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The aim of this study was to determine the sprinting, strength, and architectural adaptations following a hip-dominant flywheel (FLY) or Nordic hamstring exercise (NHE) intervention in Australian footballers. Twenty-seven male athletes were randomized to FLY (n = 13) or NHE (n = 14) training across a 39-week period (inclusive of pre-season and in-season). Biceps femoris long head (BFlh) architecture was assessed throughout. Eccentric hamstring strength and 40 m sprint times (with force-velocity profiling) were assessed at baseline, end of pre-season, and following the intervention. After the intervention, BFlh fascicle length was longer in both groups compared to baseline (FLY: 1.16 cm, 95%CI: 0.66 to 1.66 cm, d = 1.99, p < 0.001; NHE: 1.08 cm, 95%CI: 95%CI 0.54 to 1.61 cm, d = 1.73, p < 0.001). Both groups also increased their eccentric strength (FLY: mean change 82 N, 95%CI 12 to 152 N, d = 1.34, p = 0.026; NHE: mean change 97 N, 95%CI 47 to 146 N, d = 1.77, p = 0.001). After pre-season, the NHE group improved their 5 m sprint time by 3.5% (±1.2%) and were 3.7% (±1.4%) and 2.0% (±0.5%) faster than the FLY group across 5 m and 10 m, respectively. At the end of pre-season, the FLY group improved maximal velocity by 3.4% (±1.4%) and improved horizontal force production by 9.7% in-season (±2.2%). Both a FLY and NHE intervention increase BFlh fascicle length and eccentric strength in Australian Footballers. An NHE intervention led to enhanced acceleration capacity. A FLY intervention was suggested to improve maximal sprint velocity and horizontal force production, without changes in sprint times. These findings have implications for hamstring injury prevention but also programs aimed at improving sprint performance.

This study aimed at determining the effect of kinesio-taping (KT) on muscle performance and delayed onset muscle soreness (DOMS) after exercise induced muscle damaged. Sixty-six healthy men volunteered to participate (age:18–25 y/o), who performed 200 isokinetic lengthening contractions of the dominant quadriceps. Then subjects were randomized to either control (no treatment), sham (no tape tension), or KT (10% tape tension) groups. Muscle performance was assessed by peak torque and muscular work during maximal isometric and concentric isokinetic contractions. DOMS intensity was assessed using a visual analog scale. Measurements were taken pre-exercise (Pre), 48 h and 96 h post-exercise. Repeated measures ANOVA was used for comparisons within group, and ANCOVA for comparisons among groups. Muscle damage was confirmed in all participants by an increase in CK activity level (p

In the activities of the tofu industry will be associated with muscle injury and work stress on labor productivity. In this case needed a way to find out how big the relationship between work stress with work productivity and muscle injury with worker productivity in the tofu industry. Research conducted with the population is tofu industry in Kediri Regency using non-probability sampling with purposive sampling technique. From this sample, 17 respondents were identified as having experienced work stress and injuries due to ordering excess tofu with duration 20 years to 20 tahun sampai < 80 tahun. Dilakukan penyebaran kuisioner kepada responden kemudian dilakukan uji hubungan yaitu Uji Chi-Square. Dari uji tersebut didapatkan hasil sesuai dengan hipotesis pada stress kerja memiliki hubungan dengan produktivitas yang bernilai Asymp. Sig variabel stress kerja sebesar 0,000 sudah mencapai nilai 0,000 < 0,05 dan variabel produktivitas sebesar 0,002 < 0,05. Sedangkan pada cedera otot dengan produktivitas kerja nilai Asymp. Sig variabel stress kerja sebesar 0,000 sudah mencapai nilai 0,000 < 0,05 dan variabel produktivitas sebesar 0,002 < 0,05.Â

