Hamstring strains are common injuries, the majority of which occur whilst sprinting. An understanding of the biomechanical circumstances that cause the hamstrings to fail during sprinting is required to improve rehabilitation specificity. The aim of this study was to therefore investigate the biomechanics of an acute hamstring strain. Bilateral kinematic and ground reaction force data were captured from a sprinting
Anthony G. Schache; Tim V. Wrigley; Richard Baker; Marcus G. Pandy
Background: Hamstring strain injury is a common problem within sport. Despite research interest, knowledge of risks for and management of hamstring strain is limited, as evidenced by high injury rates. Objective: To present the current best evidence for hamstring strain injury risk factors and the management of hamstring strain injury. Methods: MEDLINE, AMED, SportDiscus, and AUSPORT databases were searched (key terms “hamstring” and “strain,” “injury,” “pull,” or “tear”) to identify relevant literature published between 1982 and 2007 in the English language. Studies of adult athlete populations (older than 18 years) pertaining to hamstring strain incidence, prevalence, and/or intervening management of hamstring strain injury were included. Articles were limited to full-text randomized, controlled studies or cohort studies. Twenty-four articles were included. Articles were critically appraised using the McMaster Quantitative Review Guidelines instrument. Data pertaining to injury rates and return to sport outcomes were extracted. Each author undertook independent appraisal of a random selection of articles after establishing inter-rater agreement of appraisal. Results: Previous strain, older age, and ethnicity were consistently reported as significant risks for injury, as was competing in higher levels of competition. Associations with strength and flexibility were conflicting. Functional rehabilitation interventions had preventive effects and resulted in significantly earlier return to sport. Additionally, weak evidence existed for other interventions. Conclusion: Current evidence is inconclusive regarding most interventions for hamstring strain injury, while the effect of potentially modifiable risks is unclear. Further high-quality prospective studies into potential risks and management are required to provide a better framework within which to target interventions.
Prior, Mathew; Guerin, Michelle; Grimmer, Karen
BackgroundWhile hamstring strain injuries are common during sprinting, the mechanisms of injury are not well understood. In this study, we analyzed the running kinematics of an athlete obtained at the time of an acute hamstring strain injury. The purpose was to identify the period of the gait cycle during which the hamstring was likely injured, as well as to characterize
Bryan C. Heiderscheit; Dina M. Hoerth; Elizabeth S. Chumanov; Stephen C. Swanson; Brian J. Thelen; Darryl G. Thelen
Lecture 17Muscle injuries are among the most common, most misunderstood, and inadequately treated conditions in sports. According to some studies, muscle injuries account for 10–30% of all injuries in sport.1 Hamstring injuries are the commonest muscle injury in all sports.Hamstrings function is complex. Depending on leg positioning and relationship to the ground it can serve as a hip extensor, knee
N G Malliaropoulos
Hamstring strain injuries (HSIs) are common in a number of sports and incidence rates have not declined in recent times. Additionally, the high rate of recurrent injuries suggests that our current understanding of HSI and re-injury risk is incomplete. Whilst the multifactoral nature of HSIs is agreed upon by many, often individual risk factors and/or causes of injury are examined in isolation. This review aims to bring together the causes, risk factors and interventions associated with HSIs to better understand why HSIs are so prevalent. Running is often identified as the primary activity type for HSIs and given the high eccentric forces and moderate muscle strain placed on the hamstrings during running these factors are considered to be part of the aetiology of HSIs. However, the exact causes of HSIs remain unknown and whilst eccentric contraction and muscle strain purportedly play a role, accumulated muscle damage and/or a single injurious event may also contribute. Potentially, all of these factors interact to varying degrees depending on the injurious activity type (i.e. running, kicking). Furthermore, anatomical factors, such as the biarticular organization, the dual innervations of biceps femoris (BF), fibre type distribution, muscle architecture and the degree of anterior pelvic tilt, have all been implicated. Each of these variables impact upon HSI risk via a number of different mechanisms that include increasing hamstring muscle strain and altering the susceptibility of the hamstrings to muscle damage. Reported risk factors for HSIs include age, previous injury, ethnicity, strength imbalances, flexibility and fatigue. Of these, little is known, definitively, about why previous injury increases the risk of future HSIs. Nevertheless, interventions put in place to reduce the incidence of HSIs by addressing modifiable risk factors have focused primarily on increasing eccentric strength, correcting strength imbalances and improving flexibility. The response to these intervention programmes has been mixed with varied levels of success reported. A conceptual framework is presented suggesting that neuromuscular inhibition following HSIs may impede the rehabilitation process and subsequently lead to maladaptation of hamstring muscle structure and function, including preferentially eccentric weakness, atrophy of the previously injured muscles and alterations in the angle of peak knee flexor torque. This remains an area for future research and practitioners need to remain aware of the multifactoral nature of HSIs if injury rates are to decline. PMID:22239734
Opar, David A; Williams, Morgan D; Shield, Anthony J
Objective The objective of this study was to use magnetic resonance (MR) imaging to investigate long-term changes in muscle and tendon\\u000a morphology following a hamstring strain injury.\\u000a \\u000a \\u000a \\u000a Materials and methods MR images were obtained from 14 athletes who sustained a clinically diagnosed grade I–II hamstring strain injury between 5\\u000a and 23 months prior as well as five healthy controls. Qualitative bilateral comparisons were
Amy Silder; Bryan C. Heiderscheit; Darryl G. Thelen; Timothy Enright; Michael J. Tuite
Objective—To prospectively establish risk factors for hamstring muscle strain injury using magnetic resonance imaging (MRI) to define the diagnosis of posterior thigh injury. Method—In a prospective cohort study using two elite Australian Rules football clubs, the anthropometric characteristics and past clinical history of 114 athletes were recorded. Players were followed throughout the subsequent season, with posterior thigh injuries being docu-
G M Verrall; J P Slavotinek; P G Barnes; G T Fon; A J Spriggins
Though recent research into the diagnosis and management of hamstring disorders has resulted in early and accurate recognition\\u000a of injury, hamstring strain remains the most common form of muscle injury in the active population. With prompt recognition\\u000a of hamstring strain, an appropriate rest and rehabilitation routine may be devised by the sports clinician in the hope of\\u000a avoiding future and
George Koulouris; David Connell
Lecture 15OccurrenceHamstring strain is the most common single injury in elite soccer. To prevent these injuries and to optimise the rehabilitation it is important to analyse in what situations they occur. There are at least two distinctly different types of acute hamstring strains, one occurring during high-speed running and mainly involving the biceps femoris long head, the other during movements
Background: Little is known about the clinical features of posterior thigh injuries and their contribution to accurate diagnosis and prognostic assessment of hamstring muscle strain injury.Hypotheses: The clinical features of posterior thigh injury can be used to diagnose hamstring muscle strain and to predict duration of absence from competition.Study Design: Prospective clinical study.Methods: For two playing seasons, the clinical features
Geoffrey M. Verrall; John P. Slavotinek; Peter G. Barnes; Gerald T. Fon
Background: Hamstring strains remain one of the most prevalent injuries in Australian Rules football. The authors prospectively examined the relationship between musculotendinous stiffness of the hamstring and leg stiffness with hamstring injury in professional Australian Rules footballers during the 2006 season.Hypothesis: Higher hamstring stiffness and leg stiffness are related to noncontact, soft tissue hamstring injury risk in professional Australian Rules
Mark L. Watsford; Aron J. Murphy; Ken A. McLachlan; Adam L. Bryant; Matt L. Cameron; Kay M. Crossley; Michael Makdissi
Context: There is a wide spectrum of hamstring-related injuries that can occur in the athlete. Accurate diagnosis is imperative to prevent delayed return to sport, injury recurrence, and accurate clinical decision making regarding the most efficacious treatment. Evidence Acquisition: This review highlights current evidence related to the diagnosis and treatment of hamstring-related injuries in athletes. Data sources were limited to peer-reviewed publications indexed in MEDLINE from 1988 through May 2011. Results: An accurate diagnostic process for athletes with posterior thigh–related complaints should include a detailed and discriminative history, followed by a thorough clinical examination. Diagnostic imaging should be utilized when considering hamstring avulsion or ischial apophyseal avulsion. Diagnostic imaging may also be needed to further define the cause of referred posterior thigh pain. Conclusions: Differentiating acute hamstring strains, hamstring tendon avulsions, ischial apophyseal avulsions, proximal hamstring tendinopathies, and referred posterior thigh pain is critical in determining the most appropriate treatment and expediting safe return to play.
Background: Magnetic resonance imaging (MRI) allows for detailed evaluation of hamstring injuries; however, there is no classification that allows prediction of return to play. Purpose: To correlate time for return to play in professional football players with MRI findings after acute hamstring strains and to create an MRI scoring scale predictive of return to sports. Study Design: Descriptive epidemiologic study. Methods: Thirty-eight professional football players (43 cases) sustained acute hamstring strains with MRI evaluation. Records were retrospectively reviewed, and MRIs were evaluated by 2 musculoskeletal radiologists, graded with a traditional radiologic grade, and scored with a new MRI score. Results were correlated with games missed. Results: Players missed 2.6 ± 3.1 games. Based on MRI, the hamstring injury involved the biceps femoris long head in 34 cases and the proximal and distal hamstrings in 25 and 22 cases, respectively. When < 50% of the muscle was involved, the average number of games missed was 1.8; if > 75%, then 3.2. Ten players had retraction, missing 5.5 games. By MRI, grade I injuries yielded an average of 1.1 missed games; grade II, 1.7; and grade III, 6.4. Players who missed 0 or 1 game had an MRI score of 8.2; 2 or 3 games, 11.1; and 4 or more games, 13.9. Conclusions: Rapid return to play (< 1 week) occurred with isolated long head of biceps femoris injures with < 50% of involvement and minimal perimuscular edema, correlating to grade I radiologic strain (MRI score < 10). Prolonged recovery (missing > 2 or 3 games) occurs with multiple muscle injury, injuries distal to musculotendinous junction, short head of biceps injury, > 75% involvement, retraction, circumferential edema, and grade III radiologic strain (MRI score > 15). Clinical Relevance: MRI grade and this new MRI score are useful in determining severity of injury and games missed—and, ideally, predicting time missed from sports.
Cohen, Steven B.; Towers, Jeffrey D.; Zoga, Adam; Irrgang, Jay J.; Makda, Junaid; Deluca, Peter F.; Bradley, James P.
Posture and flexibility were assessed in 34 athletes. Subjects were divided into two groups: (1) a noninjured group that did not have a history of hamstring strain injury within the previous 12 months; (2) an injured group that had a history of hamstring strain within the previous 12 months. Ten postural components were assessed: head erectness; shoulder symmetry; spinal curvature;
L Hennessey; A W Watson
Eleven sprinters with recent hamstring injuries were compared with nine uninjured runners. The flexibility of the hamstrings and the eccentric and concentric muscle torque were measured in the hamstrings and quadriceps muscles at different angular velocities. Sprinters with a previous hamstring injury had signifi cantly tighter hamstrings than uninjured sprinters had. The uninjured sprinters had significantly higher eccen tric hamstring
Sven Jonhagen; Gunnar Nemeth; Ejnar Eriksson
Introduction: Hamstring injuries are one of the most common injuries associated with sports participation. The aim of this review is to outline identified risk factors and examine preventative strategies for reducing the occurrence of this form of injury. Methods: An electronic search of Medline and SCOPUS was carried out for key words related to the area. Results: A number of
Ross A Clark
Purpose: It has been reported that hamstring strain in athletes is commonly followed by subsequent hamstring strains (Am. J. Sports Med. 30(2) (2002) 199). The current management of these injuries is oftentimes unsuccessful and may plague the athlete throughout their sporting career. The aim of this study was to test the hypothesis that hamstring strain can be a “symptom” secondary
Matthew Wallden; Nick Walters
PurposeWe determined the relationship between hamstring injury and hamstring length in a prospective analysis of adolescent football players as well as assessing the impact of age and test type upon hamstring length.
Andrew Rolls; Keith George
Background: Strain injuries of the posterior thigh are common in soccer. It seems that previous injury and age are important risk factors, but the literature is limited. This study was conducted to see if we could identify intrinsic risk factors for hamstring injuries among male soccer players.Hypothesis: We hypothesized that previous hamstring injuries, reduced function scores, abnormalities on a clinical
Anders Hauge Engebretsen; Grethe Myklebust; Ingar Holme; Lars Engebretsen; Roald Bahr
This study reports the histochemical fiber type com position of the human hamstring muscles. Muscle spec imens from necropsy specimens were obtained from seven locations in the hamstring, four locations in the quadriceps, and one location in the adductor magnus. The hamstring muscles are shown to have a relatively high proportion of Type II fibers. Type II fibers are more
W. E. Garrett; J. C. Califf; F. H. Bassett
Background: Physicians evaluating hamstring strains in professional football players are increasingly turning to magnetic resonance imaging to support the clinical diagnosis and management of the injury. However, little information is available to assess how magnetic resonance imaging compares with the clinical evaluation in establishing the duration of rehabilitation required.Hypothesis: Magnetic resonance imaging of hamstring strains can be useful in determining
Michal E. Schneider-Kolsky; Jan Lucas Hoving; Price Warren; David A. Connell
The management of hamstring injuries can be described as vexed at best. One reason for this may be because of a lack of high-quality research into the methods of treatment, rehabilitation and prevention. As a result, an evidence-based approach to injury management does not exist. Management is based on clinical experience, anecdotal evidence and the knowledge of the biological basis
Wayne Hoskins; Henry Pollard
ObjectiveTo investigate early clinical predictors of time to return to competition and of recurrence following hamstring strain.DesignProspective observational study.SettingElite level of Australian football competition.Participant59 players who suffered a hamstring strain in 2002 season.PredictorsClinical assessment by a physiotherapist and questionnaire.Main outcome measuresTime taken to return to play and recurrence of hamstring injury within 3 weeks.ResultsPlayers taking more than 1 day to
Price Warren; Belinda J Gabbe; Michal Schneider-Kolsky; Kim L Bennell
Objectives: To identify risk factors for hamstring injury at the community level of Australian football. Methods: A total of 126 community level Australian football players participated in this prospective cohort study. To provide baseline measurements, they completed a questionnaire and had a musculoskeletal screen during the 2000 preseason. All were monitored over the season. Injury surveillance and exposure data were collected for the full season. Survival analysis was used to identify independent predictors of hamstring injury. Results: A hamstring injury was the first injury of the season in 20 players (16%). After adjustment for exposure, increasing age and decreased quadriceps flexibility were identified as significant independent predictors of the time to sustaining a hamstring injury. Older age (?23 years) was associated with an increased risk of hamstring injury (RR 3.8; 95% confidence interval (CI) 1.1 to 14.0; p = 0.044). Players with increased quadriceps flexibility (as measured by the modified Thomas test) were less likely to sustain a hamstring injury (RR 0.3; 95% CI 0.1 to 0.8; p = 0.022). Conclusions: The findings of this study can be used in the development of hamstring injury prevention strategies and to identify Australian football players at increased risk of hamstring injury.
Gabbe, B; Finch, C; Bennell, K; Wajswelner, H
Dancing involves powerful movements as well as flexibility exercises, both of which may be related to specific injuries to the musculo-tendinosus tissue, e.g., the hamstring muscle complex. In this study, the occurrence of acute and overuse injuries to the rear thigh in dancers was investigated retrospectively by means of a questionnaire. All but one (n = 98) of the student-dancers (age 17-25 years) at the Ballet Academy in Stockholm participated. The results demonstrated that, during the past 10 years, every third dancer (34%) reported that they had acute injuries and every sixth dancer (17%) had overuse injuries to the rear thigh. Most (91%) of the acute injuries were subjectively located to an area close to tuber ischiadicum. The majority (88%) stated that the acute injury occurred during slow activities in flexibility training, e.g., splits, and only a few (12%) in powerful movements. Continuing problems were reported by 70% of the acutely injured dancers. Many of the dancers neglected their acute injury (14 did not even stop the ongoing dance activity) and they also greatly underestimated the recovery time. Only 4 dancers (12%) received acute medical assistance. Thus the results, based on the recollection of the subjects, indicated that stretching could induce severe strain injuries to the proximal hamstrings in dancers. Extrapolating these results to the practice, it can be recommended that stretching exercises be executed with caution in connection with dancing sessions and training, and that, information about the seriousness and acute treatment of such injuries be added to the student-dancers' curriculum. PMID:12199872
Askling, C; Lund, H; Saartok, T; Thorstensson, A
On the basis of research, the following characteristics appear to be important factors relative to precluding hamstring strains in sprinters: bilaterality relative to hamstring and quadricep strength development, optimum strength ratios between ipsilateral antagonists throughout the range of movement, and above-normal hip-joint flexibility. (JD)
Acute hamstring injuries are the most prevalent muscle injuries reported in sport. Despite a thorough and concentrated effort to prevent and rehabilitate hamstring injuries, injury occurrence and re-injury rates have not improved over the past 28 years. This failure is most likely due to the following: 1) an over-reliance on treating the symptoms of injury, such as subjective measures of "pain", with drugs and interventions; 2) the risk factors investigated for hamstring injuries have not been related to the actual movements that cause hamstring injuries i.e. not functional; and, 3) a multi-factorial approach to assessment and treatment has not been utilized. The purpose of this clinical commentary is to introduce a model for progression through a return-to-sport rehabilitation following an acute hamstring injury. This model is developed from objective and quantifiable tests (i.e. clinical and functional tests) that are structured into a step-by-step algorithm. In addition, each step in the algorithm includes a treatment protocol. These protocols are meant to help the athlete to improve through each phase safely so that they can achieve the desired goals and progress through the algorithm and back to their chosen sport. We hope that this algorithm can serve as a foundation for future evidence based research and aid in the development of new objective and quantifiable testing methods. PMID:21256444
Mendiguchia, Jurdan; Brughelli, Matt
Hamstring injuries are the most prevalent injury in Australian Rules football. There is a lack of evidence based literature on the treatment, prevention and management of hamstring injuries, although it is agreed that the etiology is complicated and multi-factorial. We present two cases of hamstring injury that had full resolution after spinal manipulation and correction of lumbar-pelvic biomechanics. There was
Wayne T Hoskins; Henry P Pollard
Background: The incidence of acute hamstring injuries is high in several sports, including the different forms of football.Purpose: The authors investigated the preventive effect of eccentric strengthening of the hamstring muscles using the Nordic hamstring exercise compared with no additional hamstring exercise on the rate of acute hamstring injuries in male soccer players.Study Design: Randomized controlled trial; Level of evidence,
Jesper Petersen; Kristian Thorborg; Michael Bachmann Nielsen; Esben Budtz-Jørgensen; Per Hölmich
OBJECTIVE--To determine whether the use of thermal pants might reduce the risk of hamstring injury in rugby players. METHODS--44 male rugby players from the Cape Province, South Africa, who had previously suffered a hamstring injury were given the choice of wearing thermal warming pants or not, and were then monitored for the development of hamstring injuries during the 1992 season.
P A Upton; T D Noakes; J M Juritz
The objectives of this study were to measure strain in the ACL during simulated: (1) hamstring activity alone, (2) quadriceps activity alone, and (3) simultaneous quadriceps and hamstring activity. Seven knee speci mens removed from cadavers were studied. Heavy sutures applied to load cells were attached to the hamstring and quadriceps tendons. Loads were then applied manually (hamstrings) and\\/or with
P. Renström; S. W. Arms; T. S. Stanwyck; R. J. Johnson; M. H. Pope
Objectives: To investigate the relation between current flexibility training protocols, including stretching, and hamstring strain rates (HSRs) in English professional football clubs. Method: Questionnaire based data on flexibility training methods and HSRs were collected from 30 English professional football clubs in the four divisions during the 1998/99 season. Data were coded and analysed using cross tabulation, correlation, and multiple regression. Results: Flexibility training protocols were characterised by wide variability, with static stretching the most popular stretching technique used. Hamstring strains represented 11% of all injuries and one third of all muscle strains. About 14% of hamstring strains were reinjuries. HSRs were highest in the Premiership (13.3 (9.4)/1000 hours) with the lowest rates in Division 2 (7.8 (2.9)/1000 hours); values are mean (SD). Most (97%) hamstring strains were grade I and II, two thirds of which occurred late during training/matches. Forwards were injured most often. Use of the standard stretching protocol (SSP) was the only factor significantly related to HSR (r = –0.45, p = 0.031) in the correlation analysis, suggesting that the more SSP is used, the lower the HSR. About 80% of HSR variability was accounted for by stretching holding time (SHT), SSP, and stretching technique (STE) in the multiple regression equation: HSR = 37.79 – (0.33SHT – 10.05SSP + 2.24STE) ± 2.34. SHT (negatively correlated with HSR) was the single highest predictor, and accounted for 30% of HSR variability, and an additional 40% in combination with SSP. Conclusions: Flexibility training protocols in the professional clubs were variable and appeared to depend on staffing expertise. Hamstring stretching was the most important training factor associated with HSR. The use of SSP, STE, and SHT are probably involved in a complex synergism which may reduce hamstring strains. Modification of current training patterns, especially stretching protocols, may reduce HSRs in professional footballers.
Dadebo, B; White, J; George, K
Streptococcal myositis is a very rare bacterial infection of muscle with a high mortality. Diagnosis is difficult because of the paucity of clinical signs and symptoms at the onset. However, presentation of the disease appears to have changed over the last 50 years. A case of streptococcal myositis is presented (misdiagnosed as hamstring injury), which more closely reflects the current
N Kang; D Antonopoulos; A Khanna
Proximal hamstring injury represents a spectrum of trauma to either the bone or the soft tissues. Injuries can be complete or incomplete. Complete injuries usually require surgical treatment.We discuss the operative management of eight consecutive cases of chronic complete proximal hamstring injuries (injury to surgery >2.5 months). Of the eight patients, three patients had soft tissue avulsions, which were reattached
G. Shyamalan; M. Bircher
Water skiing is associated with severe injuries to the proximal hamstring muscles. We wanted to define the mechanism of injury, describe the associated patho logic changes, determine the functional limitations of patients, and suggest measures to prevent injury. Twelve patients with water skiing-related hamstring injuries were included. Six patients were experienced skiers and six were novices. The mechanism of injury
Peter I. Sallay; Robert L. Friedman; Philip G. Coogan; William E. Garrett
Background: The incidence of hamstring muscle injuries in professional rugby union is high, but evidence-based information on risk factors and injury-prevention strategies in this sport is limited.Purpose: To define the incidence, severity, and risk factors associated with hamstring muscle injuries in professional rugby union and to determine whether the use of hamstring strengthening and stretching exercises reduces the incidence and
John H. M. Brooks; Colin W. Fuller; Simon P. T. Kemp; Dave B. Reddin
ObjectivesAlthough previous research shows that the hamstring length–tension relationship during eccentric contractions plays a role in hamstring injury, training methods to promote beneficial adaptations are still unclear. The purpose of this pilot study was to determine whether an eccentric hamstring specific training programme results in favourable adaptations.
