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Purpose: Performing back squats with elastic bands has been widely used in resistance training. Although research demonstrated greater training effects obtained from adding elastic bands to the back squat, little is known regarding the optimal elastic resistance and how it affects neuromuscular performance. This study aimed to compare the force, velocity, power, and muscle activity during back squats with different contributions of elastic resistance. Methods: Thirteen basketball players performed 3 repetitions of the back squat at 85% of 1-repetition maximum across 4 conditions: (1) total load from free weight and (2) 20%, (3) 30%, and (4) 40% of the total load from elastic band and the remaining load from free weight. The eccentric and concentric phases of the back squat were divided into upper, middle, and bottom phases. Results: In the eccentric phase, mean velocity progressively increased with increasing elastic resistance, and muscle activity of the vastus medialis and rectus femoris significantly increased with the largest elastic resistance in the upper phase (P ≤.036). In the concentric phase, mean power (P ≤.021) and rate of force development (P ≤.002) significantly increased with increasing elastic resistance. Furthermore, muscle activity of the vastus lateralis and vastus medialis significantly improved with the largest elastic resistance in the upper phases (P ≤.021). Conclusion: Velocity, power, rate of force development, and selective muscle activity increased as the elastic resistance increased in different phases during the back-squat exercise. [ABSTRACT FROM AUTHOR]

Training load monitoring is employed to quantify training demands, to determine individual physiological adaptions and to examine the dose–response relationship, ultimately reducing the likelihood of injury and making a meaningful impact on performance. The purpose of this study is to explore the relationship between training load and injury in competitive swimmers, using the session rate of perceived exertion (sRPE) method. Data were collected using a prospective, longitudinal study design across 104 weeks. Data were collected from 34 athletes centralised in two of Swim Ireland's National Centres. Bayesian mixed effects logistic regression models were used to analyse the relationship between sRPE-TL and medical attention injuries. The average weekly swim volume was 33.5 ± 12.9 km. The weekly total training load (AU) averaged 3838 ± 1616.1. A total of 58 medical attention injury events were recorded. The probability of an association between training load and injury ranged from 70% to 98%; however, evidence for these relationships was deemed weak or highly uncertain. The findings suggest that using a single training load metric in isolation cannot decisively inform when an injury will occur. Instead, coaches should utilise monitoring tools to ensure that the athletes are exposed to an appropriate training load to optimise physiological adaptation. Future research should strive to investigate the relationship between additional risk factors (e.g., wellbeing, lifestyle factors or previous injury history), in combination with training load and injury, in competitive swimmers. [ABSTRACT FROM AUTHOR]

Distal fibula fracture is a common injury of the lower limb. Significantly displaced distal fibula fracture is treated with surgical fixation under general, spinal, or regional anesthesia. We present a case of displaced distal fibula fracture with both the regional anesthesia and operation performed by the same attending orthopedic surgeon. The patient underwent successful ultrasound‐guided regional anesthesia as well as open reduction and internal fixation. This case report highlights the technical detail for ultrasound‐guided regional anesthesia and surgical fixation by surgeon. [ABSTRACT FROM AUTHOR]

Despite coaching pedagogy researchers advocating that sports coaches employ a range of core coaching practices to positively impact player learning, coaches' actual practices remain under-investigated. Guided by Complex Learning Theory (CLT), the aim of this study was to investigate the extent to which coaches in a high-performance team sport setting report employing a range of in-session core coaching practices during both on-field and off-field sessions and their perceptions of how such practices impact player learning. Twelve Gaelic football coaches took part in semi-structured interviews. A reflective thematic analysis of the data developed four themes – (1) application of questioning by the coaches, (2) difficulties and challenges experienced when using questioning, (3) using video analysis to maximise learning and (4) the coach as a facilitator of player learning. Findings showed that coaches were aware of and employing many of the core practices advocated in the sports coaching literature. Coaches employed varied questioning to give players an active role within both on-field and video review sessions to enhance their overall game understanding. However, numerous challenges expressed by coaches suggested it was not a consistent tool in their coaching practice. The coaches recognised the need to facilitate player learning by employing core practices which encourage player autonomy and prolonged dialogue, although this was mostly reported to take place in off-field activities such as video analysis and pre/post session meetings. The current study highlighted an epistemological gap with some coaches demonstrating awareness of advocated strategies but failing to support these claims with tangible examples in their practice. This investigation supports the application of CLT as a suitable theoretical framework in which to interpret the core practices coaches employ in their practice. The introduction of CLT to coaches may promote a sustained and sophisticated application of core coaching practices within the delivery of coaching sessions. [ABSTRACT FROM AUTHOR]

Introduction: Revision surgery in the spine poses considerable challenges due to the presence of scar tissue and structural differences, necessitating careful surgical planning and precise techniques. In this technical note, we focus on lumbar unilateral biportal endoscopy (UBE) for single‐level reoperations, outlining principles and methods for handling soft tissue in such cases. Materials and Methods: We reviewed our surgical approach for lumbar reoperations with UBE, emphasizing the importance of meticulous preoperative planning and bone‐centered manipulation. Our technique involves utilizing biportal endoscopy for enhanced visualization and employing specific strategies for managing scar tissue, including the "pull‐and‐cut technique." We present two illustrative cases to demonstrate the application of our method. Results: The described approach yielded successful outcomes in both cases presented. Case 1 involved a posterior interlaminar approach for a recurrent disc at the L4–5 level, while Case 2 utilized a far lateral approach for recurrent disc herniation at the L4–5 level. Both surgeries were completed with relatively short operation time, minimal blood loss, and immediate improvement in symptoms postoperatively. Conclusion: Lumbar UBE offers a promising option for safe and effective reoperation in spinal surgery. Our technique, emphasizing bone‐centered manipulation and specific strategies for scar tissue management, provides excellent visibility and enables precise tissue handling. Overall, UBE facilitates relatively simple and safe reoperations, contributing to improved patient outcomes in the challenging field of spinal surgery. [ABSTRACT FROM AUTHOR]