Design Prospective cohort. Objective To explore the association between preseason assessments of (1) isometric hip adductor and abductor strength using a novel field test and (2) the Copenhagen Hip and Groin Outcome Score (HAGOS) and subsequent hip/groin injury in male professional soccer players. Methods In total, 204 male elite soccer players from 10 professional A-League and English Football League Championship clubs underwent assessments of hip adductor and abductor strength and completed the HAGOS in the 2017–2018 preseason. All subsequent hip/groin injuries were reported by team medical staff. Data reduction was conducted using principal-component analysis. The principal component for the HAGOS and 3 principal components for strength and imbalance measures were entered, with age and prior hip/groin injury, into a multivariable logistic regression model to determine their association with prospectively occurring hip/groin injury. Results Twenty-four players suffered at least 1 hip/groin injury throughout the 2017–2018 season. The principal component for between-limb abduction imbalance (peak strength in the preferred kicking limb – nonpreferred limb) (odds ratio [OR] = 0.58; 95% confidence interval [CI]: 0.38, 0.90; P = .011), the principal component for peak adduction and abduction strength (OR = 0.71; 95% CI: 0.51, 1.00; P = .045), and the principal component for the HAGOS (OR = 0.77; 95% CI: 0.62, 0.96; P = .022) were independently associated with a reduced risk of future hip/groin injury. Receiver operating characteristic curve analysis of the whole model revealed an area under the curve of 0.76, which indicates a fair combined sensitivity and specificity of the included variables but an inability to correctly identify all subsequently injured players. Conclusion Hip abduction imbalance favoring the preferred kicking limb, higher levels of hip adductor and abductor strength, and superior HAGOS values were associated with a reduced likelihood of future hip/groin injury in male professional soccer players.

Aims The aim of the HIPGEN consortium is to develop the first cell therapy product for hip fracture patients using PLacental-eXpanded (PLX-PAD) stromal cells. Methods HIPGEN is a multicentre, multinational, randomized, double-blind, placebo-controlled trial. A total of 240 patients aged 60 to 90 years with low-energy femoral neck fractures (FNF) will be allocated to two arms and receive an intramuscular injection of either 150 × 106 PLX-PAD cells or placebo into the medial gluteal muscle after direct lateral implantation of total or hemi hip arthroplasty. Patients will be followed for two years. The primary endpoint is the Short Physical Performance Battery (SPPB) at week 26. Secondary and exploratory endpoints include morphological parameters (lean body mass), functional parameters (abduction and handgrip strength, symmetry in gait, weightbearing), all-cause mortality rate and patient-reported outcome measures (Lower Limb Measure, EuroQol five-dimension questionnaire). Immunological biomarker and in vitro studies will be performed to analyze the PLX-PAD mechanism of action. A sample size of 240 subjects was calculated providing 88% power for the detection of a 1 SPPB point treatment effect for a two-sided test with an α level of 5%. Conclusion The HIPGEN study assesses the efficacy, safety, and tolerability of intramuscular PLX-PAD administration for the treatment of muscle injury following arthroplasty for hip fracture. It is the first phase III study to investigate the effect of an allogeneic cell therapy on improved mobilization after hip fracture, an aspect which is in sore need of addressing for the improvement in standard of care treatment for patients with FNF. Cite this article: Bone Jt Open 2022;3(4):340–347.

This study aims to determine possible associations between strength parameters, injury rates, and performance outcomes over six seasons in professional basketball settings. Thirty-six male professional basketball players [mean ± standard deviation (SD): age, 30.5 ± 4.7 years; height, 199.5 ± 9.5 cm; body mass, 97.9 ± 12.9 kg; BMI 24.6 ± 2.5 kg/m2] participated in this retrospective observational study, conducted from the 2008–09 to the 2013–14 season. According to their epidemiological records, each player followed an individual plan designed within different strength training programs: Functional (n = 16), Eccentric (n = 8), or Resistance (n = 12). Seven hundred and fourteen valid records were obtained from 170 individual strength tests during 31 sessions. Tests performed were leg press, squat, and jerk. Parameters recorded were force, power, velocity, peak velocity, and time to peak velocity for strength; time loss injury and muscle injury for injury rate; and games won, games lost, and championships for performance outcomes. All the strength variables and injuries are independent of the strength programs (p < 0.01). The correlation analysis showed very significant relationships between muscular injuries and time to peak velocity (r = 0.94; p < 0.01), significant relationships between force and games lost (r = 0.85; p < 0.05), and muscular injuries with games lost (r = –0.81; p < 0.05) per season. Mean values per season described a possible association of force, time to peak velocity, and muscular injuries with performance outcomes (R2 = 0.96; p < 0.05). In this specific context, strength variables and injury rate data show no association with a single type of strength training program in this cohort of high-performance basketball players.

