Sports Medicine Research: In the Lab & In the Field (Sports Med Res)
Wednesday, August 24, 2016

Has There Been Any Change in ACL Injury Rates?

Collegiate ACL injury rates across 15 sports: National Collegiate Athletic Association injury surveillance system data update (2004-2005 through 2012-2013)

Agel J, Rockwood T, and Klossner D. Clin J Sport Med. 2016. [Epub Ahead of Print].

Take Home Message: Anterior cruciate ligament (ACL) injury affect a small number of athletes. While overall ACL injury rates are decreasing, ACL injuries still affect a disproportionally higher number of women than men.

Anterior cruciate ligament (ACL) injury research has led to the implementation of preventative programs to decrease the risk of injury. Updated injury surveillance data can be useful in both evaluating the effectiveness of current clinical practice as well as directing future research. Therefore, Agel, Rockwood, and Klossner used NCAA ACL injury surveillance data to determine the rate of ACL injury among collegiate athletes from 2004 to 2013. This is an update of the data previously reported for the 15 academic years between 1988 to 2004.
Monday, August 22, 2016

How much is too much? International Olympic Committee consensus statements on load in sport and risk of injury and illness

How much is too much? (Part 1) International Olympic Committee consensus statement on load in sport and risk of injury

Soligard T, Schwellnus M, Alonso JM, Bahr R, Clarsen B, Dijkstra HP, Gabbett T, Gleeson M, Hägglund M, Hutchinson MR, Janse van Rensburg C, Khan KM0, Meeusen R, Orchard JW, Pluim BM, Raftery M, Budgett R, Engebretsen L. Br J Sports Med. 2016 Sep;50(17):1030-41. doi: 10.1136/bjsports-2016-096581.

How much is too much? (Part 2) International Olympic Committee consensus statement on load in sport and risk of illness

Schwellnus M, Soligard T, Alonso JM, Bahr R, Clarsen B, Dijkstra HP, Gabbett TJ, Gleeson M, Hägglund M, Hutchinson MR, Janse Van Rensburg C, Meeusen R0, Orchard JW, Pluim BM, Raftery M, Budgett R, Engebretsen L. Br J Sports Med. 2016 Sep;50(17):1043-52. doi: 10.1136/bjsports-2016-096572.

The International Olympic Committee organized an expert group to review the “evidence for the relationship of load—including rapid changes in training and competition load, competition calendar congestion, psychological load and travel—and health outcomes in sport.” Part 1 for risk of injury covers terminology and definitions, monitoring of load and injury, load and risk of injury in athletes, practical guidelines for load management, and research directions for load management in sport. Part 2 for risk of illness covers terminology and definitions, measures and monitoring, load and risk of illness in athletes, practical clinical guidelines, and suggested research.

Wednesday, August 17, 2016

Integrating Injury Prevention in Schools!

A School-Based Injury Prevention Program to Reduce Sport Injury Risk and Improve Healthy Outcomes in Youth: A Pilot Cluster-Randomized Controlled Trial

Richmond SA, Kang J, Doyle-Baker PK, Nettel-Aguirre A, & Emery CA.  Clin J Sport Med. 2016;26:291–298. doi: 10.1097/JSM.0000000000000261

Take Home Message: An injury prevention warm-up two to three times a week in a junior high school physical education class decreased injuries and improved overall fitness.

We have had multiple posts on Sports Med Res about the effectiveness of injury prevention programs for reducing the risk of injuries among high school and collegiate athletes.  Researchers have not evaluated the effectiveness of these programs in many younger groups and have not taken into consideration aerobic intensity.  The authors of this randomized trial wanted to evaluate the effectiveness of an injury prevention program in reducing injuries as well as improving body composition and fitness levels in a youth school-based population (11 to 15 year olds).
Wednesday, August 10, 2016

Hands off the Hands-free Ultrasound If You Are Looking for Deep Heating Effects

Comparison of Hands-free Ultrasound and Traditional Ultrasound for Therapeutic Treatment

Melanson H., Draper DO., Mitchell UH., Eggett DL. Athl Train Sports Health Care 2016;8(4):177-184

Take Home Message: A hands-free ultrasound unit at 1 MHz failed to increase the temperature deep in the gastrocnemius after 10 minutes.

