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PubMedDate not supplied

Preparticipation health screening of young athletes. Results of 1268 examinations.

The major purpose of the preparticipation physical examination of athletes is to screen for conditions that could predispose the athlete to injury or death. However, this examinations offered to many of the athletes in this country fail to adequately accomplish this. This study analyzed the preparticipation health exams of prospective sports participants from all public schools in Richmond County, Georgia for two consecutive years. We sought to identify the components of a preparticipation exam which most accurately identified athletes who were at risk of sustaining injury. The most frequently reported problems on the health history were previous injuries, previous hospitalizations, and joint problems. These were consistent over the two years. The problems recorded most frequently on the physical exam involved the lower extremities, mouth, teeth, heart, eyes, and genitalia. However the prevalence of abnormalities found during the first year of the study was significantly lower than that identified in the second study. Analysis of the findings resulted in a more standardized approach to the examination and in an improved examination form.

Adolescent↗
PubMedDate not supplied

Some biomechanical aspects of the foot and ankle in athletes with and without shin splints.

Thirteen adult male athletes (long-distance runners and orienteerers without foot problems) and 35 male athletes with shin splints were compared with respect to: 1) the position of the lower leg and the heel while standing, 2) the passive range of mobility in the subtalar joint, and 3) the angular displacement between the calcaneus and the midline of the lower leg (Achilles tendon angle) while running with bare feet on a treadmill. In standing, the two groups differed statistically significantly in the Achilles tendon angle, which values were greater in the shin splint group. With respect to passive mobility, the athletes with shin splints had significantly greater (P less than 0.05-0.01) angular displacement values in inversion, eversion, and in their sum than the control group. While running, the Achilles tendon angle of the shin splint group was significantly greater (P less than 0.01) at the heel strike. Further, the shin splints group had a significantly greater (P less than 0.01) angular displacement between the heel strike and the maximal everted position. The results suggest structural and functional differences in the feet and ankles between healthy athletes and those with shin splints.

Achilles Tendon↗
PubMedDate not supplied

The aging athlete.

In summary, the purpose of this material is to demonstrate that the aging athlete does differ from the younger competitor in many facets. There are physiological, structural, and psychosocial differences which distinguish them as a unique entity in the athletic world. Despite the unavoidable alterations that the passage of time imposes on our bodies, these competitors are still capable of incredible performances of strength, skill, and endurance. In reference to injury, these athletes are at risk from both their current program and their past indiscretions. The literature strongly suggests that the greatest threat to the health of the aging athlete is not the aging process itself but rather inactivity. Astrand concurs with this and states that "there is less risk in activity than in continuous inactivity--it is more advisable to pass a careful physical examination if one intends to be sedentary in order to establish whether one's state of health is good enough to stand the inactivity." It appears that the body systems were designed to reinforce activity and when there is disuse, a large number of atrophic changes take place. It has been estimated that regular exercise may be able to retard the physiologic decline associated with old age as much as 50%. Taken in this light, exercise is truly a fountain of youth from which we can all rejuvenate ourselves. Science has proven that life does not begin at 40, but it has also demonstrated that it does not have to end there. As one author so aptly states, "Not too many years ago the words grandma and grandpa conjured images of rocking chairs and inactivity."(ABSTRACT TRUNCATED AT 250 WORDS)

Aging↗
PubMedDate not supplied

Acute brachial neuropathy in athletes.

Acute brachial neuropathy is an uncommon etiology of shoulder pain and disability. It can, however, present in association with athletic activity and therefore must be included in the differential diagnosis of athletes with such symptomatology. Findings that should alert the examiner to the possible presence of acute brachial neuropathy include 1) onset with noncontact as well as contact sports, 2) rather acute onset of pain without specific inciting trauma, 3) persistent, often severe pain that continues despite rest, 4) patchy brachial plexus and/or peripheral nerve involvement, and, 5) dominant arm predominance of symptoms and signs. Electromyography and nerve conduction studies often can confirm the diagnosis. Treatment begins with rest and continues through a rehabilitation phase. Followup of athletes with acute brachial neuropathy discloses that weakness may persist in the affected muscles. Absolute strength parity may be difficult to achieve, so permission to participate in athletics must be given on a case by case basis.

Adolescent↗
PubMedDate not supplied

Injuries in intercollegiate rodeo athletes.

