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Effect of Chronic Ankle Sprain on Pain, Range of Motion, Proprioception, and Balance among Athletes.International Journal of Environmental... Jul 2020: Ankle sprains are common among physically active individuals, especially among athletes. Majority of those who suffer ankle sprains have residual symptoms including...
: Ankle sprains are common among physically active individuals, especially among athletes. Majority of those who suffer ankle sprains have residual symptoms including pain, episodes of giving way, compromised proprioception and neuromuscular control, and re-injury leading to chronic ankle instability. The aim of this study was to see the effect of chronic ankle sprain on pain, range of motion, proprioception, and, static and dynamic balance among athletes. : A total of 80 athletes, aged 18 to 25 years, involved in track-and-field sports were invited to participate in this study. They were divided in two groups. Athletes with history of grade 1 or 2 ankle sprain on either side requiring medical care who reported at least three episodes of ankle giving way in past 12 months were included in group A. An equal number of healthy athletes without any history of ankle sprain or injury in the lower limbs in the past one year matched by sex, age, height, weight, and limb dominance, were included in group B (control). : Participant's pain, range of motion, proprioception and balance (static and dynamic) was measured using visual analog scale, half circle goniometer, degree of foot position sense, single leg stance time and Y-balance test respectively. : Although there were no differences in the active ankle joint range of motion ( > 0.05) in comparison to the control group, athletes with chronic ankle sprain reported mild pain and statistically significant ( < 0.05) deficits in foot proprioception, static and dynamic balance. : Deficits in foot proprioception, static and dynamic balance even one year after the ankle sprain could be the reason for limitations in the dynamic defense system of the joint that predisposes to recurrent injury and instability. It is essential to understand the normal clinical course and risk factors for athletes who sustain sprain before devising a long term comprehensive rehabilitation program that focuses on mechanical and functional insufficiencies in order to improve their functional performance and prevent the risk of recurrent sprain.
Topics: Adolescent; Ankle Injuries; Athletes; Athletic Injuries; Chronic Disease; Female; Humans; Male; Pain; Postural Balance; Proprioception; Range of Motion, Articular; Sprains and Strains; Young Adult
PubMed: 32718066
DOI: 10.3390/ijerph17155318 -
Sports Health 2019Hockey is a skillful contact sport with an elevated injury risk at higher levels of play. An understanding of injury incidence, type, mechanism, and severity at various... (Review)
Review
CONTEXT
Hockey is a skillful contact sport with an elevated injury risk at higher levels of play. An understanding of injury incidence, type, mechanism, and severity at various levels of competition aids the clinician treating these athletes. The purpose of this clinical review is to discuss the epidemiology of hockey injuries at various levels of participation, including youth, high school, junior, college, and professional.
EVIDENCE ACQUISITION
A literature search was performed by a review of PubMed, Embase, and Cochrane databases and included articles published from 1988 to 2017. Studies were included in this review if determined to be of high quality and containing injury data relevant to the levels of competition. Pertinent data regarding ice hockey injury epidemiology and prevention at various levels of competition were analyzed.
STUDY DESIGN
Clinical review.
LEVEL OF EVIDENCE
Level 4.
RESULTS
Youth, high school, junior, college, and professional hockey players have unique injury patterns. Injuries occur much more often in a game compared with a practice, and injury risk increases with each level of competition. Preventative measures, such as mandatory facial protection and delayed body checking in games until age 13 years, are proven strategies to reduce the risk of facial injury and concussion.
CONCLUSION
An understanding of common injury types and mechanisms according to age and level of play aids the clinician in diagnosis and management. This information can also guide preventative strategies in the areas of education, coaching, rule enforcement, rule modifications, equipment improvement, and sportsmanship.