Ross Clark; Adam Bryant; John-Paul Culgan; Ben Hartley
Hamstring strain injuries often occur near the proximal musculotendon junction (MTJ) of the biceps femoris. Post-injury remodeling can involve scar tissue formation, which may alter contraction mechanics and influence re-injury risk. The purpose of this study was to assess the affect of prior hamstring strain injury on muscle tissue displacements and strains during active lengthening contractions. Eleven healthy and eight subjects with prior biceps femoris injuries were tested. All previously injured subjects had since returned to sport and exhibited evidence of residual scarring along the proximal aponeurosis. Subjects performed cyclic knee flexion-extension on an MRI-compatible device using elastic and inertial loads, which induced active shortening and lengthening contractions, respectively. CINE phase-contrast imaging was used to measure tissue velocities within the biceps femoris during these tasks. Numerical integration of the velocity information was used to estimate two-dimensional tissue displacement and strain fields during muscle lengthening. The largest tissue motion was observed along the distal MTJ, with the active lengthening muscle exhibiting significantly greater and more homogeneous tissue displacements. First principal strains magnitudes were largest along the proximal MTJ for both loading conditions. The previously injured subjects exhibited less tissue motion and significantly greater strains near the proximal MTJ. We conclude that localized regions of high tissue strains during active lengthening contractions may predispose the proximal biceps femoris to injury. Furthermore, post-injury remodeling may alter the in-series stiffness seen by muscle tissue and contribute to the relatively larger localized tissue strains near the proximal MTJ, as was observed in this study.
Silder, Amy; Reeder, Scott B.; Thelen, Darryl G.
BACKGROUND: Hamstring injury is one of the most common injuries affecting gaelic footballers, similar to other field sports. Research in other sports on whether residual hamstring weakness is present after hamstring injury is inconsistent, and no study has examined this factor in irish gaelic footballers. The aim of this study was to examine whether significant knee muscle weakness is present
Kieran O'Sullivan; Brian O'Ceallaigh; Kevin O'Connell; Amir Shafat
ObjectiveHamstring injuries are a common occurrence among professional football cheerleaders. The purpose of this study is to identify the effects of an eccentric, closed-chain hamstring exercise intervention on hamstring injury–associated pain during the course of the football season among professional football cheerleaders.
Jay S. Greenstein; Barton N. Bishop; Jean S. Edward; Robert V. Topp
Holder-Powell HM, Rutherford OM. Unilat- eral lower limb injury: its long-term effects on quadriceps, hamstring, and plantarflexor muscle strength. Arch Phys Med Rehabil 1999;80:717-720. Objective: To ascertain if long-term deficits in quadriceps, hamstring, and plantarflexor muscle strength remain after unilateral lower-limb musculoskeletal injury and to quantify whether improvements in performance continue once a subject concludes rehabilitation and returns to everyday
Heather M. Holder-Powell; Olga M. Rutherford
Hamstring injuries are the most prevalent muscle injury in sports involving rapid acceleration and maximum speed running. Injury typically occurs in an acute manner through an eccentric mechanism at the terminal stages of the swing phase of gait. Biceps femoris is most commonly injured. Re-injury rates are high and management is a challenge given the complex multi-factorial aetiology. The high
Wayne Hoskins; Henry Pollard
Background: Hamstring strain injuries are among the most common injuries seen in sports. Management is made difficult by the high recurrence rates. Typical time to return to sport varies but can be prolonged with recurrence. Eccentric strength deficits remain post?injury, contributing to reinjury. Eccentric training has shown to be an effective method at prevention of hamstring injury in multiple systematic reviews and prospective RCTs but limited prospective rehabilitation literature. Functional dry needling is a technique that has been reported to be beneficial in the management of pain and dysfunction after muscle strains, but there is limited published literature on its effects on rehabilitation or recurrence of injury. Purpose: The purpose of this case report is to present the management and outcomes of a patient with hamstring strain, treated with functional dry needling and eccentric exercise. Case Description: The subject was an 18?year?old collegiate pole?vaulter who presented to physical therapy with an acute hamstring strain and history of multiple strains on uninvolved extremity. He was treated in Physical Therapy three times per week for 3 weeks with progressive eccentric training and 3 sessions of functional dry needling. Outcomes: By day 12, his eccentric strength on the involved extremity was greater than the uninvolved extremity and he reported clinically meaningful improvement in outcome scores. By Day 20, he was able to return to full sports participation without pain or lingering strength deficits. Discussion: The patient in this case report was able to return to sport within 20 days and without recurrence. He demonstrated significant decreases in pain and dysfunction with dry needling. He had greater strength on the injured extremity compared to contra?lateral previously injured extremity. Conclusions: This case illustrates the use of functional dry needling and eccentric exercise leading to a favorable outcome in a patient with hamstring strain. Level of Evidence: Level 4
Westrick, Richard B.; Zylstra, Edo; Johnson, Michael R.
The hamstring muscles, located in the posterior thigh, include the biceps femoris, the semimembranosus, and the semitendinosus. The proximal portions of the hamstring muscles are subject to a variety of injuries and pathology. Many of these entities affect the origin of the hamstrings, including the tendinous enthesis, the underlying ischial tuberosity, and the surrounding tissues. Tendinosis and small partial tears at the origin are the result of chronic attrition. They may be accompanied by bursitis or hamstring syndrome. Apophysitis occurs in teenagers prior to complete fusion of the ischial apophysis and results from repeated traction injuries on the apophysis without discrete displacement. Abrupt injury at the origin from forced flexion of the hip results in osseous avulsions of the apophysis in teenagers and proximal tendon ruptures in adults. Other entities affect the muscles distal to the tendon origins. These injuries include strains and partial tears of the musculotendinous junction from acute indirect trauma, delayed onset muscle soreness from overuse of the muscle group without discrete remembered injury, and contusions and myositis ossificans from direct blunt impact. The imaging features of these injuries and pathology are fairly specific and diagnostic, with the exception of some cases of myositis ossificans and chronic ischial avulsions. PMID:18382942
Davis, Kirkland W
Background: Magnetic resonance (MR) imaging has established its usefulness in diagnosing hamstring muscle strain and identifying features correlating with the duration of rehabilitation in athletes; however, data are currently lacking that may predict which imaging parameters may be predictive of a repeat strain.Purpose: This study was conducted to identify whether any MR imaging-identifiable parameters are predictive of athletes at risk
George Koulouris; David A. Connell; Peter Brukner; Michal Schneider-Kolsky
Background: The hamstring muscles are well positioned to limit both anterior tibial translation and anterior cruciate ligament strain during the knee flexion phase of a jump landing. We hypothesized that systematically increasing or decreasing hamstring tension during the knee flexion phase of a simulated jump landing would significantly affect peak relative strain in the anterior cruciate ligament. Methods: Ten cadaveric knees from four male and six female donors (mean age [and standard deviation] at the time of death, 60.3 ± 23.6 years) were mounted in a custom fixture to initially position the specimen in 25° of knee flexion and simulate axial impulsive loading averaging 1700 N to cause an increase in knee flexion. Quadriceps, hamstring, and gastrocnemius muscle forces were simulated with use of pretensioned linear springs, with the tension in the hamstrings arranged to be increased, held constant, decreased, at “baseline,” or absent during knee flexion. Impulsive loading applied along the tibia and femur was monitored with use of triaxial load transducers, while uniaxial load cells monitored quadriceps and medial and lateral hamstring forces. Relative strain in the anterior cruciate ligament was measured with use of a differential variable reluctance transducer, and tibiofemoral kinematics were measured optoelectronically. For each specimen, anterior cruciate ligament strains were recorded over eighty impact trials: ten preconditioning trials, ten “baseline” trials involving decreasing hamstring tension performed before and after three sets of ten trials conducted with increasing hamstring tension, constant hamstring tension, or no hamstring tension. Peak relative strains in the anterior cruciate ligament were normalized for comparison across specimens. Results: Increasing hamstring force during the knee flexion landing phase decreased the peak relative strain in the anterior cruciate ligament by >70% compared with the baseline condition (p = 0.005). Neither a constant hamstring muscle force nor the absence of a hamstring force significantly changed the peak strain in the anterior cruciate ligament relative to the baseline condition. Conclusions: Increasing hamstring muscle force during the knee flexion phase of a simulated jump landing significantly reduces the peak relative strain in the anterior cruciate ligament in vitro. Clinical Relevance: It may be possible to proactively limit peak anterior cruciate ligament strain during the knee flexion phase of jump landings by accentuating hip flexion, thereby increasing the tension in active hamstring muscles by lengthening them.
Withrow, Thomas J.; Huston, Laura J.; Wojtys, Edward M.; Ashton-Miller, James A.
A case is reported of an adolescent sprinter who was chronically disabled by pain after non-operative management for an acute hamstring injury. He had sustained an avulsion fracture of the ischial apophysis with displacement of 2.5 cm. Avulsion fractures of the ischial apophysis with displacement of 2 cm or more are unusual, but they frequently result in a symptomatic non-union,
C. T. Servant; C. B. Jones
The aim of this study was to concurrently model the influence of a number of physical and performance parameters on subsequent incidence of hamstring injury in a squad of English Premier League soccer players. Thirty six healthy, male, elite, professional soccer players (age 22.6±5.2 years, height 1.81±0.08m, mass 75.8±9.4kg, lean mass 69.0±8.0kg) were assessed during the first week of pre-season
Gary Henderson; Christopher A. Barnes; Matthew D. Portas
Hamstring injuries are common forms of muscle strains in athletes but a complete rupture of a proximal hamstring origin is rare. Often there is a considerable delay in diagnosis and stringent treatment because of its rarity, difficulty in clinical diagnosis, and initial attempts of conservative care. We report two cases of acute complete rupture of the proximal hamstring tendons treated with early surgical repair. The diagnosis and treatment of this unusual injury are discussed.
Kwak, Ho Yoon; Choi, Yun Sun; Jang, Mun Suk
Recurrent hamstring injuries are a major problem in sports such as football. The aim of this paper was to use a clinical example to describe a treatment strategy for the management of recurrent hamstring injuries and examine the evidence for each intervention. A professional footballer sustained five hamstring injuries in a relatively short period of time. The injury was managed successfully with a seven-point programme-biomechanical assessment and correction, neurodynamics, core stability, eccentric strengthening, an overload running programme, injection therapies and stretching/relaxation. The evidence for each of these treatment options is reviewed. It is impossible to be definite about which aspects of the programme contributed to a successful outcome. Only limited evidence is available in most cases; therefore, decisions regarding the use of different treatment modalities must be made by using a combination of clinical experience and research evidence. PMID:23322894
Brukner, Peter; Nealon, Andrew; Morgan, Christopher; Burgess, Darren; Dunn, Andrew
This is a case?control study on the relationship between strength of the hamstrings and quadriceps muscle and running injuries. Sixteen male runners, who had sustained a medically treated running injury during the year prior to this study, were matched for weekly running distance and age with 16 male noninjured control runners. All subjects were fit at the time of measurement.
Willem Van Mechelen; Hynek Hlobil; Martin H. G. Rep; Wico Strobos; Han C. G. Kemper
Background: A soccer-specific balance training has been shown to decrease injury incidence of the anterior cruciate ligament and ankle sprains in randomized controlled trials. However, hamstring injuries and tendinopathy remain significant issues in soccer.Hypothesis: Proprioceptive training can reduce the incidence of hamstring muscle injuries and tendinopathy in elite soccer. There is a dose-effect relationship between balance training duration and injury
Robert Kraemer; Karsten Knobloch
The effect of a sports chiropractic manual therapy intervention on the prevention of back pain, hamstring and lower limb injuries in semi-elite Australian Rules footballers: a randomized controlled trial
BACKGROUND: Hamstring injuries are the most common injury in Australian Rules football. It was the aims to investigate whether a sports chiropractic manual therapy intervention protocol provided in addition to the current best practice management could prevent the occurrence of and weeks missed due to hamstring and other lower-limb injuries at the semi-elite level of Australian football. METHODS: Sixty male
Wayne Hoskins; Henry Pollard
Objective. The aim of this study was to investigate the interaction between hamstrings contraction and tibial translation during isometric quadriceps contraction (IQC) and their effects on cruciate ligament forces.Methods. A mathematical model of the knee in the sagittal plane was used with simple geometric representation for the model muscles, ligaments and bones. A mechanical analysis was used to calculate muscle,
A Imran; JJ O'Connor
Context Hamstrings strains are common and debilitating injuries in many sports. Most hamstrings exercises are performed at an inadequately low hip-flexion angle because this angle surpasses 70° at the end of the sprinting leg's swing phase, when most injuries occur. Objective To evaluate the influence of various hip-flexion angles on peak torques of knee flexors in isometric, concentric, and eccentric contractions and on the hamstrings-to-quadriceps ratio. Design Descriptive laboratory study. Setting Research laboratory. Patients and Other Participants Ten national-level sprinters (5 men, 5 women; age = 21.2 ± 3.6 years, height = 175 ± 6 cm, mass = 63.8 ± 9.9 kg). Intervention(s) For each hip position (0°, 30°, 60°, and 90° of flexion), participants used the right leg to perform (1) 5 seconds of maximal isometric hamstrings contraction at 45° of knee flexion, (2) 5 maximal concentric knee flexion-extensions at 60° per second, (3) 5 maximal eccentric knee flexion-extensions at 60° per second, and (4) 5 maximal eccentric knee flexion-extensions at 150° per second. Main Outcome Measure(s) Hamstrings and quadriceps peak torque, hamstrings-to-quadriceps ratio, lateral and medial hamstrings root mean square. Results We found no difference in quadriceps peak torque for any condition across all hip-flexion angles, whereas hamstrings peak torque was lower at 0° of hip flexion than at any other angle (P < .001) and greater at 90° of hip flexion than at 30° and 60° (P < .05), especially in eccentric conditions. As hip flexion increased, the hamstrings-to-quadriceps ratio increased. No difference in lateral or medial hamstrings root mean square was found for any condition across all hip-flexion angles (P > .05). Conclusions Hip-flexion angle influenced hamstrings peak torque in all muscular contraction types; as hip flexion increased, hamstrings peak torque increased. Researchers should investigate further whether an eccentric resistance training program at sprint-specific hip-flexion angles (70° to 80°) could help prevent hamstrings injuries in sprinters. Moreover, hamstrings-to-quadriceps ratio assessment should be standardized at 80° of hip flexion.
Guex, Kenny; Gojanovic, Boris; Millet, Gregoire P.
IntroductionHamstring muscle strains can lead to an increased risk of reinjury. We recently proposed a clinical classification system for acute hamstring strains. We studied the effect of the grade of the initial injury on the subsequent risk of reinjury. We hypothesised that there would be no difference in reinjury rate between acute low grade (grade I and II) and high
T Isinkaye; N Malliaropoulos; K Tsitas; N Maffulli
The purpose of this work was to investigate the effect of multidirectional soccer-specific fatigue on hamstring muscle strength and angle of peak torque. Sixteen male semi-professional soccer players (mean±S.D.: age: 21.3±2.9 years; height 185.0±8.7cm; body mass 81.6±6.7kg) completed the SAFT90, a multidirectional, intermittent 90-min exercise protocol based on data from English Championship soccer matches. Prior to exercise (t0), at half-time
K. Small; L. McNaughton; M. Greig; R. Lovell
OBJECTIVE: To review common repetitive strain injuries (RSIs) that occur in the workplace, emphasizing diagnosis, treatment, and etiology of these conditions. QUALITY OF EVIDENCE: A MEDLINE search from January 1966 to June 1999 focused on articles published since 1990 because RSIs are relatively new diagnoses. MeSH headings that were explored using the thesaurus included "cumulative trauma disorder," "overuse injury," and "repetitive strain injury." The search was limited to English articles only, and preference was given to randomized controlled trials. MAIN MESSAGE: Repetitive strain injuries result from repeated stress to the body's soft tissue structures including muscles, tendons, and nerves. They often occur in patients who perform repetitive movements either in their jobs or in extracurricular activities. Common RSIs include tendon-related disorders, such as rotator cuff tendonitis, and peripheral nerve entrapment disorders, such as carpal tunnel syndrome. A careful history and physical examination often lead to the diagnosis, but newer imaging techniques, such as magnetic resonance imaging and ultrasound, can help in refractory cases. Conservative management with medication, physiotherapy, or bracing is the mainstay of treatment. Surgery is reserved for cases that do not respond to treatment. CONCLUSION: Repetitive strain injury is common; primary care physicians must establish a diagnosis and, more importantly, its relationship to occupation. Treatment can be offered by family physicians who refer to specialists for cases refractory to conservative management.
O'Neil, B. A.; Forsythe, M. E.; Stanish, W. D.
Injuries to the infrapatellar branch(es) of the saphenous nerve in anterior cruciate ligament reconstruction with four-strand hamstring tendon autograft: vertical versus horizontal incision for harvest
The goal of this study is to evaluate the incidence rate of iatrogenic injuries to the infrapatellar branch(es) of saphenous nerve during ACL reconstruction with four-strand hamstring tendon autograft. Retrospective review of 226 patients that underwent 230 arthroscopically assisted primary ACL reconstructions with four-strand hamstring tendon autograft, between March 2002 and December 2004. The patients were separated into two groups.
Stergios G. Papastergiou; Harilaos Voulgaropoulos; Petros Mikalef; Evangelos Ziogas; Georgios Pappis; Ioannis Giannakopoulos
Background Hamstring strains are among the most frequent injuries in sports, especially in events requiring sprinting and running. Distal tears of the hamstring muscles requiring surgical treatment are scarcely reported in the literature. Objective To evaluate the results of surgical treatment for distal hamstring tears. Design A case series of 18 operatively treated distal hamstring muscle tears combined with a review of previously published cases in the English literature. Retrospective study; level of evidence 4. Setting Mehiläinen Sports Trauma Research Center, Mehiläinen Hospital and Sports Clinic, Turku, Finland. Patients Between 1992 and 2005, a total of 18 athletes with a distal hamstring tear were operated at our centre. Main outcome measurements At follow?up, the patients were asked about possible symptoms (pain, weakness, stiffness) and their return to the pre?injury level of sport. Results The final results were rated excellent in 13 cases, good in 1 case, fair in 3 cases and poor in 1 case. 14 of the 18 patients were able to return to their former level of sport after an average of 4?months (range 2–6?months). Conclusions Surgical treatment seems to be beneficial in distal hamstring tears in selected cases.
Lempainen, Lasse; Sarimo, Janne; Mattila, Kimmo; Heikkila, Jouni; Orava, Sakari
Although high rates of ACL injuries are seen in contact sports, the majority of injuries occur as a result of a no contact mechanism. The mechanism causing this injury usually falls into one of three categories: planting and cutting, straight knee landing, and one-step stop landing with the knee in hyperextension. Depending on the specific parameters of the group assessed,
Meghan Eileen Lyons
Background Muscle strains are one of the most common complaints treated by physicians. High-force lengthening contractions can produce\\u000a very high forces resulting in pain and tissue damage; such strains are the most common cause of muscle injuries. The hamstring\\u000a muscles are particularly susceptible as they cross two joints and regularly perform lengthening contractions during running.\\u000a We describe a patient with return
Brett B. Clark; David Jaffe; R. Frank Henn; Richard M. Lovering
Computational models are often used as tools to study traumatic brain injury. The fidelity of such models depends on the incorporation\\u000a of an appropriate level of structural detail, the accurate representation of the material behavior, and the use of an appropriate\\u000a measure of injury. In this study, an axonal strain injury criterion is used to estimate the probability of diffuse
Rika M. Wright; K. T. Ramesh
Background: Musculotendinous stiffness provides an estimate of resistance to joint perturbation, thus contributing to joint stability. Females demonstrate lesser hamstring stiffness than males, potentially contributing to the sex discrepancy in anterior cruciate ligament injury risk. However, it is unclear if the sex difference in hamstring stiffness is due to differences in muscle size or to inherent\\/material prop- erties of the
J. Troy Blackburn; David R. Bell; Marc F. Norcross; Jeff D. Hudson; Megan H. Kimsey
Background: Hamstring muscle strains often recur. The authors studied the effect of the grade of initial injury on the subsequent risk of reinjury.Hypothesis: No difference in reinjury rate between acute low-grade (grades I and II) and high-grade (III and IV) hamstring muscle strains would be seen.Study Design: Cohort study (prognosis); Level of evidence, 1.Methods: Between 1999 and 2007, the authors
Nikolaos Malliaropoulos; Tomide Isinkaye; Kostas Tsitas; Nicola Maffulli
The purpose of this study was to assess the limits of hamstring tightness in 369 children by using three common tests. The straight leg-raise test averaged 100 degrees at birth, increasing to 110 degrees at age 1 year, before decreasing to 80 degrees by age 5-6 years. It then remained constant to skeletal maturity. Hamstring tightness is present if this angle is < 80 degrees in children younger than 2 years. After this age, the limit decreased steadily to plateau at 60 degrees by the age of 6 years. The popliteal angle measured the maximum 180 degrees from birth to age 2 years. This angle then decreased to average 155 degrees by age 6 years and remained steady. An angle < 125 degrees suggests significant hamstring tightness. The touching-toes test showed minimal variation between age groups averaging, 1 +/- 3 cm. Distances reached < -5 cm in children aged up to 6 years and < -15 cm in those older than 6 indicate excessively tight hamstrings. Little difference was seen between sides, although girls demonstrated less hamstring tightness. All tests showed a positive correlation with the grade of ligamentous laxity, but no association with the child's stage of puberty could be detected. PMID:8989707
Kuo, L; Chung, W; Bates, E; Stephen, J
Background and objectivesHamstring tightness is present in almost all population of the world. Poor hamstring flexibility in often associated with injuries to the lower back and lower extremities in athletes. Improper training often results in diminished flexibility. Stretching has been promoted for years as an integral part of training programme to decrease the risk of injury. Static stretching and ballistic
C K Kishore Kumar; Surajeet Chakrabarty
The present study examined the neuromuscular activation characteristics of the hamstrings during the 'Nordic' hamstrings exercise (NHE) and changes in the eccentric strength of the knee flexors with NHE training. Initially, the normalised root mean square electromyographic (EMG) activity of the hamstrings of both limbs during various phases (90-61°, 60-31° and 30-0° of knee extension) of the NHE were determined in 18 soccer players. Subsequently participants were randomly allocated to either a training (n=10) or control group. The isokinetic eccentric peak torques of the dominant and non-dominant limbs were recorded at 60, 120 and 240°/s pre- and post-training. The EMG values of both limbs were comparable (P=0.184) and greater EMG activity was recorded at more extended knee positions of the NHE (P=0.001). 4 weeks of NHE training significantly improved peak torque by up to 21% in all assessment conditions. Data indicate the hamstrings of both limbs are engaged identically during the NHE and training results in gains in the eccentric peak torque of the hamstrings of both limbs; these gains may augment the force that the hamstrings can withstand when forcefully stretched, attenuating injury risk. PMID:22895870
Iga, J; Fruer, C S; Deighan, M; Croix, M D S; James, D V B
Objective: Hamstring injuries can be quite debilitating and often result in chronic problems. Eccentric muscle actions are often the last line of defense against muscle injury and ligament disruption. Traditionally, the focus of hamstring strength rehabilitation has been on concentric muscle actions. The purpose of our study was to compare hamstring muscle strength gains in concentric and eccentric hamstring strength training. Design and Setting: A randomized-group design was used to examine differences in 1-repetition maximum (1 RM) and isokinetic strength values among 3 groups of subjects. Subjects were tested in a biomechanics laboratory using an isokinetic dynamometer, while training was carried out in a physical therapy outpatient clinic. Subjects: Twenty-seven healthy male subjects (age = 22.9 ± 3.1 years, wt = 81.8 ± 12.9 kg, ht = 178.6 ± 7.2 cm) participated in this study. Subjects were randomly assigned to 1 of 3 treatment groups: eccentric training, concentric training, or control. Measurements: Subjects performed hamstring curls using an isotonic weight training device. Pretest 1 RM weight values were determined for all subjects using a standardized 1 RM protocol. In addition, maximum concentric and eccentric isokinetic strength values for knee-flexion strength were determined. Control group subjects refrained from weight training for 6 weeks. Subjects in the training groups trained 2 days per week for 6 weeks (12 sessions). After 6 weeks of training, all subjects returned for 1RM and isokinetic posttesting. Results: The concentric group improved 19%, while the eccentric group improved 29%. The control group subjects did not show any significant change over the 6 weeks. In addition, there were improvements in eccentric isokinetic peak torque/ body weight ratios at both 60 °s and 180° from pretesting to posttesting in the eccentric training group only. Conclusions: Our results demonstrate the effectiveness of isotonic strength training on the development of hamstring muscle strength. More important is the dramatic effect of eccentric strength training on overall hamstring muscle strength, both isotonic and isokinetic. Clinicians should consider using eccentric hamstring strengthening as part of their rehabilitation protocols for hamstring and knee injuries. ImagesFigure 1.
