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ABSTRACTObjectivesYouth soccer participation, particularly among females, continues to grow worldwide. With the high incidence of sport-related concussion (SRC) in soccer, it is important to investigate if SRC occurs disproportionally by positions. Our hypothesis was to see no positional differences in SRCs, SRC-related characteristics, and outcomes among in female youth soccer athletes.MethodsData were prospectively collected from participants at a single sports medicine institution between August 2015-April 2021. Female participants aged 8–18 diagnosed with SRC sustained during an organized soccer practice, scrimmage, or game were separated into 4 groups based on position: Forward, Midfielder, Defender, and Goalkeeper. Demographics, medical history, injury-related details, and outcomes were reviewed. A chi-square test or Fisher’s exact test was used for categorical variables. Continuous variables were compared with Mann-Whitney or Kruskal-Wallis test.ResultsTwo hundred fourteen participants were included: 52 Forwards, 65 Midfielders, 63 Defenders, and 34 Goalkeepers. There were no significant differences between the groups in age, race, ethnicity, or previous concussion history. Differences in mechanism existed with Goalkeepers most commonly reporting Head to Body Part. Goalkeepers, which make up 1/11 of the total positions on the field, had a significantly higher proportion of SRCs compared to Field Positions. (9.1% vs 15.9%)At 3-month post-enrollment, there were no significant differences in reported symptoms or return-to-play between the different positions.ConclusionIn youth female soccer players, goalkeepers sustained a higher proportion of sport-related concussions compared to field players based upon the composition of a soccer team. The mechanism of injury also differed among the different soccer positions. However, no differences in concussion characteristics, outcomes, or RTP were seen across the different soccer positions.

ABSTRACTBackgroundHurdling is a track event that is unique due to a combination of running and jumping over an apparatus. Since hurdling requires a special skillset with sprinting and jumping, athletes are at risk for various musculoskeletal injuries. However, there has been a paucity of studies describing the epidemiology of pediatric hurdle injuries.PurposeTo examine hurdle-related injury types, injured body parts, injury mechanisms, and injury settings in children and adolescents.MethodsDescriptive epidemiology study. Data from the National Electronic Injury Surveillance System, which represents emergency room visits, was retrospectively reviewed. Injury data involving hurdle injuries was searched during a 10-year period (2008–2017) with hurdlers 18 years old and younger. Injuries were classified based upon injury types, body parts, injury mechanisms, and injury settings. Descriptive statistics were used including mean ± standard deviation, frequency (N), and percentages (%).ResultsA total of 749 hurdle-related injuries were found from 333 males (44.5%) and 416 females (55.5%). The top three injury types were fracture (N = 218, 29.1%), joint sprain (N = 191, 25.5%), and contusion/hematoma/bruise (N = 78, 10.4%). The top three injured body parts were ankle (N = 140, 18.7%), knee (N = 120, 16.0%), and wrist (N = 69, 9.2%). The most common injury mechanisms were apparatus-related trips, falls, and landings (N = 594, 79.0%). Finally, injury settings consisted of track and field practices (N = 469, 62.6%), track and field meets (N = 96, 12.8%), and other settings including gym, physical education class, recess, school activities, and camps (N = 49, 6.5%).ConclusionIn pediatric hurdle athletes, the most prevalent injury type seen in the emergency room was fracture. Although most hurdle-related injuries occur in the lower extremity, wrist injuries were the third most commonly injured body location. The most common injury mechanism was apparatus-related trip, fall, and landing, and injuries most commonly occurred during track practices. In pediatric hurdle athletes seen in the emergency room, majority of injuries consisted of traumatic fractures and joint sprains at ankle, knee, and wrist, which frequently occurred with apparatus-related trip, fall, and landing mechanisms during track and field practices.

