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Introduction: Overuse musculoskeletal injuries (MSKI) remain a significant medical challenge in military personnel undergoing military training courses; further understanding of the biological process leading to overuse MSKI development and biological signatures for injury risk are warranted. The purpose of this study was to determine the association between overuse MSKI occurrence and physiological characteristics of allostatic load characterized as maladaptive biological responses to chronic stress measured by wearable devices in US Marine Corps officer candidates during a 10-wk training course. Methods: Devices recorded energy expenditure (EE), daytime heart rate (HR), sleeping HR, and sleep architecture (time and percentage of deep, light, rapid eye movement sleep, awake time, total sleep). Flux was calculated as the raw or absolute difference in the average value for that day or night and the day or night beforehand. Linear mixed-effect model analysis accounting for cardiorespiratory fitness assessed the association between overuse MSKI occurrence and device metrics (α = 0.05). Results: Sixty-nine participants (23 females) were included. Twenty-one participants (eight females) sustained overuse MSKI. Overuse MSKI occurrence in male participants was positively associated with daytime HR (β = 5.316, P = 0.008), sleeping HR (β = 2.708, P = 0.032), relative EE (β = 8.968, P = 0.001), absolute flux in relative EE (β = 2.994, P = 0.002), absolute EE (β = 626.830, P = 0.001), and absolute flux in absolute EE (β = 204.062, P = 0.004). Overuse MSKI occurrence in female participants was positively associated with relative EE (β = 5.955, P = 0.026), deep sleep time (β = 0.664, P < 0.001), and percent deep sleep (β = 12.564, P < 0.001) and negatively associated with absolute flux in sleeping HR (β = -0.660, P = 0.009). Conclusions: Overuse MSKI occurrences were associated with physiological characteristics of allostatic load, including chronically elevated HR and EE and greater time in restorative sleep stages, which may serve as biological signatures for overuse MSKI risk. [ABSTRACT FROM AUTHOR]

Background: Abdominal musculature injuries comprise the third most prevalent time-loss injury across professional baseball. Despite increased awareness and prevention attempts in the recent decade, the trends of these abdominal injury numbers in Major League Baseball (MLB) are not fully understood. Purposes: To update the trends in oblique and intercostal injuries, analyze the impact of these injuries based on time out of play, and identify factors that correlate with increased injury severity to help with recovery time prognostication for the sports medicine community. Study Design: Descriptive epidemiology study. Methods: Using the MLB Health and Injury Tracking System, the authors identified all abdominal and core musculature injuries that resulted in time out of play in MLB and Minor League Baseball (MiLB) between the 2011 and 2021 seasons. These were filtered for injuries that resulted in ≥1 days missed (DM) during spring training, the regular season, and postseason. A Student t test was utilized to assess for significant differences for all normally distributed values. Regression analysis was utilized for determining change over time. For all statistical comparisons, the threshold for alpha was set to P <.05. Results: During the study period between 2011 and 2021, there were 4560 total abdominal injuries among 3401 athletes. When filtered for in-season, time-loss injuries defined as spring training, regular season, and postseason, there were 2890 injuries. Of these, 1928 were oblique injuries, 453 were intercostal injuries, and 115 were rectus injuries. The number of oblique injuries each season increased for all of baseball (P <.001), as well as for MLB (P =.009) and MiLB (P =.012) individually. Of the 1928 oblique injuries, 498 (26%) oblique injuries occurred at the MLB level and 1430 (74%) occurred at the MiLB level. Batting and pitching-related injuries comprised 860 (45%) and 729 (38%) oblique injuries, with a total of 18,455 DM and 20,891 DM, respectively. This corresponded to a mean of 22 DM for batting injuries and 29 DM for pitching injuries (mean difference, 7.2; 95% CI, 5.27-9.13; P <.001). Conclusion: This decade-long study on professional baseball revealed a significant increase in abdominal oblique injuries across MLB and MiLB, with the largest number of injuries observed in the 2021 season. Meanwhile, there was a significant decrease in intercostal injuries across professional baseball during these years. Such injuries continue to pose challenges, leading to substantial DM per injury and affecting players from various positions. [ABSTRACT FROM AUTHOR]

