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Pediatrics Jan 2024Sports participation can have tremendous physical and mental health benefits for children. Properly implemented progressive training programs can yield a broad range of...
Sports participation can have tremendous physical and mental health benefits for children. Properly implemented progressive training programs can yield a broad range of beneficial physiologic adaptations, but imbalances of training load and recovery can have important negative consequences. Overuse injuries, for example, can result from repetitive stress without sufficient recovery that leads to accumulated musculoskeletal damage. In addition, extended periods of increased training loads that exceed the intervening recovery can have systemic consequences such as overtraining syndrome, which results in decreased performance, increased injury and illness risk, and derangement of endocrine, neurologic, cardiovascular, and psychological systems. Burnout represents one of the primary reasons for attrition in youth sports. Broadly defined as physical or mental exhaustion and a reduced sense of accomplishment that leads to devaluation of sport, burnout represents a direct threat to the goal of lifelong physical activity and the wide-ranging health benefits that it provides. This clinical report is intended to provide pediatricians with information regarding the risk factors, diagnosis, management, and prevention of these conditions to assist in the identification of at-risk children, the treatment of young athletes, and the guidance of families in the promotion of safe and healthy sport participation.
Topics: Child; Adolescent; Humans; Athletic Injuries; Sports; Athletes; Burnout, Professional; Cumulative Trauma Disorders
PubMed: 38247370
DOI: 10.1542/peds.2023-065129 -
Journal of Orthopaedic Research :... Oct 2023Several tendon and ligament animal models were presented at the 2022 Orthopaedic Research Society Tendon Section Conference held at the University of Pennsylvania, May 5... (Review)
Review
Several tendon and ligament animal models were presented at the 2022 Orthopaedic Research Society Tendon Section Conference held at the University of Pennsylvania, May 5 to 7, 2022. A key objective of the breakout sessions at this meeting was to develop guidelines for the field, including for preclinical tendon and ligament animal models. This review summarizes the perspectives of experts for eight surgical small and large animal models of rotator cuff tear, flexor tendon transection, anterior cruciate ligament tear, and Achilles tendon injury using the framework: "Why, Who, What, Where, When, and How" (5W1H). A notable conclusion is that the perfect tendon model does not exist; there is no single gold standard animal model that represents the totality of tendon and ligament disease. Each model has advantages and disadvantages and should be carefully considered in light of the specific research question. There are also circumstances when an animal model is not the best approach. The wide variety of tendon and ligament pathologies necessitates choices between small and large animal models, different anatomic sites, and a range of factors associated with each model during the planning phase. Attendees agreed on some guiding principles including: providing clear justification for the model selected, providing animal model details at publication, encouraging sharing of protocols and expertise, improving training of research personnel, and considering greater collaboration with veterinarians. A clear path for translating from animal models to clinical practice was also considered as a critical next step for accelerating progress in the tendon and ligament field.
Topics: Animals; Tendons; Anterior Cruciate Ligament Injuries; Anterior Cruciate Ligament; Tendon Injuries; Rotator Cuff Injuries
PubMed: 37573480
DOI: 10.1002/jor.25678 -
JBJS Reviews Aug 2023» Approximately 1 in 3 high-impact athletes develops patellar tendinopathy (PT), with the proximal insertion of the patellar tendon being the most commonly affected... (Review)
Review
» Approximately 1 in 3 high-impact athletes develops patellar tendinopathy (PT), with the proximal insertion of the patellar tendon being the most commonly affected anatomical site.» Nonoperative treatment options are effective in reducing pain and restoring functionality in most patients with PT. However, operative intervention should be considered when conservative management fails.» A comprehensive review of the literature on surgical procedures, including both open and arthroscopic approaches, was conducted with a specific focus on clinical outcomes and return to sports.» Both open surgery and arthroscopic surgery for PT have demonstrated favorable success rates and return-to-sport outcomes, with arthroscopic treatment potentially expediting the recovery process.