ABSTRACTObjectiveTo compare the common injuries of pre-high school American football quarterbacks (Pre-HS QBs) and high school American football quarterbacks (HS QBs) within the last 15 years.MethodsA retrospective chart review was performed at a sports medicine clinic at a tertiary-level pediatric medical center. Pediatric and adolescent American football quarterback patients who sustained sports-related injuries were extracted. Injury status (acute vs. overuse), injured anatomic locations, injury types, and surgical status were compared by Pre-HS QBs (<14 years old) and HS QBs (14–18 years old).ResultsA total of 121 injuries were found in 118 male Pre-HS QBs (mean age: 12.4 ± 1.6), while 302 injuries were observed in 256 male HS QBs (mean age: 15.8 ± 1.4). Overall, nearly two-third (2/3) of injuries were acute (64.3%) while a little over one-third (1/3) of injuries were overuse in nature (35.7%), and there were no differences between Pre-HS and HS QBs (58.7% vs. 66.7%, p = 0.114). The top 3 injured anatomic locations for Pre-HS QBs were elbow (20.7%), shoulder (18.2%), and head/neck (14.0%). For HS QBs, the top 3 injured anatomic locations were shoulder (24.5%), knee (17.5%), and head/neck (15.2%). There were significant differences in proportion of elbow (20.7% vs. 10.6%, p = 0.006), hip/trunk/upper leg (10.7% vs. 3.3%, p = 0.002), and knee injuries (9.1% vs. 17.5%, p = 0.028) between Pre-HS and HS QBs. Pre-HS QBs had significantly more bony/cartilaginous/labral injuries than their older counterparts (60.3% vs. 46.3%, p = 0.009) while HS QBs experienced significantly more ligamentous injuries than Pre-HS QBs (14.2% vs. 5.8%, p = 0.015).ConclusionsQB-associated injuries were distinctively different between Pre-HS and HS QBs. Future studies are warranted to investigate relatively high proportions of elbow injuries as well as bony/cartilaginous/labral injuries found in Pre-HS QBs.

ABSTRACTIntroduction: To determine clinical parameters that are related to abnormal cardiac symptoms in physically active youth.Methods: We used Simon’s Heart Heartbytes National Youth Cardiac Registry to collect data from adolescent athletes in southeastern Pennsylvania. We collected age, race/ethnicity, abnormal cardiac symptoms, medical history, medication use, caffeine intake, and family history. We obtained height, weight, blood pressure, cardiac murmur findings, and ECGs. Echocardiogram was obtained if necessary. Binary logistic regression analysis was performed to identify independent associations between abnormal cardiac symptoms and collected variables. The odds ratio (OR), 95% confidence interval (95% CI), and p-values were used as statistical values.Results: Of the 887 athletes (543 males and 344 females, age = 16.9 ± 2.1 years, height = 166.9 ± 11.4 cm, weight = 62.0 ± 16.0 kg), 186 (21%) had abnormal cardiac symptoms including chest pain, passing out, difficulty breathing, extreme fatigue, and heart race. There was an independent association between abnormal symptoms and a past medical history (OR: 4.77, 95%CI: 3.18, 7.17, p = 0.001) and medication use (OR: 1.74, 95%CI: 1.08, 2.79, p = 0.022). In medical history, young athletes with asthma showed a greater propensity of abnormal cardiac symptoms (48.9%) compared to young athletes without (14.0%, p = 0.001). Additionally, young athletes with anxiety or depression demonstrated a higher proportion of abnormal cardiac symptoms (48.9%) than those without (19.5%, p = 0.001). Although the association between the presence of abnormal symptoms and African-American race (OR: 2.04, 95%CI: 0.96, 4.35, p = 0.065) and average daily consumption of at least 2 caffeine drinks (OR: 2.08, 95%CI: 0.86, 5.02, p = 0.103) were not significant, there was a trend to reach the a priori significance level.Conclusions: This study identified several clinical parameters that are associated with symptoms suggestive of abnormal cardiac conditions. Larger studies need to be done to better sort out the clinical history that may contribute to false positives to further reduce false positives at heart screenings.