Adductor-related groin pain is a common problem in sports. Evidence-based management of athletes with adductor strains, adductor ruptures, and long-standing adductor-related groin pain can be ...approached in a simple yet effective and individualized manner. In most cases, managing adductor-related pain in athletes should be based on specific exercises and loading strategies. In this article, I provide an overview of the different types of adductor injuries, from acute to overuse, including their underlying pathology, functional anatomy, diagnosis, prognosis, mechanisms, and risk factors. This information leads to optimal assessment and management of acute to long-standing adductor-related problems and includes primary, secondary, and tertiary prevention strategies that focus on exercise and load-based strategies. In addition, information on different options and contexts for exercise selection and execution for athletes, athletic trainers, and sports physical therapists in adductor injury rehabilitation is provided.
Background:
The incidence of anterior cruciate ligament (ACL) injuries among adolescent athletes is steadily increasing. Identification of the highest risk sports for ACL injuries by sex and ...competitive setting (ie, practice vs match) is important for targeting injury prevention programs.
Purpose:
To identify the risk of ACL injuries in adolescent athletes by sport, sex, and setting across a variety of common US and international sports.
Study Design:
Meta-analysis.
Methods:
Essentially, 3 online databases (PubMed, Embase, and Cochrane Library) were searched for all studies of ACL injuries per athlete-exposure (AE) or hours of exposure in adolescent athletes. Injuries were then pooled and incidence rates (IRs) reported per 1000 AEs or hours of exposure, with the relative risk (RR) of injuries calculated for sex-comparable sports. IRs per competitive setting (match vs practice) were also calculated.
Results:
A total of 1235 ACL injuries over 17,824,251 AEs were identified (IR, 0.069 95% CI, 0.065-0.074), with 586 of these injuries in girls across 6,986,683 AEs (IR, 0.084 95% CI, 0.077-0.091) versus 649 injuries in boys over 10,837,568 AEs (IR, 0.060 95% CI, 0.055-0.065). Girls had a higher overall rate of ACL injuries (RR, 1.40 95% CI, 1.25-1.57), with the most disproportionate risk observed in basketball (RR, 4.14 95% CI, 2.98-5.76). The risk of ACL injuries by sex was highest in girls’ soccer (IR, 0.166 95% CI, 0.146-0.189) and boys’ football (IR, 0.101 95% CI, 0.092-0.111). ACL injuries were over 8 (RR, 8.54 95% CI, 6.46-11.30) and 6 (RR, 6.85 95% CI, 5.52-8.49) times more likely to occur in a match versus a practice setting for female and male athletes, respectively.
Conclusion:
The risk of ACL injuries overall approached nearly 1 per 10,000 AEs for female athletes, who were almost 1.5 times as likely as male athletes to suffer an ACL injury across all adolescent sports. A multisport female athlete was estimated to have a nearly 10% risk of ACL injuries over her entire high school or secondary school career. Specifically, male and female adolescents playing soccer, basketball, lacrosse, and football appeared at particular risk of injuries, a finding that can be used to target an injury intervention.
Background:
Sports-related concussion (SRC) injury rates are well established in collegiate athletics through epidemiological studies using the National Collegiate Athletic Association Injury ...Surveillance System. However, few studies have examined sex differences, time loss, and missed school days in high school athletes, especially at the state level.
Purpose:
To identify sex differences in the clinical incidence of SRCs, missed school days, and time loss in high school student-athletes.
Study Design:
Descriptive epidemiological study.
Methods:
A total of 193,757 (116,434 male and 77,323 female) student-athletes (10th grade ± 1.1) participating in Michigan High School Athletic Association (MHSAA)–sponsored athletic activities were recorded in the Head Injury Reporting System. Certified athletic trainers, school athletic administrators, and coaches from MHSAA high schools reported SRC data and overall participation for the 2015-2016 academic year. Total concussive injuries, as well as missed school days and time loss for each concussive injury, were reported. The clinical incidence was calculated by dividing the number of SRCs in a particular category by the number of participants in that category and presented with 95% CIs. Relative risk ratios (RRs) were determined for sex-comparable sports.
