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Purpose Meniscal injuries are a common occurrence in sports-related activities, often leading to pain, reduced joint function, and impaired athletic performance. This study aimed to evaluate the role of ultrasound-guided intra-articular platelet-rich plasma (PRP)-rich fluid injection which was obtained through serial centrifugation in the treatment of meniscal injuries resulting from sports activities. Materials and Methods A prospective study was conducted involving 54 cases with grade I, II, and III meniscal injuries, aged 18 and 43 years. PRP-rich fluid was prepared by subjecting autologous blood samples to a two-step centrifugation process. Patients were assessed pretreatment and at regular intervals posttreatment. Results Patients reported reduced pain and improved joint functionality following treatment. Average age of the patients was 34.4 years, and average follow-up period was 275.1 days. It is noteworthy that no cases of bilateral meniscal injuries were identified; indicating that the focus was primarily on single knee injuries. Predominance of grade II injuries suggests that the PRP intervention might be particularly effective in addressing more severe meniscal tears. Conclusion The results of our study provide compelling evidence for the positive impact of PRP augmentation in meniscus repair. Our findings indicate that PRP therapy has the potential to bring about substantial benefits for individuals with meniscus tears of the knee, particularly in terms of pain relief and enhanced functional capabilities. [ABSTRACT FROM AUTHOR]

Sport-related concussions (SRCs) are prevalent in high school (HS) sports, though the determinants of, and relationships between concussion symptoms in this population remain relatively unknown. We analysed SRC data captured within the HS RIO injury surveillance system during 2014/15-2018/19. We used Generalized Estimating Equations to simultaneously assess covariate predictors of symptom presentations and identify pairwise symptom associations and employed multivariable ordinal logistic regressions to determine symptom resolution time (SRT) predictors. Among the 8,969 concussions assessed, headaches (94.3%) and dizziness (73.3%) were the most prevalently reported symptoms. In 5,953 boys' concussion assessed, class year, event type and injury mechanism emerged as determinants of various concussion symptoms, while in 3,016 girls' concussions assessed, class year, event type, injury mechanism, and sport type emerged as significant symptom determinants. In both groups, difficulty concentrating, sensitivity to light, sensitivity to noise, and disorientation were symptoms with the strongest associations with other symptoms. Odds of longer SRT were higher with greater endorsement (i.e. counts) of the subset of symptoms with strongest cross-domain associations (ORadj. = 1.35; 95% CI = [1.30, 1.40]). Our findings provide valuable information for informing sideline and follow-up clinical concussion assessment algorithms in high school athletes. [ABSTRACT FROM AUTHOR]

Immediate athletic trainer (AT) availability for acute injuries is essential as worse long-term outcomes are associated with delays in receiving medical care. Several factors have been found to influence AT availability between secondary schools, but few studies have evaluated how medical coverage varies between athlete groups. The purpose of this project was to identify factors that impact the time to AT evaluation following acute sport-related injury in a secondary school setting. Cross-sectional study. Retrospective analysis of deidentified patient records via the Athletic Training Practice-Based Research Network. High school athletes diagnosed with an acute sport-related injury during in-season play from 2010 to 2023. Time to AT evaluation was measured as the number of days between injury onset, reported by the patient, and AT evaluation. This report consists of 17 354 patient cases representing 20 different sports. Overall, 46.9% (n = 8138) of patients who sustained an injury during in-season play were evaluated by an AT the same day (range, 0–14 days). Significant group differences were reported for sex (P <.001), setting (P <.001), and sport level (P <.01), with female athletes and in-game injuries associated with longer times to AT evaluation. Freshmen were evaluated sooner than junior varsity (P <.01) and varsity (P <.001) athletes. No difference was observed between junior varsity and varsity athletes (P =.34). Almost half of patients received medical care within 24 hours following an acute injury during in-season play, highlighting how qualified health care is accessible for many student-athletes through ATs in the secondary school setting. Differences in time to AT evaluation may be attributable to sex discrepancies in immediate medical coverage between sports and injury reporting patterns among athletes. [ABSTRACT FROM AUTHOR]

Background: The ankle joint is among the most vulnerable areas for injuries during daily activities and sports. This study focuses on individuals with chronic ankle instability (CAI), comparing the biomechanical characteristics of the lower limb during side-step cutting under various conditions. The aim is to analyze the impact of kinesiology tape (KT) length on the biomechanical properties of the lower limb during side-step cutting, thereby providing theoretical support and practical guidance for protective measures against lower-limb sports injuries. Methods: Twelve subjects with CAI who met the experimental criteria were recruited. Each subject underwent testing without taping (NT), with short kinesiology tape (ST), and with long kinesiology tape (LT), while performing a 45° side-step cutting task. This study employed the VICON three-dimensional motion capture system alongside the Kistler force plate to synchronously gather kinematic and kinetic data during the side-step cutting. Visual 3D software (V6.0, C-Motion, Germantown, MD, USA) was utilized to compute the kinematic and kinetic data, while OpenSim 4.4 software (Stanford University, Stanford, CA, USA) calculated joint forces. A one-way Analysis of Variance (ANOVA) was conducted using SnPM, with the significance threshold established at p < 0.05. The Origin software 2021 was used for data graphic processing. Results: KT was found to significantly affect joint angles, angular velocities, and moments in the sagittal, frontal, and transverse planes. LT increased hip and knee flexion angles as well as angular velocity, while ST resulted in reduced ankle inversion and increased knee internal rotation. Both types of KT enhanced hip abduction moment and knee adduction/abduction moment. Additionally, LT reduced the ankle joint reaction force. Conclusions: These findings suggest that the application of KT over a short duration leads to improvements in the lower-limb performance during side-step cutting motions in individuals with CAI, thus potentially decreasing the risk of injury. [ABSTRACT FROM AUTHOR]

Background: Flow limitations in the iliac arteries (FLIA) is a sport-related vascular condition increasingly recognised as an occupational risk for professional cyclists and other endurance athletes. Surgical reconstruction is the definitive treatment for athletes wishing to continue competition. However, less information has been published regarding conservative management options and return-to-sport (RTS) guidelines. Objective: Our aim was to review the existing literature on conservative treatment of FLIA, identify knowledge gaps and propose an RTS framework for athletes returning to competition. Methods: A comprehensive literature review was performed using the Ovid-MEDLINE, PubMed, Embase and PEDro databases for publications relevant to conservative management of FLIA. A scoping review was conducted following PRISMA-ScR guidelines. Original, peer-reviewed publications in English describing conservative or postoperative management for athletes with FLIA were included. Additional grey literature and clinical expertise were consulted to inform RTS guidelines. Results: Overall, 62 studies were included in this review. In total, 11 categories of conservative modalities were extracted and presented qualitatively in terms of the information source (discussion or results statements) and perspective of the authors (positive, negative or mixed). We have proposed RTS guidelines covering pre-operative preparation and postoperative rehabilitation based on the available literature, clinical experience, and drawing from other areas of sports medicine research. Conclusion: There is insufficient literature evaluating the effectiveness of conservative management options for FLIA to establish best practices. Considering the importance of RTS for competitive athletes, we proposed practical guidelines to help with clinician and patient decision making. Future consensus should be sought for RTS best practices. [ABSTRACT FROM AUTHOR]

The present study has two main goals: to conduct a systematic review of musculoskeletal injuries experienced by badminton players, and to examine the management of such injuries. Searches were conducted of the PROSPERO, PubMed, Scopus, and SPORTDiscus databases, from their inception until March 2023. The papers analysed were all based on a study population consisting of individuals aged 18 years or more, diagnosed with badminton-related injuries. The methodological quality assessments was using the Newcastle-Ottawa Scale and REVMAN. A total of 28 studies were included in the systematic review. In total, the analysis included 2435 participants. Of these athletes, 35.6% (1012) were female and 64.4% (1503) were male. By type of injury, sprains were the most commonly studied and the most prevalent, accounting for 36.06% of the sample. These were followed by muscle injuries, representing 23.86% of the total. Injuries to the joints were the least prevalent, accounting for 4.97% of the sample. Lower limb injuries accounted for 52.15% of the total. Of these, ankle injuries were the most common. Despite the generally low quality of the studies considered, the evidence suggests that musculoskeletal injuries, especially to the lower limb, most commonly affect badminton players of all levels. [ABSTRACT FROM AUTHOR]

