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PubMed2006

Rapid rehabilitation programme following sacral stress fracture in a long-distance running female athlete.

Stress fractures occur in normal bone due to mechanical overload by cyclic stress increasing the osteoclastic activity, thus facilitating weakening leading to fracture of bones. Long-distance running may lead to stress fractures of the mid- and distal tibia and of the metatarsal bones. Stress fractures to the sacrum are rare. Certain factors for stress fractures in runners have been identified, such as leg-length inequality, a high longitudinal arch of the foot, forefoot varus, and menstrual irregularities in case of female athlete triad. We report on a 22-year-old female runner (usually training 140 km/week) suffering a sacral fatigue-type fracture. The female athlete triad with eating disorders, dysmenorrhea, and osteopenia was ruled out. Sexual hormone blood samples proofed normal values. The diagnosis was performed using magnetic resonance imaging 2 weeks after the onset of buttock pain. A conservative treatment regimen was initiated with strict physical rest for the first 2 weeks, and then gradual increase of physical activity with 60-90 min of daily cycling and moderate 2 x 60 min cross-training. After another 2 weeks time, daily 60-90 min of walking, Nordic pole walking, and moderate strength training two times a week was performed. At 7 weeks running was started, gradually increased to 90 km/week without any pain. A rapid rehabilitation programme after sacral stress fractures involving low impact physical activity, such as Walking and Nordic pole walking, is applicable to female athletes after ruling out the female athlete triad.

Adult↗

PubMed2026

Comparative adipokine profile in middle-aged master athletes, untrained adults, and young individuals.

BACKGROUND: Adipose tissue is an active endocrine organ involved in metabolic regulation and systemic inflammation, processes that are altered during aging. Nevertheless, the adipokine profile associated with lifelong physical training in master. athletes remains incompletely characterized. AIM: This study investigated circulating concentrations of adiponectin, leptin, resistin, insulin, and the leptin-to-adiponectin and adiponectin-to-resistin ratios in four male groups: endurance master athletes (ME), master sprinters (MS), untrained middle-aged adults (UMA), and untrained young adults (YU). METHODS: ME (n = 17, 50.5 ± 9.6 years), MS (n = 30, 50.3 ± 6.2 years), UMA (n = 16, 48.5 ± 7.5 years), and YU (n = 23, 23.7 ± 4.0 years) underwent anamnesis, anthropometric assessments, and serum concentrations of adiponectin, leptin, resistin, and insulin using commercial ELISA kits. RESULTS AND DISCUSSION: Significant group differences were observed for all variables (p < 0.001). UMA exhibited higher concentrations of leptin, insulin, and resistin, together with an elevated leptin-to-adiponectin ratio and a reduced adiponectin-to-resistin ratio compared with the other groups (p < 0.05). MS also presented higher leptin and insulin levels and an increased leptin-to-adiponectin ratio compared. with YU (p < 0.05), as well as a lower adiponectin-to-resistin ratio (p < 0.05). Overall, effect sizes were large across outcomes, and master athletes displayed a more favorable adipokine profile than untrained middle-aged adults, suggesting potential metabolic adaptations associated with lifelong training. CONCLUSIONS: Middle-aged master athletes exhibited a more favorable adipokine profile than untrained middle-aged adults, with values approaching those observed in young individuals.

Adipose tissue↗

PubMed1999

Reconstruction plate fixation with bone graft for mid-shaft clavicular non-union in semi-professional athletes.

From 1993 to 1997, 22 semi-professional athletes (14 men and 8 women), aged 18-33 years (mountain bike racers, soccer players, handball players, swimmers, and short distance runners) with a non-union of the middle third of the clavicle were treated operatively by reconstruction plating and bone grafting. Fourteen clavicular non-unions were caused by falls. Eight non-unions were the result of a car, motorcycle, or bicycle accident. There were 19 atrophic and 3 hypertrophic non-unions. In all patients, initially a figure-of-eight strap or a sling was used for immobilization and no radiographic union was documented within 5 months. None of the athletes had gone back to their sports and all had pain and limitation of shoulder function. For open reduction and internal fixation, an AO 3.5-mm seven-hole reconstruction plate was used. The sclerotic bone ends were freshened and a cortical bone transplant or cancellous bone from the iliac crest (depending on the shortening of the clavicle) was packed around the fracture or between the reduced fracture ends. In all athletes, radiographic consolidation was achieved after an average of 14 weeks (range, 11-16 weeks) and the average increase in the Constant and Murley Score was from 79 points preoperatively to 97 points after surgery. No operative or postoperative complications occurred and all athletes returned to their sports.