The formation of gouty tophi surrounding the prior surgical site years after an Achilles tendon repair is an extremely rare presentation for which only three previous cases have been documented in the literature. In this case, we report the presentation of a 53‐year‐old male who had an Achilles tendon repair two and a half years prior and no clinical history of gout, yet during the necessary revision procedure of his Achilles tendon, he was found to have gouty tophi surrounding the nonabsorbable sutures used during his initial surgical repair. This case presentation and the three prior ones all involve the use of nonabsorbable sutures, and these sutures may potentially serve as a nidus for the formation of gouty tophi years after a surgical procedure, even in patients who do not have a clinical history of gout. It is important for clinicians to be aware of this rare clinical presentation as potential sequelae include infectious processes and the need for revision procedures. [ABSTRACT FROM AUTHOR]

Combined medial and lateral posterior meniscal root tears in the setting of an acute anterior cruciate ligament (ACL) rupture are extremely rare. The following case report demonstrates a high school football player who sustained a noncontact knee injury while performing a spin move at practice. The patient is a 17‐year‐old high school football defensive end who was presented to the clinic 1 week following the injury complaining of persistent knee pain with associated swelling, limited range of motion (ROM), and complaint of instability. During physical examination, the patient was found to have anterior cruciate laxity. Magnetic resonance imaging (MRI) demonstrated a complete midsubstance tear of the ACL and increased signal within the posterior horn of the medial meniscus with no obvious signs of pathology localized to the lateral meniscus. ACL reconstruction (ACLR) was performed and intraoperatively, both medial and lateral root tears were found. A standard bone patellar‐tendon bone (BTB) autograft ACLR was performed with combined medial and lateral root repair utilizing a transtibial pull‐out method for both. The clinical importance is root tears with associated ACL tears can be hard to diagnose on preoperative MRI, especially laterally, so careful assessment of both meniscal roots at the time of arthroscopy is critical. Furthermore, careful creation of the needed root repair tunnels for transtibial repair is critical to avoid coalescence with the ACL tibial tunnel. [ABSTRACT FROM AUTHOR]

This study examined the relationship between motor competence (MC) and Landing Error Scoring System (LESS) performance in a sample of male junior grassroots footballers aged 10-13 years. Ninety-eight boys aged 10-13 years (mean ± SD = 11.7 ± 1 years) undertook assessment of MC, using the Test of Gross Motor Development (third edition) and anterior cruciate ligament (ACL) injury risk using the LESS. Height and mass were assessed from which maturity status was predicted. Multiple backward linear regressions indicated a significant model (p = 0.001), which explained 49% of the variance in LESS scores. Locomotor MC (β = -0.538, p = 0.001), object control MC (β = -0.261, p = 0.004), and age (β = 1.17, p = 0.03) significantly contributed to the model. Maturity offset (p = 0.100) was not significant. Analysis of covariance (controlling for age and maturity offset) indicated a significant difference in locomotor MC between those classified as poor for LESS. A similar result was observed for object control MC (p = 0.003, ηp² = 0.09), where those classed as poor for LESS had significantly poorer object control MC compared with those classed as excellent, good, and moderate. The results of this study indicate that there is a relationship between both locomotor and object control MC and errors in drop jump landing mechanics in boys aged 10-13 years, with MC explaining nearly 50% of the variance in LESS scores. Practically, this study indicates that MC, particularly locomotor MC, has potential to identify performance in jump landing tests that are associated with increased risk of ACL injury in boys who play grassroots soccer. [ABSTRACT FROM AUTHOR]

Introduction: Surgical management of intertrochanteric hip fractures is a common surgery with low rates of intraoperative complications. Vascular injuries are exceptionally rare when placing an intramedullary nail without open reduction. There are very few reported cases of direct arterial injury and active bleed at the level of the distal interlocking screw following closed reduction and intramedullary nailing of a hip fracture. We report one such case. Case Presentation: An 88‐year‐old female presented to the emergency department with a left intertrochanteric hip fracture. Closed reduction with a cephalomedullary nail fixation of the left hip fracture occurred as planned without any obvious intraoperative technical issues. The patient remained stable intraoperatively. No open reduction was required. Postoperatively, the patient developed hemorrhagic shock and required massive transfusion protocol. Angiography demonstrated an intramuscular hematoma at the level of the distal intramedullary nail interlocking screw with active extravasation. The patient subsequently required embolization. Nine days following surgery, she began Eliquis for DVT prophylaxis and was ambulating independently with signs of hematoma resolution. Discussion: Profunda femoris artery injury can stem from various mechanisms during surgery. Atherosclerosis places patients at a higher risk of complication due to rigid vessels. In this case, it is believed that drilling beyond the medial femoral cortex led to the arterial injury. Conclusion: Care should be taken to prevent drills from plunging beyond the medial femoral cortex during surgery. Cautious observation of patient's vitals and clinical course can allow for early detection of vascular complication. [ABSTRACT FROM AUTHOR]