Background: As sports have increased in popularity, the incidence of tendinopathy has also grown dramatically. Nonoperative techniques and treatments used to address these pathologies continue to evolve and improve. One such treatment, prolotherapy (PrT), has become increasingly popular and may provide patients with an alternative nonoperative treatment option. Purpose: To review high-quality randomized controlled trials (RCTs) that analyzed PrT treatments for the most common tendinopathies. Specifically, this review aims to provide meaningful data regarding methods and outcomes for each condition treated and guide professionals who are considering PrT as a treatment option. Study Design: Systematic review; Level of evidence, 2. Methods: All RCTs published in English between January 1, 1980, and July 30, 2021, and reported in Embase, Medline, and Web of Science databases were reviewed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. After the initial search, a total of 3264 articles were identified. Studies analyzing sports medicine injuries and musculoskeletal pathologies using an RCT design were included, while case-reports, case-studies, reviews, and observational studies were excluded. Two independent researchers reviewed the search results, and conflicts were resolved by discussion of inclusion and exclusion criteria among all authors. The articles' quality was evaluated using the Cochrane tool for assessing the risk of bias. Statistical analysis and graphical representations were performed using SPSS Version 28.00. Results: A total of 20 articles, including 1136 patients, met the inclusion criteria and were included in the study. Overall, in 85% of the studies, PrT was found to be effective in the treatment of tendinopathy. Specifically, PrT was superior to or as effective as the control in 83% (10/12) of the studies analyzing lateral epicondylitis (LE) and rotator cuff (RC) tendinopathies and in 88% (7/8) of the studies on plantar fasciitis (PF), Osgood-Schlatter disease (OSD), and Achilles tendinosis (AT). LE, RC, and PF tendinopathies were the most studied conditions (17/20 studies), while AT and OSD were the least studied (3/20 studies). Of the studies, 95% (19/20) used dextrose solutions, with only 1 using solutions of 2.5% phenol, 25% glycerin, and 25% dextrose in sterile water. Conclusion: Our systematic review suggests that PrT appears to be a promising alternative treatment for common tendinopathies. Most studies used a hypertonic dextrose solution. Even though further, larger randomized controlled trials comparing PrT with other orthobiologics would be beneficial, based on this review, sports medicine physiciansmay safely pursue PrT as an additional component of conservative treatment. [ABSTRACT FROM AUTHOR]

Introduction: While various interventions have been designed for managing rotator cuff tendinopathy, very little information exists on Kinesio taping in rehabilitation programs for overhead athletes. This study examines the effects of functional Kinesio taping on acromio humeral distance, pain, quality of life and disability in overhead athletes with rotator cuff tendinopathy. Material and methods: A randomized clinical trial was performed with 21 patients. The participants were randomly allocated into two treatment groups via the sealed envelope method. The experimental group received Kinesio taping with a rehabilitation program while the control group received a rehabilitation program only. Both groups received a six-week intervention and were evaluated at baseline and after six weeks by ultrasonography (USG), Western Ontario Rotator Cuff index (WORC), Disabilities of Shoulder, Arm and Hand questionnaire (DASH), and Visual Analogue Scale for pain (VAS). Results: No significant intergroup differences were found between the experimental and control groups regarding acromio humeral distance, VAS, DASH scores or WORC index (p = 0.05). Within-group analysis found significant improvements in all variables (VAS, AHD, DASH scores, WORC scores) between baseline and week 6 for both groups (p < 0.05). Conclusions: Both groups of overhead athletes with rotator cuff tendinopathy demonstrated improved acromiohumeral distance measured with 0° arm elevation based on ultrasound examination and pain, functional disability, and quality of life assessment after six-week intervention. However, the Kinesio taping did not provide any additional benefits over a rehabilitation program alone. [ABSTRACT FROM AUTHOR]

With the rapid development of national fitness and professional sports, the problem of sports trauma has become more and more prominent, which has caused serious impact on the training and competition of athletes. It is urgent to improve the level of diagnosis and treatment. The analysis technique of identifying and diagnosing cells and tissues for athletes in medical images with the help of deep learning algorithms has gradually become a popular research direction in the field of medical image diagnosis. Convolutional neural network (CNN), as an efficient deep learning algorithm, is widely used in the field of medical image diagnosis. However, since CNN models need to initialise the parameters before training, various problems may arise when the initial parameters are not properly selected. Firstly, for the initial weights of the CNN model, the traditional method is to use random initialisation, which leads to problems such as slow training speed and low diagnostic accuracy of the model. Secondly, for the selection of the hyperparameter of the model, the traditional method is to use manual adjustment or grid search, which not only consumes a lot of time and computational resources, but also usually fails to select the most suitable hyperparameter, which leads to the problems of lower diagnostic accuracy of the model. In order to solve the above problems, this paper firstly proposes a new self-supervised medical image segmentation architecture. By designing an agent task for pre-training, the model is better able to extract and process the visual information of medical images, and then fine-tuned on the segmentation task, as a way to solve the difficulty of the lack of large-scale labelled data for medical images. The effectiveness of the proposed algorithm for athletes in the medical image segmentation task is verified through a large number of experiments conducted on two mainstream datasets. And the comparison with other mainstream models shows that the model performs well in most scenarios. [ABSTRACT FROM AUTHOR]

Although research on sport-related concussion has grown substantially in the last decade, research on concussion in para sports remains limited. The aim of this scoping review is to synthesize and describe the current literature on the incidence, assessment, and management of sport-related concussion in para athletes. The literature search was conducted in CINAHL, Google Scholar, MEDLINE, SPORTDiscus, and Web of Science databases and identified 22 studies that addressed one of our research questions. A majority of studies addressed concussion in elite athletes; youth and collegiate para athletes were largely underrepresented. Fewer studies addressed concussion assessment and management, in part due to limitations in accessibility of current assessment tools for athletes with varying disabilities. Moving forward, there is a need to capture a larger range of incidence data, create modified assessment tools with para-specific normative data, and develop risk prevention strategies for para athletes. [ABSTRACT FROM AUTHOR]

Background: High ankle sprains are common athletic injuries and can be associated with long-term sequelae. Regardless of operative or nonoperative treatment, there is a paucity of data in the literature about the long-term outcomes of high ankle sprains. Hypothesis: Nonoperative treatment of high ankle sprains utilizing a standardized protocol will result in good long-term outcomes. Study Design: Case series; Level of evidence, 4. Methods: Patients who experienced a high ankle sprain without radiographic diastasis of the syndesmosis were identified from a previous study database and contacted for long-term follow-up. All patients were high school or National Collegiate Athletic Association Division IA athletes at initial injury and were treated nonoperatively with the same standardized protocol. Patients completed a questionnaire that included documentation of any interim ankle injuries, 2 different patient-reported outcome scores, and ankle radiographs to conduct Kellgren-Lawrence scoring for ankle osteoarthritis. Results: In total, 76 cases in 74 patients were identified in the database. A total of 40 patients were successfully contacted, and 31 patients (24 collegiate and 7 high school athletes) with 33 high ankle sprains completed the survey (31/40; 77.5%). The mean age at follow-up was 45 years (range, 34-50 years), with a mean time from injury to follow-up of 25 years. Overall, 93.5% (n = 29) of the respondents were male, and 42% (n = 13) of the respondents reported an ipsilateral ankle injury since their initial injury, with 16% (n = 5) having ankle or Achilles surgery. The mean Patient-Reported Outcomes Measurement Information System-10 score was 53.4 (SD, 8.3; range, 37.4-67.7), PROMIS median (IQR), 54.1 (39.9, 68.3), and the mean Self-reported Foot and Ankle Score score was 42.7 (SD, 5.86). Follow-up ankle radiographs were obtained in 11 (35%) of the respondents; 27% had Kellgren-Lawrence grade >2 osteoarthritis, and 36% had signs of heterotopic ossification on imaging. The mean tibiofibular clear space was 4.5 mm, and the mean tibiofibular overlap was 7.15 mm, with 27% of patients demonstrating some tibiotalar narrowing. Conclusion: At long-term follow-up, nonoperative management of high ankle sprains without diastasis on imaging was associated with acceptable patient-reported functional outcomes and low rates of subsequent ankle injuries. There was a high incidence of arthritis, but most cases were not clinically significant. This case series shows the natural history of nonoperatively treated high ankle sprains and may serve as a comparison for different management techniques in the future. [ABSTRACT FROM AUTHOR]