Collegiate rodeo athletes (N = 156) in the National Intercollegiate Rodeo Association (NIRA) Southern Region, were examined for injuries during a 7 month (10 rodeo) season from 1987 to 1988. Sixty-two athletes sustained a total of 138 acute injuries resulting from 3292 exposures. One hundred twenty-seven injuries (92% of total injuries) occurred in the roughstock and steer wrestling events, and 11 injuries (8%) occurred in the roping and female events. When calculating opportunity for injury, rodeo athletes face an 89% potential for injury per season. Ninety-one of the injuries incurred were upper body injuries; 47 were lower body injuries. A 6:1 exposure to injury ratio among roughstock events exemplifies the magnitude of injury potential in this sport, affecting 25% of roughstock competitors. Contusions, strains, and concussions comprised 42%, 16%, and 11% of the total injuries, respectively, whereas fractures and dislocations comprised only 5% of the total. Twenty-three percent of the injuries occurred during the completion of an athlete's ride, with 21% of injuries attributed to equipment mishaps. Frequency of injury by performance, relation of seasonal participation and exposure to injury, orthotic care, use of conditioning programs, medication history, and need for enhanced sports medicine education in this sport are discussed.

Adolescent↗
PubMedDate not supplied

Stress fractures of the femoral neck in athletes. The consequence of a delay in diagnosis.

Twenty-three patients with stress fractures of the femoral neck were followed up at an average of 6.5 years after the injury. There were 16 recreational athletes and seven elite athletes. Most injuries (N = 15) occurred during running. The diagnosis was confirmed within 3 to 104 weeks (mean, 14 weeks) after the initial onset of symptoms. Sixteen of the patients were treated with internal fixation, the remaining seven were treated conservatively. Seven patients (30%) developed complications requiring major surgery. Five of these patients had Type 3 fractures (displaced) and four had been treated with internal fixation initially. The remaining two patients had Type 1 fractures (endosteal or periosteal callus without an overt fracture line); one was treated operatively and the other conservatively. Three patients developed avascular necrosis and two were treated by hip replacement. The third patient was treated with arthrodesis. Three refractures and one pseudarthrosis were treated by osteotomy. At followup, all elite athletes stated that they had to end their career as a result of the injury. Results were rated by the ability of the athlete to return to sports. There were 9 bad or fair results, 13 good, and 1 excellent result. No difference in activity level or subjective rating was observed between the surgically and conservatively treated group either preinjury or postinjury. The most important factor influencing the complication rate seems to be the type of fracture. The high incidence of displaced fractures (Type 3) could speculatively be caused by undiagnosed tension side stress fractures. If so, the delay in correct diagnosis may be disastrous. However, we could only objectively observe this in one of our cases.

Adolescent↗
PubMedDate not supplied

Physician care for interscholastic athletes in Michigan.

Between January 1989 and March 1989 the athletic directors of the 711 high schools in the Michigan High School Athletic Association were surveyed as to what sports and levels of competition each school offered and what level of medical care was available. Fifty-seven percent of the surveyed schools returned properly completed forms. Sixty-one percent of the schools responding reported having a physician available for at least one team at some time during the year. This was almost universally the football team; with 59% of the schools with varsity football reporting a physician present at either a practice or a contest at least once during the year. Only 13% of the schools reported having a physician available for a team other than varsity football. Seventy-four percent of all varsity teams had neither a physician nor an athletic trainer present at any time during the year. Comparison of the results of this study with similar studies performed in Michigan in 1975 and 1979, as well as studies in other states, demonstrates that despite the increased awareness and popularity of sports medicine, there has been no appreciable change in the amount of access interscholastic athletes have to physician care.

Adolescent↗
PubMedDate not supplied

Arthroscopic treatment of shoulder impingement in athletes.

Twenty-nine patients (1 high school athlete, 9 college athletes, and 20 recreational or nonathletes) with Neer stage II impingement syndrome were treated by arthroscopic subacromial decompression after their injuries failed to improve with conservative therapy. Followup averaged 32.2 months, and results were rated based on subjective responses and the UCLA Shoulder Rating Scale. Of the results, 82.2% were rated as satisfactory, while 17.2% were unsatisfactory. The greatest margin of improvement was in the pain rating. Postoperatively, 65.5% of the patients returned to their previous level of activity and 56% of the collegiate athletes returned to their previous competitive level. The average time to return to college-level competitive athletics for the recreational or nonathletes was 6.6 months (average 5.4). There were no infections or neurovascular complications in the series.

Adolescent↗
PubMedDate not supplied

Repair of distal biceps tendon ruptures in athletes.

