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Clinical Journal of Sport Medicine :... Jan 2020Kayak racing has been an Olympic sport since 1936. The sport is evolving with the introduction of ocean skis and stand-up-paddle boards (SUP). Musculoskeletal injury...
INTRODUCTION
Kayak racing has been an Olympic sport since 1936. The sport is evolving with the introduction of ocean skis and stand-up-paddle boards (SUP). Musculoskeletal injury incidence surveys have been conducted for ultra-marathon events, but no data have been published for other racing formats.
OBJECTIVE
To identify and compare the rates and types of injuries sustained by paddling athletes as a function of discipline and training parameters in Sprint, Marathon, Ultra-Marathon, and Ocean events.
METHODS
Competitors from 6 kayak and/or ocean surf-ski races in Australia were surveyed. Before each race, competitors were asked to complete a questionnaire. The questionnaire investigated paddling-related injuries over the previous 5 years, athlete morphology, flexibility, equipment and its setup, training volume, and environment.
RESULTS
Five hundred eighty-three competitors were surveyed. Disciplines included 173 racing-kayak (K1), 202 touring-kayak, 146 ocean-skis, 42 SUP, and 20 other. The top 5 paddling-related injuries were shoulder (31%), low back (23.5%), wrist (16.5%), neck (13.7%), and elbow (11.0%). The highest percentage of injury was found in K1 paddlers for shoulder (40.5%), SUP for low back (33.3%), and ocean-ski for wrist (22.6%). After controlling for on-water training hours, the relative risk (RR) of wrist injury was significantly increased in ocean-ski paddlers (1.86) and in paddlers with decreased flexibility (1.53-1.83). Relative risk of shoulder and low-back injury was significantly increased in athletes with lower training volumes (1.82-2.07). Younger athletes had lower RR of wrist and shoulder injury (0.58-0.62).
Topics: Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Back Injuries; Child; Competitive Behavior; Female; Humans; Male; Middle Aged; Musculoskeletal System; Neck Injuries; Physical Conditioning, Human; Risk Factors; Sex Distribution; Shoulder Injuries; Water Sports; Wrist Injuries; Young Adult; Elbow Injuries
PubMed: 29781908
DOI: 10.1097/JSM.0000000000000565 -
Emergency Medicine Clinics of North... Feb 2020Acute musculoskeletal injuries are commonly seen in our emergency departments, and are commonly missed. There are many reasons for more missed injures and a significant... (Review)
Review
Acute musculoskeletal injuries are commonly seen in our emergency departments, and are commonly missed. There are many reasons for more missed injures and a significant one is over-reliance on radiographs. An emergency department orthopedic assessment goes far beyond the radiographs. A focused, yet comprehensive history is vital to understand the forces and mechanism of injury. That injury must be understood in the context of the patient, because older and much younger patients have weaker bone. Finally, the physical examination is instrumental in localizing the pathology and is essential to put radiograph results in the proper clinical context.
Topics: Disease Management; Emergency Medicine; Humans; Orthopedic Procedures; Physical Examination; Radiography; Wounds and Injuries
PubMed: 31757244
DOI: 10.1016/j.emc.2019.09.001 -
The Journal of the American Academy of... Jul 2019Evaluation of coagulation is vital in the care of the orthopaedic patients, particularly in the subspecialties of trauma, spine, arthroplasty, and revision surgery... (Review)
Review
Evaluation of coagulation is vital in the care of the orthopaedic patients, particularly in the subspecialties of trauma, spine, arthroplasty, and revision surgery resulting from blood loss and coagulopathies. Although conventional tests (prothrombin time/international normalized ratio, activated partial thromboplastin time, platelet count, and fibrinogen) are most commonly used, others like thromboelastography (TEG) are also available to the orthopaedic surgeons. TEG is a blood test developed in the 1950s, which provides a snapshot of a patient's coagulation profile by evaluating clot formation and lysis. Recently, TEG has been used to assess traumatic coagulopathy. The coagulation parameters measured by the TEG are reaction time (R-time), time to reach a certain clot strength (K-value), speed of fibrin build up (α-angle), maximum clot amplitude, and percentage decrease of clot in 30 minutes (LY30). Using these values, traumatologists have developed a better, faster, and more accurate overview of a patient's resuscitation and more successfully direct blood product use. However, many orthopaedic surgeons-despite performing surgical procedures that risk notable blood loss and postoperative clotting complications-are unaware of the existence of the TEG blood test and the critical information it provides. Increasing awareness of the TEG among orthopaedic surgeons could have a notable effect on numerous aspects of musculoskeletal care.