Background: Surgical outcomes for proximal hamstring avulsion injury (PHAI) are well documented, yet comparative analyses with nonsurgical approaches remain scarce. Purpose: To compare the functional outcomes between surgical and nonsurgical interventions for PHAI. Study Design: Cohort study; Level of evidence, 3. Methods: This comparative study, conducted at a sports surgery center between January 2012 and July 2021, focused on patients with primary PHAI. The study was a retrospective analysis of prospectively collected data. Group selection involved utilizing propensity score matching to compare an arm of patients who were surgically treated (indications included patients with complete injury, patients with partial injury with >2 cm of retraction, and patients for whom 6 months of nonsurgical treatment failed) with another arm of patients who refused surgery. The primary outcome was evaluated using the Parisian Hamstring Avulsion Score (PHAS). The secondary outcomes included the Tegner Activity Scale (TAS) score; University of California, Los Angeles (UCLA) score; rate and quality of return to sport (RTS); and patient satisfaction. Results: The study included 32 patients (mean age, 55.8 years [SD, 8.4 years]) in the nonsurgical treatment arm and 95 patients in the surgical treatment arm (mean age, 53.4 years [SD, 7.7 years]) (P >.05). The interval from injury to treatment was 5.7 months (SD, 9.6 months) for the surgical group and 12.7 months (SD, 25.9 months) for the nonsurgical group (P >.05). At the final follow-up (nonsurgical group: mean, 56.5 months [SD, 28.2 months]; surgical group: mean, 50.7 months [SD, 33.1 months]), the PHAS was significantly higher in the surgical group (mean, 86.3 [SD, 13.7]) compared with the nonsurgical group (mean, 69.8 [SD, 15.1]) (P <.0001). Higher activity scores were also observed in the surgical group for the TAS and UCLA scores (P =.0224 and P =.0026, respectively). A higher percentage of the surgical group (68.4%) returned to sports compared with the nonsurgical group (46.9%) (P =.0354), with a greater proportion in the surgical group returning at the same or higher level (67.7% vs 26.7%) (P =.0069). Additionally, a higher satisfaction level was reported by patients in the surgical group (89.5%) in contrast to the nonsurgical group (25%) (P <.0001). Three patients in the surgical group experienced complications (2 reruptures and 1 hyperesthesia at the pudendal nerve territories). Odds ratios (ORs) indicated that patients in the surgical group were significantly more likely to achieve or exceed median scores for the PHAS (OR, 6.79; P <.001), TAS score (OR, 2.29; P =.045), and UCLA score (OR, 3.63; P =.003), as well as to RTS at any level (OR, 2.46; P =.031) or at the preinjury level or higher (OR, 6.04; P <.001). Conclusion: This study demonstrated that surgical treatment of PHAI significantly enhances long-term functional scores, including the PHAS, TAS score, UCLA score, satisfaction, and RTS, at a mean follow-up of >4 years compared with nonsurgical treatment. Registration: NCT02906865 (ClinicalTrials.gov identifier) [ABSTRACT FROM AUTHOR]

After sport-related concussion (SRC), immediate access to a certified athletic trainer (AT) is important to ensure proper treatment. However, resource allocation and coverage may differ between male and female youth sports. To compare resource allocation between male and female sports in the following areas: (1) rates of immediate on-field evaluation by an AT at the time of injury, (2) time to general health care presentation, and (3) time to SRC clinic presentation. Retrospective cohort study. Regional sports concussion center. Athletes aged 14 to 18 years who presented to a regional sports concussion center from November 2017 to April 2022. The primary exposure of interest was sex (male or female). The primary outcome was immediate on-field evaluation by an AT (yes or no). Secondary outcomes included time to general health care and SRC clinic presentation. Descriptive statistics, χ2 analyses, and linear regressions were performed. Covariates included age, history of prior concussions, and statistically significant demographics. A total of 832 patients with SRC were included (age = 16.2 ± 1.2 years, 66.5% male). Female athletes had lower rates of attention-deficit/hyperactivity disorder (χ2 = 10.404, P =.001) and higher rates of anxiety and depression (χ2 = 12.891, P <.001) compared with male athletes. The average time to presentation to general health care and the SRC clinic did not differ between males and females, but AT on-field evaluation occurred more in male (40.3%) than female (32.3%) athletes (χ2 = 8.677, P =.013). Multivariable linear regression found that AT on-field evaluation was a significant predictor of time to general health care presentation (β = −.085, P =.015) but not SRC clinic presentation (β = −.055, P =.099). History of prior concussions was a significant predictor of time to initial health care contact (β =.083, P =.018). History of anxiety and depression (β =.136, P <.001) and initial evaluation by emergency department or urgent care (β =.305, P <.001) were significant predictors of delayed time to SRC clinic presentation. Among 832 concussed youth athletes, female athletes were evaluated less frequently by an AT immediately after injury. Furthermore, not being evaluated by an AT on field was significantly associated with a longer time to health care presentation. Future investigations should elucidate resource equity among male and female athletes. [ABSTRACT FROM AUTHOR]

Background: Growing interest has motivated recent studies to examine differences in recovery after sport-related concussion (SRC) by sex. However, heterogeneity in study design, participants, and recovery outcomes has led to mixed findings. Further work is needed to evaluate potential differences by sex and to investigate the role of related characteristics, such as sport contact-level, in recovery timelines. This study aimed to investigate whether concussion recovery trajectories differ by sex, considering a priori clinical and demographic covariates, and accounting for the sequence of recovery outcomes. Our secondary question was whether sport contact-level modifies the relationship between sex and time to outcomes. Using data from the Ivy League–Big Ten Epidemiology of Concussion Study, we included SRCs reported across five academic years; 2015–2020 (February 2020). We used Cox proportional hazards regressions to estimate associations between sex and time from injury to three outcomes: (1) symptom resolution, (2) return to academics, (3) return to full play, accounting for measured confounders. Results: Among 1160 SRCs (male, n = 667; female, n = 493) with complete data, median age overall was 20 years (25th-75th percentiles:19–21), and most occurred among athletes playing high-contact sports (78.0%). Males were slightly more likely to complete symptom resolution over time compared to females (HR = 1.18, 95%CI = 1.05–1.33), but results were attenuated in fully adjusted models (HR 1.13, 95%CI = 0.99–1.29). Similarly, the HR of full academic return for males compared to females was 1.22 (95%CI = 1.07–1.38), but was attenuated in fully adjusted models (HR = 1.11, 95%CI = 0.97–1.28). The HR of full return to play for males compared to females was 1.14 (95%CI = 1.02–1.28), and was attenuated after adjustment (HR = 1.06, 95%CI = 0.93–1.20) as well. The interaction between sex and playing a high/low-contact sport was not statistically significant across models, though differences were apparent. Conclusions: Among a cohort of collegiate athletes with SRC, recovery timelines appeared similar between male and female athletes, adjusting for measured confounders. Differences by sex, considering sport contact-level, were evident and may be important clinically and in future studies. This study used robust methods, accounting for nesting in the sequence of RTP outcomes. Results inform concussion management protocols and planned qualitative work to further elucidate how collegiate athletes experience concussion recovery. Key Points: Heterogeneity in study design, participants, and recovery outcomes has led to mixed findings in determining differences in recovery trajectories after concussion by sex. We found that having longer time to symptom resolution, and also the sequence of having academic return before symptoms resolve and longer time to academic return were confounders in the relationship between sex and RTP timelines. Time to sequential recovery outcomes appeared similar between male and female athletes, adjusting for observable confounders. Further differences by sex were evident when considering contact-level, and may be important to consider clinically and in future research. Results indicate that differences in concussion recovery trajectories by sex may be largely attributed to and driven by differences in sports with a men's or women's team only, such as football, and this should be explored further. [ABSTRACT FROM AUTHOR]