Topics: Humans; Athletes; Conservative Treatment; Musculoskeletal Diseases; Pain; Tendinopathy
PubMed: 37590404
DOI: 10.2106/JBJS.RVW.23.00076 -
The Journal of Small Animal Practice Oct 2023Mobility impairments associated with musculoskeletal diseases, such as osteoarthritis and degenerative joint disease, affect approximately 200,000 dogs annually and pose... (Review)
Review
Mobility impairments associated with musculoskeletal diseases, such as osteoarthritis and degenerative joint disease, affect approximately 200,000 dogs annually and pose a notable challenge to canine health and welfare. Osteoarthritis causes the remodelling of synovial joints, alongside inflammation and impaired mechanical function which can be extremely debilitating. Secondary osteoarthritis commonly affects dogs and can be exacerbated by previous joint abnormalities, such as patellar luxation or cranial cruciate ligament rupture. Although musculoskeletal diseases can affect dogs of any age, the early subtle signs of gait abnormalities are perhaps missed by owners, thus, dogs may be in the latter stages of osteoarthritis progression when they are presented to veterinarians. Dogs showing subtle signs of gait abnormalities must be presented to veterinary practices for acute diagnosis to prevent long-term deterioration. Musculoskeletal diseases, such as osteoarthritis and degenerative joint disease, are commonly diagnosed via visible radiographic changes. However, veterinarians can use a combination of subjective and objective clinical scoring systems, such as clinical metrology instruments and gait assessment in conjunction with radiography to aid their diagnosis and longitudinal monitoring of musculoskeletal diseases. These scoring systems may be more sensitive to earlier signs of mobility impairments in dogs, ultimately, promoting increased canine health and welfare by enabling pain reduction, improvement of muscle strength and preservation of joint function. Current canine mobility scoring systems available to veterinarians will be discussed in turn throughout this review for implementation into clinical practice.
Topics: Dogs; Animals; Stifle; Osteoarthritis; Joint Diseases; Anterior Cruciate Ligament Injuries; Inflammation; Dog Diseases
PubMed: 37455329
DOI: 10.1111/jsap.13650 -
Military Medicine Nov 2023Elite military trainees are burdened by high numbers of musculoskeletal (MSK) injuries and are a priority military population for injury prevention. This research aims...
INTRODUCTION
Elite military trainees are burdened by high numbers of musculoskeletal (MSK) injuries and are a priority military population for injury prevention. This research aims to describe the MSK complaint epidemiology of trainees undertaking special forces (SF) training in the Australian Defence Force (ADF). One barrier to accurate injury surveillance in military populations is that traditional surveillance methods rely on personnel engaging with the military healthcare system to collect injury data. This approach is likely to underestimate the injury burden as it is known that many military personnel, particularly trainees, avoid reporting their injuries because of various motives. Subsequently, the insights from surveillance systems may underestimate the injury burden and limit the ability to inform prevention requirements. This research aims to actively seek MSK complaint information directly from trainees in a sensitive manner to mediate injury-reporting behaviors.
MATERIALS AND METHODS
This descriptive epidemiology study included two consecutive cohorts of ADF SF trainees from 2019 to 2021. Musculoskeletal data items and their respective recording methods were based on international sports injury surveillance guidelines and adapted to a military context. Our case definition encompassed all injuries or physical discomforts as recordable cases. A unit-embedded physiotherapist retrospectively collected MSK complaint data from selection courses and collected prospective data over the training continuum. Data collection processes were external to the military health care system to mediate reporting avoidance and encourage injury reporting. Injury proportions, complaint incidence rates, and incidence rate ratios were calculated and compared between training courses and cohorts.
RESULTS
In total, 334 MSK complaints were reported by 103 trainees (90.4%), with a complaint incidence rate of 58.9 per 1,000 training weeks (95% CI, 53.0-65.5). Of these MSK complaints, 6.4% (n = 22) resulted in time loss from work. The lumbar spine (20.6%, n = 71) and the knee (18.9%, n = 65) were the most frequently affected body parts. Most of the MSK complaints were reported during selection courses (41.9%), followed by field survival and team tactics (23.0%) and urban operations courses (21.9%). Physical training accounted for 16.5% of complaints. Fast-roping training was associated with more severe MSK complaints.