Topics: Athletic Injuries; Brain Concussion; Competitive Behavior; Contusions; Facial Injuries; Fractures, Bone; Head Protective Devices; Hockey; Humans; Incidence; Lacerations; Sprains and Strains; United States
PubMed: 31158326
DOI: 10.1177/1941738119849105 -
Foot and Ankle Clinics Jun 2023Injuries of the medial ankle ligament complex (MALC; deltoid and spring ligament) are more common following ankle sprains than expected, especially in eversion-external... (Review)
Review
Injuries of the medial ankle ligament complex (MALC; deltoid and spring ligament) are more common following ankle sprains than expected, especially in eversion-external rotation mechanisms. Often these injuries are associated with concomitant osteochondral lesions, syndesmotic lesions, or fractures of the ankle joint. The clinical assessment of the medial ankle instability together with a conventional radiological and MR imaging is the basis for the definition of the diagnosis and therefore the optimal treatment. This review aims to provide an overview as well as a basis to successfully manage MALC sprains.
Topics: Humans; Ankle Joint; Ankle; Ligaments, Articular; Sprains and Strains; Ankle Injuries; Ankle Fractures
PubMed: 37137629
DOI: 10.1016/j.fcl.2023.01.009 -
Medicine and Science in Sports and... Jun 2020Hyperbaric oxygen therapy (HBOT) is a well-established treatment for a variety of conditions. Hyperbaric oxygen therapy is the administration of 100% oxygen breathing in... (Review)
Review
Hyperbaric oxygen therapy (HBOT) is a well-established treatment for a variety of conditions. Hyperbaric oxygen therapy is the administration of 100% oxygen breathing in a pressure vessel at higher than atmospheric pressure (1 atmosphere absolute = 101 kPa). Typically, treatment is given daily for between 1 and 2 h at pressures of 2.0 to 2.8 ATA, depending on the indication. Sporting injuries are often treated over 3 to 10 sessions. Hyperbaric oxygen therapy has been documented to be effective and is approved in 14 medical indications by the Undersea and Hyperbaric Medical Society, including, but not limited to, carbon monoxide poisoning, compromised skin grafts and flaps, crush injuries, necrotizing soft tissue infections, and nonhealing ulcers with arterial insufficiencies. Recently, HBOT for sports musculoskeletal injuries is receiving increased attention. Hyperbaric oxygen therapy may allow injured athletes to recover faster than normal rehabilitation methods. Any reduction in collegiate and professional athletes' rehabilitation period can be financially significant for top-level sports teams; however, further research is required to confirm HBOT's benefits on sports musculoskeletal injuries. The purpose of this review to discuss the current understanding of HBOT as a treatment modality for common musculoskeletal injuries in sport medicine. Moreover, we will highlight the advantages and disadvantages of this modality, as well as relevant clinical and research applications.
Topics: Athletic Injuries; Contusions; Humans; Hyperbaric Oxygenation; Ligaments; Musculoskeletal System; Myalgia; Oxygen Consumption; Sprains and Strains; Tendon Injuries
PubMed: 31876671
DOI: 10.1249/MSS.0000000000002257 -
The American Journal of Sports Medicine Jun 2023Hamstring injuries are common among athletes. Considering the potentially prolonged recovery and high rate of recurrence, effective methods of prevention and risk factor... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Hamstring injuries are common among athletes. Considering the potentially prolonged recovery and high rate of recurrence, effective methods of prevention and risk factor management are of great interest to athletes, trainers, coaches, and therapists, with substantial competitive and financial implications.
PURPOSE
To systematically review the literature concerning evidence-based hamstring training and quantitatively assess the effectiveness of training programs in (1) reducing injury incidence and (2) managing injury risk factors.
STUDY DESIGN
Systematic review and meta-analysis; Level of evidence, 1.
METHODS
A computerized search of MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, and SPORTDiscus with manual screening of selected reference lists was performed in October 2020. Randomized controlled trials investigating methods of hamstring injury prevention and risk factor management in recreational, semiprofessional, and professional adult athletes were included.