Rotator cuff (RC) tears present a treatment challenge due to muscle atrophy and degeneration, fatty infiltration, and fibrosis. The purpose of this study was to generate a high time-resolution model of RC tear in rabbits and to characterize the progression of architectural and histological changes. Thirty-five female New Zealand White rabbits (age: 6 months) underwent left supraspinatus tenotomy. Five rabbits were used to evaluate immediate muscle architectural changes. The remaining 30 rabbits underwent right shoulder sham surgery and sacrifice at 1, 2, 4, 8, or 16 weeks. Histology was used to quantify muscle fiber cross-sectional area (CSA), muscle degeneration and regeneration, and fat localized to inter- versus intrafascicular regions. Muscle fiber CSA decreased by 26.5% compared to sham at 16 weeks (effect of treatment, p

Background: While pectoralis major (PM) tears are rare injuries in National Football League (NFL) athletes (previous study reported only 10 PM ruptures between 2000 and 2010), the incidence of these injuries has increased over the past decade. The impact these injuries have on a player’s performance after return has not been measured. Purpose/Hypothesis: To identify player characteristics that may predispose to PM tears and to determine the impact of this injury on return to play and performance. We hypothesized that there would be no difference in performance between the year before and after their injury. Study Design: Descriptive epidemiology study. Methods: NFL players who experienced PM tears between the years 2010 and 2018 were identified using publicly available reports. Several individual player characteristics were identified and recorded, and the return-to-play rates after injury were determined for each position. The pre- and postinjury Pro Football Focus grades of players who met inclusion criteria were compared. A paired t test analysis of the change in player performance was used for analysis. Results: In this study, 63 ruptures were identified between 2010 and 2018. Linebackers had the highest incidence of PM tear compared with any other position. Of all injuries, 79.3% were sustained by defensive players. The majority of PM tears occurred during games. Only 6.9% of players who sustained the injury were suspended for performance-enhancing drug use during their professional career. A total of 85.7% of players returned to play in the NFL after injury. Among those who returned to play there were no significant changes in player performance from pre- to post-injury. Conclusion: NFL players demonstrated 85.7% return-to-play rates and no significant drop-off in performance after PM ruptures. During the time period studied, there was an increase in incidence of PM ruptures compared with the previous decade. Further investigation is needed to determine potential causes for the increased incidence of PM ruptures in NFL players.

Purpose Platelet rich plasma (PRP) is widely used in orthopaedics, but is still heavily debated. Therefore, a survey among the German “Working Group for Clinical Tissue Regeneration” of the German Society of Orthopaedics and Traumatology was conducted to achieve a consensus about the current therapeutical potential of PRP. Methods A first survey (n = 65 experts, all orthopaedic/trauma surgeons) was conducted (n = 13 questions). Following, a second round (n = 40 experts) was conducted with 31 questions to achieve consensus in 5 categories: three most common indications, PRP application, future research areas. Results Therapeutic PRP application was regarded as useful (89%), possibly even more important in the future (90%). Most common indications were tendon pathologies (77%), osteoarthritis (OA) (68%), muscle injuries (57%) and cartilage damage (51%). Consensus was reached in 16/31 statements. The application of PRP for early knee OA (Kellgren-Lawrence grade II) was regarded as potentially useful, as well as for acute and chronic tendinopathies. For chronic lesions (cartilage, tendons), multiple injections (2–4) were seen preferable to singular injections. However, no sufficient data exists on the time interval between the injections. Standardization of PRP preparation, application, frequency, as well as determining the range of indication is strongly recommended. Conclusions There is a need of further standardization of the PRP preparation methods, indication and application protocols for knee OA and other indications, which must be further evaluated in basic science studies and randomized controlled clinical trials. Level of evidence Consensus of expert opinion, Level V.

Laboratory medicine in sports medicine is taking on an ever-greater role in the assessment and monitoring of an athlete&rsquo, s health condition. The acute or intense exercise practiced by elite athletes can lead to the appearance of infections, inflammations, muscle injuries or cardiovascular disorders, whose diagnosis is not always rapid and efficient, as there is no continuous monitoring of the athlete. The absence of such monitoring can have serious consequences in terms of recovery of the professional athlete. These imbalances can induce metabolic adaptations which translate into alterations of specific parameters in terms of concentration and activity. The aim of this study was to follow the variation of specific biochemical biomarkers in a basketball team participating to the maximum championship during different phases of the agonistic season. The evaluation of serum biomarkers can help doctors to safeguard the athlete&rsquo, s health and sports trainers to adapt workouts, thus avoiding the appearance of diseases and injuries that in some cases can be underestimated by becoming irreversible ailments that do not allow the athlete to return to a healthy state. This information can be useful to create athlete biologic passports.

