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Sports Medicine and Arthroscopy Review Sep 2019Special Operations Combat Personnel (SOCP) face significant challenges and occupational demands that put them at significant risk for musculoskeletal injury.... (Review)
Review
Special Operations Combat Personnel (SOCP) face significant challenges and occupational demands that put them at significant risk for musculoskeletal injury. Musculoskeletal injury leads to lost-duty days, medical disqualification, and compromises operational readiness and mission success. Optimizing human performance and developing injury prevention strategies can position SOCP for success, but human performance optimization is a complex process that demands the integration of multiple disciplines to address a broad range of capabilities necessary for this success. The Warrior Model for Human Performance Optimization outlines a step-by-step approach to human performance optimization embedded within a scientific, evidenced-based approach to injury prevention and performance optimization that includes a step to ensure specificity of training and interventions. This evidence-based approach can insure that SOCP capabilities match the demands of occupation enabling them to successfully execute their occupation tasks without risk of injury. While the focus of this review is on military personnel, the same principles have application to nonmilitary high-performance athletes.
Topics: Humans; Military Personnel; Musculoskeletal System; Physical Functional Performance; Population Surveillance; Wounds and Injuries
PubMed: 31361719
DOI: 10.1097/JSA.0000000000000248 -
Seminars in Musculoskeletal Radiology Jun 2020Team handball is a fast high-scoring indoor contact sport with > 20 million registered players who are organized in > 150 federations worldwide. The combination... (Review)
Review
Team handball is a fast high-scoring indoor contact sport with > 20 million registered players who are organized in > 150 federations worldwide. The combination of complex and unique biomechanics of handball throwing, permitted body tackles and blocks, and illegal fouls contribute to team handball ranging among the four athletic sports that carry the highest risks of injury. The categories include a broad range of acute and overuse injuries that most commonly occur in the shoulder, knee, and ankle. In concert with sports medicine, physicians, surgeons, physical therapists, and radiologists consult in the care of handball players through the appropriate use and expert interpretations of radiography, ultrasonography, CT, and MRI studies to facilitate diagnosis, characterization, and healing of a broad spectrum of acute, complex, concomitant, chronic, and overuse injuries. This article is based on published data and the author team's cumulative experience in playing and caring for handball players in Denmark, Sweden, Norway, Germany, Switzerland, and Spain. The article reviews and illustrates the spectrum of common handball injuries and highlights the contributions of sports imaging for diagnosis and management.
Topics: Athletic Injuries; Biomechanical Phenomena; Brain Concussion; Humans; Musculoskeletal System; Risk Factors
PubMed: 32987422
DOI: 10.1055/s-0040-1710064 -
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 -
Military Medicine Jul 2022Neuromusculoskeletal injuries (NMSKIs) are the primary cause of ambulatory visits, lost duty days, and disability discharges in the U.S. Military. Methods for accurately...
INTRODUCTION
Neuromusculoskeletal injuries (NMSKIs) are the primary cause of ambulatory visits, lost duty days, and disability discharges in the U.S. Military. Methods for accurately grouping injury diagnoses are required to allow for surveillance and research identifying risk factors and prevention strategies. The CDC method of grouping these diagnoses includes only the S and T codes (Injury, poisoning, and certain other consequences of external causes) from the ICD-10-CM. However, this does not include the majority of the NMSKI depleting soldier readiness; the M (Disease of the musculoskeletal system and connective tissue) and G (Diseases of the nervous system) codes should be included as these also contain injuries. The goal was to develop a new matrix that would comprehensively capture all NMSKIs experienced by military personnel. This paper details the development of the Occupational Military Neuromusculoskeletal Injury (OMNI) Matrix and characterizes the number and rates of active duty U.S. Army injuries as measured by the OMNI compared to other matrices.
MATERIALS AND METHODS
A team of researchers including physical therapists, physician assistants, occupational therapists, physicians, and epidemiologists developed the OMNI. The OMNI utilizes the commonly accepted injury definition inclusive of any anatomical complaint resulting in pain or dysfunction and categorizes injuries from the G, M, S, and T codes. The OMNI follows the CDC's matrix structure with three body region levels, each becoming more specific, and adds two levels called Description of the Injury. Additionally, the OMNI categorizes injuries as Injury Type (Acute, Overuse, Either, or Not Applicable), NMSKI-Type (NMSKI, NMSKI that could be caused by occupational/training tasks, and not an NMSKI), and a miscellaneous category that demarks injuries as Superficial, Blood Vessels, and/or Internal Organs. The different grouping methods in the OMNI provide standardization for many possible injury case definitions. The OMNI allows these injury categories to be included/excluded in a standardized fashion to meet the researchers' scientific questions. To enumerate the number of NMSKI that would be captured by the available matrices, the OMNI, the CDC's matrix, and the U.S. Army Public Health Center's (APHC) Taxonomy of Injuries were applied to active duty Army outpatient population data and all incident NMSKI diagnostic codes entered in electronic medical provider encounters for calendar years 2017 and 2018.
RESULTS
Using the OMNI resulted in the capture of over 800,000 more injuries than the CDC's matrix and over 200,000 more than the APHC Taxonomy. The NMSKI rate utilizing the OMNI was 193 per 100 soldier-years in 2017 (892,780 NMSKI) compared to 23 per 100 soldier-years for the CDC's matrix, and 141 per 100 soldier-years for the APHC Taxonomy.
CONCLUSION
The OMNI provides an updated standardized method of assessing injuries, particularly in occupational military injury research, that can be utilized for Military Performance Division of injury across many countries and still allow for replication of methods and comparison of results. Additionally, the OMNI has the capacity to capture a greater burden of injury beyond what is captured by other available matrices.