Accidental Falls↗

PubMed1995

Specificity and sensitivity of the anterior slide test in throwing athletes with superior glenoid labral tears.

This study documents the sensitivity and specificity of a clinical test to aid in the diagnosis of superior glenoid labral lesions. The anterior slide test, a method of applying an anteriorly and superiorly directed force to the glenohumeral joint, was performed on several groups of athletes. These included symptomatic athletes with isolated superior labral tears, rotator cuff tears, and instabilities, and asymptomatic athletes with rotational deficits. In addition, non-throwing athletes were tested. The sensitivity of the test was 78.4%, and the specificity was 91.5%. This study shows that the anterior slide test can be used in the clinical examination, in that it has high specificity for superior labral lesions, but not enough sensitivity to be the sole diagnostic criterion for these lesions.

Adolescent↗

PubMed2004

Special concerns of the female athlete.

The majority of injuries sustained by female athletes are due to participation in sports rather than their sex. Anatomic, hormonal,and functional differences should be understood when treating the female athlete. Screening should be done for eating disorders and the female athlete triad. Female athletes have increased rates of injury to the anterior cruciate ligament and patellofemoral disorders compared with their male counterparts.

Adult↗

PubMed2005

Electromyographic analysis of the knee during jump landing in male and female athletes.

Many noncontact anterior cruciate ligament (ACL) injuries in female athletes occur at foot strike during jump landing when the knee is extended. This study was undertaken to determine the activation level of the quadriceps and hamstring muscles electromyographically. Fifteen healthy volunteers (eight women and seven men), all of whom were collegiate basketball players, participated in the study. The maximum voluntary contraction (MVC) of the vastus medialis (VM) at a knee flexion angle of 15-45 degrees was significantly higher in women than in men. There was no significant difference in overall mean hamstring activity in men and women over the same knee flexion range. However, when the knee flexion angle was 15 degrees , 20 degrees , and 25 degrees , hamstring activity was significantly lower in female athletes. These results suggest that female athletes have a higher risk of ACL injury during jump landing due to increased anterior tibial translation force with quadriceps muscle activity. Female athletes require greater hamstring activation, and it is suggested that exercising this muscle will increase its activity when the knee is extended, thus preventing ACL injury during actual sport motions.

Adult↗

PubMed2006

Female athlete triad and stress fractures.

Stress fractures are a common occurrence in athletes, and the incidence of stress fractures in female Division 1 collegiate athletes is double that of men. Hormonal influences on bone and bone morphology may influence the risk for fracture. A high level of suspicion and special imaging procedures allow for accurate diagnosis of these fractures. In stress fractures that are associated with the female athlete triad, addressing the three aspects of the triad--eating disorders, amenorrhea, and osteoporosis--are critical for successful treatment. Preparticipation screening for the presence of signs of the female athlete triad by monitoring weight, energy level, menstrual cycles, and bone mineral density may help to prevent the occurrence of stress fractures in this population.

Amenorrhea↗

PubMed2005

The college athlete.

Participation in sports is important to many college students. Student athletes come from different levels of previous sport experience as they enter collegiate athletics. The primary source of student medical care is the campus student health center. The health care providers at student health centers attend to many of the sports-related concerns of student athletes. Preparticipation evaluation provides an opportunity to assess the general health of the student athlete and to identify conditions that might increase the risk of further injury. Sudden cardiac death and sports-associated concussions have generated much interest and are reviewed in this article. Other areas reviewed here include use of drugs and supplements, ankle sprains, acute knee ligament injuries, back pain, and shoulder impingement syndrome.

Athletic Injuries↗

PubMed2001

Treatment of the athlete with multidirectional shoulder instability.