Purpose The objective of this study was to investigate the ability of elastosonography (USE) in the identification of different grades of muscular injuries, comparing its effectiveness with traditional ultrasound (US) survey and by relating the results to the clinical classification of muscular pain. Methods In the period between August 2014 and May 2016, we conducted a prospective cohort study on a population of 34 young male professional athletes belonging to the same under-17 football club (Ancona 1905). Injuries were recorded according to location, type, mechanism, recurrence, and whether they occurred with or without contact. Muscle pain was classified, after a physical examination, according to the classification of Mueller-Wohlfahrt et al. All athletes were evaluated by musculoskeletal US and USE in hours following the trauma/onset of pain. Results Seventy injuries were documented among 19 players. Muscle/tendon injuries were the most common type of injury (49%). USE showed areas of edema in nine lesions that were negative at the US examination and previously classified as fatigue-induced muscle disorders. These nine players took more time to return to physical activity compared with others with injuries classified into the same group, but negative at USE evaluation. Conclusion USE is a valuable aid in the diagnosis and prognostic evaluation of muscle injury, as it detects pathologic changes that are not visible with the B-mode US. Level of Evidence This is a Level III, observational cohort study.

After patients has been trapped into skeletal muscle injury, hypoxic and dysfunctional mitochondria brings about a crisis in energy supply that severely disrupts the repair of skeletal muscle. This study aims to elucidate injury-induced adaptations in the mitochondria and provide statistics for the role of complex II in instilling cells with energy under hypoxic conditions. Fifty-six male Wistar rats were divided into control, 12 h, 2 d, 5 d, 7 d, 10 d, 15 d, and 30 d postinjury groups. Contusion injury was made via an instrumented drop-mass technique delivering single impact to the posterior surface of the gastrocnemius of one limb of the rats. ROS levels, loss of mitochondrial membrane potential (MMP), activities of marker enzymes (miCK, LDH, and ALP), and activities of complexes I–III were determined. Our findings reveal that the first 2 d postinjury, especially at 12 h, is the period with most severe oxidative stress. After injury, the activities of mitochondrial complexes I–III display different behaviors based on time and various energy production mechanisms. Our results highlight that complex II participates in electron transport in the acute phase of blunt trauma. We proposed that CII could be a therapeutic target in muscle lesions. Keywords: Muscle injuries, Mitochondria, Complex II, Time-course changes

Background:The hook test is a sensitive and specific tool that has been previously described for diagnosing distal biceps tendon ruptures in an efficient, cost-effective manner. However, its application in postoperative evaluations after surgical repair of distal biceps tendon ruptures is not documented.Hypothesis/Purpose:We hypothesized that the hook test result returns to normal at some point postoperatively after distal biceps repair. This information could be used in decision making during follow-up examinations with both normal and abnormal findings.Study Design:Cohort study (diagnosis); Level of evidence, 3.Methods:We retrospectively reviewed records of distal biceps repair. Between July 1, 2003, and July 1, 2016, a total of 56 patients underwent distal biceps repair and also had clear documentation of the results of the hook test during the postoperative period. Hook test results consisted of “intact,” “abnormal,” or “absent.” The timing of the return to a normal hook test result was recorded.Results:Overall, 51 of 57 (89%) repairs were documented to have the hook test result return to “intact.” The test result returned to intact by a mean of 10 weeks after surgery (range, 2 weeks to 15 months). The biceps tendon was intact according to the hook test at the 4-month follow-up in 45 of the 51 patients (88%) in whom it ultimately returned. The hook test result was abnormal in 5 repairs in 5 patients with only a short-term follow-up, ranging from 2 to 7 weeks postoperatively. One patient with an abnormal hook test result at 2 weeks postoperatively underwent revision and was confirmed to have a partial tear of the biceps insertion. His hook test result returned to intact 3 months after revision repair.Conclusion:The hook test result returns to normal in patients who undergo distal biceps repair in the primary and revision settings with adequate follow-up. The vast majority of patients have a normal hook test result by 4 months postoperatively. An abnormal hook test result at 4 months postoperatively may indicate a failed repair and should prompt further investigation.