RESULTS
Of 2602 articles identified, 108 were included. Eccentric training reduced the incidence of hamstring injury by 56.8% to 70.0%. Concentric hamstring strength increased with eccentric (mean difference [MD], 14.29 N·m; 95% CI, 8.53-20.05 N·m), concentric, blood flow-restricted, whole-body vibration, heavy back squat, FIFA 11+ (Fédération Internationale de Football Association), and plyometric training methods, whereas eccentric strength benefited from eccentric (MD, 26.94 N·m; 95% CI, 15.59-38.30 N·m), concentric, and plyometric training. Static stretching produced greater flexibility gains (MD, 10.89°; 95% CI, 8.92°-12.86°) than proprioceptive neuromuscular facilitation (MD, 9.73°; 95% CI, 6.53°-12.93°) and dynamic stretching (MD, 6.25°; 95% CI, 2.84°-9.66°), although the effects of static techniques were more transient. Fascicle length increased with eccentric (MD, 0.90 cm; 95% CI, 0.53-1.27 cm) and sprint training and decreased with concentric training. Although the conventional hamstring/quadriceps (H/Q) ratio was unchanged (MD, 0.03; 95% CI, -0.01 to 0.06), the functional H/Q ratio significantly improved with eccentric training (MD, 0.10; 95% CI, 0.03-0.16). In addition, eccentric training reduced limb strength asymmetry, while H/Q ratio and flexibility imbalances were normalized via resistance training and static stretching.
CONCLUSION
Several strategies exist to prevent hamstring injury and address known risk factors. Eccentric strengthening reduces injury incidence and improves hamstring strength, fascicle length, H/Q ratio, and limb asymmetry, while stretching-based interventions can be implemented to improve flexibility. These results provide valuable insights to athletes, trainers, coaches, and therapists seeking to optimize hamstring training and prevent injury.
Topics: Adult; Humans; Athletic Injuries; Randomized Controlled Trials as Topic; Hamstring Muscles; Sprains and Strains; Leg Injuries; Soft Tissue Injuries; Risk Factors; Muscle Strength
PubMed: 35384731
DOI: 10.1177/03635465221083998 -
The Physician and Sportsmedicine Nov 2020Ankle sprains are a common sports-related injury, and female athletes are more likely to sustain this injury than their male counterparts. Previous reviews have...
Ankle sprains are a common sports-related injury, and female athletes are more likely to sustain this injury than their male counterparts. Previous reviews have evaluated the efficacy of prevention programs in reducing ankle sprains in athletes, but no reviews have specifically focused on female athletes. The objective of this systematic review was to examine the sex-specific effectiveness of neuromuscular training (NMT) programs in reducing the risk of ankle sprains in female athletes. A search of PubMed, Ovid Medline, Embase, and Web of Science databases was performed using the terms: . Studies selected for inclusion were written in English, evaluated female athletes in organized athletics or reported female-specific data for mixed-sex cohorts, included a non-NMT comparison, and used ankle injury rate outcome measures. Seven articles were selected for inclusion, which evaluated a combined 5,187 female basketball, handball, volleyball, soccer, and floorball players. Two studies reported significant differences between NMT participants and controls, concluding the greatest effects were observed in preventing non-contact ankle sprains. The remaining 5 studies, although not statistically significant, revealed an evident trend toward the efficacy of ankle injury prevention with NMT programs. Current available evidence supports the efficacy of NMT in preventing ankle sprains in female athletes. When designing NMT programs, investigators should consider utilizing comprehensive approaches that incorporate strength, balance, plyometric, and agility training as the studies with significant findings created comprehensive NMT programs. Further investigations into sport- and female-specific programs are warranted.
Topics: Ankle Injuries; Athletic Injuries; Basketball; Female; Humans; Physical Conditioning, Human; Proprioception; Soccer; Sprains and Strains; Volleyball
PubMed: 32067546
DOI: 10.1080/00913847.2020.1732246 -
Journal of Sport Rehabilitation Mar 2020Hamstring strain injury (HSI) is the most prevalent injury in football (soccer), and a few intrinsic factors have been associated with higher injury rates.
CONTEXT
Hamstring strain injury (HSI) is the most prevalent injury in football (soccer), and a few intrinsic factors have been associated with higher injury rates.
OBJECTIVE
To describe the prevalence of the main intrinsic risk factors for HSI in professional and under-20 football players.
DESIGN
Cross-sectional study.
SETTING
Physiotherapy laboratory, Federal University of Health Sciences of Porto Alegre (Brazil).
