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Take Home Message: Evidence of increased alpha angles has been shown in ice hockey players as compared to non-hockey playing matched controls. Even at young ages, signs of bony abnormality linked to femoroacetabular impingement are present.
Femoroacetabular impingement (FAI) is a common radiographic finding among athletes participating in sports requiring hip flexion, hip internal rotation, and repetitive cyclic motions. Cam-deformity FAI is marked by the aspherical shape of the femoral head, and is radiographically defined by an alpha angle 55˚. Hockey players employ a skating pattern that is suspected to cause cam-deformity but it remains unclear how common cam-deformities are among asymptomatic young ice hockey players. Therefore, Philippon and colleagues conducted a cohort study to determine how common a large alpha angle was among 61 youth hockey players and 27 youth skiers.... Read more »
Philippon, M., Ho, C., Briggs, K., Stull, J., & LaPrade, R. (2013) Prevalence of Increased Alpha Angles as a Measure of Cam-Type Femoroacetabular Impingement in Youth Ice Hockey Players. The American Journal of Sports Medicine. DOI: 10.1177/0363546513483448
Take Home Message: High adherence to a neuromuscular injury prevention program like the FIFA 11 decreases the risk of injury.
Injury prevention programs typically are multifaceted warm-up programs that focus on neuromuscular recruitment. Although various programs aim to improve performance and decrease injury risk no investigation has shown a link between improved physical performance and the quality and adherence of neuromuscular injury prevention training. Therefore, Steffen and colleagues completed a cluster-randomized trial to assess the influence of player adherence and delivery method of the FIFA 11 injury prevention program (approximately 20 minutes, 15 exercises) on injury risk among females.... Read more »
Steffen K, Emery CA, Romiti M, Kang J, Bizzini M, Dvorak J, Finch CF, & Meeuwisse WH. (2013) High adherence to a neuromuscular injury prevention programme (FIFA 11 ) improves functional balance and reduces injury risk in Canadian youth female football players: a cluster randomised trial. British Journal of Sports Medicine. PMID: 23559666
Take Home Message: Hyaluronic acid injections decrease factors related to collagen degradation. Some blood tests may differentiate responders and nonresponders to these injections.
Knee osteoarthritis, one of the leading causes of disability, has no cure and current treatments commonly involve medications to decrease inflammation and pain. Hyaluronic acid (HA) injections have become a popular form of treatment for knee osteoarthritis. However, the mechanism of action has yet to be determined. Therefore, the authors examined serum biomarkers of collagen breakdown (Coll2-1 and Coll2-1 NO2) in 45 patients with various stages of knee osteoarthritis before (-15 days), at the time of injection, and following treatment (30 and 90 days) with HA injections.... Read more »
Henrotin Y, Chevalier X, Deberg M, Balblanc JC, Richette P, Mulleman D, Maillet B, Rannou F, Piroth C, Mathieu P.... (2013) Early decrease of serum biomarkers of type II collagen degradation (Coll2-1) and joint inflammation (Coll2-1 NO2 ) by hyaluronic acid intra-articular injections in patients with knee osteoarthritis: A research study part of the Biovisco study. Journal of Orthopaedic Research, 31(6), 901-7. PMID: 23423846
Take Home Message: Fitness level may influence baseline concussion symptom reporting with fitter individuals reporting fewer concussion symptoms. Athletes also appear to report more concussion symptoms when reporting after exercise.
Baseline testing in concussion management, including graded symptom assessment, has become commonplace in multiple sports on almost every level of competition. Different assessment tools (e.g., Sideline Concussion Assessment Tool [SCAT3], Immediate Post-Concussion Assessment and Cognitive Testing [ImPACT]) establish a baseline for many nonspecific symptoms so that post-injury symptoms may be compared to baseline results. Previous research has shown that multiple factors, including physical-activity level, can result in reports of more neurological symptoms. Therefore, Mrazik, et al sought to evaluate if an individual’s fitness level correlated with report of concussion symptoms at baseline. They hypothesized that after exertion, athletes with higher fitness levels would report fewer symptoms at baseline.... Read more »
Mrazik, M., Naidu, D., Lebrun, C., Game, A., & Matthews-White, J. (2013) Does an Individual's Fitness Level Affect Baseline Concussion Symptoms?. Journal of Athletic Training, 2147483647. DOI: 10.4085/1062-6050-48.3.19
Take Home Message: Elite soccer athletes may be at an increased risk for knee and ankle osteoarthritis compared with the general population. This group should be identified as high risk and preventative measures should be taken.
