Sports Medicine Research: In the Lab & In the Field (Sports Med Res)
Wednesday, April 26, 2017

ACL Symmetry Comparison – Timing Could Be Everything

Limb Symmetry Indexes Can Overestimate Knee Function After ACL Injury

Wellsandt E, Failla MJ, & Snyder-Mackler L. J Ortho Sport Phys Ther. 2017; Published online ahead of print

Take Home Message: If we compare a post-surgical knee to the uninvolved limb it may be ideal to test the uninvolved limb before surgery rather than later.

A patient trying to return to their previous level of activity after an anterior cruciate ligament (ACL) reconstruction must work hard to improve strength and function.  Upon return, they are still at a high risk for another ACL tear and long-term complications from their injury.  Clinicians commonly use limb symmetry indexes to assess what is “normal” for a patient during hop and strength tests.  However, the uninvolved limb might be a poor standard to hold a patient to.  The authors of this study compared limb symmetry indexes and estimated pre-injury capacity among 70 ACL reconstruction patients.
Monday, April 24, 2017

Psychological Issues Related to Illness and Injury in Athletes and the Team Physician: A Consensus Statement-2016 Update

Psychological Issues Related to Illness and Injury in Athletes and the Team Physician: A Consensus Statement-2016 Update.

Med Sci Sports Exerc. 2017 May;49(5):1043-1054. doi: 10.1249/MSS.0000000000001247.

An updated consensus statement on psychological issues related to illness and injury among athletes has been developed by a collaboration of 6 organizations: American Academy of Family Physicians, American Academy of Orthopaedic Surgeons, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and the American Osteopathic Academy of Sports Medicine. The goal of the statement is “to help the team physician improve the care of the athlete by understanding the relationship between psychological issues and athletic performance, illness, injury, treatment, and [return to play]”. The document covers psychological antecedents of athletic injuries, psychological reactions accompanying athletic injury, psychological issues of athletic illness and injury treatment and rehabilitation, psychological issues and return to play, select psychological issues in athletes (e.g., stress/anxiety, depression, disordered eating/eating disorders), and referring athletes to the mental health care network.

Wednesday, April 19, 2017

Simple Balance Test Is Able To Identify Non Contact Lower Extremity Injury Risk

Star Excursion Balance Test Anterior Asymmetry is Associated with Injury Status in Division I Collegiate Athletes

Stiffler MR, Bell DR, Sanfilippo JL, Hetzel SJ, Pickett KA, Heiderscheit BC. J Orthop Sports Phys Ther. 2017; 29:1-27.

Take Home Message: A clinician could use Star Excursion Balance Test anterior asymmetries to possibly differentiate collegiate athletes at greater risk for non-contact knee or ankle injury.

Clinicians use the Star Excursion Balance Test (SEBT) to identify athletes at risk for lower extremity injury. However, athletes’ performance on SEBT has been inconsistent across populations. Factors such as sex and type of sport the athlete plays may contribute to this discrepancy. It is unclear if these factors affect the relationship between SEBT score and risk of injury. Therefore, the authors retrospectively evaluated whether preseason SEBT scores from 147 healthy athletes were related to who experienced a non-contact knee or ankle injury during a season, while controlling for sport, sex, and athletic exposure (starter vs. non starter).
Monday, April 17, 2017

Athlete before Athletic: Consequences of Sport Specialization on Youth Athlete Health

The association of sport specialization and training volume with injury history in youth athletes.

Post EG, Trigsted SM, Riekena JW, Hetzel S, McGuine TA, Brooks MA.
Bell DR. Am J Sports Med. March 2017; [Epub ahead of print]

Take Home Message: An athlete engaged in highly specialized sport participation was more likely to report an injury within the previous year.

The positive benefits of youth sport participation are well-documented, but an emergence of specialized training among youth athletes has led to volume and frequency recommendations by professional medical organizations. These recommendations were well-intended but generated on limited evidence. The authors aimed to establish a relationship between sport specialization and injury history in youth athletes and identify the association of training volume recommendations and injury history.
Wednesday, April 12, 2017

Acute Care Needs to Focus More on Preventing Chronic Ankle Issues

Current Trends in the Management of Lateral Ankle Sprains in the United States

Feger MA, Glavniano NR, Donavan L, Hart JM, Saliba SA, Park JS, & Hertel J. Clin J Sport Med. 2017; 27:145-152. doi: 10.1097/JSM.0000000000000321

Take Home Message: Most common care after an ankle sprain involved multiple physician visits. Very few patients receive supervised rehabilitation. 

Lateral ankle sprains are one of the most common acute injuries among physically active individuals.  Ankle sprains cause short-term pain and disability and may cause long-term chronic ankle instability and joint damage.  Therefore, the question remains as to how ankle sprains are managed and whether the deficits exist due to initial management or if they develop after recovery from the primary injury.  The authors of this study aimed to describe lateral ankle sprain management within 30 day of injury using a database of national health insurance records in the United States for 2007 to 2011.
Friday, April 7, 2017

FIFA 11 ... (But Really FIFA 11 +) Programs Are Effective in Reducing Football (Soccer) Injuries

Effect of specific exercise-based football injury prevention programmes on the overall injury rate in football: a systematic review and meta-analysis of the FIFA 11 and 11+ programmes

Thorborg K, Krommes KK, Esteve E, Clausen MB, Bartels EM, Rathleff MS. Br J Sports Med. 2017 Apr;51(7):562-571. doi: 10.1136/bjsports-2016-097066. Epub 2017 Jan 13.

Take Home Message: The FIFA 11+ program reduces injury rates in recreational and sub-elite soccer players.

There are a variety of training programs to prevent injury in athletics, particularly in soccer. Many of these programs target anterior cruciate ligament (ACL) injury prevention but these programs are also able to reduce the risk of injury in general. The FIFA Medical Assessment and Research Centre (F-MARC) created the FIFA 11 and 11+ programs to reduce injury and allow for continued participation in soccer. While various investigators have implemented these programs, their effects on injury have been conflicting. Therefore, the authors conducted a meta-analysis to pool data from individual studies to increase our ability to precisely estimate the possible effects of these programs.
Wednesday, April 5, 2017

Elbow Stress May Compromise Elbow Health

Risk factors for cartilage damage and osteoarthritis of the elbow joint: case-control study and systematic literature review

Spahn G, Lipfert JU, Maurer C, Hartmann B, Schiele R, Holm Torsten K, Gifka J, Hofmann GO. Arch Orthop Trauma Surg. 2017; 137(4):557-566

Take Home Message: Workers and athletes exposed to greater elbow stress (from vibration, high forces, or high repetition) may be more likely to develop elbow osteoarthritis. 

Elbow anatomy is complex and the joint is often put under mechanical stress.  This stress spans across both sexes and many occupations, from athletics to construction or assembly. Review of the literature fails to demonstrate if osteoarthritis (OA) of the elbow joint is related to trauma, age-related changes, occupation, or if there is no relationship between OA and these possible risk factors. Therefore, Spahn and colleagues reviewed previous research and conducted a case-control study to compare people with no elbow joint issues to a group of patients who experienced chronic symptoms that required elbow surgery.