Kaminski, Thomas W.; Wabbersen, Chuck V.; Murphy, Robert M.
Along with the enjoyment and the other positive benefits of sport participation, there is also the risk of injury that is elevated in contact sport. This review provides a summary of injury incidence in Australian rules football (ARF), identifies injury risk factors, assesses the efficacy of interventions to reduce injury risk and makes recommendations for future research. The most common injuries were found to be muscle strains, particularly hamstrings; joint ligament sprains, especially ankle; haematomas and concussion. The most severe joint injury was anterior cruciate ligament rupture. Mouthguards are commonly worn and have been shown to reduce orofacial injury. There is evidence that thigh pads can reduce the incidence of thigh haematomas. There is a reluctance to wear padded headgear and an attempt to assess its effectiveness was unsuccessful due to low compliance. The most readily identified risk factor was a history of that injury. There were conflicting findings as to the influence strength imbalances or deficit has on hamstring injury risk in ARF. Static hamstring flexibility was not related to risk but low hip flexor/quadriceps flexibility increased hamstring injury risk. High lower-limb and high hamstring stiffness were associated with an elevated risk of hamstring injury. Since stiffness can be modulated through strength or flexibility training, this provides an area for future intervention studies. Low postural balance ability was related to a greater risk of ankle injury in ARF, players with poor balance should be targeted for balance training. There are preliminary data signifying a link between deficiencies in hip range of motion and hip adductor strength with groin pain or injury. This provides support for future investigation into the effectiveness of an intervention for high-risk players on groin injury rate. Low cross-sectional area of core-region muscle has been associated with more severe injuries and a motor control exercise intervention that increased core muscle size and function resulted in fewer games missed due to injury. A randomized controlled trial of the effectiveness of eccentric hamstring exercise in decreasing hamstring injury rate in ARF players was unsuccessful due to poor compliance from muscle soreness; a progressive eccentric training intervention for ARF should be given future consideration. Jump and landing training reduced injury risk in junior ARF players and it would be advisable to include this component as part of a neuromuscular training intervention. A multifaceted programme of sport-specific drills for hamstring flexibility while fatigued, sport skills that load the hamstrings and high-intensity interval training to mimic match playing conditions showed some success in reducing the incidence of hamstring injuries in ARF. A countermeasure designed to reduce injury risk is more likely to be adopted by coaches and players if it also has the scope to enhance performance. PMID:23529288
This study correlates force generation and healing in muscle after controlled strain injury. Right tibialis ante rior (TA) muscles from 30 rabbits were strained to approximately 80% of failure while the left TA muscles served as control. Both injured and control muscles were then tested for ability to generate force. Seven animals were sacrificed immediately after testing and the muscles
Pantelis K. Nikolaou; Beth L. Macdonald; Richard R. Glisson; Anthony V. Seaber; William E. Garrett
We introduce an anatomic reconstruction technique for the medial patellofemoral ligament using a free hamstring autograft in skeletally immature patients. We dock the 2 ends of the graft in the superior-medial patella using sockets and secure the femoral graft attachment in a socket tunnel distal to the physis. This technique minimizes the risk of injury to the growth plate and still enables accurate and successful anatomic positioning of the hamstring autograft.
Ladenhauf, Hannah N.; Berkes, Marschall B.; Green, Daniel W.
BackgroundThe re-injury rate of the hamstring muscle group is reported as high as 12%. This emphasises the need for better testing procedures when considering increasing the workload or allowing a player to return to sport.ObjectiveTo test the between-days reliability of functional exercises of the hamstring muscles using wireless surface Electromyography (sEMG; Kine ehf).DesignThe study was a test-retest design and sEMG
K Kotila; T Sveinsson; Á Árnason
We introduce an anatomic reconstruction technique for the medial patellofemoral ligament using a free hamstring autograft in skeletally immature patients. We dock the 2 ends of the graft in the superior-medial patella using sockets and secure the femoral graft attachment in a socket tunnel distal to the physis. This technique minimizes the risk of injury to the growth plate and still enables accurate and successful anatomic positioning of the hamstring autograft. PMID:23875142
Ladenhauf, Hannah N; Berkes, Marschall B; Green, Daniel W
The structural and functional strength of a muscle immediately after an experimentally created strain injury was examined to provide clinically relevant information for the early treatment of muscle strain injuries. The extensor digitorum longus muscles of 12 adult male rabbits were studied. Contractile force and shortening, and peak load were determined for control muscles. A nondisruptive strain injury was created
Dean C. Taylor; James D. Dalton; Anthony V. Seaber; William E. Garrett
The purpose of present study was to investigate differences in myofibroblast development after haze-generating injury in different commonly used strains of mice. The inbred mouse strains used in this study were Balb/c, C57BL/6, C3H/HeJ and DBA/1J. All mice had uniform irregular phototherapeutic keratectomy with an excimer laser according to a previously published method to generate stromal haze. DBA/1J mice generated significantly greater density of alpha smooth muscle actin (SMA)-positive myofibroblasts in the anterior stroma compared to Balb/c (p < 0.05), C57BL/6 (p < 0.05) and C3H/HeJ (p < 0.01) mice. The C3H/HeJ strain had significantly lower density of SMA-positive myofibroblasts compared to other three mouse strains. These results indicate that mouse strain must be considered in designing experiments and interpreting the results of experiments in which corneal haze and myofibroblast generation is studied in mice. Further investigation of genetics underlying mouse strain variation could provide insight into the corneal wound healing and haze generation processes. PMID:23791965
Singh, Vivek; Torricelli, Andre A M; Nayeb-Hashemi, Neema; Agrawal, Vandana; Wilson, Steven E
To determine if host factors influence the time course and extent of lung injury after acute inhalation of ozone (O3), we evaluated the physiologic and biologic response of nine genetically diverse inbred strains of mice (C57BL\\/6J, 129\\/SvIm, BTBR, BALB\\/cJ, DBA\\/ 2J, A\\/J, FVB\\/NJ, CAST\\/Ei, and C3H\\/HeJ) exposed to O3 (2.0 ppm 3 h). Whole lung lavage determined that 129\\/Svlm, BTBR,
Jordan D. Savov; Gregory S. Whitehead; Jianme Wang; Guochun Liao; Jonathan Usuka; Gary Peltz; W. Michael Foster; David A. Schwartz
Fatigue may reduce a dancer's ability to maintain the muscle synergies required for stable human movement. Therefore, fatigue presents as a potential risk factor for injury in dancers. Activation patterns of the quadriceps and hamstrings muscle groups in athletic populations have been consistently reported to alter in response to fatigue during landing tasks. It is unknown whether dancers demonstrate similar muscle activation patterns, nor if dancers respond to fatiguing protocols, with regard to muscle activation, in the same manner as their athletic counter-parts. The purpose of this study was to assess quadriceps and hamstrings activation levels in a cohort of dancers performing drop landings before and after completion of a dance-specific fatigue protocol, the High Intensity Dance Performance Fitness Test. Quadriceps and hamstrings co-contraction ratios significantly increased between pre- and post-fatigue conditions in a similar fashion to that reported in the literature. Therefore, the neuromuscular activation of the knee extensors and flexors in dancers changed in response to the dance-specific fatiguing protocol. Furthermore, quadriceps and hamstrings co-contraction ratios were substantially greater than previously reported in other athletic populations, due to low hamstrings activation levels. Future investigation of dancer biomechanical adaptations to fatigue would be beneficial to further examine the potential implications for injury risk. PMID:24069945
McEldowney, Kasey M; Hopper, Luke S; Etlin-Stein, Hannah; Redding, Emma
THELEN, D. G., E. S. CHUMANOV, D. M. HOERTH, T. M. BEST, S. C. SWANSON, L. LI, M. YOUNG, and B. C. HEIDERSCHEIT. Hamstring Muscle Kinematics during Treadmill Sprinting. Med. Sci. Sports Exerc., Vol. 37, No. 1, pp. 108-114, 2005. Introduction\\/Purpose: The objective of this study was to characterize hamstring muscle kinematics during sprinting, so as to provide scientific data
DARRYL G. THELEN; ELIZABETH S. CHUMANOV; DINA M. HOERTH; THOMAS M. BEST; STEPHEN C. SWANSON; LI LI; MICHAEL YOUNG; BRYAN C. HEIDERSCHEIT
Poor muscle flexibility has often been associated with injury. Therapeutic heating modalities are frequently used to increase the extensibility of the muscle. The purpose of this study was to compare immediate changes in hamstring flexibility following the application of superficial (moist heat pack) and deep (1 MHz ultrasound) heating modalities. Twenty-four college aged subjects met the inclusion criteria and volunteered
Nicole Lee Lounsberry
In a prospective study over the two years 1981-1982, there were 1186 separate sporting injuries treated at a Sports Injury Clinic. Just over 75% of patients were aged between 16 and 25 years old, while 80% were male. Football, Rugby, Running, Squash and Rowing contributed over 70% of these injuries. The commonest injuries were to the lower limb and lumbar region. In 43% of knee injuries there was strain of the collateral ligaments, while another 26% had patello-femoral pain. Short distance running was associated with an increase in shin splints, tibial stress fractures and hamstring injuries. Long distance running was associated with an increase in ankle and foot injuries. Sports Injury Clinics can benefit the injured athlete and there appears to be a need for their development in major hospitals. PMID:6661608
Devereaux, M D; Lachmann, S M
Context : Greater hamstrings stiffness is associated with less anterior tibial translation during controlled perturbations. However, it is unclear how hamstrings stiffness influences anterior cruciate ligament (ACL) loading mechanisms during dynamic tasks. Objective : To evaluate the influence of hamstrings stiffness on landing biomechanics related to ACL injury. Design : Cross-sectional study. Setting : Research laboratory. Patients or Other Participants : A total of 36 healthy, physically active volunteers (18 men, 18 women; age = 23 ± 3 years, height = 1.8 ± 0.1 m, mass = 73.1 ± 16.6 kg). Intervention(s) : Hamstrings stiffness was quantified via the damped oscillatory technique. Three-dimensional lower extremity kinematics and kinetics were captured during a double-legged jump-landing task via a 3-dimensional motion-capture system interfaced with a force plate. Landing biomechanics were compared between groups displaying high and low hamstrings stiffness via independent-samples t tests. Main Outcome Measure(s) : Hamstrings stiffness was normalized to body mass (N/m·kg(-1)). Peak knee-flexion and -valgus angles, vertical and posterior ground reaction forces, anterior tibial shear force, internal knee-extension and -varus moments, and knee-flexion angles at the instants of each peak kinetic variable were identified during the landing task. Forces were normalized to body weight, whereas moments were normalized to the product of weight and height. Results : Internal knee-varus moment was 3.6 times smaller in the high-stiffness group (t22 = 2.221, P = .02). A trend in the data also indicated that peak anterior tibial shear force was 1.1 times smaller in the high-stiffness group (t22 = 1.537, P = .07). The high-stiffness group also demonstrated greater knee flexion at the instants of peak anterior tibial shear force and internal knee-extension and -varus moments (t22 range = 1.729-2.224, P < .05). Conclusions : Greater hamstrings stiffness was associated with landing biomechanics consistent with less ACL loading and injury risk. Musculotendinous stiffness is a modifiable characteristic; thus exercises that enhance hamstrings stiffness may be important additions to ACL injury-prevention programs. PMID:23768123
Blackburn, J Troy; Norcross, Marc F; Cannon, Lindsey N; Zinder, Steven M
Caused by strain deformation in brain tissue, diffuse axonal injury (DAI) is one of the most devastating types of traumatic brain injury; it frequently occurs in automobile crashes. Although offering detailed anatomical structures, finite-element human head models require complete knowledge of material properties of the head and need high computational capacity. Similar to a brain injury model developed in the
H. Zou; J. P. Schmiedeler
Rupture of the anterior cruciate ligament (ACL) is one of the most serious sports-related injuries and requires long recovery\\u000a time. The quadriceps and hamstring muscles are functionally important to control stability of the knee joint complex. Fatigue,\\u000a however, is an important factor that may influence stabilizing control and thus cause ACL injuries. The objective of this\\u000a study was therefore to
Mark Melnyk; Albert Gollhofer
The purpose of this study was to understand the detailed architectural properties of the human hamstring muscles. The long (BFlh) and short (BFsh) head of biceps femoris, semimembranosus (SM) and semitendinosus (ST) muscles were dissected and removed from their origins in eight cadaveric specimens (age 67.8±4.3 years). Mean fiber length, sarcomere length, physiological cross-section area and pennation angle were measured. These data were then used to calculate a similarity index (?) between pairs of muscles. The results indicated moderate similarity between BFlh and BFsh (?=0.54) and between BFlh and SM (?=0.35). In contrast, similarity was low between SM and ST (?=0.98) and between BFlh and SM (?=1.17). The fascicle length/muscle length ratio was higher for the ST (0.58) and BFsh (0.50) compared with the BFlh (0.27) and SM (0.22). There were, however, high inter-correlations between individual muscle architecture values, especially for muscle thickness and fascicle length data sets. Prediction of the whole hamstring architecture was achieved by combining data from all four muscles. These data show different designs of the hamstring muscles, especially between the SM and ST (medial) and BFlh and BFsh (lateral) muscles. Modeling the hamstrings as one muscle group by assuming uniform inter-muscular architecture yields less accurate representation of human hamstring muscle function. PMID:22564790
Kellis, Eleftherios; Galanis, Nikiforos; Kapetanos, George; Natsis, Konstantinos
Several experimental models of peripheral neuropathy show that a significant upregulation of spinal dynorphin A and its precursor peptide, prodynorphin, is a common consequence of nerve injury. A genetically modified mouse strain lacking prodynorphin does not exhibit sustained neuropathic pain after nerve injury, supporting a pronociceptive role of elevated levels of spinal dynorphin. A null mutation of the ? isoform
L. R. GARDELL; M. IBRAHIM; R. WANG; Z. WANG; M. H. OSSIPOV; T. P. MALAN JR; F Porreca; J Lai
The surgical technique for repair of acute proximal hamstring tears is relatively recent. Installation of the patient is critical. The approach is either vertical under the gluteal fold in case of a complete tear with tendon retraction of more than 6 cm, or horizontal in the gluteal fold for retraction of less than 6 cm or for partial tears. After identification and neurolysis of the sciatic nerve, transosseous tendon reinsertion is performed with three or four metal or resorbable suture anchors. A rigid brace keeping the leg at 30° of flexion is worn for few days, then replaced by an articulated knee brace for 45 days, which limits extension but allows full flexion. Rehabilitation is begun early. Thirty-four patients underwent surgery for acute proximal hamstring tear and received this treatment. All of the athletic patients were able to return to their pre-injury activities after a mean 5.7 ± 1.6 months (2.3-9.3 months). PMID:22926295
Lefevre, N; Bohu, Y; Klouche, S; Herman, S
Despite the higher incidence of anterior cruciate ligament (ACL) injuries in female than in male athletes few authors have studied the effects of gender on the outcome of ACL reconstruction. This prospective study compared the results of ACL reconstruction using the patellar tendon and hamstring techniques in men and women. We prospectively followed 80 comparable athletes (46 males, 32 females)
Alberto Gobbi; Marcin Domzalski; Jose Pascual
OBJECTIVE: Functional strength deficits associated with chronic isolated posterior cruciate ligament (PCL) insufficiency have received limited attention in the literature. The purpose of this study was to determine the eccentric and concentric isokinetic moment characteristics of the quadriceps and hamstrings in a sample of patients with isolated PCL injury. METHODS: Eccentric and concentric mean average and average peak moments were
C. L. MacLean; J. E. Taunton; D. B. Clement; W. Regan
In athletes, anterior cruciate ligament (ACL) reconstruction is recommended after injury to restore the normal knee function and allow subsequent return to sport. Successful ACL reconstruction with patellar tendon (PT) and hamstring tendon (HT) grafts combined with a well-structured rehabilitation program could bring athletes back to their previous level of sport activities. We prospectively followed-up 100 athletes who underwent ACL
Alberto Gobbi; Ramces Francisco
The main purposes of this study were to investigate the acute effects of static and dynamic lower limb stretching routines: (a) on peak torque, total external work and joint angle at peak torque of the hamstrings during maximal eccentric isokinetic leg flexion; (b) on unilateral hamstring to quadriceps (H/Q) strength ratios; as well as (c) to determine whether static and dynamic routines elicit similar responses. A total of 49 active adults completed the following intervention protocols in a randomised order on separate days: (a) non-stretching (control condition), (b) static stretching, and (c) dynamic stretching. After the stretching or control intervention, eccentric isokinetic peak torque, the angle of peak torque and total external work were assessed with participants prone at 1.04 and 3.14 rad · s(-1). Unilateral strength ratios of the knee were also recorded. Measures were compared via a fully-within-groups factorial analysis of variance (ANOVA). There were no main effects for eccentric isokinetic peak torque, angle of peak torque, total external work and unilateral H/Q strength ratios. The results suggest that dynamic and static stretching has no influence on eccentric strength profile and unilateral H/Q strength ratios and hence both forms of stretching do not reduce these two primary risk factors for muscle injury. PMID:23230900
Ayala, Francisco; De Ste Croix, Mark; Sainz De Baranda, Pilar; Santonja, Fernando
BackgroundLower-extremity strength profile can be used in injury prevention, conditioning and rehabilitation of volleyball players.ObjectivesThe goals were: (1) to describe the concentric and eccentric quadriceps (Q) and hamstrings (H) muscle function in volleyball players, (2) to evaluate the differences in Q and H strength, strength ratios and bilateral strength asymmetry among age groups, playing positions and playing levels, (3) to
V Hadzic; E Dervisevic; M Veselko
Background Muscle strains are one of the most common injuries treated by physicians. Standard conservative therapy for acute muscle strains usually involves short-term rest, ice, and non-steroidal anti-inflammatory medications, but there is no clear consensus on how to accelerate recovery. Hypothesis Local delivery of platelet-rich plasma (PRP) to injured muscles hastens recovery of function. Study Design Controlled laboratory study. We used an established animal model of injury to test the effects of autologous platelet-rich plasma PRP on recovery of contractile function. Methods In vivo, the tibialis anterior muscles (TA) of anesthetized Sprague-Dawley rats were injured by a single (large strain) lengthening contraction or multiple (small strain) lengthening contractions, both of which result in a significant injury. The TA was injected with either PRP, PPP (platelet-poor plasma, as a sham treatment), or received no treatment. Results Both injury protocols yield a similar loss of force. The PRP only had a beneficial effect at one time point after the single contraction injury protocol. However, PRP had a beneficial effect at several time points after the multiple contraction injury protocol, and resulted in a faster recovery time to full contractile function. The sham injections had no effect compared to no treatment. Conclusion Local delivery of PRP can shorten recovery time after a muscle strain injury. Recovery of muscle from the high repetition protocol has already been shown to require myogenesis, whereas recovery from a single strain does not. This difference in mechanism of recovery may explain why PRP was more effective in the high repetition protocol, as PRP is rich in growth factors that can stimulate myogenesis. Since autologous blood products are safe, PRP may be a useful product to use in clinical treatment of muscle injuries.
Hammond, Jason W.; Hinton, Richard Y.; Ann Curl, Leigh; Muriel, Joaquin M.; Lovering, Richard M.
We compared the outcome of anterior cruciate ligament reconstruction using hamstring tendon autograft with outcome using patellar tendon autograft at 2 years after surgery. Patients had an isolated anterior cruciate ligament injury and, apart from the grafts, the arthroscopic surgical technique was identical. Prospective assessment was performed on 90 patients with isolated anterior cruciate ligament injury undergoing reconstruction with a
Ian S. Corry; Jonathan M. Webb; Amanda J. Clingeleffer; Leo A. Pinczewski
Background Very little is known about the effects of applied torque about the long axis of the tibia in combination with muscle loads on anterior cruciate ligament biomechanics. The purpose of this study was to determine the effect of muscle contraction and tibial torques applied about the long axis of the tibia on anterior cruciate ligament strain behavior. Methods Six cadaver knee specimens were used to measure the strain behaviour of the anterior cruciate ligament. Internal and external axial torques were applied to the tibia when the knee was between 30° and 120° of flexion in combination with the conditions of no muscle load, isolated quadriceps load, and simultaneous quadriceps and hamstring loading. Findings The highest anterior cruciate ligament strain values were measured when the muscles were not loaded, when the knee was at 120° of flexion, and when internal tibial torques were applied to the knee. During muscle loading the highest anterior cruciate ligament strain values were measured at 30° of flexion and then the strain values gradually decreased with increase in knee flexion. During co-contraction of the quadriceps and hamstring muscles the anterior cruciate ligament was unstrained or minimally strained at 60°, 90° and 120° of knee flexion. Intepretation This study suggests that quadriceps and hamstring muscle co-contraction has a potential role in reducing the anterior cruciate ligament strain values when the knee is in deep flexion. These results can be used to gain insight into anterior cruciate ligament injury mechanisms and to design rehabilitation regimens.
Fujiya, Hiroto; Kousa, Petteri; Fleming, Braden C; Churchill, David L; Beynnon, Bruce D
OBJECTIVE: Functional strength deficits associated with chronic isolated posterior cruciate ligament (PCL) insufficiency have received limited attention in the literature. The purpose of this study was to determine the eccentric and concentric isokinetic moment characteristics of the quadriceps and hamstrings in a sample of patients with isolated PCL injury. METHODS: Eccentric and concentric mean average and average peak moments were measured for 17 patients with a history of conservatively treated isolated PCL injury using an isokinetic dynamometer. Quadriceps and hamstring isokinetic moments were recorded from 10 degree to 90 degree of knee flexion. Strength ratios were calculated and compared with those reported in the literature for healthy subjects. RESULTS: The hamstrings of the involved side (eccentric/concentric (E/C) ratio = 1.06) were significantly weaker (p<0.05) eccentrically than those of the contralateral side (E/C ratio = 1.29). All hamstrings/quadriceps (H/Q) ratios were less than the universally accepted value of 0.60 and the eccentric H/Q ratio for the injured extremity was significantly lower than the non-injured (p<0.05). In a bilateral comparison, the injured/non-injured (I/N) ratio was less than 1.00 for concentric quadriceps, eccentric quadriceps, and hamstring isokinetic moments. Calculation of the E/C ratio showed that, for the quadriceps, it was 1.08 on the injured side and 1.07 on the non-injured extremity. CONCLUSIONS: Eccentric strengthening should be an integral part of functionally rehabilitating the quadriceps and hamstrings of athletes who suffer from the complications associated with chronic isolated PCL insufficiency. ???