While participation in elite-level sports is often viewed as a good thing, there is an established increased risk of short-term injuries (e.g., sprains, strains). This increased injury risk may leave athletes at an increased risk for long-term disability (e.g., osteoarthritis [OA]). The purpose of this systematic review was to investigate the prevalence of knee and ankle OA among former elite-level soccer players.... Read more »
Kuijt, M., Inklaar, H., Gouttebarge, V., & Frings-Dresen, M. (2012) Knee and ankle osteoarthritis in former elite soccer players: A systematic review of the recent literature. Journal of Science and Medicine in Sport, 15(6), 480-487. DOI: 10.1016/j.jsams.2012.02.008
Take Home Message: The balance error scoring system (BESS) test is more effective in assessing high school age students’ concussions compared to the Balance Accelerometer Measure (BAM) assessment. The tandem leg stances on firm and foam surface of the BESS test are the most sensitive and specific positions for the detection of a concussion.
Assessing balance after a concussion provides useful information not only for diagnosis and prognosis but also during the athlete’s return to play progression. Many clinicians evaluate balance with the balance error scoring system (BESS), which may be imprecise and susceptible to inter-rater error; however, it was specifically designed to assess concussion injuries. In contrast, the Balance Accelerometer Measure (BAM), which is assessed by the patient wearing small sensors, provides accurate balance assessments but was not designed to assess concussed athletes. Therefore, the purpose of this study was to compare the BAM test with the BESS test regarding the ability to detect differences in postural differences between 43 high school students with concussions compared to 27 age-matched controls.... Read more »
Furman GR, Lin CC, Bellanca JL, Marchetti GF, Collins MW, & Whitney SL. (2013) Comparison of the Balance Accelerometer Measure and Balance Error Scoring System in Adolescent Concussions in Sports. The American Journal of Sports Medicine. PMID: 23585486
Take Home Message: The Wii Balance Board is an acceptable substitute for measuring the center of pressure during single leg stance balance tests.
While a laboratory grade force plate is the gold standard for both testing and training balance, these force plates are limited to research laboratories. Due to the importance of balance testing and training during the rehabilitation process, a cost effective, widely available and portable force plate is desirable. Therefore, Huurnink and colleagues compared a laboratory grade, in-floor force plate to the Wii Balance Board (WBB).... Read more »
Huurnink A, Fransz DP, Kingma I, & van Dieën JH. (2013) Comparison of a laboratory grade force platform with a Nintendo Wii Balance Board on measurement of postural control in single-leg stance balance tasks. Journal of Biomechanics, 46(7), 1392-5. PMID: 23528845
Take Home Message: NSAIDs are a common treatment method for musculoskeletal injuries; however, over-the-counter availability, overuse, self-medication, and trends of initial use in high school may interfere with appropriate consumption among college athletes.
Nonsteroidal anti-inflammatory drugs (NSAIDs), a common treatment for athletic injuries, are generally safe medications when used short-term but can become problematic when used long-term and without oversight from a medical professional. There is a discrepancy between the amount of NSAIDs used in athletics and the number of studies that address their safety in athletics. In this cross-sectional study, Holmes et al. surveyed 211 collegiate football players at two institutions on two occasions (beginning of 2006 and 2009 seasons) regarding their NSAID use during the respective seasons.... Read more »
Holmes N, Cronholm PF, Duffy AJ 3rd, & Webner D. (2013) Nonsteroidal Anti-Inflammatory Drug Use in Collegiate Football Players. Clinical Journal of Sport Medicine. PMID: 23528841
Take Home Message: Achilles tendon pathology is associated with variation within a gene (TIMP2) responsible for inhibiting enzymes responsible for collagen degradation. Genetic pre-screening of at-risk individuals may help guide individualized treatment strategies.