Treatment of multidirectional instability in the athlete continues to be a challenging problem. Nonoperative treatment remains the initial treatment of choice in most athletes. However, some patients will fail nonoperative treatment and might require operative intervention. An open capsular shift procedure is indicated in nonoverhead athletes, most contact athletes and in most revision situations. However, the advances in thermal treatment of the capsule have made arthroscopic electrothermal capsulorrhaphy increasingly attractive as an alternative to the open approach for the primary treatment of multidirectional instability. Longer follow-ups will be necessary before definitive statements can be made regarding the arthroscopic techniques.

Arthrography↗

PubMed1999

Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: randomised trial.

BACKGROUND: Groin pain is common among athletes. A major cause of long-standing problems is adductor-related groin pain. The purpose of this randomised clinical trial was to compare an active training programme (AT) with a physiotherapy treatment without active training (PT) in the treatment of adductor-related groin pain in athletes. METHODS: 68 athletes with long-standing (median 40 weeks) adductor-related groin pain--after examination according to a standardised protocol--were randomly assigned to AT or PT. The treatment period was 8-12 weeks. 4 months after the end of treatment a standardised examination was done. The examining physician was unaware of the treatment allocation. The ultimate outcome measure was full return to sports at the same level without groin pain. Analyses were by intention to treat. FINDINGS: 23 patients in the AT group and four in the PT group returned to sports without groin pain (odds ratio, multiple-logistic-regression analysis, 12.7 [95% CI 3.4-47.2]). The subjective global assessments of the effect of the treatments showed a significant (p=0.006) linear trend towards a better effect in the AT group. A per-protocol analysis did not show appreciably different results. INTERPRETATION: AT with a programme aimed at improving strength and coordination of the muscles acting on the pelvis, in particular the adductor muscles, is very effective in the treatment of athletes with long-standing adductor-related groin pain. The potential preventive value of a short programme based upon the principles of AT should be assessed in future, randomised, clinical trials.

Adolescent↗

PubMed1983

The adolescent. Athletics and development.

An appreciation of adolescent growth and development is essential to the understanding of problems faced by the adolescent athlete. Early adolescence (ages 10-15 years) can be characterized as the body period. Physical growth is genetically determined and can be influenced by disease, injury, and nutrition. Early maturers are subject to adult expectations which may lead to either failure or excessive acclaim. Middle adolescence (ages 15-18 years) is the sexuality period, with special emphasis on gender identity. Friendships are critical, and athletics can be a focal point for showing love and affection without social fear. Late adolescence (ages 18-22 years) is the separation period. Young people with athletic skills leave home to face greater athletic and academic pressure and competition in college. Adjustment to this final adolescent period is achieved through learning to lose as well as win with grace and dignity.

Adolescent↗

PubMed2001

[Pubic osteomyelitis in athletes].

INTRODUCTION: Pubic osteomyelitis has been described in three situations: children in whom Staphylococcus aureus is the preeminent pathogen; elderly patients who have undergone genitourinary procedures, and parenteral drug abusers. In contrast, pubic osteomyelitis in athletes has been described less often. We report three cases of acute staphylococcal pubic osteomyelitis in young athletic men and present a review of the literature. EXEGESIS: The clinical presentation in each case was acute groin, hip, or perineal pain; fever; inability to bear weight; and pubic symphysis tenderness. The diagnosis was established by blood culture and radiologic changes. CONCLUSIONS: Staphylococcus aureus pubic osteomyelitis should be suspected in athletes who have febrile hip or groin pain. The pathogenesis of this disease is thought to involve preexisting trauma or athletic injury and subsequent seeding of this area during transient bacteremia. Prolonged antimicrobial therapy is required for the cure, and debridement with curettage may be necessary if patients have persistent infection or sequestra.

Adolescent↗

PubMed2003

On-the-field evaluation of an athlete with a head or neck injury.

Head and cervical spine sports-related injuries are intimately associated. The on-field evaluation and management of the athlete with these injuries is of paramount importance to stabilize the athlete and prevent further injury. Clinicians need to be aware of the differential diagnoses and consider each possibility based on the mechanism of injury. Although recognition of head and cervical spine injuries has resulted in significant reductions of catastrophic neurological injuries, especially in the cervical spine, further advances to decrease the incidence and long-term sequelae of head and neck injuries are needed. The first step is education of the athlete and the individuals involved in the care of that athlete.