Introduction: Ankle sprains are the second most common sports injury after knee injuries, with about 85% of them affecting the lateral ankle ligaments. These injuries are particularly prevalent in sports like basketball and volleyball. Purpose: To investigate the effect of Aquatic therapy as an early rehabilitation protocol for elite athletes with acute lateral ankle sprain grade III on back-to-sport time, dynamic balance, pain, Athletic performance, and muscle power compared to land-based exercise training. Methods: Thirty elite athletes have ankle sprain grade III with sprain onset from 1 to 7 days, their age ranges from 18–30 years old were recruited. All participants are professional athletes; mainly participating in above-head sports such as volleyball and basketball. The patients were randomly allocated into two treatment groups: Group I (control group): 15 patients received a conventional physical therapy program of structured therapeutic exercise program, manual therapy and land-based exercises, in addition to external support, and Group II (Aquatic therapy group): 15 patients received aquatic training. Visual Analog Scale (VAS) was used to measure the pain intensity, while the dynamic balance was measured by the Star Excursion Balance Test. Athletic performance was measured by HOP Tests (Single, Triple, 6-m, and Cross-over hops) aided by the Agility T-Test (ATT) and Illinois Agility Test (IAT). Muscle power was tested by a Single Leg Press. Finally, back to sports time was recorded for each participant in both groups. Results: There was a significant interaction effect of Aquatic therapy and time for VAS (p < 0.001), single hop (p < 0.001), triple hop (p < 0.001), cross-over hop (p < 0.001), IAT (p = 0.019) and ATT (p < 0.001) of both affected and nonaffected. There was no significant interaction effect of Aquatic therapy and time for 6-MHT of affected (p = 0.923), and nonaffected (p = 0.140). There was a significant main effect of time for all dependent variables (p < 0.001) except for 6-MHT of affected (p = 0.939), nonaffected (p = 0.109), and IAT (p = 0.099). The Star excursion dynamic balance test (SEBT) and Single leg press revealed a significant difference between groups on affected and non-affected sides (p < 0.001*). Lastly and most importantly the back-to-sport time revealed a significant difference in the return-to-sport time in favor of the Aquatic therapy group who returned faster than the control group (p < 0.001*). Conclusion: Aquatic therapy is more effective than traditional protocols regarding early rehabilitation of acute ankle sprain grade III in Elite professional athletes for reducing pain intensity, improving dynamic balance and athletic performance and power and accelerating their return to sports time. Because aquatic therapy produces better outcomes, it is advised to be included in the rehabilitation programs of athletic patients with acute ankle sprains grade III. [ABSTRACT FROM AUTHOR]

Objectives: Combat sports continue to be a popular form of recreation within the United States. With this continually increasing popularity and participation comes an increase in associated injuries as well. Despite this, there remains a paucity of studies characterizing injury patterns, types, and anatomic distributions of injuries sustained during participation in combat sports, thus necessitating further investigation. The goal of this study is to provide an updated description of injuries within combat sports, specifically to the upper extremity and presenting to US emergency departments (EDs). It is our hope that this information may be utilized by participants and trainers to help develop preventative strategies, as well as by health care professionals to diagnose patients and provide the appropriate treatment more readily and accurately. Methods: A retrospective analysis was performed utilizing data from the United States Consumer Product Safety Commission's (CPSC) National Electronic Injury Surveillance System (NEISS) between 2003 and 2022. Data were limited to product codes 1200 (unclassified sports or recreational activity), 1207 (boxing), 1270 (wrestling), and 3257 (martial arts). The year designation variable was added to each year's remaining dataset, and all years were concatenated into a single compiled dataset containing 84,812 observations. Beginning in 2019, the NEISS database updated their gender designations to include sexes which were unidentified or non-binary. Designations of unidentified or nonbinary genders were removed from the dataset, reducing the sample size to 84,807 observations. Data were then filtered to include only injuries of the upper extremity, reducing sample size to 29,364. Anatomic regions of interest included shoulder, upper arm, elbow, forearm, wrist, hand, and fingers. Narratives were reviewed to remove unclassified injuries that did not describe a combat sport of any type, injuries where the reference was to a different primary cause, or terminology overlap. For example, boxing injuries occurring from punching bag arcade games were excluded. Finally, several diagnoses were excluded, such as contusion, crushing injuries, dermatitis, puncture wounds, hematomas, hemorrhages, and other/not stated. Diagnoses of interest included dislocations, fractures, and strains/sprains. The final sample size was 12,642. Injury rates for specific injury types and upper extremity subregions were described as percentages of total injuries, both within each sport category and across all sports. Injury rates were also assessed on a year-by-year basis, and year-to-year variation within and between sports was assessed using chi-square tests. Results: Of the 12,642 upper extremity injuries for which patients presented to US EDs between the years 2003 and 2022, nearly half were sustained from wrestling (6230, 49.3%) whereas the remaining half were more evenly distributed between boxing (3318, 26.2%) and martial arts (3094, 24.5%). There was a significant effect of time on injury distributions by sport (chi-square test: X2 =80.89, P < 0.001). Even when accounting for the years during COVID-19, significant differences between sports and over time were still detected. When assessing anatomic regions injured by sport, wrestling unsurprisingly accounted for most shoulder (59.5%), upper arm (67.7%), elbow (75.3%), forearm (57.6%), and finger (50.3%) injuries given the amount of overall wrestling injuries compared to boxing and martial arts. Boxing, however, accounted for most hand (64.1%) and wrist (37.7%) injuries, despite fewer overall injuries compared to wrestling. The most frequently injured regions within boxing, wrestling, and martial arts were the hand (40.1%), shoulder, (33.8%), and shoulder (28%), respectively. Regarding injury types, wrestling accounted for the highest percentage of each type, including dislocations (55.7%), fractures (46.9), and strains/sprains (50%). Remaining frequencies for dislocations, fractures, and strains/sprains were roughly equal in distributions for boxing and martial arts. Strains/sprains were much more common than dislocations in each sport as well, with a ~4:1 ratio in boxing, and a ~3:1 ratio in wrestling and in martial arts. The most common specific injuries (anatomic region + injury type) sustained across all sports were shoulder strain/sprain (14.7%), followed by hand fractures (13.1%), wrist strain/sprain (9.5%), finger fractures (8.7%), forearm fractures (7.2%), shoulder dislocation (7.1%), finger strain/sprain (6.4%), shoulder fractures (6.2%), wrist fractures (5.4%), and elbow strain/sprain (5.0%). Wrestling accounted for most of these injuries; however, boxing accounted for the majority of hand fractures and dislocations, as well as strains/sprains of the wrist and upper arm. Conclusions: This study demonstrates significant variability in pattern and location of injuries sustained from wrestling, boxing, and martial arts. By providing updated insight regarding the temporal trends and injury patterns to the upper extremity in boxing, wrestling, and martial arts, this study may assist in the efforts to continue advancing safety measures in a group of sports that continues to gain interest in the United States. [ABSTRACT FROM AUTHOR]

Context: Speedball is an increasingly popular racquet sport played in more than 25 countries. Our objective was to describe injury incidence and patterns among Egyptian national-level speedball athletes. Design: Descriptive epidemiological. Methods: We conducted a survey of athletes who were registered with the Egyptian Speedball Federation during the 2018-2019 professional season. The survey inquired about injury types and athlete exposures (AEs). The response rate was 63% (100/160 athletes). Respondent ages ranged from 18 to 41 years. We analyzed demographic characteristics; number, location, and mechanism of injuries; treatment; and speedball participation time lost because of injury. Results: Of 100 respondents, 65 reported having sustained at least one injury during the season for a total of 90 injuries and a rate of 4.7 injuries per 1000 AEs (95% confidence interval. 3.7 to 5.7). More injuries occurred during practice (77%) than during competition (23%). Thirty percent of respondents reported having missed a competition because of injury. The most frequent anatomic locations of injury were the shoulder (50%; 2.4/1000 AEs), elbow (14%; 0.68/1000 AEs), and low back (9%; 0.4/1000 AEs). The most frequently cited causes of injury were increased intensity of training (40%) and lack of warming up (18%). Seventy-seven percent of injured respondents underwent treatment by a health care professional, and 9% of these respondents underwent surgery. Conclusion: The shoulder was the most common anatornic location for injuries in speedball athletes. Our results suggest that attention should be directed toward sport-specific injury prevention and intervention strategies because speedball is a fast-growing sport in several countries. [ABSTRACT FROM AUTHOR]

The aims of this systematic review and meta-analysis were to evaluate the effect of photobiomodulation (PBM) on musculoskeletal pain in injured athletes and to determine if the effects of PBM allowed injured athletes to return to play faster. Electronic databases (MEDLINE Complete, CINAHL, and SPORTDiscus, PubMed, Web of Science, and Embase) were systematically searched (up to and including November 7, 2023) for peer-reviewed randomized controlled trials (RCTs) meeting criteria. Six RCTs, representing 205 competitive and recreational athletes with a mean age of 24 years, were included in the analysis. There were 6 intervention groups using standard physical therapy (n = 1), placebo PBM (n = 4), and aloe gel (n = 1) lasting between 10 minutes and 8 weeks in duration. The level of significance set for the study was p < 0.05. Overall, the use of PBM indicated a positive effect on pain reduction for PBM vs. control groups, standardized mean differences = 1.03, SE = 0.22, 95% confidence intervals = [0.43-1.63], p = 0.0089, but the 2 RCTs found evaluating the effect of PBM on time to return to play after injury in athletes do not support a benefit. Allied healthcare professionals may use PBM to reduce pain, thus allowing an athlete to return to their normal bio-mechanical movement faster; however, limited evidence suggests that PBM does not reduce time to return to play after an injury. [ABSTRACT FROM AUTHOR]