Therapeutic ultrasound is an effective deep heating modality (heating to a depth of ~2 to 5 cm) when used properly. Traditional ultrasound treatments are labor intensive, time consuming, and prone to clinician error (e.g., treating too large an area, moving the sound head too fast). There is a hands-free ultrasound unit; however, there is little research whether the hands-free unit produces the same deep heating effects as traditional ultrasound. Therefore, the authors conducted a randomized cross-over experiment with 16 healthy participants (6 males and 10 females, age ~22 years, average gastrocnemius subcutaneous fat thickness ~0.85 cm) to determine whether the Rich-Mar AutoSound would be as effective as a traditional ultrasound at increasing the temperature of the gastrocnemius muscle during a 10-minute, 1 MHz, 1.0 W/cmtreatment.
Wednesday, August 3, 2016

Quick Clinical Model to Identify Chronic Ankle Instability

Comparison Between Single and Combined Clinical Postural Stability Tests in Individuals With and Without Chronic Ankle Instability

Ko J, Rosen AB, Brown CN. Clin J Sport Med 2016;0:1–6

Take Home Message: Clinicians may be able to use the single-leg hop test and Star Excursion Balance Test to identify people with chronic ankle instability.

There has been immense interest in trying to prevent or treat chronic ankle instability, which is characterized by recurrent episodes of giving way and functional limitations. However, the only measures that have demonstrated high reliability of identifying chronic ankle instability are self-reported questionnaires, and it is difficult to determine functional limitations without objective measures. Therefore, the authors assessed if clinical tests independently and/or in combination could accurately differentiate individuals with and without chronic ankle instability to determine which tests could best match self-report perception of function.
Wednesday, July 27, 2016

We’ll Ask the Question Again? Surgery or Nonoperative Treatment?

Is anterior cruciate ligament reconstruction effective in preventing secondary meniscal tears and osteoarthritis?

Sanders TL, Kremers HM, Bryan AJ, Fruth KM, Larson DR, Pareek A, Levy BA, Stuart MJ, Dahm DL, Krych AJ. Am J Sports Med. 2016 Jul;44(7):1699-707.

Take Home Message: Patients who sustained an anterior cruciate ligament (ACL) rupture were more likely to develop secondary meniscal injury and arthritis when compared to a matched cohort. Specifically, those that were treated nonoperatively or with delayed surgery may be more likely to develop secondary meniscal injury, develop arthritis, and be in need of a total knee replacement when compared with those patients treated with early surgery.

After an anterior cruciate ligament (ACL) rupture, physically active patients often receive an ACL reconstruction if they wish to return to some level of activity. However, there is conflicting evidence about the long-term benefits of an ACL reconstruction. Therefore, Sanders and colleagues completed a retrospective study to 1) evaluate the protective benefits of ACL reconstruction (ACLR) with regards to meniscal tears and physician-diagnosed arthritis, 2) determine if there is an optimal time frame for undergoing treatment, and 3) identify predictive factors of long-term disability.
Wednesday, July 20, 2016

After ACL Surgery…Close Enough? NO WAY!

Likelihood of ACL graft rupture: not meeting six clinical discharge criteria before return to sport is associated with a four times greater risk of rupture

Kyritsis P, Bahr R, Landreau P, Miladi R, & Witvrouw E.  Br J Sp Med. Published Online First: May 23, 2016. doi: 10.1136/bjsports-2015-095908

Take Home Message: Patients should attain all objective criteria goals prior to returning to sport.  A professional athlete who fails to meet functional criteria for return-to-sport or who has a low hamstring:quadriceps ratio is at greater risk for an anterior cruciate ligament graft rupture.

Athletes and clinicians are often focused on how quickly can we return a patient to sport after an anterior cruciate ligament (ACL) rupture.  There is no “set” return-to-play parameters that need to be met, and oftentimes clinicians think an athlete is “close enough” or will regain the remaining deficits upon return to sport.  However, history of an ACL injury is one of the largest risk factors for sustaining another ACL injury. Hence, the authors conducted a prospective cohort study to evaluate whether certain return-to-play criteria (e.g., functional assessments) were associated with risk of an ACL graft rupture after return to sport.