Over the past few decades, advances in pharmacological, catheter-based, and surgical reperfusion have improved outcomes for patients with acute myocardial infarctions. However, patients with large infarcts or those who do not receive timely revascularization remain at risk for mechanical complications of acute myocardial infarction. The most commonly encountered mechanical complications are acute mitral regurgitation secondary to papillary muscle rupture, ventricular septal defect, pseudoaneurysm, and free wall rupture; each complication is associated with a significant risk of morbidity, mortality, and hospital resource utilization. The care for patients with mechanical complications is complex and requires a multidisciplinary collaboration for prompt recognition, diagnosis, hemodynamic stabilization, and decision support to assist patients and families in the selection of definitive therapies or palliation. However, because of the relatively small number of high-quality studies that exist to guide clinical practice, there is significant variability in care that mainly depends on local expertise and available resources. [ABSTRACT FROM AUTHOR]

Muscle injury accounts for about one-third of total sports-related injuries. The lower limb muscles have one of the highest predisposition for injury in high-level professional athletic sports, such as the National Football League. The commonest group of muscles injured among football players include the hamstrings, followed by the quadriceps. Muscle injuries lead to significant time, off the field and affect return to play. Sports physicians and teams have been keen on assessing such injuries and also relying on multiple tools to safely return the player back to the field. MRI plays a key role in evaluation, follow-up, and assessment for return to play (RTP). In this review, we will discuss details of muscle anatomy, incidence of muscle injuries, injury mechanisms, and use of MRI in assessment, grading, follow-up and in predicting the natural course of muscle injuries in the high-end athletic players. While the use of MRI is clear in diagnosis, and for follow up of muscle injuries, there is some limitation in its ability to predict RTP, based on current MRI classification systems. Footballers who have clinical injuries without MRI evidence of significant muscle injury (grade 0 and 1) have a shorter period of RTP. Injuries classified as high grade (3 and 4) on MRI do not correlate well with time to RTP. Further trials are required to improve the capability of MRI in its prediction of RTP. [ABSTRACT FROM AUTHOR]

Context: Among US collegiate soccer players, the incidence rate and the event characteristics of hamstrings strains differ between sexes, but comparisons in the return-to-participation (RTP) time have not been reported. Objective: To compare the RTP time between male and female collegiate soccer players and analyze the influence of event characteristics on the RTP time for each sex. Design: Descriptive epidemiology study. Setting: Data were collected from collegiate teams that voluntarily participated in the National Collegiate Athletic Association Injury Surveillance System. Patients or Other Participants: Collegiate soccer athletes who sustained 507 hamstrings strains (306 men, 201 women) during the 2004 through 2009 fall seasons. Main Outcome Measure(s): Nonparametric statistics were used to evaluate RTP time differences between sexes and among categories of each event characteristic (ie, time of season, practice or competition, player position). Negative binomial regression was used to model the RTP time for each sex. All analyses were performed separately for first-time and recurrent strains. Results: We found no differences in the RTP time between sexes for first-time (median: men ¼ 7.0 days, women ¼ 6.0 days; P¼.07) or recurrent (median: men¼11 days, women¼5.5 days; P ¼ .06) hamstrings strains. For male players with first-time strains, RTP time was increased when the strain occurred during competition or the in-season/postseason and varied depending on the division of play. Among female players with first-time strains, we found no differences in RTP time within characteristics. For male players with recurrent hamstrings strains, the RTP time was longer when the injury occurred during the in-season/ postseason. Among female players with recurrent strains, RTP time was longer for forwards than for midfielders or defenders. Conclusions: Although we found no differences in the RTP time after hamstrings strains in male and female collegiate soccer players, each sex had unique event characteristics that influenced RTP time. [ABSTRACT FROM AUTHOR]

Activities of enzymes involved in muscle damage [creatine kinase (CK) and aspartate aminotransferase (AST)] and levels of malondialdehyde (MDA) as a marker of oxidative stress were monitored in the plasma of 27 members of an America's Cup yachting crew. The preventive benefits of allopurinol on muscle damage were also tested. In racing period A, the crew was divided into two groups according to their tasks on board. Blood samples from all 27 sailors were obtained before the start of a 5-day fleet race, after the last race, and after the ten match races. In period B, crew members were divided at random into two groups. One group (13 participants) received 300 mg/day of allopurinol 3 h before racing. The other ten members received placebo. Blood samples were collected just before and after the second round of the Louis Vuitton Cup. All participants showed increased CK and AST activities after the racing period A. The increase in CK activity was highest in sailors involved in strenuous physical work. At the end of period A, plasma MDA levels were higher in all participants as compared with non-participant athletes. In period B, a significant decrease in CK activity, but not in AST, appeared among participants receiving allopurinol. Plasma MDA decreased in sailors treated with allopurinol, but this reduction did not reach statistical significance. America's Cup is a sailing sport with high physical demands, as shown by the increase in muscle-damage markers. Treatment with allopurinol appeared to decrease the levels of muscle damage markers. [ABSTRACT FROM AUTHOR]