MacLean, C. L.; Taunton, J. E.; Clement, D. B.; Regan, W.
|Compared the differences in the concentric hamstrings to quadriceps (H:Q) ratio among athletes in different sports at three velocities. Measurement of H:Q ratio of both knees among male and female college athletes indicated that the H:Q ratio increased as velocity increased. No differences existed for the H:Q ratio for sport or side of body. (SM)|
Rosene, John M.; Fogarty, Tracey D.; Mahaffey, Brian L.
Abstract The present study directly compares the effects of experimental brain injury in two commonly used rat strains: Fisher 344 and Sprague-Dawley. We previously found that Fisher rats have a higher mortality rate and more frequent seizure attacks at the same injury level than Sprague-Dawley rats. Although strain differences in rats are commonly accepted as contributing to variability among studies, there is a paucity of literature addressing strain influence in experimental neurotrauma. Therefore this study compares outcome measures in two rat strains following lateral fluid percussion injury. Fisher 344 and Sprague-Dawley rats were monitored for changes in physiological measurements, intracranial pressure, and electroencephalographic activity. We further analyzed neuronal degeneration and cell death in the injured brain using Fluoro-Jade-B (FJB) histochemistry and caspase-3 immunostaining. Behavioral studies using the beam walk and Morris water maze were conducted to characterize strain differences in both motor and cognitive functional recovery following injury. We found that Fisher rats had significantly higher intracranial pressure, prolonged seizure activity, increased FJB-positive staining in the injured cortex and thalamus, and increased caspase-3 expression than Sprague-Dawley rats. On average, Fisher rats displayed a greater amount of total recording time in seizure activity and had longer ictal durations. The Fisher rats also had increased motor deficits, correlating with the above results. In spite of these results, Fisher rats performed better on cognitive tests following injury. The results demonstrate that different rat strains respond to injury differently, and thus in preclinical neurotrauma studies strain influence is an important consideration when evaluating outcomes.
Rolfe, Andrew; Register, David; Levasseur, Joseph E.; Churn, Severn B.; Sun, Dong
We conducted a prospective cohort study from 1993 to 1997 to determine the frequency and severity of injury in men's Canada West university football. The Canadian Intercollegiate Sport Injury Registry was used to document baseline preseason data, daily athlete participation, and subsequent injury from five varsity football teams. An injury was defined as "any injury resulting in one or more complete or partial sessions of time loss" or "any concussion or transient neck neurologic injury." The annual proportion of injured athletes ranged from 53.5% to 60.4%, with a 5-year total of 1,811 injuries. Regression analysis indicated that the rate of nonconcussion, nonneck neurologic injuries increased. Concussion (N = 110), hamstring strain (N = 88), and brachial plexus (N = 84) injuries were the most common, specific injury diagnoses. Knee injuries resulted in the highest rate of severe (greater than or equal to 7 sessions of time loss) injury and resulted in the most time loss (3,350.5 sessions). Ligament sprains and muscle strains and spasms accounted for approximately half of all injury diagnoses. A total of 1,173 injuries (65%) were related to contact between players or between players and other obstacles. Future studies should be conducted to identify risk factors for the ultimate purpose of implementing injury prevention strategies. PMID:10921643
Meeuwisse, W H; Hagel, B E; Mohtadi, N G; Butterwick, D J; Fick, G H
BackgroundFamily caregivers of individuals with stigmatized conditions can experience stigma-by-association and discrimination. Moderate-to-severe traumatic brain injury (TBI) may elicit a stigma response if there are visible physical or neurobehavioral effects of the injury. Stigma is a considerable source of stress and may contribute to caregiver strain and stress-related mental health outcomes. We measured the frequency of perceived stigma and discrimination
Sean M. Phelan; Joan M. Griffin; Wendy L. Hellerstedt; Nina A. Sayer; Agnes C. Jensen; Diana J. Burgess; Michelle van Ryn
The aim of this study was to investigate the injury incidence and injury characteristics of a Spanish sub-elite professional football team during four consecutive seasons. A team was followed prospectively from the season 2003-2004 to 2006-2007 and individual player exposure and time loss injuries were recorded during all club training sessions and matches. A total of 313 time-loss injuries were recorded. The mean injury incidence was 10.9 injuries/1000 hours (5.2 injuries/1000 training hours and 44.1 injuries/1000 match hours). The injury incidence during competitive matches was higher (p < 0.001) than in friendly matches (55.8 vs. 22.6 injuries/1000 hours). The incidence of major injuries (>28 days absence) was 0.4 injuries/1000 hours. The thigh was the most commonly (35%) injured region and caused 29% of all competitive match absence. Muscle injuries in the four main groups of the lower limbs (hamstrings, adductors, quadriceps and calf muscles) caused 43% of competitive match unavailability. The results of this study show that the risk to sustain a major injury in the course of the season was low for sub- elite footballers in comparison to elite players. Thigh strains were the first cause of absence in competition due to injury. Key points The incidence of major injuries (absence greater than 4 weeks) was lower in a Spanish sub-elite football team than in elite European teams. The risk of sustaining an injury was 2.5 fold higher (p < 0.001) in official than in friendly matches. Lower limb muscular (hamstrings, quadriceps, hip adductors and calf muscles) and joint (knee and ankle) injuries were the main causes of match unavailability.
Mallo, Javier; Gonzalez, Pablo; Veiga, Santiago; Navarro, Enrique
Groin injury is among the most common cited injuries in the sports of ice hockey, soccer, Australian Rules football, calisthenics and cricket. There are very few prospective studies examining risk factors for groin strain injury in sport. There is support for an association of previous injury and greater abductor to adductor strength ratios as well as sport specificity of training and pre-season sport-specific training, as individual risk factors in groin strain injury in athletes. Core muscle weakness or delayed onset of transversus abdominal muscle recruitment may increase the risk of groin strain injury. Debate exists in the literature regarding the role of adductor strength and length as well as age and/or sport experience as risk factors for groin injury. There is no strong evidence to support a causal association for any of these risk factors and groin injury. PMID:17887812
Maffey, Lorrie; Emery, Carolyn
The hamstring muscles are regularly implicated in recurrent injuries, movement dysfunction and low back pain. Links between limited flexibility and development of neuromusculoskeletal symptoms are frequently reported. The Bowen Technique is used to treat many conditions including lack of flexibility. The study set out to investigate the effect of the Bowen Technique on hamstring flexibility over time. An assessor-blind, prospective, randomised controlled trial was performed on 120 asymptomatic volunteers. Participants were randomly allocated into a control group or Bowen group. Three flexibility measurements occurred over one week, using an active knee extension test. The intervention group received a single Bowen treatment. A repeated measures univariate analysis of variance, across both groups for the three time periods, revealed significant within-subject and between-subject differences for the Bowen group. Continuing increases in flexibility levels were observed over one week. No significant change over time was noted for the control group. PMID:21665103
Marr, Michelle; Baker, Julian; Lambon, Nicky; Perry, Jo
Objective The objective of this study was to describe the MR and sonographic findings in latissimus dorsi (LD) muscle strain in athletes,\\u000a and to review the most common injuries described in the literature, most of which are humeral avulsions.\\u000a \\u000a \\u000a \\u000a \\u000a Material and methods Four injuries and two reinjuries of the myotendinous junction of the LD were followed from the day of injury until
Carles Pedret; Ramon Balius; Fernando Idoate
This study presents the ankle ligament strains and ankle joint moments during an accidental injury event diagnosed as a grade I anterior talofibular ligament (ATaFL) sprain. A male athlete accidentally sprained his ankle while performing a cutting motion in a laboratory setting. The kinematic data were input to a three-dimensional rigid-body foot model for simulation analyses. Maximum strains in 20 ligaments were evaluated in simulations that investigated various combinations of the reported ankle joint motions. Temporal strains in the ATaFL and the calcaneofibular ligament (CaFL) were then compared and the three-dimensional ankle joint moments were evaluated from the model. The ATaFL and CaFL were highly strained when the inversion motion was simulated (10% for ATaFL and 12% for CaFL). These ligament strains were increased significantly when either or both plantarflexion and internal rotation motions were added in a temporal fashion (up to 20% for ATaFL and 16% for CaFL). Interestingly, at the time strain peaked in the ATaFL, the plantarflexion angle was not large but apparently important. This computational simulation study suggested that an inversion moment of approximately 23 N m plus an internal rotation moment of approximately 11 N m and a small plantarflexion moment may have generated a strain of 15-20% in the ATaFL to produce a grade I ligament injury in the athlete's ankle. This injury simulation study exhibited the potentially important roles of plantarflexion and internal rotation, when combined with a large inversion motion, to produce a grade I ATaFL injury in the ankle of this athlete. PMID:23654290
Wei, Feng; Fong, Daniel Tik-Pui; Chan, Kai-Ming; Haut, Roger C
The length scales involved in the development of diffuse axonal injury typically range from the head level (i.e., mechanical loading) to the cellular level. The parts of the brain that are vulnerable to this type of injury are mainly the brainstem and the corpus callosum, which are regions with highly anisotropically oriented axons. Within these parts, discrete axonal injuries occur mainly where the axons have to deviate from their main course due to the presence of an inclusion. The aim of this study is to predict axonal strains as a result of a mechanical load at the macroscopic head level. For this, a multi-scale finite element approach is adopted, in which a macro-level head model and a micro-level critical volume element are coupled. The results show that the axonal strains cannot be trivially correlated to the tissue strain without taking into account the axonal orientations, which indicates that the heterogeneities at the cellular level play an important role in brain injury and reliable predictions thereof. In addition to the multi-scale approach, it is shown that a novel anisotropic equivalent strain measure can be used to assess these micro-scale effects from head-level simulations only. PMID:22434184
Cloots, R J H; van Dommelen, J A W; Kleiven, S; Geers, M G D
Measuring a bone's response to impact has traditionally been done using strain gauges that are attached directly to the bone. Accelerometers have also been used for this purpose because they are reusable, inexpensive and can be attached easily. However, little data are available relating measured accelerations to bone injury, or to judge if accelerometers are reasonable surrogates for strain gauges in terms of their capacity to predict bone injuries. Impacts were applied with a custom designed pneumatic impact system to eight fresh-frozen human cadaveric radius specimens. Impacts were repeatedly applied with increasing energy until ultimate failure occurred. Three multiaxial strain gauge rosettes were glued to the bone (two distally and one proximally). Two multiaxial accelerometers were attached to the distal dorsal and proximal volar aspects of the radius. Overall, peak minimum and maximum principal strains were calculated from the strain-time curves from each gauge. Peak accelerations and acceleration rates were measured parallel (axial) and perpendicular (off-axis) to the long axis of the radius. Logistic generalized estimating equations were used to create strain and acceleration-based injury prediction models. To develop strain prediction models based on the acceleration variables, Linear generalized estimating equations were employed. The logistic models were assessed according to the quasi-likelihood under independence model criterion (QIC), while the linear models were assessed by the QIC and the marginal R(2). Peak axial and off-axis accelerations increased significantly (with increasing impact energy) across all impact trials. The best injury prediction model (QIC?=?9.42) included distal resultant acceleration (p?0.001) and donor body mass index (BMI) (p?0.001). Compressive and tensile strains were best predicted by separate uni-variate models, including peak distal axial acceleration (R(2?)=?0.79) and peak off-axis acceleration (R(2?)=?0.79), respectively. Accelerometers appear to be a valid surrogate to strain gauges for measuring the general response of the bone to impact and predicting the probability of bone injury. PMID:23083198
Burkhart, Timothy A; Dunning, Cynthia E; Andrews, David M
Recognition related to the need for ergonomic design improvements among health care workers, management and administration, and equipment manufacturers is growing. The future should bring new concepts and innovations which can provide many benefits. Beyond the potential reduction in caregiver injuries, many possibilities exist to improve patient outcomes through better equipment design. As an additional benefit, applying the principles of ergonomics may enhance and increase caregiver productivity through a reduction of patient transfers required, and by minimizing staff required to ambulate patients. Another added value to applying ergonomics to equipment design is the development of convertible furnishing which could create a reduction in operating and capital expenses by reducing the need for some furnishings. Equipment such as cardiac chairs, sling scales, patient chairs, special rental surfaces, and other features might be incorporated into bed design. Ergonomic programs make sense and provide opportunities to create win-win situations throughout the health care industry. Current and future innovations will provide improvements resulting in outcomes from which everyone will benefit. These benefits include a higher quality of work life for health care workers and an improved quality of care for patients. PMID:12846458
Fragala, Guy; Bailey, Livia Pontani
Context: An arthrogenic muscle response (AMR) of the soleus and peroneal muscles has been previously demonstrated in individuals with chronic ankle instability (CAI), but the presence of AMR in muscles acting on joints proximal to unstable ankles has not been previously explored. Objective: To determine if AMR is present in the quadriceps and hamstrings muscles of those with and without unilateral CAI. Design: Case control. Setting: University research laboratory. Patients or Other Participants: Twenty subjects with unilateral CAI (12 males, 8 females: age = 19.9 ± 3.7 years; height = 170.3 ± 15.6 cm; mass = 78.0 ± 23.1 kg) and 21 controls (16 males, 5 females: age = 23.2 ± 5.4 years; height = 173.9 ± 12.7 cm; mass = 87.2 ± 24.6 kg) with no previous ankle injuries. Main Outcome Measure(s): The central activation ratio (CAR), a measure of motoneuron pool excitability during maximal voluntary isometric contraction, for the hamstrings and quadriceps muscles was measured in both limbs using the superimposed burst technique. Results: The CAI group demonstrated quadriceps CARs that were significantly larger in their involved limbs (.87 ± .09), as compared with their uninvolved limbs (.84 ± .08), whereas no significant side-to-side difference was seen in the control group (sham involved = .80 ± .11, sham uninvolved = .81 ± .11). When values from both the involved and uninvolved limbs were averaged, the hamstrings CAR was significantly lower for the CAI group (.94 ± .03) than for the control group (.96 ± .03). Conclusions: Arthrogenic inhibition of the hamstrings muscles bilaterally and facilitation of the quadriceps muscle ipsilateral to the involved limb were noted in subjects with unilateral CAI. Motoneuron pool excitability appears to be altered in muscles that act on joints proximal to the ankle in those with unilateral CAI.
Sedory, Edward J; McVey, Eric D; Cross, Kevin M; Ingersoll, Christopher D; Hertel, Jay
Background: The reason for the higher incidence of anterior cruciate ligament injury from non-contact mechanisms in female athletes is not known. Stability of the joint from dynamic restraints occurs through proprioceptive and kinaesthetic mechanisms providing a flexion moment. Reflexive muscle activation is different between the sexes, but it is unclear if sex differences exist in the ability to dynamically stabilise joints through a neuromuscular feed forward process as measured by preactivation of the muscles. Objective: To determine if the level of preactivation of the gastrocnemius and hamstring muscles during dynamic activity is affected by sex. Methods: Thirty four healthy active subjects, evenly grouped by sex, participated in the study. Maximum voluntary contraction normalised electromyographic (EMG) activity of the quadriceps, hamstrings, and gastrocnemius muscles was recorded during downhill walking (0.92 m/s) and running (2.08 m/s) on a 15° declined treadmill. Preactivation of the EMG signal was calculated by setting a mark 150 milliseconds before foot strike, as indicated by a footswitch. Multiple t tests for sex differences of preactivity mean percentage (M-EMG%) during the downhill activities were performed. Results: The female subjects had a higher M-EMG% for the medial hamstrings than the male subjects (31.73 (9.89) and 23.04 (8.59) respectively; t(2,32) = 2.732, p = 0.01) during walking. No other muscles exhibited a sex difference in M-EMG% during either activity. Conclusion: The female subjects in this study showed higher medial hamstring preactivation. However, this may be because they were not injured, indicating their propensity for joint stabilisation. A long term prospective study is required to eliminate this potential explanation. No sex difference in gastrocnemius preactivation was seen, adding to the controversy about whether this muscle contributes to feed forward joint stability. Further research of preactivation of the musculature of the leg is required.
DeMont, R; Lephart, S
To describe physical strain during activities of daily living (ADL), 44 men with spinal cord injuries (C4-L5) performed a set of standardised tasks. The physical strain was defined as the highest heart rate response expressed as a percentage of the individual heart rate reserve (%HRR). The physical strain averaged over the subjects who performed all tasks (n = 24) was
T W J Janssen; C A J M van Oers; H E J Veeger; A P Hollander; L H V van der Woude; R H Rozendal
The objective of this study was to assemble and synthesize the best available literature from 2004 to 2008 on musculoskeletal injury and pain in dancers. MEDLINE and CINAHL were the primary sources of data. Indexed terms such as dance, dancer, dancing, athletic injuries, occupational injuries, sprains and strains, musculoskeletal diseases, bone density, menstruation disturbances, and eating disorders were used to search the databases. Citations were screened for relevance using a priori criteria, and relevant studies were critically reviewed for scientific merit by the best-evidence synthesis method. After screening, 19 articles were found to be scientifically admissible. Data from accepted studies were abstracted into evidence tables relating to: prevalence and associated factors; incidence and risk factors; intervention; and injury characteristics and prognosis of musculoskeletal injury and pain in dancers. Principal findings included: a high prevalence and incidence of lower extremity, hip and back injuries; preliminary evidence that psychosocial and psychological issues such as stress and coping strategies affect injury frequency and duration; history of a previous lateral ankle sprain is associated with an increased risk of ankle sprain in the contralateral ankle in dance students; fatigue may play a role in ACL injury in dancers; acute hamstring strains in dancers affect tendon more than muscle tissue, often resulting in prolonged absence from dance. It is concluded that, while there are positive developments in the literature on the epidemiology, diagnosis, prognosis, treatment, and prevention of MSK injuries and pain in dancers, much room for improvement remains. Suggestions for future research are offered. PMID:22687721
Jacobs, Craig L; Hincapié, Cesar A; Cassidy, J David
Introduction: Less muscle elasticity of the hamstrings increases the risk of muscle strain. Muscle balance is the purpose of muscle stretching. The active knee-extension test (AKE) represents an established test of muscle elasticity. For evaluating the test results standard values are necessary. The aim of this study is to measure standard values of the AKE test in a collective of healthy male and female fitness athletes and to determine factors of muscle elasticity.Material and Methods: We performed the AKE test in 119 healthy fitness athletes (56 women, 63 men) evaluated biometric and anthropometric data, examined joint function in knee and hip activity scores (WOMAC, Lysholm score, Tegner score, UCLA-acitivity scale), psychological score (HADS scale) and clinical evidence of rheumatoid criteria (ACR). Unpaired t-test and multiple regressions were calculated.Results: The average knee extension deficit was as measured 31.6 ± 12.6° (men: 35.6 ± 10.4°; women 27.1 ± 13.5°, p = 0.0002), factors like "female gender", "physical work", "sports activities for many years", "hip flexion" and "body fat content" influence the muscle elasticity.Discussion: For the first time, standard values for the AKE test are available, allowing an estimation of muscle elasticity of the hamstrings. Factors like "female gender", "physical work" and "sports activities for many years" affect the muscle elasticity, while "body fat content" and "hip flexion" are combined to female gender and are considered as indirect factors of hamstring flexibility. PMID:23784808
Schulze, A; Böhme, D; Weiss, C; Schmittner, M D
The objective of this article is to describe the clinical outcome of the transitional double-bundle procedure for anatomical ACL reconstruction. Subjects included 78 patients (average age 25 years) who had undergone ACL reconstruction with the transitional double-bundle procedure with multi-stranded hamstring tendons. The femoral socket for the anteromedial (AM) graft was created at 5-6 mm from the mid-sagittal line of the intercondylar notch at 2:00 or 10:00, and that for the posterolateral (PL) graft was drilled adjacent to the AM socket at 3:00 or 9:00. For the tibial side, two tunnels were made at the center of the footprint of the AM and PL bundles of the normal ACL. Patients were evaluated at 24 months or longer postoperatively based on the IKDC Knee Examination Form. Subjectively, 32 knees (41%) were graded as normal; 41 (53%), as nearly normal; 4 (5%), as abnormal; and 1 (1%) as graft rupture by re-injury. The average side-to-side difference in anterior laxity at manual maximum force with the KT-2000 arthrometer was 0.9 mm +/- 1.2. Seventy patients (93%) had a range between -1 mm and 2 mm. In conclusion the transitional double-bundle ACL reconstruction provided a satisfactory outcome after a short-term follow-up. PMID:19137278
Toritsuka, Yukiyoshi; Amano, Hiroshi; Kuwano, Masahiro; Iwai, Takao; Mae, Tatsuo; Ohzono, Kenji; Shino, Konsei
Abstract The selected strain of rodent used in experimental models of traumatic brain injury is typically dependent upon the experimental questions asked and the familiarity of the investigator with a specific rodent strain. This archival study compares the injury responsiveness and recovery profiles of two popular outbred strains, the Long-Evans (LE) and the Sprague-Dawley (SD), after brain injury induced by lateral fluid percussion injury (LFPI). General findings include a significantly longer duration of unconsciousness in LE rats, but similar durations of apnea. Both strains displayed the same level of initial FPI-induced behavioral deficits, followed by a more rapid rate of functional recovery in SD rats. Cortical volume loss was not significantly different, but close inspection of the data suggests the possibility that LE rats may be more susceptible to damage in the hemisphere contralateral to the injury site than are SD rats. It is hoped that the information provided here encourages greater attention to the subtle differences and similarities between strains in future pre-clinical efficacy studies of traumatic brain injury.
Tan, Arlene A.; Quigley, Andrea; Smith, Douglas C.