Background Regular exercise leads to changes in muscle metabolism. The consequence of this is the adaptation to higher training loads.The aim of this study was to evaluate biomechanical and biochemical parameters describing the functions of skeletal muscles in periods when changes in training forms were introduced. Methods Seventeen male sweep-oar rowers, members of the Polish national rowing team, participated. The study was carried out at the beginning and at the end of the preparatory period. In the first and second examination measurements of torques of selected muscle groups and blood biochemical analysis were performed. Results There was observed a statistically significant decrease in the relative global force of the right lower limb between both terms of examination. A statistically significant increase in maximum torque was found for torso flexors. In the case of muscles responsible for torso rotation, a statistically significant decrease in the torque values of right torso rotators was observed. A significant difference was found with respect to creatine kinase activity, total testosterone concentration, total testosterone to cortisol ratio and total phenolics concentration (p Conclusion The study shows that the rowers’ training should be more focused on building the strength of lower limbs to prevent the overload of lumbar spine and that the amount of force developed may be significantly affected by the antioxidant potential of rowers.

Introducción: El salvamento acuático en Colombia es una actividad de alto riesgo, debido a que la presencia de lesiones es muy común en esta población, a pesar que existe literatura científica que hace referencia a las lesiones deportivas en lo salvavidas, esta se encuentra en su mayoría en salvavidas en playa, siendo muy limitada la información referente al personal de salvamento en aguas confinadas, en Colombia no se encuentran registros de lesiones en salvavidas en general, siendo esta información nula. Objetivos: Realizar una revisión de la literatura sobre el salvamento acuático y planes de prevención en la ocupación laboral en salvavidas, para entender el contexto colombiano. Metodología: Se realizó una búsqueda de literatura científica en bases de datos Ebsco Host, Scopus, Proquest, Pubmed, Google Scholar, Science Direct, Sports Discus, Scielo, en idiomas inglés, portugués y español, entre los años 2000-2018, utilizando palabras claves: salvamento acuático, lesiones deportivas y ocupación laboral. Información que se sistematizó en una matriz de datos en donde se relacionaron los artículos encontrados, de acuerdo a las categorías establecidas. Resultados: Se seleccionaron 47 referencias en total, las que fueron clasificadas y analizadas en cuatro categorías: Salvamento acuático, Salvavidas, Ocupación laboral, Planes de prevención. Conclusiones: Se encuentra evidencia importante que responde a las cuatro categorías de la revisión, sin embargo, se hace necesario, realizar investigaciones acordes al contexto colombiano, que incluyan necesariamente la población de salvavidas, además, crear planes de prevención de lesiones para los salvavidas, teniendo en cuenta. Introduction: The aquatic rescue in Colombia is a high risk activity, because the presence of injuries is very common in this population, although there is scientific literature that refers to sports injuries in the lifeguard, this is in its Most in lifeguards on the beach, with very limited information regarding rescue personnel in confined water, in Colombia there are no records of injuries in lifeguards in general, this information being null. Objectives: To carry out a review of the literature on aquatic rescue and prevention plans in labor occupation in lifeguards, to understand the Colombian context. Methodology: A search of scientific literature was performed in databases Ebsco Host, Scopus, Proquest, Pubmed, Google Scholar, Science Direct, Sports Discus, Scielo, in English, Portuguese and Spanish, between the years 2000-2018, using words keys: aquatic rescue, sports injuries and occupation. Information that was systematized in a data matrix where the found articles were related, according to the established categories. Results: A total of 47 references were selected, which were classified and analyzed in four categories: Water rescue, Lifeguard, Occupation, Prevention plans. Conclusions: There is important evidence that responds to the four categories of the review, however, it is necessary to conduct research according to the Colombian context, which necessarily includes the population of lifeguards, in addition, create injury prevention plans for lifeguards, taking into account, their risk factors and occupation. Incluye referencias bibliográficas