CONCLUSIONS
Musculoskeletal complaints are highly prevalent in ADF SF trainees. Complaints are more frequently reported in selection and qualification training courses than in physical training. These activities are priorities for focused research to understand injury circumstances in ADF elite training programs to inform injury prevention strategies. A strength of our study is the data collection methods which have provided greater MSK complaint information than past research; however, much work remains in conducting consistent and accurate surveillance. Another strength is the use of an embedded physiotherapist to overcome injury-reporting avoidance. Embedded health professionals are recommended as continued practice for ongoing surveillance and early intervention.
Topics: Humans; Australia; Retrospective Studies; Prospective Studies; Musculoskeletal Diseases; Athletic Injuries; Military Personnel
PubMed: 37311061
DOI: 10.1093/milmed/usad215 -
Georgian Medical News Nov 2023Sports injuries among children and adolescents typically involve mild bruises and sprains. However, any sport can cause injuries to the musculoskeletal system. It is... (Review)
Review
Sports injuries among children and adolescents typically involve mild bruises and sprains. However, any sport can cause injuries to the musculoskeletal system. It is crucial to prevent such injuries through proper training and supervision to ensure the safety of young athletes. Therefore, when providing medical care to these patients, physicians must have the appropriate qualifications and skills and take into account the specific nature and location of injuries in each sport. Training programs and performance standards for young athletes should consider participants' biological age, physical and psychological immaturity, rather than their chronological age to prevent serious musculoskeletal injuries in child and youth sports. This review outlines the incidence of sports injuries in adolescents and considers how biological and social factors (factors related to coaches, peers and parents), influence the incidence and nature of injuries in different sports. Coaches and parents, though, have the ability to reduce the risk of injury by selecting suitable sports activities, employing the right equipment, enforcing rules, promoting safe playing conditions, and ensuring adequate supervision. Healthcare providers involved in the prevention and treatment of injuries in young athletes must possess the skillset to diagnose and assess the severity and risk to the athlete's future health and performance.
Topics: Child; Humans; Adolescent; Athletic Injuries; Sports; Athletes; Health Personnel; Physicians
PubMed: 38236101
DOI: No ID Found -
Cardiovascular and Interventional... Nov 2023Transarterial embolization for the treatment of chronic musculoskeletal diseases is gaining increasing interest in the field of interventional radiology. Overuse sports... (Review)
Review
Transarterial embolization for the treatment of chronic musculoskeletal diseases is gaining increasing interest in the field of interventional radiology. Overuse sports injury is defined as an injury occurring in the absence of a single, identifiable traumatic cause. In the treatment of this condition, there is a need for reliable results and a quick return to activity. Minimally invasive treatments with short periods of missed practice are required. Intra-arterial embolization has the potential to meet this need. In this article, we describe cases of embolization for refractory overuse sports injuries including patellar tendinopathy, pes anserine, plantar fasciitis, triangular fibrocartilage complex injury, hamstring injury, infrapatellar fat pad inflammation, Achilles tendinopathy, delayed union metatarsal bone fracture, lumbar spondylolysis, and repetitive hamstrings strain.
Topics: Humans; Athletic Injuries; Achilles Tendon; Tendinopathy; Cumulative Trauma Disorders; Embolization, Therapeutic
PubMed: 37433909
DOI: 10.1007/s00270-023-03496-w -
Georgian Medical News Nov 2023Orthopaedic surgeries pose various risks to the health of orthopaedic surgeons: radiation, noise, infection, chemical exposure, and musculoskeletal injury. These are... (Review)
Review
Orthopaedic surgeries pose various risks to the health of orthopaedic surgeons: radiation, noise, infection, chemical exposure, and musculoskeletal injury. These are associated with short and long-term health problems including malignancy and teratogenicity. Orthopaedic surgeons' health is critical to ensure optimal patient care. Most of these hazards can be obviated or minimized by adopting rigorous prevention protocols and raising awareness. Further related research is warranted and guidelines regarding prevention need to be framed by regulatory bodies.