PARTICIPANTS
A total of 101 football players (52 professional and 49 under-20 players).
INTERVENTION
An evidence-based testing protocol for screening HSI risk factors.
MAIN OUTCOME MEASURES
Anamnesis, ultrasonography of the hamstrings, passive straight-leg raise test, Functional Movement Screen, and isokinetic dynamometry were performed. Eleven HSI risk factors for each leg were assessed, besides the player's age as a systemic risk factor. Reports were delivered to the coaching staff.
RESULTS
Professionals had greater prevalence of HSI history compared with under-20 players (40% vs 18%). No between-group differences were found for the other screening tests. Altogether, 30% of players had already sustained at least one HSI; 58% had a history of injuries in adjacent regions; 49% had short biceps femoris fascicles; 66% and 21% had poor passive and active flexibility, respectively; 42% and 29% had deficits in functional movements and core stability, respectively; 7% and 26% presented bilateral imbalance for hamstring concentric and eccentric strength, respectively; 87% and 94% obtained low values for hamstring-to-quadriceps conventional and functional ratios, respectively. Two-thirds of players had 3 to 5 risk factors per leg. None of the players was fully free of HSI risk factors.
CONCLUSION
Most football players present multiple risk factors for sustaining an HSI. Hamstring weakness is the most prevalent risk factor, but the teams should also be aware of deficits in flexibility, core stability, functional movements, and hamstring fascicle length.
Topics: Adolescent; Adult; Athletic Injuries; Cross-Sectional Studies; Exercise Test; Hamstring Muscles; Humans; Male; Mass Screening; Muscle Strength; Prevalence; Risk Factors; Soccer; Sprains and Strains; Ultrasonography; Young Adult
PubMed: 30747574
DOI: 10.1123/jsr.2018-0084 -
British Journal of Sports Medicine Nov 2021Despite being the most commonly incurred sports injury with a high recurrence rate, there are no guidelines to inform return to sport (RTS) decisions following acute...
BACKGROUND
Despite being the most commonly incurred sports injury with a high recurrence rate, there are no guidelines to inform return to sport (RTS) decisions following acute lateral ankle sprain injuries. We aimed to develop a list of assessment items to address this gap.
METHODS
We used a three-round Delphi survey approach to develop consensus of opinion among 155 globally diverse health professionals working in elite field or court sports. This involved surveys that were structured in question format with both closed-response and open-response options. We asked panellists to indicate their agreement about whether or not assessment items should support the RTS decision after an acute lateral ankle sprain injury. The second and third round surveys included quantitative and qualitative feedback from the previous round. We defined a priori consensus being reached at >70% agree or disagree responses.
RESULTS
Sixteen assessment items reached consensus to be included in the RTS decision after an acute lateral ankle sprain injury. They were mapped to five domains with 98% panellist agreement-PAASS: ain (during sport participation and over the last 24 hours), nkle impairments (range of motion; muscle strength, endurance and power), thlete perception (perceived ankle confidence/reassurance and stability; psychological readiness), ensorimotor control (proprioception; dynamic postural control/balance), port/functional performance (hopping, jumping and agility; sport-specific drills; ability to complete a full training session).
CONCLUSION
Expert opinion indicated that pain severity, ankle impairments, sensorimotor control, athlete perception/readiness and sport/functional performance should be assessed to inform the RTS decision following an acute lateral ankle sprain injury.
TRIAL REGISTRATION NUMBER
ACTRN12619000522112.
Topics: Ankle Injuries; Athletic Injuries; Consensus; Humans; Return to Sport; Sprains and Strains
PubMed: 34158354
DOI: 10.1136/bjsports-2021-104087 -
Journal of Orthopaedic Surgery and... Apr 2023The combination of resistance training (RT) and aerobic training is believed to achieve the best effects. Several different aerobic training methods have emerged in...
BACKGROUND
The combination of resistance training (RT) and aerobic training is believed to achieve the best effects. Several different aerobic training methods have emerged in combination with or as a substitute for traditional RT. This study wished to verify which RT is safest in terms of injury prevalence and incidence. Also, it ascertained the characteristics of the injured subjects, the level of severity of the injuries and what definitions of injuries the available studies use.