Results:
The overall clinical incidence for all sports was 1.7 per 100 player-seasons (95% CI, 1.6-1.8) and 1.9 (95% CI, 1.8-2.0) for male sports and 1.5 (95% CI, 1.4-1.6) for female sports. Female athletes were at a 1.9 (95% CI, 1.8-2.2) times greater risk for enduring SRCs than male athletes in sex-comparable sports, with a greater risk in baseball/softball (RR, 2.7 95% CI, 1.9-3.8), basketball (RR, 2.5 95% CI, 2.1-2.9), and soccer (RR, 1.6 95% CI, 1.4-1.9). Female student-athletes had significantly longer time loss than male student-athletes (P < .001). The mean number of missed school days did not differ between sexes (P = .70).
Conclusion:
High school female student-athletes have a higher risk for an SRC in all sex-comparable sports except lacrosse. This may be because of biomechanical differences of the head-neck segment, hormonal differences, and the fact that female athletes are more likely to report symptoms after a suspected SRC.
Clinical Relevance:
Despite sex differences in the clinical incidence of SRCs and time loss from participation in high school sports, the numbers of missed school days are relatively similar between sexes.
To estimate the incidence, type and severity of musculoskeletal injuries in youth and adult elite athletics athletes and to explore risk factors for sustaining injuries.
Prospective cohort study ...conducted during a 52-week period.
Male and female youth and adult athletics athletes ranked in the top 10 in Sweden (n=292).
199 (68%) athletes reported an injury during the study season. Ninety-six per cent of the reported injuries were non-traumatic (associated with overuse). Most injuries (51%) were severe, causing a period of absence from normal training exceeding 3 weeks. Log-rank tests revealed risk differences with regard to athlete category (p=0.046), recent previous injury (>3 weeks time-loss; p=0.039) and training load rank index (TLRI; p=0.019). Cox proportional hazards regression analyses showed that athletes in the third (HR 1.79; 95% CI 1.54 to 2.78) and fourth TLRI quartiles (HR 1.79; 95% CI 1.16 to 2.74) had almost a twofold increased risk of injury compared with their peers in the first quartile and interaction effects between athlete category and previous injury; youth male athletes with a previous serious injury had more than a fourfold increased risk of injury (HR=4.39; 95% CI 2.20 to 8.77) compared with youth females with no previous injury.
The injury incidence among both youth and adult elite athletics athletes is high. A training load index combing hours and intensity and a history of severe injury the previous year were predictors for injury. Further studies on measures to quantify training content and protocols for safe return to athletics are warranted.
Background:
Male athletes participating in certain elite sporting activities may be at an increased risk for development of hip osteoarthritis (OA) later in life. However, the strength of the ...association of participation in sporting activities with the increased risk of hip OA has not been well summarized.
Purpose:
To investigate the association of certain high-impact sporting activities with the risk of development of hip OA in elite athletes by conducting a systematic review of the available literature.
Study Design:
Systematic review; Level of evidence, 3.
Methods:
PubMed, Cochrane, and EMBASE databases were searched to identify all potential studies. Eleven studies met the inclusion criteria, which included participation in elite-level sporting activities, greater than 50% male athletes in the study population, diagnosis of hip OA by radiograph, hospital admission or total hip arthroplasty (THA), and greater than 80% follow-up. Exclusion criteria were recreational sporting activities, primarily female cohorts as there was a dearth of available literature on the topic, and self-reported symptoms without radiographic confirmation of diagnosis. Most studies were with European athletes, where elite-level was defined as involvement in national- or professional-level competition.