Exploring sports-related musculoskeletal injuries and treatment characteristics in middle school sports may help inform patient care decisions such as appropriate medical coverage. To describe injury and treatment characteristics of middle school–aged athletes receiving care from athletic trainers within the Athletic Training Practice-Based Research Network (AT-PBRN). Descriptive study. Middle school. Middle school–aged athletes (n = 1011; male = 503, female = 506, 2 declined to answer) with sports-related musculoskeletal injuries. Electronic patient records were analyzed from the AT-PBRN from 59 athletic trainers across 14 states between 2010 and 2022. Summary statistics (frequency, percentages, median, and interquartile ranges [IQR]) were used to describe injury (age at injury, sex, sport, body part, and diagnosis) and treatment characteristics (type of treatment, number of visits, and number of procedures per visit). Football (17.7%, n = 179), basketball (17.6%, n = 178), and soccer (14.9%, n = 151) reported the highest number of injuries. The ankle (17.2%, n = 174), knee (16.5%, n = 167), and head (14.1%, n = 143) were the most common injury locations. Concussion (13.0%, n = 131), ankle strain/sprain (12.4%, n = 125), and thigh/hip/groin sprain/strain (11.1%, n = 112) were the most reported diagnoses. Therapeutic exercise or activities (27.6%, n = 1068), athletic trainer evaluation or re-evaluation (24.7%, n = 957), and hot/cold packs (19.8%, n = 766) were the most common services, with a median of 2 visits (IQR = 1 to 4) and 2 procedures (IQR = 1 to 2) per visit. Football, basketball, and soccer reported the most musculoskeletal injuries for middle school-aged athletes. Concussions were the most frequent diagnosis, followed by ankle sprains/strains. Our findings are similar to prior investigations at the high school and collegiate levels. Treatments at the middle school level were also similar to those that have been previously reported at the high school level with therapeutic exercise/activity, athletic trainer evaluation or re-evaluation, and hot/cold packs being the most common treatments. This information may be useful for informing patient care decisions at the middle-school level. [ABSTRACT FROM AUTHOR]

An emergency action plan (EAP) is a written document detailing the preparations and on-site emergency response of health care professionals and other stakeholders to medical emergencies in the prehospital setting. The EAP is developed to address any type of catastrophic injury response and should not be condition specific. The objective of this National Athletic Trainers' Association position statement is to provide evidence-based and consensus-based recommendations for developing and implementing an EAP for sports settings. These recommendations were developed by a multidisciplinary expert panel that performed (1) a comprehensive review of existing EAP evidence, (2) a modified Delphi process to define consensus recommendations, and (3) a strength of recommendation taxonomy determination for each recommendation. An EAP is an essential tool designed to facilitate emergency preparedness and an efficient, coordinated emergency response during an athletic event. A comprehensive EAP should consider modes to optimize patient outcomes, the various stakeholders needed to develop the plan, the factors influencing effective implementation of the EAP, and the roles and responsibilities to ensure a structured response to a catastrophic injury. These evidence-informed recommendations outline the necessary steps for emergency planning and provide considerations for the immediate management of patients with catastrophic injuries. Increasing knowledge and implementation of the EAP to manage patients with catastrophic injuries improves the overall response and decreases errors during an emergency. [ABSTRACT FROM AUTHOR]

A quiz about athletic therapy and training is presented.

The article focuses on the extensive preparation required for athletes aiming to compete in the Olympic Games. Topics include the rigorous screening and medical assessments athletes undergo, the importance of injury prevention and management, and the role of sports psychology in enhancing athletic performance.

Musculoskeletal injuries occur frequently in sport during practice, training, and competition. Injury assessment and management are common responsibilities for the team physician. Initial Assessment and Management of Musculoskeletal Injury—A Team Physician Consensus Statement is title 23 in a series of annual consensus documents written for the practicing team physician. This statement was developed by the Team Physician Consensus Conference, an annual project-based alliance of six major professional associations. The goal of this document is to help the team physician improve the care and treatment of the athlete by understanding the initial assessment and management of selected musculoskeletal injuries. [ABSTRACT FROM AUTHOR]

The article focuses on case presentations at the American Medical Society for Sports Medicine Case Podium, covering various sports-related medical conditions. Topics include Surfer's Myelopathy, Massive Hemothorax from Rib Osteochondroma, and Bilateral Subscapularis Tear with Lesser Tuberosity Avulsions, among others.

Esports' increasing popularity has led to esport athletes receiving similar healthcare to traditional athletes. Thus, this study aims to identify how athletic trainers have been integrated into the esports healthcare team and identify the attitudes of athletic trainers toward esports through a novel online survey. Of the 151 responses received, 13 reported experiences with esports, and they identified common injuries and explained how their skills were utilized; 138 reported no experience with esports and were divided based on positive, neutral, or negative sentiment. More information should be disseminated to athletic trainers on the uniqueness of esport activity. [ABSTRACT FROM AUTHOR]

Background: Recent evidence suggests that for completely displaced midshaft clavicular fractures, surgery offers no clear benefit over nonoperative treatment in a general adolescent population from 10 to 18 years of age. However, the comparative outcomes of comminuted and/or severely shortened clavicular fractures specifically in older adolescent athletes have not been explored in a focused, methodologically rigorous fashion. Hypothesis: The study hypothesis was that outcomes would be superior in older adolescent athletes who underwent operative treatment compared with nonoperative treatment for comminuted and/or severely shortened clavicular fractures. Study Design: Cohort study; Level of evidence, 2. Methods: A level 2, multicenter, prospective cohort study investigating the outcomes of midshaft fractures in adolescents between 2013 and 2017 was filtered to analyze the subcohorts of athletes 14 to 18 years of age with either fracture comminution or fracture shortening of ≥25 mm or both. Patient characteristics, injury mechanisms, fracture characteristics, and treatments were compared. Complications, rates, timing of return to sports (RTS), and patient-reported outcomes (PROs) were analyzed. Results: The 2 treatment groups, which included 136 older adolescent athletes (69 nonoperative, 67 operative), showed similar distributions of primary sport type, competition level, comminution, shortening, and 2-year PRO response rate (n = 99; 73%). The operative group demonstrated 3 mm–greater mean superior displacement, which was therefore statistically controlled for as a confounder in the comparative PRO analysis. No 2-year differences in nonunion, delayed union, symptomatic malunion, refracture, clinically significant complications, or rates of RTS were detected between treatment groups. The difference in timing of RTS (operative, 10.3 weeks; nonoperative, 13.5 weeks) was statistically significant. After controlling for the minor difference in superior displacement, regression analysis and matched comparison cohorts demonstrated no differences between the nonoperative and operative groups in mean or dichotomized PRO scores. Conclusion: In this prospective, multicenter cohort study investigating older adolescent athletes with comminuted and/or severely shortened clavicular fractures, contrary to the study hypothesis, there were no differences in complications, RTS, or PROs between nonoperatively and operatively treated patients at 2 years. Comparably excellent outcomes of severe clavicular fractures in adolescent athletes can be achieved with nonoperative treatment. [ABSTRACT FROM AUTHOR]

This review explores the application of the conservative management model for pain to sports-related concussions (SRCs), framing concussions as a distinct form of pain syndrome with a pathophysiological foundation in central sensitization. Drawing parallels with proven pain management models, we underscore the significance of a proactive approach to concussion management. Recognizing concussions as a pain syndrome allows for the tailoring of interventions in alignment with conservative principles. This review first covers the epidemiology and controversies surrounding prolonged concussion recovery and persistent post-concussion symptoms (PPCS). Next, the pathophysiology of concussions is presented within the central sensitization framework, emphasizing the need for early intervention to mitigate the neuroplastic changes that lead to heightened pain sensitivity. Five components of the central sensitization process specific to concussion injuries are highlighted as targets for conservative interventions in the acute period: peripheral sensitization, cerebral metabolic dysfunction, neuroinflammation, glymphatic system dysfunction, and pain catastrophizing. These proactive interventions are emphasized as pivotal in accelerating concussion recovery and reducing the risk of prolonged symptoms and PPCS, in line with the philosophy of conservative management. [ABSTRACT FROM AUTHOR]