Ten athletes with distal biceps tendon ruptures that had been anatomically repaired with a double-incision techniques were reviewed to determine their functional recovery. All of the patients were men, with an average age of 40 years (range, 25 to 49). Eight of the 10 patients were weight lifters or body builders, and 7 had participated on a competitive level at some point in their athletic careers. Six injured their dominant extremity, and 4 their nondominant extremity. Isokinetic muscle testing of supination and flexion was performed in 8 patients and the results were compared to a control group. Followup averaged 50 months (range, 12 to 105). Patients uniformly graded their subjective results as excellent, with a group mean rating of 9.75 on a 10-point scale. All athletes returned to full, unlimited activity. The contour of the biceps muscle was restored in all cases. Isokinetic muscle testing demonstrated that in those patients with a repaired dominant extremity, supination strength and endurance was normal; in flexion, they had normal strength, but averaged 20% less endurance. Testing of the group that had the nondominant extremity repaired revealed a supination strength deficit of 25%, but normal endurance. Flexion strength and endurance were essentially normal in this group. Anatomic repair of a distal biceps tendon rupture gives consistently excellent subjective and good objective results in athletes, particularly for those sports with high strength demands such as weight lifting and body building. Rehabilitation of the operated arm, especially the repaired nondominant extremity, should be emphasized.

Adult↗
PubMedDate not supplied

Obturator nerve entrapment. A cause of groin pain in athletes.

Chronic groin pain in athletes is often difficult to diagnose and treat. There are many anatomic structures in the inguinal and groin region that have the potential to cause pain. We report 32 cases of a previously undescribed condition in athletes of "obturator neuropathy," a fascial entrapment of the obturator nerve where it enters the thigh. This condition represents a type of groin pain in athletes that is treatable by surgical means. There is a characteristic clinical pattern of exercise-induced medial thigh pain commencing in the region of the adductor muscle origin and radiating distally along the medial thigh. Needle electromyography demonstrates denervation of the adductor muscles. Surgical neurolysis treatment provides the definitive cure of this problem, with athletes returning to competition within several weeks of treatment. The surgical findings are entrapment of the obturator nerve by a thick fascia overlying the short adductor muscle. The role of conservative treatment in the management of this condition is unknown at present.

Adolescent↗
PubMed2003

Return to activity after sesamoidectomy in athletically active individuals.

Sesamoidectomy of the first metatarsophalangeal joint in athletically active patients may be indicated in cases of chronic sesamoiditis resistant to nonsurgical care or symptomatic displaced fractures or nonunion. Painful scar, hallux deviation, and delayed return to activity are all potential complications. These need to be considered especially when performing surgery in the athletically active individual. Twenty-six sesamoidectomies in 24 patients (21 females and 3 males) were reviewed for type of sesamoidectomy, incision location, time to return to activity, and complications. Mean age was 35.4 years (range, 16-68 years) with mean follow-up 86.4 months. Eleven athletes (defined as professional or varsity level sports) operated on had a mean return to activity of 7.5 weeks (range, 4-10 weeks), while 13 "active" patients had a mean return to activity of 12.0 weeks. This difference was statistically significant using the t-test, (p < .02). There were 10 fibular and 16 tibial sesamoids excised. Complications included one hallux varus and two cases of postoperative scarring with neuroma-like symptoms, all associated with fibular sesamoidectomy; there was one case of hallux valgus deformity with tibial sesamoidectomy. Despite the functional importance of tibial and fibular sesamoids, athletically active individuals can return to sports after a sesamoidectomy as early as 7.5 weeks.

Adolescent↗
PubMed1986

Results of surgery in athletes with plantar fasciitis.

Plantar fasciitis is a common cause of pain, particularly in runners and certain other athletic groups. This syndrome must be distinguished from certain other conditions, such as the tarsal tunnel syndrome and achillodynia. Conservative therapy including rest, orthotics, heel cups, anti-inflammatory agents, and icing reduce symptoms in most patients. A few athletes may need surgery to continue running. The authors released the plantar fascia and excised areas of mucinoid degeneration in 15 athletes. Fourteen returned to full athletic activity.

Athletic Injuries↗
PubMed2002

Back injuries in the pediatric athlete.

Pediatric and adolescent athletes presenting with back pain are much more likely to have a pathologic cause for their symptoms than are adult patients. For this reason, it is important for those caring for younger athletes to maintain a high index of suspicion for some of the more common pathologic causes of back pain in this population. Diagnostic evaluation should be undertaken more quickly in pediatric and adolescent athletes. Sports-related diagnoses that must be considered include disc-related back pain, atypical Scheuermann's kyphosis, spondylolysis, and spondylolisthesis. Patients of this age may also present with conditions not associated with activity, including discitis, classic Scheuermann's disease, rheumatologic disease, and spinal tumors. History and physical exam provide valuable information to help guide further diagnostic studies which, in turn, will determine necessary treatment. No definitive studies are available regarding the diagnosis and treatment of spondylolysis and spondylolisthesis. Health professionals need to consider the expertise of a local radiologist when deciding upon diagnostic imaging procedures. The athlete's age and sport played can contribute to the appropriate treatment plan.