Increased patellofemoral joint (PFJ) stress has been implicated in the development of PFJ pathologies. Previous studies have identified a relationship between reduced hamstring length and patellofemoral pain syndrome. Hamstring stretching is also recommended in the management thereof. However, the relationship between reduced hamstring length and PFJ stress has not been explored in vivo during activities that load the PFJ, such
Enda F. Whyte; Kieran Moran; Conor P. Shortt; Brendan Marshall
This study was undertaken to determine the effect of distal hamstring lengthening (DHL) on hip and knee sagittal kinematics, and to investigate the validity of modeled hamstring length for clinical use. Patient group consisted of 28 patients (56 limbs, mean age 7.4 years) with spastic diplegia who underwent bilateral DHL and tendo-Achilles lengthening with/without rectus femoris transfer (RFT) (DHL+RFT subgroup, 40 limbs; DHL subgroup, 16 limbs). Kinematic data was obtained by gait analysis, and hamstring lengths were obtained using a musculoskeletal modeling technique. Postoperatively, knee extension improved (p<0.001) without aggravating anterior pelvic tilt (p=0.565). However, DHL aggravated anterior pelvic tilt in the DHL subgroup (2.2 degrees, p=0.011). In terms of concurrent validity, hamstring length was found to be correlated with mean pelvic tilt (r=0.798, p<0.001) and popliteal angle (r=-0.425, p=0.001), but the correlation between hamstring length and knee flexion at initial contact was minimal (r=0.068, p=0.753). In terms of construct validity, DHL did not lengthen mean hamstring length (p=0.918). In conclusion, DHL appeared to significantly improve knee motion in patients with spastic diplegia. Furthermore, DHL did not increase pelvic tilt, when performed with RFT. Modeled hamstring length is believed to have limited validity in patients with cerebral palsy, because it does not reflect knee kinematics or postoperative change when DHL was combined with multilevel surgery. PMID:19665381
Park, Moon Seok; Chung, Chin Youb; Lee, Sang Hyeong; Choi, In Ho; Cho, Tae-Joon; Yoo, Won Joon; Park, B S Myoung Yl; Lee, Kyoung Min
ABSTRACT:: Though many different hamstring strengthening exercises exist, the effect on site specific activation of these exercises on different muscles of the leg is unclear. This study investigated the effects of the eccentric leg curl (LC) and lunge (L) exercises on the biceps femoris long head (BFl), biceps femoris short head (BFs), semitendinosus (ST), semimembranosus (SM) and adductor magnus (AM). Each leg of 11 male professional soccer players was randomly assigned to an LC or L exercise protocol (3 sets of 6 repetitions). Functional magnetic resonance imaging (fMRI) of the subjects' thighs were performed before and 48 hours after the intervention. Fifteen axial scans of the thigh interspaced by a distance of 1 / 15 right femur length (Lf) were obtained. The fMRI data were analyzed for signal intensity (SI) changes. No significant changes were observed in absolute short tau inversion recovery (STIR) values for the SM and BFs. Significant changes for the ST (?21-45%) from sections 4 to 10, AM (?2-13%) at section 4, and BFl (? -3 vs 8%) at section 7 were noted. LC exercises load all regions of the ST muscle. L exercises load the proximal regions of the BFl and AM. These findings may have relevance when designing protocols for prevention and rehabilitation of hamstring injuries. PMID:22592171
Mendiguchia, J; Garrues, M A; Cronin, J B; Contreras, B; Arcos, A Los; Malliaropoulos, N; Maffulli, N; Idoate, F
Although many different hamstring strengthening exercises exist, the effect on site specific activation of these exercises on different muscles of the leg is unclear. This study investigated the effects of the eccentric leg curl (LC) and lunge (L) exercises on the biceps femoris long head (BFl), biceps femoris short head (BFs), semitendinosus (ST), semimembranosus (SM), and adductor magnus (AM). Each leg of 11 male professional soccer players was randomly assigned to an LC or L exercise protocol (3 sets of 6 repetitions). Functional magnetic resonance imaging (fMRI) of the subjects' thighs were performed before and 48 hours after the intervention. Fifteen axial scans of the thigh interspaced by a distance of 1/15 right femur length (Lf) were obtained. The fMRI data were analyzed for signal intensity changes. No significant changes were observed in absolute short tau inversion recovery values for the SM and BFs. Significant changes for the ST (?21-45%) from sections 4 to 10, AM (?2-13%) at section 4, and BFl (? -3 vs. 8%) at section 7 were noted. LC exercises load all the regions of the ST muscle. The L exercises load the proximal regions of the BFl and AM. These findings may have relevance when designing protocols for prevention and rehabilitation of hamstring injuries. PMID:23443215
Mendiguchia, Jurdan; Garrues, Mirian A; Cronin, John B; Contreras, Bret; Los Arcos, Asier; Malliaropoulos, Nikos; Maffulli, Nicola; Idoate, Fernando
Two men visited our Emergency Room because of a water-ski-accident. At physical examination, there was hematoma at the upper leg with loss of strength at extension of the hip and flexion of the knee. Both patients had a palpable gap just distal of the ischial tuberosity. Further imaging by sonography and MR-scan showed a rupture of the proximal hamstring tendon. Treatment was operative refixation of the hamstring tendons at the ischial tuberosity. After treatment consisted of brace for 4 weeks after operation. Both patients returned to their pre-operatively sports, though at a lower level. Surgical treatment of a complete proximal rupture of the hamstrings is recommended in case of sportive patients. PMID:19688217
Floor, Sebastiaan; van der Veen, Alex H; Devilee, Roger J
Background Muscle injuries are one of the commonest injuries affecting athletes. It often leads to significant pain and disability causing loss of training and competition time. With current treatment, the duration to return-to-play ranges form six weeks to never, depending on injury severity. Recent researches have suggested that autologous platelet-rich plasma (PRP) injection into the injured site may hasten soft tissues healing. To-date, there has been no randomised clinical trials to evaluate the effects of PRP on muscle healing. The aim of this study is to examine the effects of autologous PRP on duration to return-to-play after muscle injury. Methods and design A randomised, single blind controlled trial will be conducted. Twenty-eight patients aged 18?years and above with a recent grade-2 hamstring injury will be invited to take part. Participants will be randomised to receive either autologous PRP injection with rehabilitation programme, or rehabilitation programme only. Participants will be followed up at day three of study and then weekly for 16?weeks. At each follow up visit, participants will be assessed on readiness to return-to-play using a set of criteria. The primary end-point is when participants have fulfilled the return-to-play criteria or end of 16?weeks. The main outcome measure of this study is the duration to return-to-play after injury. Conclusion This study protocol proposes a rigorous and potential significant evaluation of PRP use for grade-2 hamstring injury. If proven effective such findings could be of great benefit for patients with similar injuries. Trial registration Current Controlled Trials ISCRTN66528592
We report herein a very rare case of semitendinosus tear that formed a tumor in the popliteal region after not having recovered\\u000a as a result of only being instructed to rest. The soft tissue tumor was discovered on ultrasonography 4 months after pain\\u000a and sensation of discomfort appeared in the popliteal region. We considered this symptom as dependent on the presence
Yasuaki Tohma; Yoshiyuki Fujisawa; Masataka Shimaya; Toru Morishita; Yasuhito Tanaka
Repetitive strain injury is a common occupational hazard but has not been previously reported in a child. With the escalating use of computers both in the home for recreational purposes and in schools for teaching, the possible incidence of hand and wrist problems may need to be highlighted. Perhaps "hand care" instruction should be implemented in UK schools as prophylaxis. PMID:11130299
Macgregor, D M
The heterogeneity of the primary mechanical mechanism of spinal cord injury (SCI) is not currently used to tailor treatment strategies because the effects of these distinct patterns of acute mechanical damage on long-term neuropathology have not been fully investigated. A computational model of SCI enables the dynamic analysis of mechanical forces and deformations within the spinal cord tissue that would otherwise not be visible from histological tissue sections. We created a dynamic, three-dimensional finite element (FE) model of the rat cervical spine and simulated contusion and dislocation SCI mechanisms. We investigated the relationship between maximum principal strain and tissue damage, and compared primary injury patterns between mechanisms. The model incorporated the spinal cord white and gray matter, the dura mater, cerebrospinal fluid, spinal ligaments, intervertebral discs, a rigid indenter and vertebrae, and failure criteria for ligaments and vertebral endplates. High-speed (? 1 m/sec) contusion and dislocation injuries were simulated between vertebral levels C3 and C6 to match previous animal experiments, and average peak maximum principal strains were calculated for several regions at the injury epicenter and at 1-mm intervals from +5 mm rostral to -5 mm caudal to the lesion. Average peak principal strains were compared to tissue damage measured previously in the same regions via axonal permeability to 10-kD fluorescein-dextran. Linear regression of tissue damage against peak maximum principal strain for pooled data within all white matter regions yielded similar and significant (p<0.0001) correlations for both contusion (R(2)=0.86) and dislocation (R(2)=0.52). The model enhances our understanding of the differences in injury patterns between SCI mechanisms, and provides further evidence for the link between principal strain and tissue damage. PMID:22320127
Russell, Colin M; Choo, Anthony M; Tetzlaff, Wolfram; Chung, Tae-Eun; Oxland, Thomas R
Resistance to stretch, electromyographic (EMG) response to stretch, stretch discomfort and maximum range of motion (ROM) were measured during passive hamstring stretches performed in the slump test position (neural tension stretch) and in the upright position (neutral stretch) in eight healthy subjects. Stretches were performed on an isokinetic dynamometer at 5°/s with the test thigh flexed 40° above the horizontal, and the seat back at 90° to the horizontal. Surface EMG signals were recorded from the medial and lateral hamstrings during stretches. Knees were passively extended to maximum stretch tolerance with test order (neural tension vs neutral) alternated between legs. For neural tension stretches, the cervical and thoracic spine were manually flexed. Maximum ROM was 8° less for the neural tension stretch vs the neutral stretch (P<0.01). Resistance to stretch was 14-15% higher for the neural tension stretch vs the neutral stretch (P<0.001) at common joint angles in the final third of ROM. Stretch discomfort and EMG response were unaffected by neural tension. In conclusion, an increased passive resistance to stretch with the addition of neural tension during passive hamstring stretch despite no change in the EMG response indicates that passive extensibility of neural tissues can limit hamstring flexibility. PMID:20738821
McHugh, M P; Johnson, C D; Morrison, R H
Muscle strength imbalance can be an important factor in hamstrings muscle strain. A hamstrings/quadriceps (H/Q) strength ratio based on concentric peak torque values (Hcon:Qcon) has traditionally been used to describe the potential for knee-joint destabilization. Because certain standard actions in soccer are explosive, the analysis of the H/Q strength ratio based on the rate of torque development (Hrtd:Qrtd) might also be useful in the evaluation of joint stability. The objective of this study was to compare the Hrtd:Qrtd between professional soccer players with heterogeneous values of Hcon:Qcon. Thirty-nine professional soccer players took part in the following procedures on different days: 1) Familiarization session with the isokinetic dynamometer, and 2) Two maximal isometric actions and five maximal concentric actions at 60°·s(-1) for hamstrings (H) and quadriceps (Q). Participants were ranked according to their Hcon:Qcon ratio. The median third was excluded to form a high torque group (HTG), and a low torque group (LTG). Peak isometric (H) and concentric (H and Q) torques and rate of torque development (H) were significantly greater in the HTG group. Similarly, Hcon:Qcon (0.68 ± 0.02 vs. 0.52 ± 0.03) and Hrtd:Qrtd (0.54 ± 0.12 vs. 0.43 ± 0.16) were significantly greater in the HTG group than in the LTG group. There was no significant correlation between Hcon:Qcon and Hrtd:Qrtd. It can be concluded that Hcon:Qcon and Hrtd:Qrtd are determined, but not fully defined, by shared putative physiological mechanisms. Thus, the physiologic and clinical significance of Hcon:Qcon and Hrtd:Qrtd to an athlete's individual evaluation might be different. Key pointsSoccer players with high (0.66-0.70) and low (0.50-0.54) conventional concentric hamstrings:quadriceps ratios (Hcon:Qcon) tend to demonstrate similar profiles (i.e., high and low, respectively) in their rate of the torque development H/Q ratio (Hrtd:Qrtd).The lack of a significant relationship between Hcon:Qcon and Hrtd:Qrtd suggests that these ratios are determined, but not fully defined, by shared putative physiological mechanisms.Preseason screening programs that monitor hamstrings:quadriceps ratios should recognize that the physiologic and clinical significance of Hcon:Qcon and Hrfd:Qrfd to an athlete's individual evaluation might be different. PMID:24149348
Greco, Camila C; Da Silva, Wendell L; Camarda, Sérgio R A; Denadai, Benedito S
As the number of manual handling injuries in carers and nurses continues to be very high, the problem of how to prevent injury has not been solved. Despite the obvious need for optimum working environments, the literature does not really support that an ergonomics or systems approach solves the injury problem. Similarly, the evidence for training as a preventive strategy
Background: Anterior cruciate ligament reconstruction is commonly performed with autogenous hamstring tendon grafts.Purpose: To ascertain the effects of braiding on ultimate tensile strength and stiffness of hamstring tendon graft.Study Design: Controlled laboratory study.Methods: Sixteen fresh-frozen semitendinosus and gracilis tendons were harvested from eight matched (right and left) human cadaveric specimens. Both sets of hamstring tendons from each matched pair were
Peter J. Millett; Bruce S. Miller; Matthew Close; William I. Sterett; William Walsh; Richard J. Hawkins
While gender-based differences in knee joint anatomies\\/laxities are well documented, the potential for them to precipitate gender-dimorphic ACL loading and resultant injury risk has not been considered. To this end, we generated gender-specific models of ACL strain as a function of any six degrees of freedom (6DOF) knee joint load state via a combined cadaveric and analytical approach. Continuously varying
Kiyonori Mizuno; Jack T. Andrish; Antonie J. van den Bogert; Scott G. McLean
We examined the effect of fatigue of the quadriceps muscles on coactivation of the hamstring muscles and determined if the\\u000a response is different between two isokinetic speeds in ten males and ten females with no history of knee pathology. Electromyographic\\u000a data were recorded from the vastus lateralis and biceps femoris muscles during 50 maximal knee extensions at isokinetic speeds\\u000a of
Joseph P. Weir; Dennis A. Keefe; Jason F. Eaton; Robert T. Augustine; Dawn M. Tobin
Objective: To evaluate the effects of one 10-minute stretch on muscle stiffness in subjects with short hamstrings.Design: Randomized control trial.Setting: Laboratory for human movement sciences in the department of rehabilitation of a university hospital.Subjects: Sixteen students from the Department of Human Movement Sciences participated with informed consent in the experiment. Subjects were limited to men and women without a history
Jan P. K. Halbertsma; Annette I. van Bolhuis; Ludwig N. H. Göeken
Summary Hamstring tendons are widely used for anterior cruciate ligament (ACL) reconstruction of the knee. Certain anatomical considerations must be taken into account when harvesting the hamstring tendons to be used in ACL reconstruction. These anatomical considerations are discussed in this review article.
Charalambous, Charalambos Panayiotou; Kwaees, Tariq Adam
Introduction: We report results of the anterior cruciate ligament reconstruction using a four-strand hamstring graft without detachment of the tibial insertion of the tendons. Material and Methods: In 74 patients the hamstring graft was fixed using an endobutton on the femoral side and a barbed staple on the tibial side. There were 69 male and 5 female patients. The mean
M. Salman Ali; A. Kumar; S. Adnaan Ali; T. Hislop
Purpose of Study : Success in sports depends on athlete's ability to develop and perfect a specific set of coordination and joint range of motion\\/flexibility. Purpose of the study to investigate the effectiveness of Muscle Energy Technique (MET) on hamstring flexibility in normal Indian collegiate males. Material and Methods : 20 healthy collegiate male subjects with hamstring tightness were randomly
Mohd. Waseem; Shibili Nuhmani; C. S. Ram
Study Design: Systematic literature review. Objective: Investigate the literature regarding the most effective positions, techniques, and durations of stretching to improve hamstring muscle flexibility. Background: Hamstring stretching is popular among physical therapists, athletic trainers, and fitness\\/coaching professionals; however, numerous stretching methodologies have been proposed in the literature. This fact establishes a need to systematically summarize available evidence in an attempt
Laura C. Decoster; Joshua Cleland; Carolann Altieri; Pamela J. Russell
To examine stiffness, energy, and passive torque in the dynamic and static phases of a stretch maneuver in the human hamstring muscle in vivo we used a test- retest protocol and a repeated stretches protocol. Re sistance to stretch was defined as passive torque (in newton-meters) offered by the hamstring muscle group during passive knee extension as measured using an
S. Peter Magnusson; Erik B. Simonsen; Per Aagaard; Michael Kjaer
Hamstring tendons are widely used for anterior cruciate ligament (ACL) reconstruction of the knee. Certain anatomical considerations must be taken into account when harvesting the hamstring tendons to be used in ACL reconstruction. These anatomical considerations are discussed in this review article. PMID:23738306
Charalambous, Charalambos Panayiotou; Kwaees, Tariq Adam
High hamstring tendinopathy (HHT) is an overuse injury that occurs most commonly in runners. The management of HHT is often challenging and the research supporting many interventions is limited. Eccentric exercise has been proven effective in the treatment of various tendinopathies but has not been thoroughly studied with HHT. Soft tissue mobilization, including ASTYM, is often utilized in the treatment of tendinopathies, though there is limited evidence supporting this approach. The purpose of this paper is to present the case of a patient referred to physical therapy with bilateral HHT. The patient was a 41-year-old recreational runner that had an insidious onset of right buttock pain 12 months prior to initiating therapy and left buttock pain 9 months prior. Her primary complaints included an inability to run, pain with prolonged or brisk walking, and pain with sitting on hard surfaces. The patient was treated in physical therapy two times per week for 16 visits with treatment focused on eccentric hamstring strengthening and ASTYM. By her eighth visit, the patient was able to walk 2·5 miles without pain and by her 12 visit, she was able to jog 1 mile before the onset of pain. After 16 visits, the patient reported that she was approximately 95% improved, was able to run 2·5 miles without pain, and had no pain with sitting on hard surfaces. This case suggests that eccentric exercise combined with ASTYM may be an effective treatment for HHT.
McCormack, Joshua R
Strain of the medial head of the gastrocnemius muscle (GM) is a common injury that can be confirmed by ultrasound (US) or magnetic resonance imaging. We report a case of strain injury of the medial head of the GM, with a hematoma between the soleus muscle and the GM. US revealed an enlarged hypoechoic area between the soleus and the GM. By US-guided puncture, only a small amount of old blood was evacuated. Hence we undertook a surgical approach. It was performed under general endotracheal anesthesia, in the prone position. The most superficial area of hematoma was shown by US. A sharp 4-mm trocar was inserted in the posteromedial side of the calf and the hematoma was partially evacuated by suction. The cavity was washed out with saline solution. The arthroscope was then inserted. A second portal was made laterally and a shaver was inserted under optic control. The inflow pressure was not allowed to exceed 45 mm Hg. The shaver was used to remove blood coagula and fibrin septa that divided the cavity. The fibrous cavity membrane was debrided. By the end of the procedure, the circumference of the leg was reduced by 3 cm and the skin was softer on palpation. The patient was discharged the next day. One week after surgery, US examination revealed only a thin hypoechoic area in place of the previous collection. Two weeks after surgery, he was able to walk painlessly, and at 6 weeks he had regained normal walking activity. PMID:16904602
Cicvari?, Tedi; Susti?, Alan; Mileti?, Damir; Veselko, Matjaz; Mozetic, Vladimir; Spanjol, Josip
Repetitive strain injuriesof the upper extremities refer to pain in the forearm, wrist and hand, caused by excessive strain. Diagnoses include tenosynovitis, epicondylitis and carpal tunnel syndrome. Treatment is aimed at alleviating pain, restoring normal physical functioning and maintain ability to work. Preventive interventions have shown some attenuation of discomfort but no effects on disease prevalance or sick leave days. Return to work interventions seem to decrease length of sickness absences. Part time work has hastened return to work and decreased sickness absences in musculoskeletal disorders. PMID:23901734
Liira, Helena; Haukka, Eija; Karppinen, Jaro; Linnanen, Päivi; Malmivaara, Antti; Pasternack, Iris; Sirola, Joonas; Vilikari-Juntura, Eira; Waris, Eero
This study was undertaken to determine the effect of distal hamstring lengthening (DHL) on hip and knee sagittal kinematics, and to investigate the validity of modeled hamstring length for clinical use. Patient group consisted of 28 patients (56 limbs, mean age 7.4 years) with spastic diplegia who underwent bilateral DHL and tendo-Achilles lengthening with\\/without rectus femoris transfer (RFT) (DHL+RFT subgroup,
Moon Seok Park; Chin Youb Chung; Sang Hyeong Lee; In Ho Choi; Tae-Joon Cho; Won Joon Yoo; B. S. Myoung Yl Park; Kyoung Min Lee
Background: The results of revision anterior cruciate ligament reconstruction are limited in the current literature, and no studies have previously documented the outcome of revision anterior cruciate ligament reconstruction using solely hamstring tendon grafts.Hypothesis: Revision anterior cruciate ligament reconstruction with 4-strand hamstring tendon graft affords acceptable results and is comparable to reported outcomes with the bone–patellar tendon–bone graft.Study Design: Case
Lucy J. Salmon; Leo A. Pinczewski; Vivianne J. Russell; Kathryn Refshauge
The aim of the study was to evaluate changes in hamstring flexibility in 120 asymptomatic children who participated in a 6-week program consisting of one physiotherapy session per week and daily home exercises. The recruitment criteria included age (10–13 years), no pain, injury or musculoskeletal disorder throughout the previous year, physical activity limited to school sport. Subjects were randomly assigned to one of the three groups: (1) post-isometric relaxation – PIR (n?=?40), (2) static stretch combined with stabilizing exercises – SS (n?=?40) and (3) stabilizing exercises – SE (n?=?40). Hamstring flexibility was assessed with straight leg raise (SLR), popliteal angle (PA) and finger-to-floor (FTF) tests. The examinations were conducted by blinded observers twice, prior to the program and a week after the last session with the physiotherapist. Twenty-six children who did not participate in all six exercise sessions with physiotherapists were excluded from the analysis. The results obtained by 94 children were analyzed (PIR, n?=?32; SS, n?=?31; SE, n?=?31). In the PIR and SS groups, a significant (P<0.01) increase in SLR, PA, FTF results was observed. In the SE group, a significant (P<0.001) increase was observed in the SLR but not in the PA and FTF (P>0.05). SLR result in the PIR and SS groups was significantly (P<0.001) higher than in the SE group. As far as PA results are concerned, a significant difference was observed only between the SS and SE groups (P?=?0.014). There were no significant (P?=?0.15) differences regarding FTF results between the three groups. Post-isometric muscle relaxation and static stretch with stabilizing exercises led to a similar increase in hamstring flexibility and trunk forward bend in healthy 10–13-year-old children. The exercises limited to straightening gluteus maximus improved the SLR result, but did not change the PA and FTF results.
Czaprowski, Dariusz; Leszczewska, Justyna; Kolwicz, Aleksandra; Pawlowska, Paulina; Kedra, Agnieszka; Janusz, Piotr; Kotwicki, Tomasz
Background Referees in Gaelic games are exposed to injury risk in match-play and training. Little is currently know about the degree of exposure or the prevalence of injury in this group. The aim of this study was to determine the time commitment to refereeing and training in elite-level Gaelic referees and to establish, for the first time, point and period (past 12 months) prevalence of Gaelic games injury in these officials. Methods A retrospective survey was posted to the complete list of 111 male referees who officiated in elite-level competition in Gaelic football and hurling at the end of the 2005 competition season. Data were summarised using percentages with 95% Confidence Intervals. Results The response rate was 80% (n = 89). Mean age was 42 ± 6 years, ranging from 28–55 years. Forty eight percent were football referees, 25% were hurling referees and 27% refereed both football and hurling. Most referees (69%) officiated at 3–4 games weekly (range 1–6) and most (62%) trained 2–3 times per week (range 1–7). Fourteen percent (n = 12) were currently injured (95% CI 9–21%). Annual injury prevalence was 58% (95% CI 46 to 70%) for football, 50% (95% CI 33 to 67%) for hurling and 42% (95% CI 27 to 58%) for dual referee groups. Sixty percent of injuries were sustained while refereeing match play. The majority (83%, n = 40) were to the lower limb and the predominant (56%, n = 27) injury mechanism was running or sprinting. The most prevalent injuries were hamstring strain (n = 12, 25% of injuries) and calf strain (n = 9, 19% of injuries). Injury causing time off from refereeing was reported by 31% of all referees (95% CI 24 to 40%, n = 28), for a median duration of 3 weeks. Conclusion Participation in official duties and training is high in elite Gaelic games referees, despite the amateur status of the sports. Gaelic games injury is common in the referee cohort, with lower limb injury predominating. These injuries have implications for both the referee and for organisation of the games.
