in dancers is often due to chronic compartment syndrome, stress fracture of the posteromedial or anterior tibia. Knee pain can arise from patellofemoral syndrome, patellar tendon insertional pathologies, or a combination of both. Hip and back problems are also prevalent in dancers. To speed injury recovery of dancers, it is important for the sports medicine team to cooperate fully. This permits the dancer to benefit from accurate diagnosis, technique correction where necessary, the full range of manual therapies to joint and soft tissue, appropriate strengthening programmes and maintenance of dance fitness during any time out of class with Pilates-based exercises and nutrition advice. Most overuse ballet conditions respond well to a combination of conservative therapies. Those dancers that do require surgical management still depend heavily on ballet-specific rehabilitation for a complete recovery.

Ankle Injuries↗
PubMed1995

Exercise loading of tendons and the development of overuse injuries. A review of current literature.

This review examines recent studies on the effects of exercise on tendons in animal models. Although tendon adaptation to exercise has been described using histology, morphometry, ultrasonography and molecular biology, precise measurements of excess tendon loading during exercise protocols have not been reported. Only a few studies have attempted to evaluate the mechanical strength of exercised tendons. The long term effect of exercise on tendons appears to be positive, but researchers have suggested that periods of mechanical weakness occur in tendons during adaptation to loading conditions. Studies documenting changes associated with the terminal state of pathological tendons are also summarised. Unfortunately, there are no descriptions of tendon tissue in the early stages of overuse injury. Since blood flow is commonly implicated in the emergence of tendinitis, the final section covers recent work on blood flow and tendon physiology. Related research identifying cellular mediators (hyperthermia, hypoxia, and oxidative stress) involved in the development of tendinitis is also presented. Suggestions for further research into exercise loading and the development of tendon overuse injuries are made.

Adaptation, Physiological↗
PubMed1995

Injuries and bungee jumping.

Bungee jumping is a recreational sport that has gained world-wide popularity since its inception in 1955. Over 2 million individuals have performed bungee jumps since that time. The injuries and deaths which have occurred have made safety an integral issue in the practice of the sport. Although early reports of significant injuries are infrequent, more recent investigations have indicated severe sequelae, including ocular haemorrhage, peroneal nerve palsy and quadriplegia. Reports of minor trauma have also been numerous. Aetiology includes natural forces, impact, technician error, equipment failure and repetitive stress. Free-falling approximately 60 to 120m (200 to 400ft) and then being jerked to safety at the last minute creates a certain amount of unavoidable, and almost desired risk. A reduction in acute trauma may be possible with immediate changes in equipment, technique and regulations. Further studies are warranted to determine the future direction and safety of this recreational sport.

Athletic Injuries↗
PubMed1996

Injuries in cross-country skiing: a critical appraisal of the literature.

This study comprehensively reviews and critically appraises recent literature on cross-country skiing injuries. Particular attention was paid to the study design when reviewing the literature, thereby producing a measure of internal and external validity. From these data, the factors associated with the aetiology, frequency, site distribution and types of cross-country skiing injuries are examined. The incidence of injury in cross-country skiing is estimated to be between 0.49 and 5.63 per 1000 skier days. The most common injuries are medial collateral ligament sprains of the knee, and ulnar collateral ligament sprains of the thumb. Overuse and cold injuries (e.g. hypothermia and frostbite) appear to be common as well, although the data do not provide an estimate of incidence. Comments in the literature on prevention of these injuries are mainly empirical: they recommend safer equipment, wise choice of terrain and a general increase in skier awareness of ways to prevent injury. However, rigorous studies that adequately evaluate preventive intervention strategies have yet to be conducted. Cross-country skiing is relatively safe and a suitable activity for physical fitness and rehabilitation. In the future, studies employing an analytical design will be required to evaluate the effectiveness of injury prevention intervention strategies.

Arm Injuries↗
PubMed1997

Anatomical factors associated with overuse sports injuries.

