Sports Medicine Research: In the Lab & In the Field (Sports Med Res)
Monday, March 2, 2015

Tau-A Could be a Grade A Concussion Tool for Safe Return To Play

Serum tau fragments predict return to play in concussed professional ice hockey players

Shahim P., Linemann T., Inekci D., Karsdal MA., Blennow K.,Tegner Y., Zetterberg H., Henriksen K. Journal of Neurotrauma. Epub ahead of print.

Take Home Message: The Tau-A biomarker is a potential biomarker to distinguish those at risk for prolonged recovery following a concussion.

Diagnosis and return to play following a concussion rely heavily on subjective information from athletes. Thus, there is a great need to develop an objective tool, such as a blood test, to diagnose and monitor a concussion. Therefore, the authors evaluated professional Swedish ice hockey players to determine the utility of 2 fragments of tau, an intracellular protein in the central nervous system, (tau-A & tau-C) for diagnosis and prognosis of sports-related concussions.
Wednesday, February 25, 2015

Consider the Landing Surface When Thinking About Landing Techniques

Unstable surface improves quadriceps:hamstring co-contraction for anterior cruciate ligament injury.

Shultz R, Slider A, Malone M, Braun HJ, and Dragoo JL. Sports Health. 2015. [Epub Ahead of Print].

Take Home Message: College athletes have decreased quadriceps:hamstring activation ratio, increased peak hamstring activation, and increased trunk sway when landing on an unstable surface versus a stable surface.

Proper co-contraction of the hamstrings and quadriceps muscle groups is critical in stabilizing the knee joint to reduce the risk of sustaining an anterior cruciate ligament injury. While previous literature has demonstrated a correlation between jump training on an unstable surface and a reduction in ACL injuries, no study has looked at the quadriceps:hamstring activation ratio (Q:H ratio)  during these tasks, which could help clinicians gauge how important this training regime may be. Therefore, Shultz and colleagues recruited 39 female National Collegiate Athletic Association (NCAA) Division 1 college athletes and compared Q:H ratio during landing on a stable surface and an unstable surface.
Wednesday, February 18, 2015

Fear and Exercise Importance in Returning from ACL Injury

Perceived personal importance of exercise and fears of re-injury: a longitudinal study of psychological factors related to activity after anterior cruciate ligament reconstruction

Gignac MA, Cao X, White LM, Hurtig M, Kunz M, & Marks PH. BMC Sports Science, Medicine and Rehabilitation. 2015, 7:4.

Take Home Message: Fear of re-injury, exercise importance, and age are associated with return to activities after an anterior cruciate ligament reconstruction. 

A patient’s perceived importance of exercise and fear of re-injury are very important when recovering from anterior cruciate ligament (ACL) surgery.  Short- and long-term outcomes of successful return to activity and previous levels of activity may be affected by these perceptions.  The authors of this study investigated perceptions of exercise and re-injury fears pre-surgery and annually up to three years post-surgery in 95 participants.
Monday, February 16, 2015

What’s the Real Story? Effect of Fatigue on Acromiohumeral Distance and Scapular Position

Acromiohumeral Distance and 3-Dimensional Scapular Position Change After Overhead Muscle Fatigue

Maenhout A1, Dhooge F, Van Herzeele M, Palmans T, Cools A. J Athl Train. 2015 Jan 16. [Epub ahead of print]

Take Home Message: After overhead shoulder fatigue, healthy individuals have an increase in acromiohumeral distance and altered scapular position, consistent with a protective, impingement-sparing situation.

Muscle fatigue due to overhead sports has been hypothesized to contribute to shoulder impingement (and subsequent rotator cuff pathology) by altering the position of the scapula and narrowing the subacromial space.  However, conflicting evidence exists in the literature and as a result, no consensus has been established.  This may be due to the fact that most investigators use different fatiguing protocols that do not resemble overhead sports activity and only indirectly measure the subacromial space.  Therefore, the objective of this study was to assess the effect of a fatigue protocol that resembled overhead sports activity on scapular position and acromiohumeral distance, which is indicative of the amount of subacromial space.
Wednesday, February 11, 2015

Fatigue May Increase Anterior Tibial Translation

Neuromuscular fatigue and tibiofemoral joint biomechanics when transitioning from non-weight bearing to weight bearing.

Schmitz RJ, Kim H, and Shultz SJ. J Athl Training. 2015. 50(1): 23-29.

Take Home Message: Following a fatiguing exercise protocol, participants showed increased anterior tibial translation, compressive force, and knee flexion range of motion during the transition from non-weight-bearing to weight-bearing. This illustrates an inability of the lower extremity muscles to stabilize the knee joint.

An athlete is at greater risk for a noncontact injury, such as an anterior cruciate ligament (ACL) tear, later in games. While it is believed that fatigue may play a role in ACL injury, little evidence exists to support this. If this can be verified, clinicians may be able to identify strategies to better train athletes to stabilize the knee joint in a fatigued state and limit the risk of sustaining an ACL injury. Therefore, Schmitz and colleagues completed a cross-sectional study to assess the impact of a fatiguing exercise protocol on tibiofemoral biomechanics when transitioning from non-weight-bearing to weight-bearing.
Monday, February 9, 2015

The Team Physician and Strength and Conditioning of Athletes for Sports: A Consensus Statement

The team physician and strength and conditioning of athletes for sports: a consensus statement

Med Sci Sports Exerc. 2015 Feb;47(2):440-5. doi: 10.1249/MSS.0000000000000583.

A new consensus statement regarding the team physician and strength and conditioning of athletes for sports has been published in Medicine & Science in Sports & Exercise. The goal of this document was “to optimize the performance of the athletes and minimize the risk of injury and illness.” The document covers strength and conditioning principles (e.g., specificity, progressive overload), sport-specific strength and conditioning, strength and conditioning program implementation, injury and illness implications of strength and conditioning, as well as selected current issues in strength and conditioning.

Wednesday, February 4, 2015

Mom or Dad’s Bad Knees May be Inheritable, but are They Inevitable?

The association of genes involved in the angiogenesis-associated signalizing pathway with risk of anterior cruciate ligament rupture

Rahim M, Gibbon A, Hobbs H, van der Merwe W, Posthumus M, Collins M, & September AV. Journal of Orthopaedic Research. 2014, 32(12):1612-1618.

Take Home Message:  Specific genotypes that influence new blood vessel growth are more common among individuals with an anterior cruciate ligament tear.

The growing trend to investigate an individual’s genetic coding to determine if they are more likely to sustain an injury can help us identify individuals at risk for injury and understand why people may be susceptible to injury. Genetic variations that influence the composition of an anterior cruciate ligament (ACL) may increase the risk of ACL ruptures (see related posts below).  Genes that are related to new blood vessel formation (angiogenesis) may influence the composition of ACLs but no one has examined if genetic variations in these genes are related to ACL tears.  The authors of this case-control study aimed to identify if individuals who had suffered an ACL injury had genetic coding differences from physically active controls.