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Context: Despite the availability of specialized assessment tools, psychological readiness is usually not considered when deciding to return to sport (RTS) after sport injury. Reinjury anxiety, self-confidence, and functional attention may be associated with sport reinjury, making it important to evaluate these factors before RTS., Objective: To predict lower extremity reinjury in soccer players using self-confidence, functional attention, and reinjury anxiety as predictive variables., Design: Prospective cohort study., Setting: Laboratory., Patients or Other Participants: Sixty-two male soccer players, who were older than 18 years of age, suffered from lower extremity injuries, had completed the rehabilitation program, and were ready to RTS., Main Outcome Measure(s): Before returning to the sport, participants completed a preseason questionnaire on their previous injuries, self-confidence, reinjury anxiety, and level of functional attention. The primary outcome measured was the risk of reinjury during the upcoming competitive season, and logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) to determine the association between each risk factor and reinjury., Results: The overall reinjury rate was 5.56 injuries per 1000 hours of play. Self-confidence scores of ≤47 increased the risk of reinjury by 2.26 times (relative risk = 2.26; 95% CI, 1.31-3.91; OR = 5.00; 95% CI, 1.56-16.04), and each unit increase in self-confidence score reduced the risk of reinjury by 10% (OR = 0.90; CI, 0.82-0.99; P = .03). Regarding reinjury anxiety, a score of >22 was associated with 2.43 times the risk of reinjury (relative risk = 2.43; 95% CI, 1.44-4.13; OR = 6.46; 95% CI, 1.93-21.69), and each unit increase in reinjury anxiety score increased the risk of injury by 45% (OR = 1.45; CI, 1.13-0.87; P = .004)., Conclusions: Increased reinjury anxiety and decreased self-confidence are associated with higher odds of lower extremity reinjury in male soccer players. To reduce the risk of reinjury, athletic trainers and sport psychologists should take these psychological factors into account when evaluating the psychological readiness of soccer players with a history of lower extremity injury to RTS., (© by the National Athletic Trainers’ Association, Inc.)

Objective: To assess the effectiveness of exercise-based injury-prevention programs in preventing sports injuries in team handball players., Data Sources: Scopus, PubMed, Web of Science, SPORTDiscus, and CINAHL from inception until April 2023., Study Selection: Studies were included if they were randomized controlled trials or prospective cohort studies, contained a population of competitive team handball players, included an intervention designed specifically to prevent or reduce the risk of team handball injuries, and reported injury incidence rates specific to team handball players. Two researchers independently evaluated studies for inclusion and assessed their methodological quality., Data Extraction: Study design, intervention details, participant characteristics, and the number of injuries in each group were extracted from each study by 2 independent researchers. The outcome of interest was the incidence rate of injury. Injury data were classified into 5 groups: shoulder injuries, lower extremity injuries, knee injuries, anterior cruciate ligament injuries, and ankle injuries. Extracted data were analyzed using a random-effects model to compute the overall effect estimates of injury-prevention programs in reducing the risk of injuries. Odds ratios (ORs) with 95% CIs were calculated based on the number of injuries in each group., Data Synthesis: Meta-analyses were conducted independently for each injury classification. Results indicated that prevention programs reduced the risk of shoulder injuries (OR = 0.60; 95% CI = 0.42, 0.85; P = .004), lower extremity injuries (OR = 0.59; 95% CI = 0.37, 0.95; P = .03), knee injuries (OR = 0.53; 95% CI = 0.35, 0.78; P = .002), anterior cruciate ligament injuries (OR = 0.66; 95% CI = 0.45, 0.96; P = .03), and ankle injuries (OR = 0.57; 95% CI = 0.40, 0.81; P = .002) in team handball players., Conclusions: In team handball players, injury-prevention programs appear to effectively reduce the risk of shoulder, lower extremity, knee, ankle, and anterior cruciate ligament injuries., (© by the National Athletic Trainers’ Association, Inc.)

Context: Considering current models that highlight the role of psychological components in pain management, mindfulness practice may be an effective strategy in the management of pain., Objective: To examine the effects of adding an 8-week mindfulness program to exercise therapy on the perceptions of pain severity, knee function, fear of movement, and pain catastrophizing of female recreational runners with patellofemoral pain (PFP)., Design: Randomized controlled clinical trial., Setting: University laboratory., Patients or Other Participants: Thirty female runners (age = 28.3 ± 7.08 years) with PFP were randomly assigned to the exercise or mindfulness-exercise group., Intervention(s): The exercise-only group followed a protocol (18 weeks, 3 sessions/wk) that featured training modifications to help control injury-related symptoms. The mindfulness-exercise group received an 8-week mindfulness intervention in addition to the exercise protocol. The mindfulness component started 4 weeks before the exercise component; therefore, the 2 components overlapped during the first 4 weeks of the intervention., Main Outcome Measure(s): Usual pain, pain during stepping, and pain during running were assessed using visual analog scales. Functional limitations of the knee were assessed using the Knee Outcome Survey. Fear of movement, pain catastrophizing, and coping strategies were measured via the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, and the Coping Strategies Questionnaire, respectively. These outcomes were assessed at baseline, at week 9, and after 18 weeks., Results: Pain during running, pain during stepping, and functional limitations of the knee were less for the mindfulness-exercise group than for the exercise-only group (P values < .05). The mindfulness-exercise group reported greater perceived treatment effects than the exercise-only group (P < .05). Pain catastrophizing was less and coping strategies were more favorable for mindfulness-exercise participants than for exercise-only participants (P values < .05)., Conclusions: Mindfulness practice can be an effective adjunct to exercise therapy in the rehabilitation of PFP in recreational female runners., (© by the National Athletic Trainers' Association, Inc.)

Context: Foam rolling (FR) is considered an effective postexercise modality for reducing delayed-onset muscle soreness and enhancing recovery of muscle function. However, the effects of FR on muscle and joint proprioception have not been investigated., Objective: To examine the effects of FR on muscle and joint proprioception after an intense exercise protocol., Design: Controlled laboratory study., Setting: University-based laboratory., Patients or Other Participants: A total of 80 healthy, physically active male students were randomly assigned to either the FR (n = 40; age = 22.8 ± 3.3 years, height = 176.4 ± 5.3 cm, mass = 74.2 ± 6.4 kg) or passive-recovery (PR; n = 40; age = 23.0 ± 3.2 years, height = 178.1 ± 5.5 cm, mass = 74.6 ± 6.2 kg) group., Intervention(s): Participants in both groups performed 4 sets of 25 repetitions of voluntary maximal eccentric contractions at 60°/s from 20° to 100° of knee flexion to induce exercise-induced muscle damage. The exercise was followed by either PR or 2 minutes of FR immediately (1 hour) and 24, 48, and 72 hours postexercise., Main Outcome Measure(s): Muscle soreness, pressure-pain threshold, quadriceps-muscle strength, joint position sense, isometric force sense, and threshold to detect passive movement at baseline and immediately, 24, 48, and 72 hours postexercise after FR., Results: Foam rolling resulted in decreased muscle pain, increased pressure-pain threshold, improved joint position sense, attenuated force loss, and reduced threshold to detect passive movement compared with PR at 24 and 48 hours postexercise., Conclusions: Foam rolling postexercise diminished delayed-onset muscle soreness and improved recovery of muscle strength and joint proprioception. These results suggested that FR enhanced recovery from exercise-induced damage.