Overuse injuries develop when repetitive stress to bone and musculotendinous structures damages tissue at a greater rate than that at which the body can repair itself. A combination of extrinsic factors, such as training errors and environmental factors, and intrinsic or anatomical factors, such as bony alignment of the extremities, flexibility deficits and ligamentous laxity, predispose athletes to develop overuse injuries. Malalignant of the lower extremity, including excess femoral anteversion, increased Q angle, lateral tibial torsion, tibia vara, genu varum or valgum, subtalar varus and excessive pronation are frequently cited as predisposing to knee extensor mechanism overuse injuries. These and other forms of malalignment have also been implicated in iliotibial band syndrome, medial tibial stress syndrome, lower extremity stress fractures and plantar fasciitis. Muscle inflexibility aggravates and predisposes to the development of a variety of overuse injuries, especially those occurring in children and adolescents, including the traction apophysitises. Flexibility deficits may be improved by an appropriate stretching programme. Unfortunately, lower extremity malalignment is less amenable to intervention. Orthotics are often prescribed to improve lower extremity alignment. However, studies have not shown that orthotics have any effect on knee alignment and, while they can alter subtalar joint alignment, the clinical benefit of this remains unclear. Awareness of anatomical factors that may predispose to overuse injuries allows the clinician to develop individual prehabilitation programmes designed to decrease the risk of overuse injury. In addition, the clinician can advise the athlete on the importance of avoiding extrinsic factors that may also predispose to overuse injury.

Arm↗
PubMed1997

Rotator cuff pathology in athletes.

The rotator cuff is the primary dynamic stabiliser of the glenohumeral joint and is placed under significant stress during overhead and contact sports. Mechanisms of injury include repetitive microtrauma, usually seen in the athlete involved in overhand sports, and macrotrauma associated with contact sports. Rotator cuff injury and dysfunction in the overhand athlete may be classified based on aetiology as primary impingement, primary tensile overload, and secondary impingement and tensile overload resulting from glenohumeral instability. A thorough history and physical examination are paramount in the evaluation, classification and treatment planning of the athlete with rotator cuff pathology. Imaging studies are a helpful adjunct to the history and physical. Athletes with primary impingement are usually middle aged or older and often have chronic shoulder pain and sometimes weakness associated with overhand sporting activities. Night pain is typical of full thickness rotator cuff tears. Impingement signs are positive and strength of elevation and external rotation are often limited. They usually respond to a nonoperative rehabilitation programme centred on decreasing inflammation, restoring range of motion and strengthening the rotator cuff and scapular stabilisers. Depending on the degree of cuff pathology, acromioplasty, debridement of partial cuff tears, and repair of full thickness tears are usually successful in those who fail a rehabilitation programme. Overhand athletes with cuff pathology secondary to subtle anterior instability are usually young and complain of pain and decreased throwing velocity. Instability may be so subtle that it is only detectable through a positive relocation test on examination. The majority of these athletes do not have a Bankart lesion on magnetic resonance imaging or arthroscopic examination. Arthroscopic examination usually demonstrates anterior capsular laxity (positive 'drive-through' sign), as well as superior-posterior labral and cuff injury typical of internal impingement. If rehabilitation alone is not successful, a capsulolabral repair followed by rehabilitation may allow the athlete to return to their previous level of competition. The athlete with an acute episode of macrotrauma to the shoulder resulting in cuff pathology usually presents with pain, limited active elevation and a positive 'shrug sign'. Arthroscopy and debridement of thickened, inflamed or scarred subacromial bursa with cuff repair or debridement as indicated is usually successful in those who do not respond to a rehabilitation programme.

Arthroscopy↗
PubMed1998

Elbow, forearm and wrist injuries in the athlete.