Objective: To describe the presentation and management of lumbar bone stress injuries (LBSI), recurrent LBSI, and lumbar nonunited defects in elite Australian male and female cricket players. Design: Retrospective case series. Setting: Professional domestic and international cricket teams over 13 seasons. Participants: Elite Australian cricket players. Independent variables: Symptomatic LBSI requiring time off cricket and lumbar nonunited defects, both confirmed by imaging. Main outcome measures: Incidence, presentation, history, healing, and management. Results: 211 LBSI were identified at an average incidence of 5.4 per 100 players per season. LBSI were most common in male pace bowlers younger than 20 years of age (58.1 per 100 players per season), however, were also observed in older players, females, and non-pace bowlers. Recurrent LBSI accounted for 33% (27%-40%) of all LBSI. Median days to return to match availability was 182 (128-251) days for all LBSI, with a shorter time frame observed for new and less severe injuries, and male spin bowlers. Healing was demonstrated in 87% (81%-91%) of all LBSI cases. 29 nonunited defects were identified and predisposed subsequent pain, LBSI, and spondylolisthesis. Conclusions: LBSI are experienced by approximately 5.4 in every 100 elite Australian cricket players per season, with a high time cost of approximately 4 to 8 months. Nonunited defects also have a high time cost with associated subsequent lumbar spine issues. The findings of this study reinforce the importance of early detection and conservative management of LBSI, particularly for younger male pace bowlers and players with recurrent LBSI, which may be supported by MRI. [ABSTRACT FROM AUTHOR]

Copyright of Salud, Ciencia y Tecnología is the property of Fundacion Salud, Ciencia y Tecnologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Context: Despite evidence implicating cervicogenic symptoms in the development of persistent postconcussion symptoms, factors that influence utilization of cervical clinical tests to identify cervicogenic symptoms following concussion are poorly understood. Objective: Explore barriers to the utilization of cervical clinical testing in multifaceted concussion evaluation. Design: Cross-sectional. Setting: Online survey. Patients or Other Participants: A total of 122 athletic trainers (AT) (age = 42.6 [6.4] y; female = 51.6%; 52% >10 y of clinical practice; 68% master's degree or greater; 35% treated a minimum of 15 concussions/y). Main Outcome Measure(s): Perceived importance, clinical experience, number of concussions treated, utilization of cervical clinical tests following nonspecific cervical pathology and following concussion, comfort with cervical treatment modalities following a concussion, and recommendation for cervical-specific therapy to treat persistent postconcussion symptoms. Results: Ordinal logistic regression revealed perceived importance had the strongest positive impact on AT's likelihood of high utilization of cervical clinical testing following concussion (95% CI,.17 to.99; P =.005), while clinical experience (95% CI, −.43 to.29; P =.71) and number of concussions treated/y (95% CI, −.21 to.31; P =.71) had no bearing. Moreover, low comfort with cervical treatments following a concussion (95% CI, −2.86 to −.26; P =.018) and low utilization of cervical clinical testing following nonspecific cervical pathology (95% CI, −7.01 to −3.39; P ≤.001) had a strong positive impact on high utilization of cervical clinical testing following concussion. Two logistic regression models demonstrated how recommendations for cervical-specific therapy in persistent post-concussion symptom patients could be predicted based on (1) cervical test utilization and (2) perceptions and clinical experience with 79% and 78%, respectively. Conclusions: Perceived importance played a major role in utilization of cervical clinical test following concussion. ATs who utilized common cervical treatments when dealing with non-concussive injuries were more likely to utilize those same treatments to treat comorbid cervical pathology following a concussion. [ABSTRACT FROM AUTHOR]

Context: A multidisciplinary approach is one of the many forms of professional practice that can be utilized by sports medicine professionals to provide care to injured athletes. While this approach has been empirically supported in the health care domain, studies supporting its utilization in the sport injury rehabilitation context—particularly at the high school level—are limited. Objective: To investigate former high school athletes' experiences of a multidisciplinary model of care for sport injury rehabilitation. Design: Cross-sectional survey design. Setting: In-person, in a classroom setting at 2 Division I universities. Patients: A total of 186 former high school athletes. Main Outcome Measure: An author-constructed instrument developed using the multidisciplinary model of care for sport injury rehabilitation as a guide. Results: Family, athletic coaches, and athletic trainers were the closest professionals/individuals that injured athletes reported interacting with during sport injury rehabilitation. The data also revealed that these professionals/individuals had the closest and most direct relationships with the injured athletes. Conclusions: The findings from the present study provided support for the utilization of the multidisciplinary model of care for sport injury rehabilitation with high school athletes. [ABSTRACT FROM AUTHOR]

Background: Taping is a preventive measure commonly used for protecting and strengthening the ankle joint to prevent further musculoskeletal damage. Ankle taping prevents excessive range of motion (ROM) of the ankle joint and allows the improvement of proprioception to adjust balance. Appropriate ankle stability is essential for various activities, such as sprinting, turning, cutting, and jumping, which are associated with agility. Aim: To assess the acute effect of Kinesio taping and athletic taping on the ankle ROM of athletes with chronic ankle sprain during various agility tests that include sprinting, turning, and cutting actions. Methods: Twenty-five physically active volunteers with chronic ankle sprain performed the Illinois, 5-0-5, 10-m shuttle, hexagon, compass drill, and T agility tests in 3 ankle conditions (nontaped, Kinesio taped, and athletic taped), in random order. Ankle ROM was recorded using the Vicon motion capture system. Results: In comparison with the nontaped ankle condition, in the ankle Kinesio-taping condition, the results showed a significant increase of ankle ROM in the sprinting part of the Illinois, 5-0-5, 10-m shuttle, and T agility tests (P ≤ .01), whereas in the ankle athletic-taping condition, no significant difference was found in ankle ROM during all agility tests. Conclusion: In sports that need linear sprinting, Kinesio taping seems to be a suitable intervention for the improvement of sports performance as it provides increased ankle ROM. [ABSTRACT FROM AUTHOR]

Acupuncture is gaining popularity and wider acceptance as a treatment modality within the field of sports medicine. Our objective was to provide a comprehensive review of the existing literature pertaining to acupuncture in sports medicine to shed light on approaches utilized in acupuncture while revealing its personalized nature and its impact on athletes' preparation, performance, and recovery. We evaluated acupuncture research in the context of medicine and sports-related injury treatment, assessing its impact on athletic performance across demographics of athletes. Athletes participating in most sports have shown positive outcomes from acupuncture interventions. Acupuncture improves peak oxygen levels, maximum heart rate, delayed-onset muscle soreness, pain, swelling, explosive force production, and joint mobility. Furthermore, the efficacy of acupuncture appears to be similar regardless of age and sex. Lastly, the acceptance of acupuncture is influenced by cultural factors, with Western and traditional East Asian cultures exhibiting distinct perspectives on its rationale and mechanisms of action. Traditional East Asian acupuncturists typically employ qi and meridian theories in their acupuncture practices, with the recent incorporation of Western concepts. Acupuncture shows promise as an effective treatment for musculoskeletal pain and neuropathies in athletes across different age groups and for addressing injuries in various sports. Our comprehensive review will enhance our understanding of acupuncture's potential as a complementary or distinct therapeutic approach compared to conventional therapies. Additionally, our review explores its specific applications within different sports and delves into the cultural dimensions involved in integrating this practice into modern sports medicine. [ABSTRACT FROM AUTHOR]