Genetic risk factors have recently been identified for Achilles tendon pathology, which may allow for genetic screening and identification of at-risk patients and could help guide clinical management of this injury. Specifically, previous studies reviewed by SMR have shown that variants within genes that encode for structural and regulatory proteins (such as Col5a1 and TNC) are associated with risk of Achilles tendon pathology. However, additional genes encoding for enzymes that breakdown the extracellular matrix and their inhibitors (such as the ADAM, ADAMTS, and TIMP family of proteins) have not yet been evaluated. Therefore, the purpose of this study was to determine if variations within these genes are associated with Achilles tendon pathology. ... Read more »
El Khoury L, Posthumus M, Collins M, Handley CJ, Cook J, & Raleigh SM. (2013) Polymorphic variation within the ADAMTS2, ADAMTS14, ADAMTS5, ADAM12 and TIMP2 genes and the risk of Achilles tendon pathology: A genetic association study. Journal of Science and Medicine in Sport. PMID: 23491141
Take Home Message: Knees with a recent history of an anterior cruciate ligament injury have radiographic and biochemical differences from healthy knees.
An anterior cruciate ligament (ACL) injury predisposes a knee to osteoarthritis. Little is known about the causes and characteristics of the path from injury to osteoarthritis. Without these fundamental concepts it is challenging to determine who will develop knee osteoarthritis, optimal interventions, and how to measure if the treatments are effective at preventing early joint degeneration. Therefore, the purposes of these two studies were to investigate the early biochemical and structural changes among 39 knees after an ACL injury compared with 32 healthy knees.... Read more »
Tourville, T., Johnson, R., Slauterbeck, J., Naud, S., & Beynnon, B. (2013) Assessment of Early Tibiofemoral Joint Space Width Changes After Anterior Cruciate Ligament Injury and Reconstruction: A Matched Case-Control Study. The American Journal of Sports Medicine, 41(4), 769-778. DOI: 10.1177/0363546513477838
Tourville, T., Johnson, R., Slauterbeck, J., Naud, S., & Beynnon, B. (2013) Relationship Between Markers of Type II Collagen Metabolism and Tibiofemoral Joint Space Width Changes After ACL Injury and Reconstruction. The American Journal of Sports Medicine, 41(4), 779-787. DOI: 10.1177/0363546513476481
Take Home Message: Players sustained more head impacts and higher severity of impacts on days of diagnosed concussion compared to days with no diagnosed concussion. Also, peak linear acceleration was the best predictor of immediately diagnosed concussions.
Concussion prevention methods are difficult to develop because we lack an understanding of the relationship between head impact mechanics and subsequent concussions. We can improve our understanding by measuring impact forces during sporting events; however; most studies have only included a small number of athletes, which limited the ability to determine which biomechanical characteristics result in injury among football athletes. Therefore, the purpose of this study was to compare frequency and kinematic response of head impacts on days with and without a diagnosis of concussion and identify sensitivity and specificity of single-impact severity measures to diagnose concussive injuries.... Read more »
Beckwith JG, Greenwald RM, Chu JJ, Crisco JJ, Rowson S, Duma SM, Broglio SP, McAllister TW, Guskiewicz KM, Mihalik JP.... (2013) Head Impact Exposure Sustained by Football Players on Days of Diagnosed Concussion. Medicine and Science in Sports and Exercise, 45(4), 737-746. PMID: 23135363
Take Home Message: Coaches who are well trained to implement injury prevention, warm-up programs are as effective as the supervision of a physiotherapist at training sessions.