Topics: Humans; International Classification of Diseases; Military Personnel; Musculoskeletal System; Occupational Injuries; Risk Factors; United States
PubMed: 34279035
DOI: 10.1093/milmed/usab300 -
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 -
Clinics in Sports Medicine Oct 2022According to epidemiology studies, the majority of youth sports injuries presenting to primary care, athletic trainers, and emergency departments impact the... (Review)
Review
According to epidemiology studies, the majority of youth sports injuries presenting to primary care, athletic trainers, and emergency departments impact the musculoskeletal system. Both acute and overuse knee injuries can contribute to sports attrition before high school. Effective rehabilitation of knee injuries ensures a timely return to sports participation and minimizes the negative physical, psychological, and social consequences of becoming injured. The following article provides rehabilitation and returns to play strategies for postsurgical and nonsurgical injuries of the young athlete's knee.
Topics: Adolescent; Athletic Injuries; Child; Cumulative Trauma Disorders; Humans; Knee Injuries; Musculoskeletal System; Sports
PubMed: 36210166
DOI: 10.1016/j.csm.2022.05.007 -
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 -
Radiologie (Heidelberg, Germany) Apr 2023Due to active participation of children and adolescents in school sports as well as in club sports, sporting injuries in childhood are common. Because skeletal maturity... (Review)
Review
CLINICAL/METHODOLOGICAL ISSUE
Due to active participation of children and adolescents in school sports as well as in club sports, sporting injuries in childhood are common. Because skeletal maturity is not yet complete, injury patterns in children differ from sporting injuries in adults. Knowledge of the pathophysiologic characteristics, as well as knowledge of typical injury sequelae, is of great relevance to radiologists. This review article therefore deals with common acute and chronic sporting injuries in children.
STANDARD RADIOLOGICAL METHODS
Basic diagnostic imaging comprises conventional X‑ray imaging in two planes. In addition, sonography, magnetic resonance imaging (MRI) and computed tomography (CT) are used.
PRACTICAL RECOMMENDATIONS
Close consultation with clinical colleagues and knowledge of childhood-specific injuries help identify sports-associated trauma sequelae.
Topics: Adult; Humans; Child; Adolescent; Athletic Injuries; Sports; Magnetic Resonance Imaging
PubMed: 36811691
DOI: 10.1007/s00117-023-01123-w -
Seminars in Musculoskeletal Radiology Apr 2020Clinical diagnosis of ligament and retinacular injuries of the hand may be challenging. Ultrasound (US) enables detailed high-resolution, dynamic, and real-time... (Review)
Review
Clinical diagnosis of ligament and retinacular injuries of the hand may be challenging. Ultrasound (US) enables detailed high-resolution, dynamic, and real-time evaluation of these structures. This article is a comprehensive review of the intricate anatomy, optimal imaging technique, and normal US appearances of these ligaments and retinacula. The US features, pertinent biomechanics, clinical presentation, and differential diagnosis of injuries affecting the annular pulleys, differentiating from climber's finger; extensor hood including sagittal band and central slip rupture; proximal interphalangeal and metacarpophalangeal collateral ligaments including the Stener lesion and associated volar plate injury; and the anterior oblique or beak ligament of the trapeziometacarpal joint are reviewed. Emphasis is placed on optimal transducer positioning, value of dynamic US, injury severity, surgical indications, and other US findings with important management implications. US facilitates a timely accurate diagnosis of hand ligament and retinacular injury to ensure optimal patient management and minimize the risk of functional impairment of the hand.
Topics: Athletic Injuries; Biomechanical Phenomena; Diagnosis, Differential; Hand Injuries; Humans; Ligaments; Ultrasonography
PubMed: 32438436
DOI: 10.1055/s-0039-3402051 -
RoFo : Fortschritte Auf Dem Gebiete Der... May 2024Ultrasound (US) has numerous applications in sports traumatology. The technical progress of mobile US devices has led to increasing use of ultrasound as a primary... (Review)
Review
BACKGROUND
Ultrasound (US) has numerous applications in sports traumatology. The technical progress of mobile US devices has led to increasing use of ultrasound as a primary diagnostic tool. New applications such as elastography and 3 D vascularization are used for special indications.
METHOD
The purpose of this review is to present the current status of ultrasound in the diagnosis of sports injuries and sport traumatology including established applications and new technical advances. US is presented both in its comparison to other imaging modalities and as a sole diagnostic tool.
RESULTS AND CONCLUSION
US can be used for initial diagnosis to improve the clinical examination and for intensive short-term follow-up imaging. The main areas of application are currently the diagnosis of acute muscle and tendon injuries as well as overuse injuries. In particular, the exclusion of structural muscle injuries can be adequately ensured with US in the majority of anatomical regions. The recently published guideline on fracture ultrasound has strengthened the clinical evidence in this area, especially in comparison to conventional radiography and in the development of algorithms and standards. The increasing use of mobile ultrasound equipment with adequate image quality makes US a location-independent modality that can also be used at training sites or during road games.
KEY POINTS
· Typically used for quick, focused initial diagnostic assessment and short-term follow-up after injury. · Mobile US devices allow increased use in training centers and training camps. · New US applications (SWE, 3 D) increase standardization in follow-up of tendon injuries. · Targeted use of US for musculoskeletal diagnostic assessment saves money and frees up capacity.
CITATION FORMAT
· Lerchbaumer MH, Perschk M, Gwinner C. Ultrasound in sports traumatology. Fortschr Röntgenstr 2024; 196: 440 - 449.
Topics: Humans; Athletic Injuries; Ultrasonography; Tendon Injuries; Sports Medicine; Cumulative Trauma Disorders; Elasticity Imaging Techniques; Muscle, Skeletal; Traumatology
PubMed: 37944936
DOI: 10.1055/a-2185-8264