Copyright of Spor Hekimligi Dergisi/Turkish Journal of Sports Medicine is the property of Turkish Journal of Sports Medicine / Spor Hekimleri Dernegi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Controversies remain regarding the diagnosis, imaging, and treatment of acute adductor injuries in athletes. Purpose: To investigate the diagnostic imaging, treatment, and prevention of acute adductor injuries based on the most recent and relevant scientific evidence. Study Design: Systematic review; Level of evidence, 4. Methods: The PubMed and Web of Science databases were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify articles studying acute adductor injury in athletes. Inclusion criteria were original publication on acute adductor injury in amateur or professional athletes, level 1 to 4 evidence, mean patient age >15 years, and results presented as return-to-sport, pain, or functional outcomes. Quality assessment was performed with the CONSORT (Consolidated Standards of Reporting Trials) statement or the methodological index for non-randomized studies criteria. Articles were grouped as imaging, treatment, prevention focused, or mixed. Results: A total of 30 studies published between 2001 and 2021 were selected, involving 594 male patients with a mean age 26.2 years (range, 16-68 years). The most frequent sports were soccer (62%), basketball (14%), futsal (6%), American football (3%), and ice hockey and handball (2%). Risk factors for acute adductor injury were previous acute groin injury, adductor weakness compared with the uninjured side, any injury in the previous season, and reduced rotational hip range of motion. The frequency of complete adductor muscle tears on magnetic resonance imaging was 21% to 25%. For complete adductor tears, the average time to return to play was 8.9 weeks in patients treated nonoperatively and 14.2 weeks for patients treated surgically. Greater stump retraction was observed in individuals treated surgically. Partial acute adductor tears were treated nonoperatively with physical therapy in all studies in the present systematic review. The average time to return to play was 1 to 6.9 weeks depending on the injury grade. The efficacy of adductor strengthening on preventing acute adductor tears has controversial results in the literature. Conclusion: Athletes with partial adductor injuries returned to play 1 to 7 weeks after injury with physical therapy treatment. Nonoperative or surgical treatment is an acceptable option for complete adductor longus tendon tear. [ABSTRACT FROM AUTHOR]

Participants with chronic ankle instability (CAI) frequently display altered movement patterns during functional movements. However, it remains unclear how these altered joint kinematics during jump landing negatively affect ankle joint health in the CAI population. Calculating joint energetics may offer an important method to estimate the magnitude of lower extremity joint loading during functional movements in participants with CAI. To determine differences in energy dissipation and generation by the lower extremity during maximal jump landing and cutting among groups with CAI, copers, and controls. Cross-sectional study. Laboratory. Forty-four participants with CAI, 44 copers, and 44 controls. Kinematics and kinetics of the lower extremity and ground reaction force data were collected during a maximal jump-landing and cutting task. The product of angular velocity in the sagittal plane and joint moment data represented joint power. Energy dissipation and generation by the ankle, knee, and hip joints were calculated by integrating regions of the joint power curve. Participants with CAI displayed reduced ankle energy dissipation (35.9% ± 10.1%) and generation (31.6% ± 12.8%; P <.01) compared with copers (dissipation = 43.6% ± 11.1%; generation = 40.4% ± 12.0%) and controls (dissipation = 41.3% ± 11.1%; generation = 39.6% ± 12.0%) during maximal jump landing and cutting. Participants with CAI also displayed greater energy dissipation at the knee (45.1% ± 9.1%) than copers (39.7% ± 9.5%) during the loading phase and greater energy generation at the hip than controls (36.6% ± 16.8% versus 28.3% ± 12.8%) during the cutting phase. However, copers displayed no differences in joint energetics compared with controls. Participants with CAI displayed differences in both energy dissipation and generation by the lower extremity during maximal jump landing and cutting. However, copers did not show altered joint energetics, which may represent a coping mechanism to avoid further injuries. [ABSTRACT FROM AUTHOR]

Background: Alpine skiing is considered to be a high-risk sport due to frequent knee injuries and lower limb fractures. The most common lower limb fracture is tibial shaft fracture, while the most common ligament injuries include anterior cruciate ligament (ACL) or medial collateral ligament tears. An injury rarely described in the literature is the association of a bony leg fracture with an ACL injury and Segond fracture. Indications: While the tibial fracture can be managed with intermedullary nailing and proximal ACL tears can be managed with primary repair, the combination of treatments including fixation of the Segond fracture is uncommon. Technique Description: We report combination treatment with nailing for the tibial fracture, primary repair for the ACL avulsion, and primary fixation of Segond fracture. Results: Simultaneous reduction and fixation of the fracture and stabilization of the knee with ACL and anterolateral ligament repair in a single stage resulted in an excellent outcome with complete healing of tibial fracture, ACL repair, and Segond fixation at final follow-up. Discussion/Conclusion: Even if combined leg fracture associated with ipsilateral ACL tear and Segond fracture is a very rare injury, the described technique based on 1-stage fixation of the 3 injuries is a viable option. This surgical technique can be considered a reparative treatment, with the goal of preserving the joint. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication. Graphical Abstract This is a visual representation of the abstract. [ABSTRACT FROM AUTHOR]

Background: Apophyseal overuse injuries are self-limited with skeletal maturity; however, they may be a source of significant pain and time lost from training. There is a lack of consensus for its management with the current available treatment, which might lag behind the ongoing development of regenerative medicine. The current retrospective case study aimed to assess the potential effectiveness and short-term safety of extracorporeal shockwave therapy (ESWT) in apophyseal injuries. Methods: Data from 22 growing athletes [15 patients with Osgood-Schlatter disease and seven patients with Sever's disease] who received ESWT at a sports medicine unit in a university hospital were reviewed. All patients received low energy (= 0.1 mJ/mm2) level-focused ESWT using electrohydraulic generation technology. The clinical focusing technique was used upon applying ESWT. Results: The number of sessions received to achieve full recovery ranged from 1 to 3 sessions. The time from treatment initiation to previous activity level was 2 weeks in 14 patients (63.3%), 4 weeks in seven patients (31.8%) and 11 weeks in one patient (4.5%). No adverse events were reported. No recurrence occurred up to 3 months after the last session. Conclusion: ESWT is a potentially safe and effective treatment for apophyseal injuries. It may facilitate an early return to sport activities. [ABSTRACT FROM AUTHOR]

Enabling athletes to achieve peak performances while also maintaining high levels of health is contextually complex. We aim to describe what a 'health system' is and apply the essential functions of stewardship, financing, provision of services and resource generation to an Australian high-performance sport context. We introduce a fifth function that health systems should not detract from athletes' ability to achieve their sports goals. We describe how these functions aim to achieve four overall outcomes of safeguarding the health of the athletes, responding to expectations, providing financial and social protection against the costs of ill health, and efficient use of resources. Lastly, we conclude with key challenges and potential solutions for developing an integrated health system within the overall performance system in high-performance sport. [ABSTRACT FROM AUTHOR]

Concussions are a common injury both within and outside sport and recreational settings, and they remain a serious concern for children and youth. Any young person suspected of sustaining a concussion should be medically evaluated as soon as possible, and when the injury occurs during sport, the individual must be removed from play immediately to avoid secondary injury. A brief initial period of physical and cognitive rest is followed by supervised, stepwise return-to-learn and return-to-play protocols. All individuals involved in child and youth sports and recreation must be able to recognize risk for, and signs and symptoms of, concussion. They must also ensure that any participant suspected of sustaining a concussion is properly evaluated and managed by qualified medical personnel. Evolving data and literature have strengthened both our pathophysiological understanding of concussion and guidance for clinical management, especially related to acute care, persistent symptoms, and prevention. This statement also re-examines the relationship between bodychecking in hockey and injury rates, and advocates for a change in policy in youth hockey. [ABSTRACT FROM AUTHOR]

Adductor-related groin pain is a common problem in sports. Evidence-based management of athletes with adductor strains, adductor ruptures, and long-standing adductor-related groin pain can be approached in a simple yet effective and individualized manner. In most cases, managing adductor-related pain in athletes should be based on specific exercises and loading strategies. In this article, I provide an overview of the different types of adductor injuries, from acute to overuse, including their underlying pathology, functional anatomy, diagnosis, prognosis, mechanisms, and risk factors. This information leads to optimal assessment and management of acute to long-standing adductor-related problems and includes primary, secondary, and tertiary prevention strategies that focus on exercise and load-based strategies. In addition, information on different options and contexts for exercise selection and execution for athletes, athletic trainers, and sports physical therapists in adductor injury rehabilitation is provided. [ABSTRACT FROM AUTHOR]

Introduction. Understanding the epidemiological profile of foot and ankle's injuries in athletes is relevant for the prevention and treatment its occurrence. Objective. To describe the epidemiology and risk factors of foot and ankle injuries in athletes treated at an outpatient sports medicine clinic. The primary hypothesis is that ankle instability is the most frequent injury in athletes in the foot and ankle specialty outpatient clinic. Methods. Observational, retrospective, descriptive study with patients treated at an outpatient sports medicine clinic, between 2015 and 2020. We performed a multivariate logistic regression analysis to verify the association of gender, age and laterality with the main injuries documented. Results. 763 patients (387 men/376 women) met the inclusion criteria. The mean age was 35 years, the most prevalent diseases were chronic lateral ankle instability (n = 134, 17.6%), acute lateral ankle sprain (n = 120, 15.7%) and plantar fasciitis (n = 69, 9%). The multivariable analysis by logistic regression identified female gender and age group young adults as a risk factor for lateral ankle instability. In acute lateral ankle sprain, age was identified as a risk factor with statistical significance. In overuse injuries, only the female gender was evidenced as a risk factor. Conclusions. Our work correlated several factors such as age, gender and laterality with specific sports through multivariate analysis, adding epidemiological data to the literature [ABSTRACT FROM AUTHOR]