Athletic Injuries↗
PubMed2004

Rehabilitation of the athlete with low back pain.

The rehabilitation of athletes with low back pain should be considered an essential component of their care. Comprehensive rehabilitation begins at the time of acute injury and encompasses the period of acute care through sport-specific training and return to competition. Rehabilitation of athletes with spinal pain should include a thorough psychosocial evaluation to identify potential barriers to clinical improvement. For athletes with low back pain, establishing effective core stability is central to optimizing the functional performance of the athlete.

Acute Disease↗
PubMed2004

Etiology of low back pain in athletes.

Low back pain and injury is a common affliction for patients involved in athletic endeavors. For this reason, the health care professional should be cognizant of age-related and sports-specific considerations when evaluating athletes with low back complaints. An elevated index of suspicion with regard to specific etiologies of back pain proves invaluable in order to avoid the misdiagnosis of a more serious problem. Although a number of conditions exist that require more aggressive evaluation and treatment, the majority of low back pain in athletes is self-limiting. In this context, a treatment plan designed to increase low back and abdominal muscle strength, flexibility, and range of motion often proves beneficial not only in returning the athlete to competition, but also in preventing injury recurrence.

Athletic Injuries↗
PubMed2000

Knee functions and a return to sports activity in competitive athletes following anterior cruciate ligament reconstruction.

We investigated knee functions and a return to sports in 50 competitive athlete patients treated with arthroscopic anterior cruciate ligament reconstruction using double-looped STG augmented by woven polyester at a 1-year follow-up. There were 25 males and 25 females with a mean age of 24.3 years (range: 19-39 years). The majority of preinjury sports were basketball, volleyball and soccer. Athletic rehabilitation including agility training and sports-specific training was started at 12 weeks. Fourty patients (80%) was rated as normal or nearly normal on the assessment of International Knee Documentation Commitee postoperatively. Fourty-eight patients (96%) obtained full range of motion, and the mean quadriceps muscle strength of the injured side was 91.3%of that of the uninjured side. As for a return to sports, 46 patients (92%) were able to do fully competitive sports at a mean of 8.1 postoperative months. These results suggest that arthroscopic reconstruction using augmented double-looped STG allows early athletic rehabilitation, and lead satisfactory outcome as well as a reliable and early return to preinjury level of sport activity for the majority of the competitive athlete patients.

Adult↗
PubMed1998

Knowledge and attitudes of Arizona high-school coaches regarding oral-facial injuries and mouthguard use among athletes.

The authors assessed high-school athletic coaches' perceptions about oral-facial injuries and mouthguard use in sports that do not mandate mouthguard use. About 72 percent of the coaches said that their athletes sustained oral-facial injuries, 28 percent that some athletes used mouthguards regularly, 48 percent that athletes had sustained injuries and did not use mouthguards regularly, and 31 percent said they would not encourage mouthguard use. Advocacy for mouthguard use should focus on coaches, coaches' associations and rule-making organizations.

Adolescent↗
PubMed2003

Tumors about the knee misdiagnosed as athletic injuries.

BACKGROUND: Musculoskeletal tumors may originally mimic a traumatic condition, and, on the basis of an erroneous diagnosis of an athletic injury, an invasive diagnostic or therapeutic procedure may be performed. We determined the number of such cases treated at our institution, and we analyzed the initial and final diagnoses as well as the changes in the indicated oncologic surgical technique due to the initial erroneous diagnosis. METHODS: Twenty-five patients who had a bone or soft-tissue tumor about the knee that originally had been diagnosed as an athletic injury were referred to our institution. The complete clinical, radiographic, and pathological records were reviewed. Studies that had been performed prior to the invasive procedure and at the time of admission to our institution were evaluated to determine differences in the tumor stage and the oncologic treatment that was indicated at each time. RESULTS: Of 667 knee tumors diagnosed in our institution, twenty-five (3.7%) previously had been treated with an intra-articular procedure as a result of a misdiagnosis of an athletic injury. The final diagnoses made at our institution were a benign tumor in eleven patients and a malignant tumor in fourteen. Oncologic surgical treatment was affected in fifteen of the twenty-five patients. CONCLUSIONS: When a knee tumor is initially misdiagnosed as an athletic injury, treatment may be adversely affected by the delay in diagnosis or an inappropriate invasive procedure that results in extension of the tumor. Initial poor-quality radiographs and an unquestioned original diagnosis despite persistent symptoms were the most frequent causes of an erroneous diagnosis.

Adolescent↗