Topics: Humans; Orthopedic Procedures; Occupational Exposure; Occupational Injuries
PubMed: 38236121
DOI: No ID Found -
Injury Nov 2023The posterior sternoclavicular joint dislocation is a rare and potentially life-threatening injury, as massive haemorrhage can occur at the time of trauma, during... (Review)
Review
The posterior sternoclavicular joint dislocation is a rare and potentially life-threatening injury, as massive haemorrhage can occur at the time of trauma, during reduction manoeuvres and drilling. These injuries are rare and a collective experience of managing them is of paramount importance. We present our multidisciplinary experience of managing several of these injuries in our centre, with learning points we have identified. Assessment should include Computerised Tomography Angiography (CTA) to assess the anatomy of the joint including the proximity to the underlying innominate vein and to identify any bleeding. Both closed reduction and open reconstruction have the potential for massive haemorrhage which can be controlled successfully with direct access to the underlying vessel. We recommend that all reductions should be performed in the presence of a cardiothoracic surgeon who can gain vascular control in the head, neck, and thorax. In specific high-risk cases, pre-emptive venous catheterisation can also be considered. We recommend that a discussion and rehearsal for intra-operative bleeding should be undertaken with the whole theatre team, with roles assigned pre-emptively and to allow identification of any deficiencies in staff expertise or equipment. Of the five recent cases managed in our centre one patient had a closed reduction and four had open reductions. Success of closed reductions within 48 h is high and these can be attempted up to 10 days after injury. Our patient undergoing closed reduction had a favourable outcome and returned to professional rugby at five months. Open reduction was performed in a physeal fracture as there was a delay to surgery and callus had begun to form and had the potential to adhere to the underlying vessel. In this case we performed open reduction and stabilised with tunnelled suture fixation. Our preferred method of reconstruction uses a palmaris graft with internal figure of eight bracing. One patient had a subsequent fracture of the medial clavicle around the drill holes that healed without further intervention. Despite good reduction and stability achieved following palmaris reconstructions, two patients are experiencing ongoing symptoms of globus and one with voice change without any objective underlying cause.
Topics: Humans; Sternoclavicular Joint; Fracture Fixation, Internal; Shoulder Dislocation; Joint Dislocations; Fractures, Bone; Thoracic Injuries; Hemorrhage
PubMed: 37634999
DOI: 10.1016/j.injury.2023.110983 -
Physical Therapy in Sport : Official... Sep 2023To investigate the influence of the gender, ranking and playing position on the musculoskeletal injuries in professional padel players. (Observational Study)
Observational Study
OBJECTIVES
To investigate the influence of the gender, ranking and playing position on the musculoskeletal injuries in professional padel players.
DESIGN
An epidemiological, observational, descriptive, retrospective cross-sectional study.
PARTICIPANTS
44 injuries were reported by 36 players (20 men/16 women) who participated in the World Padel Tour 2021.
SETTING
Online questionnaire.
MAIN OUTCOME MEASURE
Descriptive statistics and injury prevalence were calculated. Spearman/Pearson correlations between sample characteristics and injury variables were calculated. The chi-square test was used to analyse the association between injury and descriptive variables. A Mann-Whitney U test was performed to compare the group differences with regard to days of absence.
RESULTS
The results showed different injury prevalence (x1000 matches) in male (10.50) and female players (15.10). A higher injury incidence in top-ranked players, both in male (44.40%) and female (58.33%) was identified, but the low-ranked players reported more severe injuries (>28 days) (p < 0.05). Top-ranked players suffered more muscle injuries (p < 0.01) and low-ranked players suffered more tendon injuries (p < 0.01). Gender, ranking and playing position did not influence the days of absence (p > 0.05).
CONCLUSIONS
This study confirms that gender and ranking position had an impact on the injury prevalence in professional padel players.
Topics: Female; Humans; Male; Athletic Injuries; Cross-Sectional Studies; Incidence; Prevalence; Retrospective Studies; Seasons
PubMed: 37413954
DOI: 10.1016/j.ptsp.2023.06.003