Injury prevention programs typically are multifaceted warm-up programs which focus on neuromuscular recruitment. While many programs exist it is difficult to assess their efficacy due to varying levels of adherence to the injury prevention program. Therefore, Steffen and colleagues completed a cluster-randomized trial to determine if implementation strategies of an effective injury prevention program influenced adherence and injury risk among female youth soccer teams. ... Read more »
Steffen K, Meeuwisse WH, Romiti M, Kang J, McKay C, Bizzini M, Dvorak J, Finch C, Myklebust G, & Emery CA. (2013) Evaluation of how different implementation strategies of an injury prevention programme (FIFA 11 ) impact team adherence and injury risk in Canadian female youth football players: a cluster-randomised trial. British Journal of Sports Medicine. PMID: 23486935
Adhesive capsulitis is very difficult to treat due to the active inflammation within the capsule and high intensity of pain. Corticosteroid injections are commonly used as a treatment; however, clinicians have used a variety of doses – with no scientific justification. Therefore, the authors investigated the optimal dose (20 mg or 40 mg) of corticosteroids among a group of 53 patients with stage 2 adhesive capsulitis.... Read more »
Yoon SH, Lee HY, Lee HJ, & Kwack KS. (2013) Optimal Dose of Intra-articular Corticosteroids for Adhesive Capsulitis: A Randomized, Triple-Blind, Placebo-Controlled Trial. The American Journal of Sports Medicine. PMID: 23507791
Take Home Message: Whole body vibration therapy may improve strength and postural control among post-ACL reconstruction patients as an adjunctive therapy to rehabilitation.
Deficits in strength, proprioception, and postural control are often evident post anterior cruciate ligament (ACL) reconstruction and can last from 6-months to 4-years post-surgery. Whole-body vibration therapy (WBVT) improves balance and postural control in many populations, and if introduced early after an ACL reconstruction it may help avoid the previously mentioned deficits. Therefore, the purpose of this randomized trial was to compare the effectiveness of early WBVT plus conventional rehabilitation with isolated rehabilitation on knee proprioception, functional performance, postural control, and peak torque among 48 participants post-ACL surgery.... Read more »
Fu CL, Yung SH, Law KY, Leung KH, Lui PY, Siu HK, & Chan KM. (2013) The effect of early whole-body vibration therapy on neuromuscular control after anterior cruciate ligament reconstruction: a randomized controlled trial. The American Journal of Sports Medicine, 41(4), 804-14. PMID: 23460328
Take Home Message: Delayed-concussion diagnoses are preceded by a higher number of impacts where as concussion diagnosed at the time of injury are associated with higher kinematic measures.
Diagnosis of a concussion is in part decided by whether an athlete reports one or more concussive signs or symptoms; however, it is not uncommon for athletes to report these signs and symptoms day(s) after an injury. The delayed reporting may be attributable to athletes not wanting to stop playing, athletes not recognizing that they were injured, the symptoms developing later, and/or perhaps different types of head impacts (e.g., locations of impact, frequency of impacts, force of impact). Understanding which factors are associated with delayed reporting may help us better understand concussions and recognize athletes who may report delayed symptoms. Therefore, researchers examined whether impacts associated with immediate diagnosis of concussion would have different characteristics (e.g., location, frequency, force) than impacts associated with delayed diagnosis.... Read more »
Beckwith JG, Greenwald RM, Chu JJ, Crisco JJ, Rowson S, Duma SM, Broglio SP, McAllister TW, Guskiewicz KM, Mihalik JP.... (2013) Timing of Concussion Diagnosis Is Related to Head Impact Exposure Prior to Injury. Medicine and Science in Sports and Exercise, 45(4), 747-754. PMID: 23135364
Take Home Message: Exercises that elicit abdominal/lumbar co-contraction coupled with shoulder and hip activation (integration exercise) provoke greater core muscle activation than muscle isolation exercises.