Athletic Injuries↗

PubMed1997

The athletic trainer's perspective.

This article provides a comprehensive understanding of the qualifications and responsibilities of an athletic trainer. It describes the athletic trainer's role in conditioning, injury prevention, and treatment of athletic injuries. The advantages of different types of flexibility, running, and strength training are also included. In addition, the importance of diet and fluid replacement are explained with the guidelines to follow, and treatment and rehabilitation programs for the injured athlete are described.

Athletic Injuries↗

PubMed1997

The athlete's heart.

We have provided an overview of the athlete's heart, focusing on the young athlete. Primary caretakers of athletes should know the major causes of exercise-related cardiac complications and sudden cardiac death and look for these conditions during preparticipation evaluations. We strongly suggest that coaches and other athletic personnel be required to learn basic life support measures such as cardiopulmonary resuscitation (CPR) and to update their skills on an annual basis. Such efforts will help prevent additional exercise-related cardiac deaths.

Adaptation, Physiological↗

PubMed1998

Medicolegal aspects of athletic head injury.

This article reviews the legal aspects of head injuries resulting from a variety of athletic activities, focusing primarily on head and brain injuries resulting from the playing of football, boxing, horseback riding, winter sports (hockey and skiing), and soccer. Part 1 give a general overview of the occurrence of head injuries in athletics and the potential for litigation. Part 2 reviews the history of and increase in sports injury litigation, as well as resulting changes in the law. In Part 3, the current status of athletic head injury litigation, the parties involved, types of claims brought, and viable defenses are discussed. Finally, Part 4 reviews different ways to reduce athletic head injury litigation through better equipment design and adequate warning and instructions for users and coaches.

Athletic Injuries↗

PubMed1998

Wrist fractures in the athlete. Distal radius and carpal fractures.

The primary prerequisites for optimal management of the athlete's fractured wrist are prompt diagnosis, anatomic and stable reduction, effective immobilization until healing is thorough, and comprehensive rehabilitation of the injured parts. Fulfillment of these fundamental criteria consistently leads to a highly favorable outcome with minimal risk of re-injury. In contrast, a compromise of these principles, especially for the sake of a speedy return to sports, invariably results in suboptimal recovery and, not infrequently, a permanent loss of skills. The exceptions to the cardinal rule that successful treatment of wrist fractures requires precise restoration of anatomic relationships are specific: displaced hamate hook fractures, displaced trapezial ridge fractures, and comminuted pisiform fractures. In such instances, successful union essentially is precluded, and early excision of the displaced fragments is the logical means of facilitating an uncomplicated recovery. For the more complex fractures requiring stabilization, continual refinements in methods of fixation are considerably diminishing fracture morbidity. The availability of small screws that provide rigid fixation of the carpus is, with increasing consistency, promoting accelerated union and rapid rehabilitation. Well-conceived combinations of low-profile, mechanically efficient external fixators and precisely used Kirschner wires achieve highly secure fracture stability for the distal radius that similarly enhances recovery with a minimum of complications. Improvements in both design and application of internal and external fixation techniques undoubtedly constitute a major advance in the management of wrist fractures among athletes. For some athletes, the return to competition can be safely expedited by the use of custom-fit protective gloves, splints, or casts. For most, however, the treatment regimen usually entails a minimum of 3 to 4 months. Although the healing and rehabilitation process is often lengthy and may seem costly, particularly in terms of time lost from competition, seldom do athletes regret the investment once they return to their highly skillful activities unencumbered by wrist impairment. Never does the sports medicine physician regret compliance with the principles of optimal care.

Athletic Injuries↗

PubMed2001

Valgus instability of the elbow in athletes.

Valgus instability of the elbow in athletes is uncommon among athletes in general, but has a higher incidence in individuals who throw repetitively. When valgus overload injury results in disabling symptoms for the athlete, surgical reconstruction of the anterior band of the ulnar collateral ligament may be indicated. This procedure has been successful in getting athletes back to premorbid levels of competition. The authors provide a comprehensive review of valgus instability of the elbow and offer their preferred method of treatment.

Athletic Injuries↗