Blake, Catherine; Sherry, James; Gissane, Conor
Purpose: To compare the effects of a 10-week training program with two different exercises - traditional hamstring curl (HC) and Nordic hamstrings (NH), a partner exercise focusing the eccentric phase - on muscle strength among male soccer players. Methods: Subjects were 21 well- trained players who were randomized to NH training (n 5 11) or HC training (n 5 10).
Roald Mjolsnes; Arni Arnason; Tor osthagen; Truls Raastad; Roald Bahr
Recent evidence has shown acute static stretching may decrease hamstring-to-quadriceps (H:Q) ratios. However, the effects of static stretching on the functional H:Q ratio, which uses eccentric hamstrings muscle actions, have not been investigated. This study examined the acute effects of hamstrings and quadriceps static stretching on leg extensor and flexor concentric peak torque (PT), leg flexor eccentric PT, and the conventional and functional H:Q ratios. Twenty-two women (mean ± SD age=20.6 ± 1.9 years; body mass=64.6 ± 9.1 kg; height=164.5 ± 6.4 cm) performed three maximal voluntary unilateral isokinetic leg extension, flexion, and eccentric hamstring muscle actions at the angular velocities of 60 and 180°/s before and after a bout of hamstrings, quadriceps, and combined hamstrings and quadriceps static stretching, and a control condition. Two-way repeated measures ANOVAs (time × condition) were used to analyze the leg extension, flexion, and eccentric PT as well as the conventional and functional H:Q ratios. Results indicated that when collapsed across velocity, hamstrings-only stretching decreased the conventional ratios (P<0.05). Quadriceps-only and hamstrings and quadriceps stretching decreased the functional ratios (P<0.05). These findings suggested that stretching may adversely affect the conventional and functional H:Q ratios. PMID:21672027
Costa, P B; Ryan, E D; Herda, T J; Walter, A A; Defreitas, J M; Stout, J R; Cramer, J T
Children with crouch gait frequently walk with improved knee extension during the terminal swing and stance phases following hamstrings lengthening surgery; however, the mechanisms responsible for these improvements are unclear. This study tested the hypothesis that surgical lengthening enables the hamstrings of persons with cerebral palsy to operate at longer muscle-tendon lengths or lengthen at faster muscle-tendon velocities during walking.
Allison S. Arnold; May Q. Liu; Michael H. Schwartz; Sylvia Ounpuu; Luciano S. Dias; Scott L. Delp
Examining the effects of fatigue on hamstrings' functioning can provide useful information regarding their role in stabilizing the knee joint. The purpose of the present investigation was to determine the effect of fatiguing, maximum effort, reciprocal isokinetic flexion-extension movements on peak torque (PT) and average torque (AVT) of the knee flexors and extensors, and agonist and antagonist medial hamstrings (MH)
Ronald Croce; J. P. Miller; Michael Horvat
A respiratory irritant, acrolein is generated by overheating cooking oils or by domestic cooking using biomass fuels, and is in tobacco smoke, an occupational health hazard in the restaurant workplace. To better understand the metabolic role of the lung and to generate insights into the pathogenesis of acrolein-induced acute lung injury, SM/J (sensitive) and 129×1/SvJ (resistant) inbred mouse strains were exposed and the lung metabolome was integrated with the transcriptome profile. A total of 280 small molecules were identified and mean values (log 2 >0.58 or 0.58, .p<0.05) were considered different for between-strain comparisons or within-strain responses to acrolein treatment. At baseline, 24 small molecules increased and 33 small molecules decreased in the SM/J mouse lung as compared to 129×1/SvJ mouse lung. Notable among the increased compounds was malonyl carnitine. Following acrolein exposure, several compounds indicative of glycolysis and branched chain amino acid metabolism increased similarly in both strains, whereas SM/J mice were less effective in generating metabolites related to fatty acid ?-oxidation. These findings suggest management of energetic stress varies between these strains, and that the ability to evoke auxiliary energy generating pathways rapidly and effectively may be critical in enhancing survival during acute lung injury in mice.
Fabisiak, James P.; Medvedovic, Mario; Alexander, Danny C.; McDunn, Jonathan E.; Concel, Vincent J.; Bein, Kiflai; Jang, An Soo; Brendt, Annerose; Vuga, Louis J.; Brant, Kelly A.; Pope-Varsalona, Hannah; Dopico, Richard A.; Ganguly, Koustav; Upadhyay, Swapna; Li, Qian; Hu, Zhen; Kaminski, Naftali; Leikauf, George D.
Despite the growing popularity of the Feldenkrais method in Australia (Wildman 1990b), little research is available investigating its efficacy. The current study investigated the effects of the Feldenkrais method on hamstring length. Forty-eight healthy undergraduate participants were randomly allocated into either Feldenkrais, relaxation, or control groups. All subjects had their right hamstring measured using a modified active knee extension test prior to the first session, prior to the fourth (final) session, and after the final session of intervention. Two-way analysis of variance with time of measurement repeated revealed no significant differences between the groups. The findings are discussed in relation to apparent ineffectiveness of the Feldenkrais Awareness Through Movement lessons used on hamstring length, exposure time to the technique, and attitudes towards the Feldenkrais method. PMID:11676714
James, Michelle; Kolt, Gregory; McConville, Janet; Bate, Patricia
The purpose of this study was to use a holistic approach to investigate changes in jumping performance, kinaesthesia, static balance, isometric strength and fast stepping on spot during a 5-day recovery period, following an acute bout of damaging exercise consisted of drop jumps and leg curls, where specific emphasis was given on the hamstring muscles. Eleven young healthy subjects completed a series of highly intensive damaging exercises for their hamstring muscles. Prior to the exercise, and during the 5-day recovery period, the subjects were tested for biochemical markers (creatine kinase, aspartate aminotransferase, and lactate dehydrogenase), perceived pain sensation, physical performance (squat jump, counter movement jump, maximal frequency leg stamping, maximal isometric torque production and maximally explosive isometric torque production), kinaesthesia (active torque tracking) and static balance. We observed significant decreases in maximal isometric knee flexion torque production, the rate of torque production, and majority of the parameters for vertical jump performance. No alterations were found in kinaesthesia, static balance and fast stepping on spot. The highest drop in performance and increase in perceived pain sensation generally occurred 24 or 48 hours after the exercise. Damaging exercise substantially alters the neuromuscular functions of the hamstring muscles, which is specifically relevant for sports and rehabilitation experts, as the hamstrings are often stretched to significant lengths, in particular when the knee is extended and hip flexed. These findings are practically important for recovery after high-intensity trainings for hamstring muscles. Key Points Hamstring function is significantly reduced following specifically damaging exercise. It fully recovers 120 hours after the exercise. Prevention of exercise-induced muscle damage is cruicial for maintaining normal training regime.
Sarabon, Nejc; Panjan, Andrej; Rosker, Jernej; Fonda, Borut
The purpose of this study was to examine the concurrent validity of 4 clinical tests used to measure hamstring muscle length. A pilot study (N = 10) was conducted to determine the intratester reliability of 4 hamstring length measures: knee extension angle (KEA), sacral angle (SA), straight leg raise (SLR), and sit and reach (SR). The pilot investigation revealed good to excellent intratester reliability (intraclass correlation coefficient = 0.92-0.95) for each of the 4 tests. Eighty-one subjects (42 men and 39 women) participated in the main investigation. Subjects were randomly tested for each of 4 assessments of hamstring length. Concurrent validity was determined using linear regression, correlation, and kappa statistics. Correlation coefficients corresponding to the concurrent validity of the six combinations of the 4 clinical tests revealed poor to fair correlation (r = 0.45-0.65). The correlation coefficients for each pair from greatest to least were SR-SA= 0.65, SLR-SR = 0.65, KEA-SLR = 0.63, KEA-SR = 0.57, SLR-SA = 0.50, and KEA-SA = 0.45. Despite the common clinical use of these measures to assess hamstring length, these tests do not have sufficient concurrent validity to be used interchangeably or to assume that they each measure the same construct (hamstring length). Based on the results of this investigation and a review of the literature, the authors recommend that researchers, clinicians, and strength and conditioning specialists adopt the KEA test as the gold standard measure for hamstring muscle length. PMID:18550977
Davis, D Scott; Quinn, Rich O; Whiteman, Chris T; Williams, Jason D; Young, Corey R
The purpose of this study was to use a holistic approach to investigate changes in jumping performance, kinaesthesia, static balance, isometric strength and fast stepping on spot during a 5-day recovery period, following an acute bout of damaging exercise consisted of drop jumps and leg curls, where specific emphasis was given on the hamstring muscles. Eleven young healthy subjects completed a series of highly intensive damaging exercises for their hamstring muscles. Prior to the exercise, and during the 5-day recovery period, the subjects were tested for biochemical markers (creatine kinase, aspartate aminotransferase, and lactate dehydrogenase), perceived pain sensation, physical performance (squat jump, counter movement jump, maximal frequency leg stamping, maximal isometric torque production and maximally explosive isometric torque production), kinaesthesia (active torque tracking) and static balance. We observed significant decreases in maximal isometric knee flexion torque production, the rate of torque production, and majority of the parameters for vertical jump performance. No alterations were found in kinaesthesia, static balance and fast stepping on spot. The highest drop in performance and increase in perceived pain sensation generally occurred 24 or 48 hours after the exercise. Damaging exercise substantially alters the neuromuscular functions of the hamstring muscles, which is specifically relevant for sports and rehabilitation experts, as the hamstrings are often stretched to significant lengths, in particular when the knee is extended and hip flexed. These findings are practically important for recovery after high-intensity trainings for hamstring muscles. Key PointsHamstring function is significantly reduced following specifically damaging exercise.It fully recovers 120 hours after the exercise.Prevention of exercise-induced muscle damage is cruicial for maintaining normal training regime. PMID:24149148
Sarabon, Nejc; Panjan, Andrej; Rosker, Jernej; Fonda, Borut
Pain in the forearm is relatively common in the community. In the workplace forearm pain is associated with work involving frequent repetition, high forces, and prolonged abnormal postures. Nevertheless, other factors are involved in the presentation and the continuation of the pain. Notable among these factors are psychosocial issues and the workplace environment—the attitude to workers and their welfare, the physical conditions, and design of the job. Primary prevention may be effective but active surveillance is important with early intervention and an active management approach. Physical treatments have not been extensively evaluated. In the established case, management should be multidisciplinary, addressing physical aspects of the job but also addressing the "yellow, blue, and black flags" which should be viewed as obstacles to recovery. For the worker "on sick" a dialogue should be established between the worker, the primary care physician, and the workplace. Return to work should be encouraged and facilitated by medical interventions and light duty options. Rehabilitation programmes may be of use in chronic cases.
Helliwell, P; Taylor, W
Although the Feldenkrais Method is rapidly gaining popularity among health professionals, only a small body of empirical research has documented its efficacy. The aim of the current study was to investigate the effects of the Feldenkrais Method on flexibility, perceived exertion and hamstring length. In Study 1, 79 healthy participants undertook measurements of flexibility (sit and reach test), perceived exertion
Claire Hopper; Gregory S. Kolt; Janet C. McConville
Summary: As a result of the morbidity associated with anterior cruciate ligament (ACL) reconstruction with a bone-patellar-tendon-bone graft, many orthopaedic surgeons prefer hamstrings as the graft for ACL reconstruction. However, this selection is not based on solid scientific evidence. In vitro research shows that this graft cannot restore control of tibial rotation. Our recent in vivo research work has also
Anastasios D. Georgoulis; Stavros Ristanis; Vasilis Chouliaras; Constantina Moraiti; Nick Stergiou
The hamstrings limit anterior cruciate ligament (ACL) loading, and neuromuscular control of these muscles is crucial for dynamic knee joint stability. Sex differences in electromechanical delay (EMD) and rate of force production (RFP) have been reported previously, and attributed to differences in musculotendinous stiffness (MTS). These characteristics define the neuromechanical response to joint perturbation, and sex differences in these characteristics
J. Troy Blackburn; David R. Bell; Marc F. Norcross; Jeff D. Hudson; Lauren A. Engstrom
Increased knee flexion during stance is a common gait deviation in the child with cerebral palsy (CP), with distal hamstring lengthening surgeries being an accepted course of treatment. Post-operatively, improvements in gait kinematics have been reported, however little change is noted in the patterns of muscle activity as portrayed by onset and offset timing in the surface electromyographic (sEMG) signals.
Richard T. Lauer; Brian T. Smith; Patricia A. Shewokis; James J. McCarthy; Carole A. Tucker
The weak point in an ACL reconstruction immediately after surgery is the tibial fixation of the graft. This factor will often limit the return to load-inducing activities. Many new hamstring-graft fixation devices have been introduced for cruciate ligament reconstruction, but there is little comparative data on their performance. This work tested the hypotheses that some of these devices will resist
Simon D. Coleridge; Andrew A. Amis
Objective: Increased muscle flexibility from static stretching is supported by the literature, but limited research has as- sessed the duration of maintained flexibility gains in knee joint range of motion after same-day static hamstring stretching. The purpose of our study was to determine the duration of ham- string flexibility gains, as measured by an active knee-extension test, after cessation of
Glen M. DePino; William G. Webright; Brent L. Arnold
The purpose of this study was to determine the influence of hamstring muscles extensibility in standing, maximal trunk flexion with knees extended and on the bicycle in lower handlebar-hands position of highly trained cyclists. Ninety-six cyclists were recruited for the study (mean ± SD, age: 30.36 ± 5.98 years). Sagittal spinal curvatures and pelvic tilt were measured in the standing position, maximal trunk flexion with knees extended (sit-and-reach test) and while sitting on a bicycle in lower handlebar-hand position using a Spinal Mouse system. Hamstring muscles extensibility was determined in both legs by passive straight leg raise test (PSLR). The sample was divided into three groups according to PSLR angle: (1) reduced extensibility (PSLR < 80º; n = 30), (2) moderate hamstring extensibility group (PSLR = 80º – 90º; n = 35), and (3) high hamstring extensibility (PSLR = > 90º; n = 31). ANOVA analysis showed significant differences among groups for thoracic (p < 0.001) and pelvic tilt (p < 0.001) angles in the sit-and-reach test. No differences were found between groups for standing and on the bicycle position. Post hoc analysis showed significant differences in all pairwise comparisons for thoracic angle (p < 0.01) and pelvic angle (p < 0.001) in the sit-and-reach test. No differences were found in lumbar angle in any posture. In conclusion, the hamstring muscles extensibility influence the thoracic and pelvic postures when maximal trunk flexion with knees extended is performed, but not when cyclists are seated on their bicycles
Muyor, Jose M.; Alacid, Fernando; Lopez-Minarro, Pedro A.
The purpose of this study was to determine the influence of hamstring muscles extensibility in standing, maximal trunk flexion with knees extended and on the bicycle in lower handlebar-hands position of highly trained cyclists. Ninety-six cyclists were recruited for the study (mean ± SD, age: 30.36 ± 5.98 years). Sagittal spinal curvatures and pelvic tilt were measured in the standing position, maximal trunk flexion with knees extended (sit-and-reach test) and while sitting on a bicycle in lower handlebar-hand position using a Spinal Mouse system. Hamstring muscles extensibility was determined in both legs by passive straight leg raise test (PSLR). The sample was divided into three groups according to PSLR angle: (1) reduced extensibility (PSLR < 80º; n = 30), (2) moderate hamstring extensibility group (PSLR = 80º - 90º; n = 35), and (3) high hamstring extensibility (PSLR = > 90º; n = 31). ANOVA analysis showed significant differences among groups for thoracic (p < 0.001) and pelvic tilt (p < 0.001) angles in the sit-and-reach test. No differences were found between groups for standing and on the bicycle position. Post hoc analysis showed significant differences in all pairwise comparisons for thoracic angle (p < 0.01) and pelvic angle (p < 0.001) in the sit-and-reach test. No differences were found in lumbar angle in any posture. In conclusion, the hamstring muscles extensibility influence the thoracic and pelvic postures when maximal trunk flexion with knees extended is performed, but not when cyclists are seated on their bicycles. PMID:23486997
Muyor, José M; Alacid, Fernando; López-Miñarro, Pedro A
Lam RY, Ng GY, Chien EP. Does wearing a functional knee brace affect hamstring reflex time in subjects with anterior cruciate ligament deficiency during muscle fatigue? Arch Phys Med Rehabil 2002;83:1009-12. Objective: To evaluate the effects of wearing a functional knee brace and muscle fatigue on hamstring reflex time in subjects with anterior cruciate ligament (ACL) deficiency. Design: Repeated-measures clinical
Rita Y. Lam; Gabriel Y. Ng; Eric P. Chien
In this study, mid to long-term results of anterior cruciate ligament reconstruction with hamstring tendons and Transfix technique\\u000a were evaluated. Anterior cruciate ligament (ACL) reconstruction with four-strand hamstring tendon was performed with Transfix\\u000a technique on 271 (198 males, 73 females; mean age 25.7; 17–52) patients with anterior cruciate ligament ruptures. The patients\\u000a were followed up with clinical examination, Lysholm and
Mehmet Asik; Cengiz Sen; Ibrahim Tuncay; Mehmet Erdil; Cem Avci; Omer F. Taser
Piriformis syndrome is a controversial entrapment neuropathy in which the sciatic nerve is thought to be compressed by the piriformis muscle. Two patients developed severe left sciatic neuropathy after piriformis muscle release. One had a total sciatic nerve lesion, whereas the second had a predominantly high common peroneal nerve lesion. Follow-up studies showed reinnervation of the hamstrings only. We conclude that piriformis muscle surgery may be hazardous and result in devastating sciatic nerve injury. PMID:22922582
Justice, Phillip E; Katirji, Bashar; Preston, David C; Grossman, Gerald E
Objective: To assess the effects of eccentric work-induced hamstring fatigue on sagittal and transverse plane (axial) knee and ankle biodynamics and kinetics during a running crossover cut directional change (functional pivot shift). Design and Setting: A pretest-posttest, single-group intervention experimental design was employed. All data were collected in a biodynamics laboratory. Subjects: Twenty healthy athletic females were trained for 3 weeks in crossover cutting before testing. Measurements: Data were sampled during 3 unfatigued and 3 fatigued (20% eccentric isokinetic knee-flexor torque reduction) crossover cut trials. Three-dimensional kinematic and ground reaction-force data were sampled at 200 Hz and 1000 Hz, respectively, and joint moment estimates were calculated. Data were standardized to initial force-plate heelstrike for comparisons of mean differences between conditions using paired t tests with Bonferroni adjustments. Pearson product-moment correlations compared kinematic and eccentric hamstring-torque relationships. Results: During internal rotation phase 1, between heelstrike and impact absorption, mean internal rotation velocity increased by 21.2°/s ± 114°/s. During internal rotation phase II, mean peak transverse plane knee rotation during propulsion decreased by 3.1° ± 9°. During internal rotation phase II, mean peak ankle plantar flexor moment onsets occurred 12.7 ± 53 milliseconds earlier, and this activation demonstrated a moderately positive relationship with the onset of mean peak knee internal rotation during propulsion and a weak negative relationship with mean peak hamstring torque/lean body weight. Conclusions: The increased knee internal rotation velocity during phase I indicates transverse plane dynamic knee-control deficits during hamstring fatigue. Earlier peak ankle plantar-flexor moments and decreased internal rotation during phase II in the presence of hamstring fatigue may represent compensatory attempts at dynamic knee stabilization from the posterior lower leg musculature during the pivot shift portion of the crossover cut. The weak relationship between decreased hamstring torque/lean body weight and delayed knee internal rotation during propulsion further supports greater dependence on ankle plantar flexors for dynamic knee stabilization compensation ImagesFigure 1.Figure 2.Figure 3.
Nyland, John A.; Caborn, David N.M.; Shapiro, Robert; Johnson, Darren L.
Non-industrial labor is still widespread in Brazil. An appropriate approach ought to consider different social specificities from those of salaried-work relations. The scope was to examine non-industrial work practices, specifically those of extractive shellfishing, and their relation to health conditions in a small-scale fishing community. It focused on the cadences and time contingencies, as well as other working conditions, related to the development of ailments such as repetitive strain injury -RSI. A qualitative-ethnographic study was conducted between 2005 and 2007 in a community of 800 inhabitants, located on Maré Island in the state of Bahia. In a population consisting of fishing households, thirty families were interviewed, observed at work and - in cases of suspected RSI -referred to a specialized health service. The seriousness of the working conditions became evident, especially with respect to RSI. By way of illustration, an average frequency of 10,200 repetitive movements per hour were verified in extractive shellfishing, while the official Brazilian norm (NR17) for a keyboarder establishes a maximum of 8,000 movements per hour. This suggests that women shellfishers ought to be included in repetitive strain injury risk groups. PMID:21860937
Pena, Paulo Gilvane Lopes; Freitas, Maria do Carmo Soares de; Cardim, Adryanna
Isokinetic quadriceps and hamstring muscle strength and knee function 5 years after anterior cruciate ligament reconstruction: comparison between bone-patellar tendon-bone and hamstring tendon autografts.