© 2018 Sports Medicine Australia Objectives: To determine injury risk-workload associations in collegiate American Football. Design: Retrospective analysis. Methods: Workload and injury data was recorded from 52 players during a full NCAA football season. Acute, chronic, and a range of acute:chronic workload ratios (ACWR: 7:14, 7:21 and 7:28 day) calculated using rolling and exponentially weighted moving averages (EWMA) were plotted against non-contact injuries (regardless of time lost or not) sustained within 3- and 7-days. Injury risks were also determined relative to position and experience. Results: 105 non-contact injuries (18 game- and 87 training-related) were observed with almost 40% sustained during the pre-season. 7–21 day EWMA ACWR's with a 3-day injury lag were most closely associated with injury (R2 = 0.54). Relative injury risks were >3× greater with high compared to moderate and low ratios and magnified when combined with low 21-day chronic workloads (injury probability = 92.1%). Injury risks were similar across positions. ‘Juniors’ presented likely and possibly increased overall injury risk compared to ‘Freshman’ (RR: 1.94, CI 1.07–3.52) and 'seniors’ (RR: 1.7, CI 0.92–3.14), yet no specific ACWR – experience or – position interactions were identified. Conclusions: High injury rates during college football pre-season training may be associated with high acute loads. In-season injury risks were greatest with high ACWR and evident even when including (more common and less serious) non-time loss injuries. Substantially increased injury risks when low 21-day chronic workloads and concurrently high EWMA ACWR highlights the importance of load management for individuals with chronic game- (non-involved on game day) and or training (following injury) absences.

The triathlon is one of the fastest developing sports in the world due to expanding participation and media attention. The fundamental change in Olympic triathlon races from a single to a multistart event is highly demanding in terms of recovery from and prevention of exercise-induced muscle injures. In elite and competitive sports, ultrastructural muscle injuries, including delayed onset muscle soreness (DOMS), are responsible for impaired muscle performance capacities. Prevention and treatment of these conditions have become key in regaining muscular performance levels and to guarantee performance and economy of motion in swimming, cycling and running. The aim of this review is to provide an overview of the current findings on the pathophysiology, as well as treatment and prevention of, these conditions in compliance with clinical implications for elite triathletes. In the context of DOMS, the majority of recovery interventions have focused on different protocols of compression, cold or heat therapy, active regeneration, nutritional interventions, or sleep. The authors agree that there is a compelling need for further studies, including high-quality randomized trials, to completely evaluate the effectiveness of existing therapeutic approaches, particularly in triathletes. The given recommendations must be updated and adjusted, as further evidence emerges.

Background:Arthroscopic surgery of the shoulder joint has become increasingly more common given its advantages over open surgery; however, one rare but potentially life-threatening complication is fluid extravasation into the surrounding tissues, causing edema, respiratory compromise, abnormal results on laboratory blood tests, and possibly death. Currently, no systematic review exists that summarizes the existing clinical research on this topic.Purpose:To perform a systematic review on fluid extravasation as a complication of shoulder arthroscopic surgery, specifically assessing clinical presentation, risk factors, management, and outcomes.Study Design:Systematic review; Level of evidence, 4.Methods:Two reviewers independently searched 3 databases (PubMed, Ovid [MEDLINE], and Embase) from database inception until July 1, 2017. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist guided the reporting and data abstraction. The methodological quality of these studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS) checklist. The results are presented in a narrative summary fashion using descriptive statistics including ranges and agreement statistics.Results:A total of 26 studies (20 case reports, 4 case series, and 2 prospective comparative studies) encompassing 205 patients (mean age, 50.8 years [range, 15-83 years]) were included. The most common signs of fluid extravasation included chest wall swelling (n = 86) and neck swelling (n = 116). In 32 patients, observation alone was sufficient. Other patients required airway intubation (n = 16), diuretics (n = 7), steroids (n = 1), and percutaneous drainage of fluid (n = 1). Clinical edema resolved after 2 to 48 hours, and patients were discharged 1 to 20 days postoperatively. Serious complications included transfer to the intensive care unit (n = 14), anterior interosseous nerve palsy (n = 4), rhabdomyolysis (n = 1), and death (n = 1).Conclusion:Fluid extravasation has the potential to be a life-threatening complication of shoulder arthroscopic surgery; however, it is most commonly managed nonoperatively, and symptoms typically resolve with no evidence of long-term complications. Intraoperative surgical decisions, such as minimizing the surgical time and volume of irrigation fluid used, may limit fluid extravasation, while careful intraoperative monitoring may facilitate prompt diagnosis and management to optimize patient outcomes.