Introduction: Sports injuries have long been recognized as a global health problem that requires a public health approach to reduce their impact. The aims of this study were to evaluate the incidence of injuries in university athletes. Methods: 70 students registered in the Oradea University Sports Club, from different sports branches, were included in the study. We apply the NCAA Injury Surveillance System adapted for Romania, by native English speakers and English language experts to ensure the cultural adaptation and efficient transposition. Results: The questionnaire results show that all subjects have suffered at least one accident since practicing sports at the University and injury occurred in competition for 40% or in practice for 60% of the respondents. The data show that 31.11% of the respondents practicing performance sports were injured in the first half of training, 26.67% in the second part of training, 24.44% of the surveyed respondents were injured in the first game, 11.11% in the second game, 4.44% in the third game, and only 2.23% were injured during the warm-up. At the level of the lower limb, most injuries were to the knee and ankle. Regarding the knee structures that were injured, 14.28% of the survey participants mentioned the collateral ligament, 21.43% anterior cruciate ligament, 7.14% posterior cruciate ligament, 42.86% meniscus and 14.29% patella and/or patellar tendon. Discussion: The main causes of these can be insufficient time allocated to the recovery after the effort, the lack of special recovery procedures and the inadequate warming up of the athletes. As a result, in order to prevent them, the physical training program should aim to increase the flexibility of the muscles, toning the muscles, increasing the mobility of the joints and training the stabilizing muscles. Conclusions: Following the analysis of the applied questionnaire, it was found that most injuries were suffered at the level of the knee and ankle, among team sports, and at the level of the upper part of the foot and heel, among athletes. [ABSTRACT FROM AUTHOR]

The National Basketball Association (NBA) has an extremely demanding competition schedule, requiring its athletes to compete in 82 regular-season games over a 6-mo period (∼3.4 games/wk). Despite the demanding schedule and high value of athletes, there is little public information on the specific game and training demands required to compete in the NBA. Although provisions in the NBA collective-bargaining agreement allow for research designed to improve player health and broaden medical knowledge, such information is sparse in the available literature. In relation to the physical demands of the NBA, the current lack of information likely results from multiple factors including limited understanding of (basketball-related) emerging technologies, impact of specific league rules, and steps taken to protect players in the age of Big Data. This article explores current limitations in describing specific game/training demands in the NBA and provides perspectives on how some of these challenges may be overcome. The authors propose that future collaborations between league entities, NBA clubs, commercial partners, and outside research institutions will enhance understanding of the physical demands in the NBA (and other health- and performance-related areas). More detailed understanding of physical demands (games, practices, and travel) and other health-related areas can augment player-centered decision making, leading to enhanced player care, increased availability, and improved physical performance. [ABSTRACT FROM AUTHOR]

The purpose of this study was to report utilization of chiropractic care during The World Games 2017 in Wroclaw, Poland. A retrospective analysis was performed on treatment records. Thirty-five chiropractors trained in sports injuries provided care for athletes and non-athletes (support personnel) who voluntarily sought chiropractic care. Data included demographics (age, sex, role, country, and sport), category of anatomical regions treated, treatment modality (manipulation, myotherapy, mobilization, taping, and other), and participants' self-reported pain ratings. A total of 1902 completed treatment forms representing 1902 encounters were included for athletes (n = 1238, 65%) and non-athletes (n = 664, 35%). There were 9385 individuals (athlete or non-athlete). Five hundred ninety of 3666 (16%) athletes and 422 of 5719 (7%) non-athletes received chiropractic treatment. Athletes represented 28 of 31 (90%) sports and 79 of 108 (73%) countries present. The thoracic spine was the most frequently treated spinal region (n = 846, 44%), followed by lumbar spine (n = 831, 44%) and cervical spine (n = 725, 38%). Frequency of treatment modalities was manipulation (n = 1610, 82%), myotherapy (n = 1522, 80%), mobilization (n = 607, 32%), and taping (n = 380, 20%). Acute injuries were more prevalent for athletes (61%) than non-athletes (35%), and athletes sought follow-up care (54%) more than non-athletes (36%). Overall, 89% of participants reported pain reduction immediately after treatment. This article describes chiropractic care utilization at a multisport event as part of a health care team. The range of treatments included manipulation myotherapy, mobilization, and taping. Although a minority of athletes and non-athletes received chiropractic treatment, many participants reported pain reduction immediately after treatment. [ABSTRACT FROM AUTHOR]

Context: Rest, ice, compression, and elevation are commonly recommended immediately after injury. Traditionally, ice bag (IB) with elastic wrap compression has been utilized; however, recently intermittent cryocompression units are being used. Limited research has evaluated tissue temperature decreases with intermittent cryocompression units. Objective: Evaluate magnitude of muscle and skin cooling. Design: Repeated-measures counterbalanced study. Setting: University research laboratory. Patients or OtherParticipants: Twelve healthy college-aged participants (4 males and 8 females; age = 23.08 [1.93] y; height = 171.66 [9.47] cm; mass = 73.67 [13.46] kg; subcutaneous thickness = 0.90 [0.35] cm) without compromised circulation or injury. Intervention(s): Salted IB, GameReady (GR), and PowerPlay-ice bag (PP-ice) were applied to the posterior aspect of the nondominant calf for 30 minutes; participants underwent each treatment in counterbalanced order. Main Outcome Measure(s): Muscle temperature measured via 21-gauge catheter thermocouple; skin temperature measured via a surface thermocouple. Temperatures were recorded at baseline and during a 30-minute treatment. Correlations were evaluated between muscle and skin temperatures. Results: Nonsignificant treatment × time interaction and nonsignificant main effect of treatment for intramuscular cooling. Mean Decrease From Baseline: IB, 6.4°C (±2.8); GR, 5.4°C (±1.1); PP-ice, 4.8°C (±2.8). Nonsignificant treatment × time interaction for skin cooling (F20,200 = 1.440, P =.65, η p 2 =.346 , and observed β = 0.773), but significant main effect for treatment (F10,100 = 5.279, P =.03, η p 2 =.883 , and observed β = 1.00). Mean Decrease From Baseline: IB, 17.0°C; GR, 16.4°C; PP-ice, 14.6°C. No significant correlation between intramuscular and skin temperatures in any condition at any time point. No significant correlation between adipose tissue thickness and maximum temperature decrease with any modality. Conclusions: Salted IB with elastic wrap compression, GR, and PP-ice produced equivalent intramuscular temperature decreases during the treatment period. [ABSTRACT FROM AUTHOR]

Background: Consumption of medication to alleviate pain is widespread in Germany. Around 1.9 million men and women take analgesics every day; some 1.6 million persons are addicted to painkillers. Analgesic use is thought also to be common in sports, even in the absence of pain. The aim of this study was to assess the extent of painkiller use among athletes. Methods: In line with the PRISMA criteria and the modified PICO(S) criteria, a systematic literature review was registered (Openscienceframework, https://doi. org/10.17605/OSF.IO/VQ94D) and carried out in PubMed and SURF. The publications identified (25 survey studies, 12 analyses of doping control forms, 18 reviews) were evaluated in standardized manner using the Newcastle-Ottawa Scale (NOS) and AMSTAR (A MeaSurement Tool to Assess systematic Reviews). Results: Analgesic use is widespread in elite sports. The prevalence varies between 2.8% (professional tennis) and 54.2% (professional soccer). Pain medication is also taken prophylactically in the absence of symptoms in some non-elite competitive sports. In the heterogeneous field of amateur sports the data are sparse and there is no reliable evidence of wide-reaching consumption of painkillers. Among endurance athletes, 2.1% of over 50 000 persons stated that they used analgesics at least once each month in connection with sports. Conclusion: Analgesic use has become a problem in many areas of professional/competitive sports, while the consumption of pain medication apparently remains rare in amateur sports. In view of the increasing harmful use of or even addiction to painkillers in society as a whole, there is a need for better education and, above all, restrictions on advertising. [ABSTRACT FROM AUTHOR]