Competitive and recreational athletes sustain a wide variety of soft tissue, bone, ligament, tendon and nerve damage to their upper extremities. Most such injuries are related to direct trauma or repetitive stress, and account for a significant amount of 'down time' for athletes participating in a wide range of sports, particularly those in which the arm is utilised for throwing, catching or swinging. Overuse injuries to the elbow include musculotendinous injuries, ulnar nerve injuries and ligamentous injuries. Osteochondrol lesions of the capitellum and posterior impingement injuries in the joint are frequently seen in athletes as well. Acute traumatic injuries to the elbow include tendon ruptures, elbow dislocations and intra-articular fractures. Forearm overuse injuries in athletes include fracture of the carpal scaphold, fracture of the hook of the hamate, Kienbock's syndrome and pisoquetral syndromes. ligamentous injuries include scapholunate, lunotriquetral and midcarpal instability injuries. Injuries to the distal radio-ulnar joint and triangular fibrocartilage are also quite common in athletes, and require careful evaluation and treatment.

Athletic Injuries↗
PubMed1998

Common sports injuries in young tennis players.

Tennis is a popular racquet sport played by boys, girls, men and women. Tennis players frequently begin playing in childhood and may continue playing into late adulthood. Preadolescent and adolescent players have open growth plates and a reduced muscle power, lower level of coordination and smaller stature compared with adult players. The physical characteristics of the young tennis player mean that unique demands are placed on the developing athlete which can, in turn, be associated with different types and patterns of injury. The most common types of injury in tennis players of all ages are muscle sprains and ligament sprains secondary to overuse. These are a particular problem in the adolescent age group because, in general, this group begin playing with a lower level of physical conditioning. Fortunately, injuries in younger players are usually not longstanding and the overuse (chronic) problems seen in older players, such as patellar tendinosis and tennis elbow, are less common in younger players. Anatomically, lower extremity injuries are twice as common as those to the upper extremity or spine, with ankle injury being the most common. Prevention of injury in young tennis players, or at least a reduction in the incidence, is possible. Some traumatic injuries, including contusions, abrasions, lacerations and fractures, may be unavoidable as a result of aggressive play, but others may be prevented by monitoring equipment and the court surface to ensure a safe field of play. The prime target of prevention in young tennis players should be overuse injuries. The principles of 'overload' and staged involvement are of particular importance in this age group. A gradual, progressive increase in the intensity of tennis practice, the slow introduction of new court surfaces and a staged progression in the teaching of tennis skills can help to reduce the incidence of injury in young tennis players.

Adult↗
PubMed1998

Common elbow injuries in sport.

Athletes of all ages and skill levels are increasingly participating in sports involving overhead arm motions, making elbow injuries more common. Among these injuries is lateral epicondylitis, which occurs in over 50% of athletes using overhead arm motions. Lateral epicondylitis is characterised by pain in the area where the common extensor muscles meet the lateral humeral epicondyle. The onset of this pathological condition begins with the excessive use of the wrist extensor musculature. Repetitive microtraumatic injury can lead to mucinoid degeneration of the extensor origin and subsequent failure of the tendon. Lateral epicondylitis can almost always be treated nonoperatively with activity modification and specific exercises. If the athlete fails to respond to nonoperative treatment after 6 months to 1 year, they are candidates for surgical intervention. Medial epicondylitis is characterised by pain and tenderness at the flexor-pronator tendinous origin with pathology commonly being located at the interface between the pronator teres and flexor carpi radialis origin. Golfers and tennis players often develop this condition because of the repetitive valgus stress placed on the medial elbow soft tissues. Careful evaluation is important to differentiate medial epicondylitis from other causes of medial elbow pain. As with lateral epicondylitis, patients with medial epicondylitis not responding to an extensive nonoperative programme are candidates for surgical intervention. A less common cause of medial elbow pain is medial ulnar collateral ligament injury. Repetitive valgus stress placed on the joint can lead to microtraumatic injury and valgus instability. When the medial ulnar collateral ligament is disrupted, abnormal stress is placed on the articular surfaces that can lead to degenerative changes with osteophyte formation. As with other elbow injuries, a strict rehabilitation regimen is first employed; ligament reconstruction is only recommended if the injury fails to improve and only in athletes requiring a high level of performance. Excessive valgus stress can also lead to posteromedial olecranon impingement on the olecranon fossa producing pain, osteophyte and loose body formation. Arthroscopic elbow debridement can often be helpful in improving motion and in reducing pain in such patients.

Athletic Injuries↗