Background. The goals of the treatment of muscle injuries are to shorten the time of healing and to avoid relapses. The aim of this study was to assess the efficacy of autologous platelet-rich plasma (PRP) in the healing of muscle injuries. Materials and methods. A multicentre, randomised, double-blind, parallel, controlled clinical trial was conducted in 71 patients (81.8% males) aged 45.6 (SD=10.0) years with muscle tears in the legs and haematoma. The haematoma was evacuated in all patients. Thirty-three patients were randomised to a single dose of autologous PRP and 38 patients to simulation of PRP administration. The primary end-point was time to complete recovery of muscle injury. Secondary end-points were pain, relapses, ultrasound parameters, and adverse events. The total follow-up per patient was 12 months. Results. Time to complete recovery after the treatment was 31.63 days (SD=15.38) in the PRP group, and 38.43 days (SD=18.58) in the control group (p=0.261). Pain decreased over time in both groups without statistical differences between them. Eight patients relapsed (seven in the control group, and one in the PRP group). There were no adverse effects related to the interventions. Discussion. Autologous PRP did not significantly improve the time to healing compared to that in the control group.

Background The aim of this study was to investigate the association between MCT1 rs1049434 polymorphism and indirect muscle injuries in elite football players. One hundred and seventy-three male elite Italian football players (age = 19.2 ± 5.3 years) were recruited from a first-league football club participating at the Official National Italian Football Championship (Serie A, Primavera, Allievi, Giovanissimi). The cohort was genotyped for the MCT1 rs1049434 polymorphism, and muscle injuries data were collected during the period of 2009–2014 (five football seasons). Methods Genomic DNA was extracted using a buccal swab, and genotyping was performed using PCR method. Structural-mechanical injuries and functional muscle disorder were included in the acute indirect muscle injury group. Results Participants with the MCT1 AA (AA = 1.57 ± 3.07, n = 69) genotype exhibit significantly higher injury incidents compared to participants with the TT genotype (TT = 0.09 ± 0.25, n = 22, P = 0.04). Conclusions The MCT1 rs1049434 polymorphism is associated with the incidence of muscle injuries in elite football players. We anticipate that the knowledge of athletes’ genetic predisposition to sports-related injuries might aid in individualizing training programs.

Objective: To examine the prevalence and factors associated with instruction-related injuries and musculoskeletal pain among group fitness instructors. Design: Descriptive epidemiology study. Settings: Online survey. Participants: Group fitness instructors from three fitness centre companies in Norway (n = 1473). Assessment of independent variables: questions regarding duration of working as a group fitness instructor, weekly instruction and exercise loading and modality, instruction-related injuries, musculoskeletal pain, use of alcohol, tobacco, snuff, menstrual dysfunction and disordered eating (Eating Disorder Inventory, EDI). The respondents were divided into high instruction loading (HIL), ≥5 h/w with instruction; and low instruction loading (LIL)