Results:
Participation across elite-level impact sports was associated with increased risk of development of hip OA when compared with matched controls (odds ratio, 1.8-8.7). Twelve of 15 studies reviewed demonstrated an odds ratio of 1.8 or greater of developing hip OA in elite-level athletes. Handball was associated with the highest rate of OA of any sport, nearly 5 times that of matched controls. Soccer players demonstrated between 2 and 9 times increased risk of hip OA as defined by radiography or THA. Hockey players demonstrated 2 to 3 times increased risk of hip OA (THA or hospital admission). Five studies investigating the association of competitive long-distance running with hip OA demonstrated inconsistent results.
Conclusion:
Currently available literature suggests that male athletes participating in elite impact sports (soccer, handball, track and field, or hockey) are at an increased risk of developing hip OA, while those participating in high-level long-distance running do not have a clearly elevated risk. Further research is warranted to elucidate the pathomechanics of development of hip OA in these patients.
'Games People Played' is, surprisingly, the first global history of sports. The book shows how sports have been practiced, experienced, and made meaningful by players and fans throughout history. It ...assesses how sports developed and diffused across the globe, as well as many other aspects, from emotion, discrimination, and conviviality; politics, nationalism, and protest; and how economics has turned sports into a huge consumer industry. It shows how sports are sociable and health-giving, and also contribute to charity. However, it also examines their dark side: sports' impact on the environment, the use of performance-enhancing drugs, and match-fixing. Covering everything from curling to baseball, boxing to motor racing, this book will appeal to anyone who plays, watches, and enjoys sports, and wants to know more of their history and global impact.
We applied the strength-energy model of self-control to understand the relationship between self-control and young athletes' behavioral responses to taking illegal performance-enhancing substances, ...or "doping." Measures of trait self-control, attitude and intention toward doping, intention toward, and adherence to, doping-avoidant behaviors, and the prevention of unintended doping behaviors were administered to 410 young Australian athletes. Participants also completed a "lollipop" decision-making protocol that simulated avoidance of unintended doping. Hierarchical linear multiple regression analyses revealed that self-control was negatively associated with doping attitude and intention, and positively associated with the intention and adherence to doping-avoidant behaviors, and refusal to take or eat the unfamiliar candy offered in the "lollipop" protocol. Consistent with the strength-energy model, athletes with low self-control were more likely to have heightened attitude and intention toward doping, and reduced intention, behavioral adherence, and awareness of doping avoidance.
Background:
Lower extremity injuries are common in high school sports and are costly, and some have poor outcomes. The FIFA 11+ injury prevention program has been shown to decrease injuries in elite ...athletes by up to 72%.
Hypothesis:
High schools in which coaches implement the FIFA 11+ injury prevention program in their athletic programs will have a decreased incidence of lower extremity injuries compared with schools using their usual prepractice warm-up.
Study Design:
Randomized controlled trial; Level of evidence, 1.
Methods:
Fourteen high schools that employed an athletic trainer were randomly assigned to either the FIFA 11+ group or control group (usual warm-up routine). Exposure to sports and injuries were recorded and used to determine the incidence rates of lower extremity injuries per athlete-exposure (AE). The FIFA 11+ program was implemented by coaches and complicance with the program recorded.
Results:
There were 196 lower extremity injuries among 1825 athletes in the FIFA 11+ group and 172 injuries among 1786 athletes in the control group (1.59 and 1.47 injuries per 1000 AEs, respectively; P = .771). The distribution of the types of injury in the 2 groups did not differ, but the body locations where the injuries occurred differed somewhat (P = .051). The FIFA 11+ group had larger proportions of thigh and foot injuries, while the control group had higher proportions of knee and ankle injuries. Group differences in injury rates varied with sport (P = .041 for interaction), but there were no significant differences in injury rates between the FIFA 11+ and control groups by sport, level of play, and sex. In the FIFA 11+ group, 62% of the coaches reported that their teams completed the full FIFA 11+ program at least once a week, and 32% reported that they completed it at least twice a week.
Conclusion:
This study did not demonstrate a reduction in lower extremity injuries in schools randomized to use the FIFA 11+ program compared with schools using their usual prepractice warm-up program. Coach-reported compliance with performing the FIFA 11+ program at least twice a week was low.
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