It is widely accepted that a strong core will benefit the individual in sports performance, rehabilitation, and general fitness. However, knowing what type of exercises to select to aid performance and prevent injuries is absolutely paramount. While most studies have focused on isolation type exercises, no studies have been done to determine if muscle isolation exercises elicits greater muscle activation compared with abdominal/lumbar co-contraction coupled with shoulder and hip activation (integration). Gotschall et al. hypothesized that isolation type exercises will elicit greater abdominal/lumbar muscle activation compared with integration-style exercises.... Read more »
Gottschall JS, Mills J, & Hastings B. (2013) Integration core exercises elicit greater muscle activation than isolation exercises. Journal of Strength and Conditioning Research, 27(3), 590-6. PMID: 22580983
Take Home Message: Despite understanding the long-term dangers of sustaining a concussion high school athletes show little evidence that they would remove themselves from athletic participation.
Various educational and procedural methods have been put into place to protect student-athletes who have incurred a concussion from sustaining a second. Despite this effort, between 20 and 60% of athletes do not report sustaining a concussion. A deeper understanding of why there is a lack of reporting of concussive symptoms would allow clinicians to effectively educate coaches and athletes, improving overall patient care. Therefore, Chrisman and colleagues completed a qualitative study to determine the barriers to reporting concussive symptoms among varsity high school athletes.... Read more »
Chrisman SP, Quitiquit C, & Rivara FP. (2013) Qualitative study of barriers to concussive symptom reporting in high school athletics. The Journal of Adolescent Health, 52(3), 330-335000. PMID: 23427783
Take Home Message: Video analysis of high school boy’s lacrosse indicated that most concussions are related to the intentional use of helmets in impacts and that the injured player is often not expecting a hit. Results from this type of reseach have already had direct implications on rule changes in lacrosse.
In lacrosse, one of the fasting growing sports in the United States, concussion is a significant concern. Understanding the mechanisms of head injury in boy’s lacrosse could help us develop new injury prevention strategies but unfortunately most of the previous research has depended on eyewitness- or self-reported details. To improve our understanding of game situations and injury mechanisms that contributes to concussions Lincoln et al. systematically examined injury mechanisms of concussion in high school boy’s lacrosse using video analysis.... Read more »
Lincoln AE, Caswell SV, Almquist JL, Dunn RE, & Hinton RY. (2013) Video Incident Analysis of Concussions in Boys' High School Lacrosse. The American Journal of Sports Medicine. PMID: 23413274
Take Home Message: Limiting shoulder abduction for 3 or 6 weeks did not reduce the rate of reinjury among patients with shoulder dislocation who were initially treated with 3 weeks of immobilization.
Shoulder dislocations typically occur from a very traumatic event, which commonly results in injury to the inferior glenohumeral ligament and the anterior-inferior labrum. After a dislocation, patients are often immobilized for 3 weeks to allow capsule and labral healing. However, even after a patient is immobilized they are at risk for another dislocation, which suggests that additional protection may be needed. Therefore, the purpose of this study was to determine the efficacy of a motion restriction band to reduce the recurrence rate of dislocations following immobilization.... Read more »
Itoi E, Hatakeyama Y, Itoigawa Y, Omi R, Shinozaki N, Yamamoto N, & Sano H. (2013) Is Protecting the Healing Ligament Beneficial After Immobilization in External Rotation for an Initial Shoulder Dislocation?. The American Journal of Sports Medicine. PMID: 23524151
Take Home Message: Back School and McKenzie exercises reduce pain and disability. McKenzie exercises may provide slightly more efficient improvements in short-term disability.
Low back pain affects many active people at some point throughout their lives. The cause and diagnosis are rarely specific and unfortunately it remains unclear which intervention program is most effective for alleviating pain and improving function. The purpose of this randomized comparative effectiveness clinical trial was to compare the effectiveness of two intervention programs (i.e., Back School and McKenzie's) to reduce non-specific low back symptoms that have been present for more than three months.... Read more »
Garcia AN, Costa LD, da Silva TM, Gondo FL, Cyrillo FN, Costa RA, & Costa LO. (2013) Effectiveness of Back School Versus McKenzie Exercises in Patients With Chronic Nonspecific Low Back Pain: A Randomized Controlled Trial. Physical Therapy. PMID: 23431213
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