Las lesiones en los isquiotibiales son el tipo de lesiones más frecuentes en el ámbito deportivo, sobre todo futbolístico. La mayoría de estas lesiones son producidas por el esfuerzo y producen una significativa pérdida de tiempo de entrenamiento y afecta a la calidad de vida de los deportistas lesionados El objetivo principal de esta revisión sistemática es verificar la eficacia de los métodos de entrenamiento a la hora de prevenir lesiones en los músculos isquiotibiales. Como objetivos secundarios se consideran los siguientes: saber si un músculo lesionado es más propenso a recaer y volver a lesionarse, si los ejercicios excéntricos son beneficiosos a la hora de prevenir las lesiones en los isquiotibiales y averiguar si la fatiga tiene relación con las lesiones de dichos músculos. Métodos: Para realizar la búsqueda de los estudios se han utilizado tres bases de datos como son Pubmed, Science Direct y PEDro ya que en otras bases de datos no encontré material adecuado para mi trabajo y tras descartar los diversos artículos que no cumplían con los criterios de selección, he obtenido un total de 13 artículos. Más tarde y una vez comenzado la lectura de los artículos, se descartaron por diversos criterios tantos que mi trabajo se basa en 5 artículos específicamente. Resultados: El entrenamiento en pretemporada de los músculos isquiotibiales a través de ejercicios excéntricos afecta positivamente a reducir el riesgo de las lesiones durante la temporada posterior. Este entrenamiento produjo mejoras en los siguientes aspectos: incremento de la fuerza tanto concéntrica como excéntrica de los isquiotibiales, el tiempo de velocidad máxima de carrera fue más corto y disminuye el riesgo de lesiones. La fatiga es un factor de riesgo importante para las lesiones en isquiotibiales y este factor se agrava más cuando en los partidos se está llegando al final de la primera parte y al final del partido y cuando los jugadores salen del vestuario a jugar las segundas partes. El trabajo de la fuerza de la musculatura isquiotibial a través del ejercicio excéntrico (Nordic Hamstring) en comparación al trabajo de la fuerza muscular realizado a través del Curl tradicional reduce el riesgo de sufrir una lesión ya que con el ejercicio excéntrico se fortalece más la musculatura con la consiguiente disminución del posible riesgo de lesión. Los jugadores que hayan sufrido anteriormente una lesión en los isquiotibiales tienen más del doble de posibilidades de sufrir una nueva lesión en comparación a los jugadores que no han sufrido una lesión anterior. La prueba de flexibilidad activa es una prueba fiable y válida para detectar deficiencias en los músculos isquiotibiales y proporcionar información adicional para el examen clínico antes de regresar a la competición. Conclusión: Padecer una lesión anterior en los músculos isquiotibiales es un factor de riesgo a la hora de sufrir posibles nuevas lesiones. Los ejercicios excéntricos a la vez que fortalecen los isquiotibiales reducen el riesgo de sufrir una lesión en la zona. La fuerza excéntrica de los isquiotibiales disminuye en función del tiempo y después del intervalo de descanso. Hay un mayor riesgo de lesiones en esos momentos específicos, especialmente en movimientos explosivos. La prueba de flexibilidad activa parece ser fiable para detectar deficiencias en dichos músculos y además proporciona información adicional para el examen clínico que se realiza antes de regresar a entrenar y a competir de nuevo. El entrenamiento específico del grupo muscular de los isquiotibiales debería de ser utilizado en el mundo del futbol, tanto desde el punto de vista de la prevención de lesiones como en la mejora en el rendimiento. Hamstring injuries are the most common type of injury in sport, especially football. Most of these injuries are caused by stress and produce a significant loss of training time and affects the quality of life for injured athletes. The main objective of this systematic review is to verify the effectiveness of the training methods in preventing hamstring injuries. Secondary objectives are considered the following: whether an injured muscle is more prone to relapse and re-injury, if eccentric exercises are beneficial in preventing hamstring injuries and determine whether fatigue is related to injuries these muscles. Methods: to search the studies have used three databases such as PubMed, Science Direct and PEDro since in other databases could not find suitable material for my work and after elimination of several items that did not meet the criteria selection, I have obtained a total of 13 articles. Results: The preseason training hamstrings through eccentric exercise positively affects reduce the risk of injuries during the postseason. This training led to improvements in the following aspects: increasing both concentric and eccentric strength of the hamstrings, the time of maximum running speed was shorter and less risk of injury. Fatigue is a risk factor for hamstring injuries and this factor is further aggravated when the games are coming to the end of the first half and after the game and when players leave the locker room to play the second part. The work force of the hamstrings through eccentric exercise (Nordic Hamstring) compared to muscle strength work done through traditional curl reduces the risk of injury because the more eccentric exercise strengthens the muscles with subsequent reduced risk of injury. Players who have previously suffered an injury in the hamstrings are more than twice as likely to suffer a new injury compared to players who have not suffered a previous injury. The active flexibility test is a reliable and valid to detect weaknesses in the hamstrings and provides additional information to the clinical examination before returning to competition. Conclusion: The previous injury of the hamstrings is a risk factor when developing new potential injury eccentric exercises to strengthen hamstring while reducing the risk of injury in the area. The hamstrings eccentric force decreases with time and after break interval. There is an increased risk of injury in those specific moments especially explosive movements. The active flexibility test appears to be reliable to detect weaknesses in the hamstrings and also provides additional information for the clinical examination is performed before returning to train and compete again. Specific training of the hamstring muscle group should be used in the world of football, both from the point of view of prevention of injuries as improving performance. Graduado o Graduada en Fisioterapia por la Universidad Pública de Navarra Fisioterapian Graduatua Nafarroako Unibertsitate Publikoan