Background: United States high school soccer participation increased 5 fold over the last 30 years. With increased participation comes increased injury incidence. Hypothesis: High school soccer injury patterns will vary by gender and type of exposure. Study Design: Descriptive epidemiologic study. Methods: Soccer-related injury data were collected over the 2005-2006 and 2006-2007 school years from 100 nationally representative United States high schools via Reporting Information Online (RIO, an Internet-based sports-related injury surveillance system). Results: Participating certified athletic trainers reported 1524 soccer injuries during 637 446 athlete exposures (AEs), for an injury rate of 2.39 per 1000 AEs, corresponding to a nationally estimated 807 492 soccer-related injuries during the 2005-2006 and 2006-2007 seasons. The injury rate per 1000 AEs was greater during competition (4.77) than practice (1.37) (rate ratio [RR] = 3.49; 95% confidence interval [CI], 3.15-3.87). Overall, the most frequent diagnoses were incomplete ligament sprains (26.8%), incomplete muscle strains (17.9%), contusions (13.8%), and concussions (10.8%). The most commonly injured body sites were the ankle (23.4%), knee (18.7%), head/face (13.7%), and thigh/upper leg (13.1%). Similar proportions of boys (57.9%) and girls (53.9%) returned to activity in <1 week. During competition, girls sustained complete knee ligament sprains requiring surgery at a rate of 26.4 per 100 000 AEs, higher than the rate among boys during competition (1.98 per 100 000 AEs) (RR = 13.3; 95% CI, 3.15-56.35) and among girls during practice (2.34 per 100 000 AEs) (RR = 11.3; 95% CI, 4.31-29.58). Player-to-player contact was more common among competition injuries (injury proportion ratio [IPR] = 2.42; 95% CI, 2.01-2.92), while noncontact mechanisms were more common among practice injuries (IPR = 2.39; 95% CI, 1.90-3.01). Conclusions: High school soccer injury patterns vary by gender and type of exposure. Identifying such differences in injury patterns is the important first step in the development of evidence-based, targeted injury prevention efforts. [ABSTRACT FROM AUTHOR]

Examines the diagnosis and treatment of peroneal tendon injuries in the U.S. Application of special diagnostic imaging; Guidelines for non-operative and operative treatment; Recommendations for postoperative rehabilitation.

Examines the prevention of muscle injuries. Clinical signs of muscle injuries; Types of injury; Factors to be considered in preventing muscle strain injuries.

Examines the incidence of hamstring injury in a male collegiate sprinter in the U.S. Clinical description of hamstring injuries; Severity of the injury; Factors contributing to hamstring injury.

Objective: Determine the association of sport specialization in female volleyball athletes with previous injury history and determine the association of sport specialization with volleyball participation opportunities., Design: Cross-sectional., Setting: Recruitment occurred from 83 Wisconsin high schools during the 2018 volleyball season., Participants: Female volleyball athletes (N = 1,588, grades 9-12, age = 15.6 ± 1.1 years)., Main Outcomes: Participants completed a pre-season questionnaire soliciting information regarding 1) demographics, 2) sport specialization, 3) sport participation, and 4) sport-related injuries in the previous 12 months. Univariable logistic regression models were used to identify associations with previous injury. Chi-square analyses were used to investigate associations between sport specialization classification and other sport participation opportunities., Results: Both moderately and highly specialized athletes were more likely to report a previous injury compared to low specialized athletes (moderate OR: 1.84 [1.29-2.62]; p < 0.001 and high OR: 2.30 [1.64-3.24]; p < 0.001). Highly specialized athletes were more likely to report participating in club volleyball, summer tournaments, and training camps in the past 12 months. Participants who reported participating in club volleyball, summer competitions, and training camps last year were more likely to report an injury., Conclusions: Specialization was associated with injury history and year-round volleyball opportunities among female adolescent volleyball athletes., Competing Interests: Declaration of competing interest The authors have no potential conflicts of interest to disclose., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

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 (R 2 =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., (Copyright © 2018 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

This article presents summaries of papers from other medical journals. Studies done on bariatric surgery show that the surgery prolongs life in obese people. Research in the U.S. showed that preoperative ischaemia of the arm reduced heart muscle injury during bypass surgery. A study of hypertension in children and teenagers demonstrated that the condition is often unrecognised in children in the U.S.