Topics: Blood Coagulation; Blood Coagulation Disorders; Blood Coagulation Tests; Hemorrhage; Humans; Orthopedic Surgeons; Postoperative Complications; Thrombelastography; Wounds and Injuries
PubMed: 30407978
DOI: 10.5435/JAAOS-D-17-00603 -
British Journal of Anaesthesia Aug 2014Trauma is the leading cause of death during the first four decades of life in the developed countries. Its haemodynamic response underpins the patient's initial ability... (Review)
Review
Trauma is the leading cause of death during the first four decades of life in the developed countries. Its haemodynamic response underpins the patient's initial ability to survive, and the response to treatment and subsequent morbidity and resolution. Trauma causes a number of insults including haemorrhage, tissue injury (nociception) and, predominantly, in military casualties, blast from explosions. This article discusses aspects of the haemodynamic responses to these insults and subsequent treatment. 'Simple' haemorrhage (blood loss without significant volume of tissue damage) causes a biphasic response: mean arterial blood pressure (MBP) is initially maintained by the baroreflex (tachycardia and increased vascular resistance, Phase 1), followed by a sudden decrease in MAP initiated by a second reflex (decrease in vascular resistance and bradycardia, Phase 2). Phase 2 may be protective. The response to tissue injury attenuates Phase 2 and may cause a deleterious haemodynamic redistribution that compromises blood flow to some vital organs. In contrast, thoracic blast exposure augments Phase 2 of the response to haemorrhage. However, hypoxaemia from lung injury limits the effectiveness of hypotensive resuscitation by augmenting the attendant shock state. An alternative strategy ('hybrid resuscitation') whereby tissue perfusion is increased after the first hour of hypotensive resuscitation by adopting a revised normotensive target may ameliorate these problems. Finally, morphine also attenuates Phase 2 of the response to haemorrhage in some, but not all, species and this is associated with poor outcome. The impact on human patients is currently unknown and is the subject of a current physiological investigation.
Topics: Analgesics, Opioid; Blast Injuries; Healthy Volunteers; Hemodynamics; Hemorrhage; Humans; Musculoskeletal System; Oxygen Consumption; Resuscitation; Wounds and Injuries
PubMed: 25038158
DOI: 10.1093/bja/aeu232 -
Current Sports Medicine Reports 2017Recent epidemiological studies have documented increased susceptibility to musculoskeletal injury after sport-related concussion, which raises questions about the... (Review)
Review
Recent epidemiological studies have documented increased susceptibility to musculoskeletal injury after sport-related concussion, which raises questions about the adequacy of current clinical practices to ensure safe return to sport. A growing body of evidence derived from advanced neuroimaging and neurological assessment methods strongly suggests that mild traumatic brain injury has long-lasting adverse effects that persist beyond resolution of clinical symptoms. Plausible interrelationships among postconcussion changes in brain structure and function support the rationale for specific methods of clinical assessment and training to target the interaction of cognitive and motor function for reduction of musculoskeletal injury risk after concussion. The findings of preliminary clinical studies are presented to support suggested strategies for reduction of postconcussion musculoskeletal injury risk, and to identify novel approaches that we consider worthy areas for further research.
Topics: Athletic Injuries; Brain Concussion; Humans; Musculoskeletal System; Neuroimaging; Post-Concussion Syndrome; Risk Management
PubMed: 29135640
DOI: 10.1249/JSR.0000000000000430 -
European Journal of Orthopaedic Surgery... Aug 2017
Topics: Bone Neoplasms; Career Choice; Humans; Interprofessional Relations; Musculoskeletal System; Orthopedics; Wounds and Injuries
PubMed: 28638949
DOI: 10.1007/s00590-017-2000-2 -
Current Sports Medicine Reports Jun 2019Musculoskeletal simulation and dynamic modeling programs have been used to gain insight into lower-limb musculoskeletal injury mechanisms. In addition to the... (Review)
Review
Musculoskeletal simulation and dynamic modeling programs have been used to gain insight into lower-limb musculoskeletal injury mechanisms. In addition to the temporospatial, kinematic, and kinetic data obtained from motion analysis systems, musculoskeletal simulation programs also can provide information on joint contact and muscle forces, musculotendinous lengths and velocities, and muscle activation levels. Musculoskeletal simulation platforms may help in the assessment of risk factors for sports-related injuries. Using musculoskeletal simulations for injury prevention programs may help lower the incidence of sports injuries, and may allow for fast recovery from injury. In this review, injury mechanisms and risk factors of some of the most common lower-limb musculoskeletal injuries, including anterior cruciate ligament, patellofemoral, and hamstring injuries were summarized from a biomechanical perspective. Also, the efficacy of musculoskeletal modeling and dynamic simulation tools in helping our understanding of these injury mechanisms was discussed.