Existing clinical studies have not proven which graft is to be preferred in anterior cruciate ligament (ACL) reconstruction. In recent years, bone-patellar tendon-bone and hamstring tendons have been the most frequently used graft types. Muscle strength deficit is one of the consequences after ACL reconstruction. The aim of this study was to evaluate possible differences in hamstring and quadriceps muscle strength and knee function 5 years after ACL reconstruction between the BPTB and the STG groups. The study group consisted of 288 patients (132 women, 156 men) with a unilateral ACL rupture who had received a BPTB (175 patients) or STG (113 patients) ACL reconstruction. Lower extremity concentric isokinetic peak extension and flexion torques were assessed at the angular velocities of 60 degrees /s and 180 degrees /s. The International Knee Documentation Committee (IKDC), the Tegner activity level, the Lysholm knee and the Kujala patellofemoral scores were also collected. Isokinetic quadriceps peak torque (percentage of the contralateral side) was 3.9% higher in the STG group than in the BPTB group at the velocity of 60 degrees /s and 3.2% higher at the velocity of 180 degrees /s and the isokinetic hamstring peak torque 2% higher in the BPTB group than in the STG group at the velocity of 60 degrees /s and 2.5% higher at the velocity of 180 degrees /s. In both groups the subjects had weaker quadriceps and hamstring muscle strength in the injured extremity compared with the uninjured one. In the single-leg hop test (according to the IKDC recommendations) there was a statistically significant difference (P = 0.040) between the groups. In the STG group, 68% of the patients had the single-leg hop ratio (injured vs. uninjured extremity) > or =90%, 31% of the patients 75-89% and 1% of the patients <75%, while in the BPTB group the corresponding percentages were 72, 21 and 7%. However, no statistically significant differences in clinical outcome were found between the groups as determined by the IKDC, Tegner activity level, Lysholm knee and Kujala patellofemoral scores. PMID:18712355
Lautamies, Riitta; Harilainen, Arsi; Kettunen, Jyrki; Sandelin, Jerker; Kujala, Urho M
Research suggests that static stretching can negatively influence muscle strength and power and may result in decreased functional performance. The dynamic warm-up (DWU) is a common alternative to static stretching before physical activity, but there is limited research investigating the effects of a DWU. The purpose of this study was to compare the acute effects of a DWU and static stretching warm-up (SWU) on muscle flexibility, strength, and vertical jump using a randomized controlled trial design. Forty-five volunteers were randomly assigned into a control (CON), SWU, or DWU group. All participants rode a stationary bicycle for 5 minutes and completed a 10-minute warm-up protocol. During this protocol, the DWU group performed dynamic stretching and running, the SWU group performed static stretching, and the CON group rested. Dependent variables were measured immediately before and after the warm-up protocol. A digital inclinometer measured flexibility (degrees) for the hamstrings, quadriceps, and hip flexor muscles. An isokinetic dynamometer measured concentric and eccentric peak torque (N·m/kg) for the hamstrings and quadriceps. A force plate was used to measure vertical jump height (meters) and power (watts). In the DWU group, there was a significant increase in hamstring flexibility (pretest: 26.4 ± 13.5°, posttest: 16.9 ± 9.4°; p < .0001) and eccentric quadriceps peak torque (pretest: 2.49 ± 0.83 N·m/kg, posttest: 2.78 ± 0.69 N·m/kg; p = 0.04). The CON and SWU did not significantly affect any flexibility, strength, or vertical jump measures (p > 0.05). The DWU significantly improved eccentric quadriceps strength and hamstrings flexibility, whereas the SWU did not facilitate any positive or negative changes in muscle flexibility, strength, power, or vertical jump. Therefore, the DWU may be a better preactivity warm-up choice than an SWU. PMID:22446678
Aguilar, Alain J; DiStefano, Lindsay J; Brown, Cathleen N; Herman, Daniel C; Guskiewicz, Kevin M; Padua, Darin A
This retrospective study compared the results after anterior cruciate ligament (ACL) reconstruction using a four-strand hamstring\\u000a tendon graft (4SHG) versus Ligament Advanced Reinforcement System (LARS) artificial ligament in 60 patients between January\\u000a 2003 and July 2004 with a minimum four-year follow-up. The KT-1000 examination, the International Knee Documentation Committee\\u000a (IKDC) scoring systems and Lysholm knee scoring scale were used to
Zhong-tang Liu; Xian-long Zhang; Yao Jiang; Bing-Fang Zeng
BackgroundSurface electromyography (sEMG) is used extensively in the assessment of hamstring muscle activity. Conventional sEMG techniques may not fully represent overall muscle activity, despite clinically standardised placement of electrodes. High density EMG provides more information about biopotential activity but it is limited to signal collection over a small surface area. Our work proposes a low density high surface area EMG
S Sakthibalan; R Twycross-Lewis; R Woledge; Y Hao; D Morrissey
Background: Ultrasound has been a widely used and well-accepted physical therapy modality for the management of musculoskeletal conditions. However, there is a lack of scientific evidence on its effectiveness. We studied the effect of two different modes of ultrasound (continuous vs pulse) in reducing the shortening of hamstrings. Methods: Thirty non-impaired men aged 20 to 30 years (mean 23.84 years)
Azadeh Shadmehr; Hasan Nadimi Astaneh
Systemic administration of kainic acid in C57BL\\/6 and FVB\\/N mice induces a comparable level of seizure induction yet results in differential susceptibility to seizure-induced cell death. While kainate administration causes severe hippocampal damage in mice of the FVB\\/N strain, C57BL\\/6 mice display no demonstrable cell loss or damage. At present, while the cellular mechanisms underlying strain-dependent differences in susceptibility remain
Paula Elyse Schauwecker
ABSTRACT To test concepts developed in our ovine model of acute respiratory distress syndrome, specifically the roles of neuropeptides and other peptide mediators, a recently developed murine model of combined smoke inhalation and burn (SB) injury was extended by applying methods for quantitative assessment of acute inflammation in the lung. Mice received SB injury per protocol, n = 5 to 7 per group. Mice were anesthetized with i.p. ketamine/xylazine, endotracheally intubated, and exposed to cooled cotton smoke (4 x 30 sec for Balb/C, 2 x 30 sec for C57BL/6). After s.c. injection of 1 mL 0.9% saline, each received a 40% total body surface area (TBSA) flame burn. Buprenorphine (0.1 mg/kg) was given i.p. for postoperative analgesia; 0.9% saline was given i.p. at 4 mL/kg per %TBSA burn. Evans Blue dye (EB) was injected i.v. 15 min before sacrifice. Lung wet/dry weight ratio was measured. In other animals, after vascular perfusion with buffered saline, lungs were sampled and analyzed for myeloperoxidase (MPO), using an EIA kit, and for their content of EB dye. There was a significant (p < 0.05) increase in EB dye content, wet/dry weight ratio, and MPO 24 h after injury in Balb/C mice. Similar increases were seen in C57BL/6 mice 48 h after SB injury, but not at 24 h. C57 mice tolerated less smoke inhalation than Balb/C mice, due to postexposure apnea, and required 48 h to show significant increases in these variables. Direct comparison between animals injured by 40% TBSA burn and 2 x 30 sec smoke exposure and sacrificed after 48 h showed significantly greater abnormality in the C57BL/6 mice. The mouse model can be used effectively to assess acute inflammation in the lung. PMID:20020853
Jacob, Sam; Deyo, Donald J; Cox, Robert A; Traber, Daniel L; Hawkins, Hal K
The aim of this study was to investigate whether the modified Tardieu scale (MTS) in a semi-standing position, used for the assessment of hamstrings spasticity, was better associated with knee extension and hamstrings activity in terminal swing than the MTS in a supine position in children with cerebral palsy (CP). Seven children diagnosed with…
Faber, Irene R.; Nienhuis, Bart; Rijs, Nique P. A. M.; Geurts, Alexander C. H.; Duysens, Jacques
To clarify the pathophysiological mechanism underlying acute renal injury caused by acute exposure to arsenic, we subcutaneously injected both BALB/c and C57BL/6 mice with sodium arsenite (NaAs; 13.5 mg/kg). BALB/c mice exhibited exaggerated elevation of serum blood urea nitrogen (BUN) and creatinine (CRE) levels, compared with C57BL/6 mice. Moreover, half of BALB/c mice died by 24 h, whereas all C57BL/6 mice survived. Histopathological examination on kidney revealed severe hemorrhages, acute tubular necrosis, neutrophil infiltration, cast formation, and disappearance of PAS-positive brush borders in BALB/c mice, later than 10 h. These pathological changes were remarkably attenuated in C57BL/6 mice, accompanied with lower intrarenal arsenic concentrations, compared with BALB/c mice. Among heavy metal inducible proteins including multidrug resistance-associated protein (MRP)-1, multidrug resistance gene (MDR)-1, metallothionein (MT)-1, and arsenite inducible, cysteine- and histidine-rich RNA-associated protein (AIRAP), intrarenal MDR-1, MT-1, and AIRAP gene expression was enhanced to a similar extent in both strains, whereas NaAs challenge augmented intrarenal MRP-1 mRNA and protein expression levels in C57BL/6 but not BALB/c mice. Moreover, the administration of a specific inhibitor of MRP-1, MK-571, significantly exaggerated acute renal injury in C57BL/6 mice. Thus, MRP-1 is crucially involved in arsenic efflux and eventually prevention of acute renal injury upon acute exposure to NaAs.
Kimura, Akihiko [Department of Forensic Medicine, Wakayama Medical University, 641-8509 Wakayama (Japan); Ishida, Yuko [Department of Forensic Medicine, Wakayama Medical University, 641-8509 Wakayama (Japan); Division of Molecular Bioregulation, Kanazawa University Cancer Research Institute, Kanazawa (Japan); Wada, Takashi [Department of Gastroenterology and Nephrology, Graduate School of Medical Science and Division of Blood Purification, Kanazawa University, Kanazawa (Japan); Yokoyama, Hitoshi [Department of Gastroenterology and Nephrology, Graduate School of Medical Science and Division of Blood Purification, Kanazawa University, Kanazawa (Japan); Mukaida, Naofumi [Division of Molecular Bioregulation, Kanazawa University Cancer Research Institute, Kanazawa (Japan); Kondo, Toshikazu [Department of Forensic Medicine, Wakayama Medical University, 641-8509 Wakayama (Japan)]. E-mail: firstname.lastname@example.org
|Many baseball players suffer from shoulder injuries related to the rotator cuff muscles. These injuries may be classified as muscular strain, tendonitis or tenosynovitis, and impingement syndrome. Treatment varies from simple rest to surgery, so it is important to be seen by a physician as soon as possible. In order to prevent these injuries, the…
Connors, G. Patrick
Participation in the sport of rowing has been steadily increasing in recent decades, yet few studies address the specific injuries incurred. This article reviews the most common injuries described in the literature, including musculoskeletal problems in the lower back, ribs, shoulder, wrist and knee. A review of basic rowing physiology and equipment is included, along with a description of the mechanics of the rowing stroke. This information is necessary in order to make an accurate diagnosis and treatment protocol for these injuries, which are mainly chronic in nature. The most frequently injured region is the low back, mainly due to excessive hyperflexion and twisting, and can include specific injuries such as spondylolysis, sacroiliac joint dysfunction and disc herniation. Rib stress fractures account for the most time lost from on-water training and competition. Although theories abound for the mechanism of injury, the exact aetiology of rib stress fractures remains unknown. Other injuries discussed within, which are specific to ribs, include costochondritis, costovertebral joint subluxation and intercostal muscle strains. Shoulder pain is quite common in rowers and can be the result of overuse, poor technique, or tension in the upper body. Injuries concerning the forearm and wrist are also common, and can include exertional compartment syndrome, lateral epicondylitis, deQuervain's and intersection syndrome, and tenosynovitis of the wrist extensors. In the lower body, the major injuries reported include generalised patellofemoral pain due to abnormal patellar tracking, and iliotibial band friction syndrome. Lastly, dermatological issues, such as blisters and abrasions, and miscellaneous issues, such as environmental concerns and the female athlete triad, are also included in this article.Pathophysiology, mechanism of injury, assessment and management strategies are outlined in the text for each injury, with special attention given to ways to correct biomechanical or equipment problems specific to rowing. By gaining an understanding of basic rowing biomechanics and training habits, the physician and/or healthcare provider will be better equipped to treat and prevent injuries in the rowing population. PMID:15974636
Rumball, Jane S; Lebrun, Constance M; Di Ciacca, Stephen R; Orlando, Karen
Dysregulation of one-carbon metabolism-related metabolic processes is a major contributor to the pathogenesis of nonalcoholic fatty liver disease (NAFLD). It is well established that genetic and gender-specific variations in one-carbon metabolism contribute to the vulnerability to NAFLD in humans. To examine the role of one-carbon metabolism dysregulation in the pathogenesis and individual susceptibility to NAFLD, we used a "population-based" mouse model where male mice from 7 inbred were fed a choline- and folate-deficient (CFD) diet for 12 wk. Strain-dependent down-regulation of several key one-carbon metabolism genes, including methionine adenosyltransferase 1? (Mat1a), cystathionine-?-synthase (Cbs), methylenetetrahydrofolate reductase (Mthfr), adenosyl-homocysteinase (Ahcy), and methylenetetrahydrofolate dehydrogenase 1 (Mthfd1), was observed. These changes were strongly associated with interstrain variability in liver injury (steatosis, necrosis, inflammation, and activation of fibrogenesis) and hyperhomocysteinemia. Mechanistically, the decreased expression of Mat1a, Ahcy, and Mthfd1 was linked to a reduced level and promoter binding of transcription factor CCAAT/enhancer binding protein ? (CEBP?), which directly regulates their transcription. The strain specificity of diet-induced dysregulation of one-carbon metabolism suggests that interstrain variation in the regulation of one-carbon metabolism may contribute to the differential vulnerability to NFLD and that correcting the imbalance may be considered as preventive and treatment strategies for NAFLD. PMID:23439872
Pogribny, Igor P; Kutanzi, Kristy; Melnyk, Stepan; de Conti, Aline; Tryndyak, Volodymyr; Montgomery, Beverly; Pogribna, Marta; Muskhelishvili, Levan; Latendresse, John R; James, S Jill; Beland, Frederick A; Rusyn, Ivan
Background Previous studies have shown that hamstring lengths are often not short in patients with cerebral palsy, which raises concerns over the benefits of distal hamstring lengthening in patients with crouch gait. In this study, the authors measured lengths of hamstrings and psoas muscles in normal subjects mimicking crouch gait and compared these with lengths in cerebral palsy patients with crouch gait. Methods Thirty-six patients with cerebral palsy and crouch gait were included in this study, and in addition, 36 age- and sex-matched normal controls were recruited. Hamstring and psoas muscle lengths in patients were evaluated using gait analysis and interactive musculoskeletal modeling software. Muscle lengths were also measured in the normal control group during normal gait and while mimicking crouch gait, and these were compared with those of cerebral palsy patient with crouch gait. Results No significant differences were observed between maximum hamstring (p=0.810) and maximum psoas (p=0.456) lengths of patients and controls mimicking crouch gait. However, patients showed significantly shorter excursions of hamstring (p=0.022) and psoas (p=0.036) muscles than controls, whereas no significant excursion differences were observed between controls during normal gait and mimicking crouch gait. Conclusions Normal controls mimicking crouch gait and cerebral palsy patients with crouch gait demonstrate similar muscle length patterns. However, mimicked crouch gait did not reproduce the excursion pattern shown by patients with crouch gait, which suggests that reduced hamstring and psoas excursion is an innate characteristic of pathologic crouch gait.
Abstract The eccentric contraction mode was proposed to be the primary stimulus for optimum angle (angle at which peak torque occurs) shift. However, the training range of motion (or muscle excursion range) could be a stimulus as important. The aim of this study was to assess the influence of the training range of motion stimulus on the hamstring optimum length. It was hypothesised that performing a single set of concentric contractions beyond optimal length (seated at 80° of hip flexion) would lead to an immediate shift of the optimum angle to longer muscle length while performing it below (supine at 0° of hip flexion) would not provide any shift. Eleven male participants were assessed on an isokinetic dynamometer. In both positions, the test consisted of 30 consecutive knee flexions at 4.19 rad · s(-1). The optimum angle was significantly shifted by ?15° in the direction of longer muscle length after the contractions at 80° of hip flexion, while a non-significant shift of 3° was found at 0°. The hamstring fatigability was not influenced by the hip position. It was concluded that the training range of motion seems to be a relevant stimulus for shifting the optimum angle to longer muscle length. Moreover, fatigue appears as a mechanism partly responsible for the observed shift. PMID:23631731
Guex, Kenny; Degache, Francis; Gremion, Gérald; Millet, Grégoire P
The purpose of this study was to examine the effects of whole-body cryotherapy (WBC) on biochemical, pain, and performance parameters during the 5-day recovery period after damaging exercise for hamstrings. Participants completed a bout of damaging exercise for the hamstring muscles on two separate occasions (control and experimental condition) separated by 10 weeks. During the control condition, subjects received no treatment after the damaging exercise. The experimental condition consisted of WBC everyday during the recovery period. WBC included single 3-min daily exposures to low temperatures (-140 to -195?°C) in the cryo-cabin. During the recovery period, subjects were tested for biochemical markers, perceived pain sensation, and physical performance (squat jump, counter movement jump, maximal isometric torque production, and maximally explosive isometric torque production). Majority of the observed variables showed statistically significant time effects (P?0.05) in control group, which indicates the presence of muscle damage. Significant interaction between the control and WBC condition was evident for the rate of torque development (P?0.05). Pain measures substantially differed between the WBC and the control condition after the exercise. Results of this study are not completely supportive of the use of WBC for recovery enhancement after strenuous training. PMID:23614691
Fonda, B; Sarabon, N
The purpose of this study is to clinically evaluate hamstring tendon anterior cruciate ligament (ACL)-reconstruction using femoral fixation with bioresorbable interference screws and with a bioresorbable transfixation device. The ACL-reconstruction using the transfixation device at the femoral side leads to less knee laxity and therefore to a better clinical outcome for the patient. Prospective randomized clinical outcome study. From February
Tim Rose; Pierre Hepp; Julia Venus; Christoph Stockmar; Christoph Josten; Helmut Lill
In this study, we compared hamstring (H) and quadriceps (Q) strength changes in men and women, as well as changes in conventional and functional H:Q ratios following an identical 12-week resistance training program. An isokinetic dynamometer was used to assess 14 male and 14 female participants before and after the intervention, and conventional…
Dorgo, Sandor; Edupuganti, Pradeep; Smith, Darla R.; Ortiz, Melchor
The purpose of this study was to investigate the effect of a simulated soccer test on the functional hamstrings-to-quadriceps ratio (H(ecc) :?Q(con)) in female soccer players. Fourteen amateur players (age, 26.1?±?4.6 years; height, 168?±?12?cm; body mass, 62.7?±?5.5?kg; body fat, 23.7?±?2.2%) performed the modified Loughborough Intermittent Shuttle Test (modified LIST). Isokinetic strength assessments of the hamstrings and quadriceps on the dominant and non-dominant legs at 120°/s were performed before and immediately after the modified LIST. H(ecc) :?Q(con) was calculated as the ratio of the peak eccentric torque of the hamstrings to the peak concentric torque of the quadriceps. A two-way univariate analysis of variance was used to assess the effect of time and leg dominance on H(ecc)?:?Q(con). The main results showed that the modified LIST led to a significant decrease in H(ecc)?:?Q(con) in the dominant (-14.1%) and non-dominant legs (-8.0%) (P?=?0.02). However, this decrease was not significantly different between dominant and non-dominant legs (P?=?0.42). These results reflect a greater risk of hamstrings tears and ACL sprains at the end of soccer matches. PMID:22107131
Delextrat, A; Baker, J; Cohen, D D; Clarke, N D
The hamstrings:quadriceps muscle strength ratio has been used as an indicator of normal balance between the knee flexors and extensors. A more functional approach to this strength ratio would be to compare opposite muscle actions of antagonistic muscle groups. The dynamic strength control ratio (DSCR) should give a more appropriate measure relating to knee function. There is a lack of
C. D. Hole; G. H. Smith; J. Hammond; A. Kumar; J. Saxton; T. Cochrane
|In this study, we compared hamstring (H) and quadriceps (Q) strength changes in men and women, as well as changes in conventional and functional H:Q ratios following an identical 12-week resistance training program. An isokinetic dynamometer was used to assess 14 male and 14 female participants before and after the intervention, and conventional…
Dorgo, Sandor; Edupuganti, Pradeep; Smith, Darla R.; Ortiz, Melchor
With over 30 million children participating in sports each year across the United States, a number of significant injuries are to be expected. Although mild injuries such as strains, sprains, and contusions predominate, catastrophic injuries do occur. Young athletes are at an increased risk for growth plate and apophyseal injuries, overuse injuries, and heat illness. Many of these sports injuries can be prevented. Prevention strategies include protective equipment, rule changes, preseason and season prevention interventions, safety measures, better coaching, education, and a societal awareness of injury and prevention. This article discusses current injury prevention for children participating in baseball, football, soccer, and ice hockey. PMID:14583164
Demorest, Rebecca A; Landry, Gregory L
Abstract Context: Because anterior cruciate ligament (ACL) injuries can occur during deceleration maneuvers, biomechanics research has been focused on the lower extremity kinetic chain. Trunk mass and changes in trunk position affect lower extremity joint torques and work during gait and landing, but how the trunk affects knee joint and muscle forces is not well understood. Objective: To evaluate the effects of added trunk load and adaptations to trunk position on knee anterior shear and knee muscle forces in landing. Design: Crossover study. Setting: Controlled laboratory environment. Patients or Other Participants: Twenty-one participants (10 men: age ?=? 20.3 ± 1.15 years, height ?=? 1.82 ± 0.04 m, mass ?=? 78.2 ± 7.3 kg; 11 women: age ?=? 20.0 ± 1.10 years, height ?=? 1.72 ± 0.06 m, mass ?=? 62.3 ± 6.4 kg). Intervention(s): Participants performed 2 sets of 8 double-leg landings under 2 conditions: no load and trunk load (10% body mass). Participants were categorized into one of 2 groups based on the kinematic trunk adaptation to the load: trunk flexor or trunk extensor. Main Outcome Measure(s): We estimated peak and average knee anterior shear, quadriceps, hamstrings, and gastrocnemius forces with a biomechanical model. Results: We found condition-by-group interactions showing that adding a trunk load increased peak (17%) and average (35%) knee anterior shear forces in the trunk-extensor group but did not increase them in the trunk-flexor group (peak: F1,19 ?=? 10.56, P ?=? .004; average: F1,19 ?=? 9.56, P ?=? .006). We also found a main effect for condition for quadriceps and gastrocnemius forces. When trunk load was added, peak (6%; F1,19 ?=? 5.52, P ?=? .030) and average (8%; F1,19 ?=? 8.83, P ?=? .008) quadriceps forces increased and average (4%; F1,19 ?=? 4.94, P ?=? .039) gastrocnemius forces increased, regardless of group. We found a condition-by-group interaction for peak (F1,19 ?=? 5.16, P ?=? .035) and average (F1,19 ?=? 12.35, P ?=? .002) hamstrings forces. When trunk load was added, average hamstrings forces decreased by 16% in the trunk-extensor group but increased by 13% in the trunk-flexor group. Conclusions: Added trunk loads increased knee anterior shear and knee muscle forces, depending on trunk adaptation strategy. The trunk-extensor adaptation to the load resulted in a quadriceps-dominant strategy that increased knee anterior shear forces. Trunk-flexor adaptations may serve as a protective strategy against the added load. These findings should be interpreted with caution, as only the face validity of the biomechanical model was assessed.