METHODS
This systematic review followed the PRISMA recommendations and was registered in PROSPERO with the number CRD42021257010. The searches were performed in the PubMed, Cochrane and Web of Science, electronic databases using the Medical Subject Headings terms "Resistance training" or "Strength training" or "Crossfit" or "Weightlifting" or "Powerlifting" combined (AND) with "Injury" or "Injuries" or "Sprain" AND "Incidence" or "Prevalence" AND "Epidemiology" or "Epidemiological" in the title or abstract. The last search was performed on March 2023. To be included in the review, the studies had to be available as full text, be clinical trials focusing on epidemiological injuries of resistance training. There was no time limit for the selection of articles. To assess the quality of the studies, the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) was used.
RESULTS
The initial literature search resulted in 4982 studies. After reading the titles, abstracts and full text, 28 articles were selected for data extraction. Seventeen investigated the injuries in HIFT/CrossFit, three in powerlifting, three in strength training, three in weightlifting and one in strongman. In addition, one study examined the HIFT/CrossFit and weightlifting. The incidence of injuries presented in the studies ranged from 0.21/1000 h to 18.9/1000 h and the prevalence of injuries was 10% to 82%. In the quality assessment for STROBE, five studies were classified at level A, 21 at level B and two at level C.
CONCLUSION
This systematic review showed that traditional strength training is the safest RT method, and strongman is the least safe regarding injuries. Few studies have been rated highly according to STROBE. Furthermore, few studies have been published on some RT methods. These two factors make it difficult to generalize the results.
Topics: Humans; Sprains and Strains; Resistance Training; Sports; Exercise; Incidence
PubMed: 37046275
DOI: 10.1186/s13018-023-03781-x -
The Journal of Orthopaedic and Sports... Feb 2020The primary aim was to compare time from acute hamstring strain injury (HSI) to return-to-play (RTP) clearance following a standardized rehabilitation protocol performed... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
The primary aim was to compare time from acute hamstring strain injury (HSI) to return-to-play (RTP) clearance following a standardized rehabilitation protocol performed within either pain-free or pain-threshold limits. Secondary aims were to compare isometric knee flexor strength, biceps femoris long head (BFLH) fascicle length, fear of movement, and reinjury occurrence at the 6-month follow-up between pain-free and pain-threshold groups.
DESIGN
Randomized controlled trial.
METHODS
Forty-three men with acute HSIs were randomly allocated to a pain-free (n = 22) or pain-threshold (n = 21) rehabilitation group. Days from HSI to RTP clearance, isometric knee flexor strength, BFLH fascicle length, fear of movement, and reinjury occurrence at the 6-month follow-up were reported.
RESULTS
Median time from HSI to RTP clearance was 15 days (95% confidence interval [CI]: 13, 17) in the pain-free group and 17 days (95% CI: 11, 24) in the pain-threshold group, which was not significantly different ( = .37). Isometric knee flexor strength recovery at 90° of hip and 90° of knee flexion was greater in the pain-threshold group at RTP clearance by 15% (95% CI: 1%, 28%) and by 15% (95% CI: 1%, 29%) at 2-month follow-up, respectively. Improvement in BFLH fascicle length from baseline was 0.91 cm (95% CI: 0.34, 1.48) greater at 2-month follow-up in the pain-threshold group. Two reinjuries occurred in both the pain-free and pain-threshold groups between RTP clearance and the 6-month follow-up.
CONCLUSION
Pain-threshold rehabilitation did not accelerate RTP clearance, but resulted in greater recovery of isometric knee flexor strength and better maintenance of BFLH fascicle length, compared to pain-free rehabilitation. .
Topics: Adult; Athletic Injuries; Double-Blind Method; Fear; Follow-Up Studies; Hamstring Muscles; Humans; Isometric Contraction; Knee; Male; Movement; Muscle Strength; Pain Threshold; Recurrence; Return to Sport; Risk Factors; Sprains and Strains; Young Adult
PubMed: 32005093
DOI: 10.2519/jospt.2020.8895