Topics: Anterior Cruciate Ligament Injuries; Athletic Injuries; Biomechanical Phenomena; Hamstring Muscles; Humans; Leg Injuries; Models, Biological; Musculoskeletal System; Patellofemoral Joint
PubMed: 31385836
DOI: 10.1249/JSR.0000000000000601 -
Osteoarthritis and Cartilage Nov 2015Inflammation is a variable feature of osteoarthritis (OA), associated with joint symptoms and progression of disease. Signs of inflammation can be observed in joint... (Review)
Review
Inflammation is a variable feature of osteoarthritis (OA), associated with joint symptoms and progression of disease. Signs of inflammation can be observed in joint fluids and tissues from patients with joint injuries at risk for development of post-traumatic osteoarthritis (PTOA). Furthermore, inflammatory mechanisms are hypothesized to contribute to the risk of OA development and progression after injury. Animal models of PTOA have been instrumental in understanding factors and mechanisms involved in chronic progressive cartilage degradation observed after a predisposing injury. Specific aspects of inflammation observed in humans, including cytokine and chemokine production, synovial reaction, cellular infiltration and inflammatory pathway activation, are also observed in models of PTOA. Many of these models are now being utilized to understand the impact of post-injury inflammatory response on PTOA development and progression, including risk of progressive cartilage degeneration and development of chronic symptoms post-injury. As evidenced from these models, a vigorous inflammatory response occurs very early after joint injury but is then sustained at a lower level at the later phases. This early inflammatory response contributes to the development of PTOA features including cartilage erosion and is potentially modifiable, but specific mediators may also play a role in tissue repair. Although the optimal approach and timing of anti-inflammatory interventions after joint injury are yet to be determined, this body of work should provide hope for the future of disease modification tin PTOA.
Topics: Animals; Cartilage, Articular; Disease Progression; Humans; Inflammation; Inflammation Mediators; Joints; Osteoarthritis; Wounds and Injuries
PubMed: 26521728
DOI: 10.1016/j.joca.2015.08.015 -
Seminars in Musculoskeletal Radiology Apr 2020The skin, nerves, and tendons are superficial anatomical structures that can easily be investigated with an ultrasound (US) examination in the emergency department (ED).... (Review)
Review
The skin, nerves, and tendons are superficial anatomical structures that can easily be investigated with an ultrasound (US) examination in the emergency department (ED). US evaluation is relatively underused in musculoskeletal evaluation when compared with other emergency applications, such as abdominal trauma, possible aortic aneurysm, and in the cardiovascular system. The aim of this article is to revise the main bone and soft tissue conditions that can be assessed using US in the ED.
Topics: Emergency Service, Hospital; Humans; Ultrasonography; Wounds and Injuries
PubMed: 32438442
DOI: 10.1055/s-0039-3402050 -
Canadian Journal of Ophthalmology.... Jun 2019Surgeons and other physicians have reported occupational musculoskeletal (MSK) pain, and it has been recently raised as a growing issue by ophthalmologists and...
OBJECTIVE
Surgeons and other physicians have reported occupational musculoskeletal (MSK) pain, and it has been recently raised as a growing issue by ophthalmologists and optometrists. What is most concerning is that it could be a serious threat to career longevity and performance. MSK pain and injury in Canadian ophthalmologists has not been quantified. Our goal was to estimate the prevalence of MSK issues, to determine the impact of MSK injuries to working hours and health, and to ascertain physician characteristics and practice patterns associated with MSK problems.
DESIGN
Survey.
PARTICIPANTS
One hundred sixty-nine ophthalmologists and 121 optometrists.
METHODS
A voluntary internet-based (Survey Monkey) survey was conducted. All Canadian ophthalmologists and ophthalmology residents were contacted via the Canadian Ophthalmological Society, and all optometrists registered through the Canadian Association of Optometrists were contacted through their respective listserve email.
RESULTS
One hundred sixty-nine ophthalmologists (response rate 17%) and 121 optometrists (2.4%) responded to a voluntary internet-based survey. Fifty percent of the ophthalmology respondents reported clinic-associated MSK pain in the preceding 12 months, compared to 61% of optometry respondents (p = 0.06). Of the ophthalmologists, 48.3% said they had experienced occupational MSK pain in the preceding 12 months, which they directly attributed to their operating room activities. Neck pain was reported in 46%, lower back in 36% and shoulder pain in 28% of ophthalmology respondents. This was compared to 34% (p = 0.04), 37% (p = 0.90) and 41% of optometrists (p= 0.02). Respondents in our survey listed "performing the same task over and over", "working in cramped or awkward positions" and "bending or twisting your neck" as the most common causes of MSK pain.
CONCLUSION
Our survey identified that a large proportion of respondents reported MSK pain associated with clinical and surgical duties. Physician-led research is needed before industry and administrative partners can develop equipment and work-spaces that are better suited to the needs of physicians.
Topics: Canada; Humans; Musculoskeletal Pain; Occupational Diseases; Ophthalmology; Prevalence; Surveys and Questionnaires; Wounds and Injuries
PubMed: 31109470
DOI: 10.1016/j.jcjo.2018.06.021