Kulas, Anthony S.; Hortobagyi, Tibor; DeVita, Paul
During the past few years electromyography has been used a lot in developing research in the science of sports; it has made a great contribution to what is called muscle biomechanics. The Biceps Femoris (long head), Semitendinosus and Semimembranosus bi-articulated muscles make up the muscle group called Hamstring; they act in articulated movements of the hip (extensors) and in articulated movement of the knee (flexors). In this sense, the Hamstring have been the object of many investigations, precisely because they are bi-articulated. All the Hamstring pass through the knee's articulation producing flexing as well as leg rotation and their effectiveness as hip extensors depends on the positioning of the knee's articulation, Hamill, Knutzen (1999). The knee's flexor muscles (Biceps Femoris - long head, Semimembranosus and Semitendinosus) were studied using electromyography with surface electrodes in 10 male subjects between 19 and 25 years old. They included five who used a stationary bicycle and five doing activities on the roman table. Knee flexing on the roman table (concentric and eccentric action) was performed in the ventral decubitus position. Surface electrodes with electro-conductive gel were used to register the action potentials; they we fixed on the skin covering the areas of interest to this study in each ventral muscle. For each type of experiment, a laboratory with all the apparatus needed for the study was created. Results, expressed in RMS, demonstrate that on the bicycle the Biceps Femoris (long head) showed an RMS of 31.81 (+/- 10.15), the Semimembranosus 65.15 (+/- 18.76) and the Semitendinosus 44.33 (+/- 44.33 (+/- 22.34). In flexing the knee the values were 188.54 (+/- 46.10) for the Biceps Femoris (long head) muscle, 480.00 (+/- 130.13) for the Semimembranosus and 303.50 (+/- 63.31) for the Semitendinosus. The verified data demonstrated greater values for the bicycle activities. The Semimembranosus muscle showed greater values in RMS for all activities studied, followed by the Semitendinosus and Biceps Femoris (long head). PMID:15378869
Bankoff, A D P; Fonseca Neto, D R; Moraes, A C
It was the purpose of this review to document the range, incidence, location and mechanism of injury occurring in the sport of rugby league. Rugby league is a collision sport played in Europe and the Pacific regions including Australia. The sport is well established and has competitions ranging from junior to elite professional. Due to the contact nature of the game, injury is relatively common. The most common injuries are musculotendinous in nature and afflict the lower limb more frequently than elsewhere. Despite the high incidence of minor (sprains/strains) to moderate musculoskeletal injury (fracture, ligament and joint injury) and minor head injuries such as lacerations, nasal fractures and concussions, rare more serious spinal cord and other injuries causing death have also been recorded. The literature on rugby league injury is small but growing and suffers from a lack of consistent definition of what an injury is, thereby causing variability in the nature and incidence/prevalence of injury. Information is lacking on the injury profiles of different age groups. Importantly, there has been little attempt to establish a coordinated injury surveillance program in rugby league in the junior or professional levels. The implementation of such programs would require a universal definition of injury and a focus on important events and competitions. The implementation could provide important information in the identification and prevention of risk factors for injury. PMID:16630745
Hoskins, W; Pollard, H; Hough, K; Tully, C
Transcutaneous electrical muscle stimulation (TEMS) has been advocated as a method to rehabilitate the postoperative ACL repaired\\/reconstructed lower ex tremity. Isolated quadriceps contraction can potentially disrupt the ACL repair\\/reconstruction; to minimize this risk simultaneous quadriceps and hamstring stimulation has been used. This study measured the in vivo defor mation of the ACL during TEMS of the quadriceps and hamstrings.Six legs
Christopher C. Kain; John A. McCarthy; Steve Arms; Malcolm H. Pope; J. Richard Steadman; Paul R. Manske; Robert A. Shively
Background: There is a lack of prospective studies comparing the long-term outcome of endoscopic anterior cruciate ligament (ACL) reconstruction with either a patellar tendon or hamstring tendon autograft.Purpose: This prospective longitudinal study compared the results of isolated endoscopic ACL reconstruction utilizing a 4-strand hamstring tendon (HT) or patellar tendon (PT) autograft over a 15-year period with respect to reinjury, clinical
Toby Leys; Lucy Salmon; Alison Waller; James Linklater; Leo Pinczewski
The goal of this study was to test the mechanical strength of 4 different cross pins currently available for femoral fixation by loading each cross pin to failure as received and determine the effect of 1 million cycles of fatigue loading. Additionally, the strength of resorbable pins was tested after prolonged exposure to biologic conditions. Six implants each of the Arthrotek LactoSorb (Biomet, Warsaw, Indiana), Mitek RigidFix (DePuy Mitek Inc, Raynham, Massachusetts), Arthrotek Bone Mulch Screw (Biomet), cortical allograft, and control were tested for 3-point failure without prior loading and after cyclic loading between 50 to 200 N at 10 Hz for 1 million cycles. The bioabsorbable pins were placed in sterile water at 37°C and tested after 2, 4, and 6 months for 3-point failure strength. All implants tested without antecedent loading demonstrated adequate strength for initial fixation for hamstring grafts. During fatigue testing, RigidFix implants (n=6) failed at 18,893±8365 cycles (with a central deformation of 0.48±0.11 mm prior to fracture). All of the other implants tested endured 1 million cycles of loading (50-200 N) without fracture or 1.5 mm central deformation. Neither of the bioabsorbable pins demonstrated a significant change in yield strength after prolonged exposure to water. All implants tested demonstrated adequate strength for initial fixation of hamstring grafts. The metal and bone implants far exceed the strength required to sustain mechanical fixation until biological fixation occurs; both polymeric implants demonstrated that they maintained enough mechanical strength to achieve this goal. PMID:20954667
Bellisari, Gregory E; Kaeding, Christopher C; Litsky, Alan S
The weak point in an ACL reconstruction immediately after surgery is the tibial fixation of the graft. This factor will often limit the return to load-inducing activities. Many new hamstring-graft fixation devices have been introduced for cruciate ligament reconstruction, but there is little comparative data on their performance. This work tested the hypotheses that some of these devices will resist graft slippage under cyclic loads better than others, and that some will have higher ultimate strength than others. Five devices were tested: WasherLoc, Intrafix fastener; and RCI, Delta Tapered, and Bicortical interference screws. Cyclic loads representing normal walking activity (1000 cycles from 70 to 220 N) and ultimate strength tests were done, using calf tibiae (similar bone density to young human tibiae) and four-strand tendon grafts, with eight tests of each device for each of cyclic and ultimate tensile strength tests. A series of graft creep tests under cyclic loads was also done. The results showed that there was no significant difference in graft construct elongation under cyclic loads (range 0.7-1.3 mm) after allowing for 0.4 mm mean graft creep. The WasherLoc gave the highest ultimate strength (945 N, p<0.001, range 490-945 N). We concluded that all devices performed well under cyclic loads that represented normal walking activity, but the ultimate strengths differed. The performance under cyclic load was better than has been published for conventional interference screws. This evidence suggests that it may now be safe to mobilise younger patients less cautiously immediately after hamstring-graft ACL reconstruction. PMID:15024559
Coleridge, Simon D; Amis, Andrew A
Alpine skiing accidents admitted to the Trondheim Regional and University Hospital during one year were recorded. Of the 339 injured, 67 per cent were male and 33 per cent were female. Eighty-seven per cent were outpatients, and 13 per cent were hospitalized. Falling accidents (67 per cent), followed by collision accidents (17 per cent), were the most common cause of injury. The injuries in the lower extremities were caused by falling and the head injuries were mostly caused by collisions. Knee ligament strains were the most common injuries, and 17 per cent of these were hospitalized and required operative treatment. Of the minor knee strains, all 44 per cent were not fully recovered after two and a half years. Seventeen patients sustained tibial fractures, eleven of them spiral fractures and six transverse fractures. The patients with spiral fractures were younger than the patients with transverse fractures. Head injuries were the most severe injuries, with eleven concussions and two epidural haematomas.
The study is focused on the biomechanical aspects of the anterior cruciate ligament (ACL) reconstruction procedures with an\\u000a emphasis on evaluating the dynamic strain of materials commonly used for this purpose. Separate and multiple, equally tensioned\\u000a strands of hamstring grafts used for the reconstruction of the ACL were biomechanically tested and compared to original ACL\\u000a and bone-patellar tendon-bone (BPTB) grafts,
Milan Handl; Milan Držík; Giuliano Cerulli; Ctibor Povýšil; Juraj Chlpík; Ferdinand Varga; Evžen Amler; Tomáš Tr?
Background: Female athletes are more likely than male athletes to injure the anterior cruciate ligament. Causes of this increased injury incidence in female athletes remain unclear, despite numerous investigations.Hypothesis: Female athletes will exhibit lower hamstring muscle activation and smaller knee flexion angles than male athletes during jump landings, especially when the knee muscles are fatigued.Study Design: Controlled laboratory study.Methods: Eight
Ray Fagenbaum; Warren G. Darling
In this study, we compared hamstring (H) and quadriceps (Q) strength changes in men and women, as well as changes in conventional and functional H:Q ratios following an identical 12-week resistance training program. An isokinetic dynamometer was used to assess 14 male and 14 female participants before and after the intervention, and conventional and functional H:Q ratios were calculated. Hamstring strength improved similarly in men and women, but improvement in quadriceps strength was significantly greater in men, while women showed only modest improvements. For the conventional and functional H:Q ratios, women showed significantly greater improvements than men. Both men and women were able to exceed the commonly recommended 0.6 conventional and 1.0 functional H:Q ratios after the 12-week lower-body resistance training program. PMID:22808699
Dorgo, Sandor; Edupuganti, Pradeep; Smith, Darla R; Ortiz, Melchor
This study evaluated the mid-term MRI appearance of partial ACL tear augmentation with quadrupled distally inserted hamstrings, while preserving the intact ACL bundle. Twenty-eight patients with ACL partial tear underwent augmentation. After 15–40 months follow-up, patients were evaluated clinically and by MRI. The mean IKDC score at follow-up was 93.8. Twenty-five patients were rated as excellent, three as fair. The mean
R. Buda; F. Di Caprio; L. Giuriati; D. Luciani; M. Busacca; S. Giannini
The purpose of this research was to determine whether a decreased hamstring activation rate among the elderly is responsible for a higher horizontal heel contact velocity and increased likelihood of slip-induced falls compared to their younger counterparts. Twenty-eight subjects from two age groups (14 young and 14 old) walked across a linear walking track with embedded force platforms while wearing a fall arresting harness attached to an overhead arresting rig for safety. In order to obtain realistic unexpected slip-induced fall data, a soapy vinyl floor surface was hidden from the subjects and unexpectedly introduced. Synchronized kinematics, kinetic and electromyography (EMG) analyses during the heel contact phase of the gait cycle while walking over slippery and non-slippery floor surfaces were examined in the study. Normalized EMG data were examined in terms of hamstring activation rate and evaluated with heel contact velocity and friction demand characteristic (as measured by peak required coefficient of friction (RCOF)) on the dry vinyl floor surface. Furthermore, slip parameters (i.e. slip distances and slipping velocity) were assessed on the soapy vinyl floor surface. The results indicated that younger adults’ hamstring activation rate was higher than older adults, whereas younger adults’ heel contact velocity was not different from older adults. These results suggested that heel contact velocity in younger adults was sufficiently reduced before the heel contact phase of the gait cycle. This could be due to the outcome of higher hamstring activation rate in younger adults in comparison to older adults. However, lower friction demand (peak RCOF), shorter slip distances, slower peak sliding heel velocity and more falls among older adults suggested that the slip initiation characteristics were not the only factors contributing to slip-induced falls among the elderly.
Lockhart, Thurmon E.; Kim, Sukwon
Hamstring muscle group dysfunction following anterior cruciate ligament reconstruction (ACL) using a semitendinosus–gracilis\\u000a autograft is a growing concern. This study compared the mean peak isometric knee flexor torque of the following three groups:\\u000a subjects 2 years following ACL reconstruction using semitendinosus–gracilis autografts (Group 1), subjects 2 years following\\u000a ACL reconstruction using tibialis anterior allografts (Group 2), and a non-injured, activity-level-matched control group
Sarah Landes; John Nyland; Brian Elmlinger; Ed Tillett; David Caborn
The aim of this study was to evaluate tibial bone tunnel enlargement following four-strand hamstring tendon anterior cruciate ligament (ACL) reconstruction, using a new method of magnetic resonance imaging (MRI) assessment. Correlation with clinical outcome was also examined. In a prospective study following ACL reconstruction, 24 patients underwent MRI and clinical assessment, at a mean follow-up of 6.5 months. A
Peter J. Fules; Rohit T. Madhav; Richard K. Goddard; Anthony Newman-Sanders; Michael A. S. Mowbray
Identification of injuries and their risk factors is required in order to develop risk controls within the context of sports injury prevention. The Australian Football Injury Prevention Project (AFIPP) was a randomised controlled trial (RCT) examining the effects of protective equipment on injury rates in Australian Rules Football. The aim of this paper is to describe the general injury profile of community level Australian Football players over one season, as recorded during this RCT. Players were recruited from the largest community football league in Victoria, Australia, during the 2001 playing season. A total of 301 players participated (64% response rate) and all injuries occurring during training and games were recorded. The overall injury incidence rate was 12.1/1000 player hours. Bruises/soft tissue injuries made up more than a quarter of all injuries (28%) and the leg (lower leg, ankle, thigh/hamstring and knee) was the most commonly injured body region. Most injuries occurred at the beginning of the season (April-May, 53% of injuries), during competition (77%) and through body contact (49.9%). Midfielders (OR = 3.39, 95% CI: 1.13, 10.14) and players aged at least 25 years (OR = 2.15, 95% CI: 1.06, 4.34) were significantly more likely to experience an injury than other playing positions and younger players. Although the injury rate in this study was lower than that in previous studies, the results are consistent with the finding that injuries tend to occur earlier in the season and more commonly during competition. Injury prevention efforts should be particularly targeted at midfielders and older players. PMID:15139169
Braham, R; Finch, C F; McIntosh, A; McCrory, P
Numerous studies have found that female athletes who participate in jumping and pivoting sports are four to six times more likely to sustain a knee ligament injury, such as anterior cruciate ligament (ACL) injury, than male athletes participating in the same sports [1-8]. A widening gender gap in the number of serious knee ligament injuries exists due to geometric growth in female athletic participation, coupled with the four- to sixfold higher injury rate. More than 50,000 serious knee injuries are projected to occur in female varsity intercollegiate and high school athletics each year [9, 10]. Most ACL injuries occur by noncontact mechanisms, often during landing from a jump or making a lateral pivot while running [2, 11]. Knee instability, due to ligament dominance (decreased medial-lateral neuromuscular control of the joint), quadriceps dominance (increased quadriceps recruitment and decreased hamstring recruitment and strength), and leg dominance (side-to-side differences in strength, flexibility, and coordination) are possible contributing factors to the increased incidence of knee injury in female athletes [5, 6]. In this review, dynamic neuromuscular analysis (DNA) training is defined, and a rationale is presented for correcting the neuromuscular imbalances that may result in dynamic knee instability during sports play. Dynamic neuromuscular training has been shown to increase knee stability and decrease knee injury rates in female athletes [5, 12.., 13.]. Preliminary research on athlete screening and injury prediction based on the three aforementioned imbalances also is presented with recommendations for developing screening protocols for the identification of high-risk athletes. PMID:12112973
Hewett, T E; Myer, G D; Ford, K R
Although allograft use for primary anterior cruciate ligament reconstruction has continued to increase during the last 10 years, concerns remain regarding the long-term function of allografts (primarily that they may stretch with time) and clinical efficacy compared with autograft tendons. We attempted to address these issues by prospectively comparing identical quadrupled hamstring autografts with allograft constructs for primary anterior cruciate ligament reconstruction in patients with a minimum followup of 3 years. Eighty-four patients (37 with autografts and 47 with allografts) were enrolled; the mean followup was 52 ± 11 months for the autograft group and 48 ± 8 months for the allograft group. Outcome measurements included objective and subjective International Knee Documentation Committee scores, Lysholm scores, Tegner activity scales, and KT-1000 arthrometer measurements. The two cohorts were similar in average age, acute or chronic nature of the anterior cruciate ligament rupture, and incidence of concomitant meniscal surgeries. At final followup, we found no difference in terms of Tegner, Lysholm, KT-1000, or International Knee Documentation Committee scores. Five anterior cruciate ligament reconstructions failed: three in the autograft group and two in the allograft group. Our data suggest laxity is not increased in allograft tendons compared with autografts and clinical outcome scores 3 to 6 years after surgery are similar. Level of Evidence: Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Edgar, Cory M.; Zimmer, Scott; Kakar, Sanjeev; Jones, Hugh
Several pathologies can cause muscle spasticity. Modified Ashworth scale (MAS) can rank spasticity, however its results depend on the physician subjective evaluation. This study aims to show a new approach to spasticity assessment by means of MMG analysis of hamstrings antagonist muscle group (quadriceps muscle). Four subjects participated in the study, divided into two groups regarding MAS (MAS0 and MAS1). MMG sensors were positioned over the muscle belly of rectus femoris (RF), vastus lateralis (VL) and vastus medialis (VM) muscles. The range of movement was acquired with an electrogoniometer placed laterally to the knee. The system was based on a LabVIEW acquisition program and the MMG sensors were built with triaxial accelerometers. The subjects were submitted to stretching reflexes and the integral of the MMG (MMG(INT)) signal was calculated to analysis. The results showed that the MMG(INT) was greater to MAS1 than to MAS0 [muscle RF (p = 0.004), VL (p = 0.001) and VM (p = 0.007)]. The results showed that MMG was viable to detect a muscular tonus increase in antagonist muscular group (quadriceps femoris) of spinal cord injured volunteers. PMID:23366325
Krueger, Eddy; Scheeren, Eduardo M; Nogueira-Neto, Guilherme N; Button, Vera Lúcia da S N; Nohama, Percy
Although allograft use for primary anterior cruciate ligament reconstruction has continued to increase during the last 10 years, concerns remain regarding the long-term function of allografts (primarily that they may stretch with time) and clinical efficacy compared with autograft tendons. We attempted to address these issues by prospectively comparing identical quadrupled hamstring autografts with allograft constructs for primary anterior cruciate ligament reconstruction in patients with a minimum followup of 3 years. Eighty-four patients (37 with autografts and 47 with allografts) were enrolled; the mean followup was 52 +/- 11 months for the autograft group and 48 +/- 8 months for the allograft group. Outcome measurements included objective and subjective International Knee Documentation Committee scores, Lysholm scores, Tegner activity scales, and KT-1000 arthrometer measurements. The two cohorts were similar in average age, acute or chronic nature of the anterior cruciate ligament rupture, and incidence of concomitant meniscal surgeries. At final followup, we found no difference in terms of Tegner, Lysholm, KT-1000, or International Knee Documentation Committee scores. Five anterior cruciate ligament reconstructions failed: three in the autograft group and two in the allograft group. Our data suggest laxity is not increased in allograft tendons compared with autografts and clinical outcome scores 3 to 6 years after surgery are similar. Level of Evidence: Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18575944
Edgar, Cory M; Zimmer, Scott; Kakar, Sanjeev; Jones, Hugh; Schepsis, Anthony A
This retrospective study compared the results after anterior cruciate ligament (ACL) reconstruction using a four-strand hamstring tendon graft (4SHG) versus Ligament Advanced Reinforcement System (LARS) artificial ligament in 60 patients between January 2003 and July 2004 with a minimum four-year follow-up. The KT-1000 examination, the International Knee Documentation Committee (IKDC) scoring systems and Lysholm knee scoring scale were used to evaluate the clinical results. The mean side-to-side difference was 2.4 +/- 0.5 mm and 1.2 +/- 0.3 mm in the 4SHG group and LARS group, respectively (P = 0.013). Although other results of ACL reconstruction, measured by IKDC evaluation, Lysholm scores and Tegner scores, showed using a LARS graft clinically tended to be superior to using a 4SHG, there were no significant differences calculated. Our results suggest that four years after ACL reconstruction using a LARS ligament or 4SHG dramatically improves the function outcome, while the patients in the LARS group displayed a higher knee stability than those in the 4SHG group. PMID:19396441
Liu, Zhong-tang; Zhang, Xian-long; Jiang, Yao; Zeng, Bing-Fang
The posterior tibial inlay technique is currently accepted as a standard operation for the posterior cruciate ligament–deficient knee. The classical technique requires a graft construct consisting of a bony part to be fitted into the posterior tibial socket. When an autogenous source is chosen, morbidity at the donor site generated by obtaining the graft with a bony part (e.g., bone–patellar tendon–bone or quadriceps tendon–bone) can be more serious than when obtaining the soft-tissue graft (e.g., hamstring). This study describes an alternative use of soft-tissue graft anchored in a bone socket at the posterior tibial margin by a transfixing cancellous screw. The graft is secured on top by a “bone washer” harvested from this bone socket to provide biological bone-tendon-bone healing. The posterior cruciate ligament remnant with integral fibers at the femur can have its tibial part revised, tensioned, and reattached concomitantly. This additional procedure is deemed to enhance joint stability and promote graft healing.
Laupattarakasem, Wiroon; Boonard, Manusak; Laupattarakasem, Pat; Kosuwon, Weerachai
Traumatic brain injury (TBI) due to closed mechanisms causes strain injuries to axons that increase in number and severity as injury severity increases. Axons that project up from the brain stem are vulnerable, even in milder concussive injuries, and include axons that participate in key monoaminergic pathways. Although called diffuse axonal injury, the supra-tentorial injury component typically shows an anterior preponderance in humans. As the injury forces increase, cerebral contusions may be superimposed on the axonal strain injuries, and these contusions show an anterior preponderance as well. The chronic neuropsychiatric manifestations of TBI reflect this injury distribution. In the cognitive sphere, these manifestations almost always include power function disturbances marked by difficulties with cognitive processing speed, multitasking, and cognitive endurance. These disturbances may then be followed by disturbances in executive function and self-awareness as injury severity increases. In the behavioral sphere, mood disturbances and disorders of behavioral control and regulation are particularly common. PMID:18075952
Lux, Warren E
Intensive treadmill training after incomplete spinal cord injury can improve functional walking abilities. To determine the changes in muscle activation patterns that are associated with improvements in walking, we measured the electromyography (EMG) of leg muscles in 17 individuals with incomplete spinal cord injury during similar walking conditions both before and after training. Specific differences were observed between subjects that eventually gained functional improvements in overground walking (responders), compared with subjects where treadmill training was ineffective (nonresponders). Although both groups developed a more regular and less clonic EMG pattern on the treadmill, it was only the tibialis anterior and hamstring muscles in the responders that displayed increases in EMG activation. Likewise, only the responders demonstrated decreases in burst duration and cocontraction of proximal (hamstrings and quadriceps) muscle activity. Surprisingly, the proximal muscle activity in the responders, unlike nonresponders, was three- to fourfold greater than that in uninjured control subjects walking at similar speeds and level of body weight support, suggesting that the ability to modify muscle activation patterns after injury may predict the ability of subjects to further compensate in response to motor training. In summary, increases in the amount and decreases in the duration of EMG activity of specific muscles are associated with functional recovery of walking skills after treadmill training in subjects that are able to modify muscle activity patterns following incomplete spinal cord injury.
Gorassini, Monica A.; Norton, Jonathan A.; Nevett-Duchcherer, Jennifer; Roy, Francois D.; Yang, Jaynie F.
Introduction The purpose of this study was to describe our transverse patella double tunnel technique to reconstruct the medial patellofemoral\\u000a ligament (MPFL) with a hamstring tendon autograft in patients who suffered recurrent dislocation of the patella, and to evaluate\\u000a the intermediate-term outcomes of reconstruction treatment.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and methods Fifty-nine consecutive knees (52 patients) with recurrent dislocation of the patella without marked predisposing
Hua Han; Yayi Xia; Xiangdong Yun; Meng Wu
We retrospectively reviewed 87 anterior cruciate ligament reconstructions using autogenous hamstring tendons with the Endobutton technique to investigate the relationship between bone tunnel enlargement and clinical outcome and to identify factors that contribute to the enlargement. The clinical outcome was evaluated using the Lysholm score and KT-1000 arthrometer. The location of the femoral tunnel with respect to Blumensaat's line, the tibial tunnel with respect to the tibial plateau, and the angle between the femoral tunnel and Blumensaat's line (femoral tunnel angle) were measured. Bone tunnel enlargement was observed in 32 patients (37%). Enlargement occurred in 22 of the femoral tunnels and 26 of the tibial tunnels. Enlargement of both tunnels occurred in 16 knees. There was no statistical difference in Lysholm scores or KT-1000 arthrometer measurements between the enlarged group and the unenlarged group. The femoral tunnel was placed more anteriorly in the enlarged femoral tunnel group than in the unenlarged femoral tunnel group. The tibial tunnel was placed more anteriorly in the enlarged tibial tunnel group than in the unenlarged tibial tunnel group. The femoral tunnel angle was significantly smaller in the enlarged femoral tunnel group than in the femoral unenlarged group. Gender, patient age, intraoperative isometricity, and graft size were not significant factors. Bone tunnel enlargement was not correlated with the clinical outcome measures. We conclude that the main factor associated with tunnel enlargement are the locations and angles of the tunnels. The windshield-wiper motion of the graft may be enhanced by changing tension in the graft due to tunnel malposition. An acute femoral tunnel angle may increase the mechanical stress on the anterior margin of the femoral tunnel. PMID:11522075
Segawa, H; Omori, G; Tomita, S; Koga, Y
Traumatic brain injuries are the leading cause of disability each year in the US. The most common and devastating consequence is the stretching of axons caused by shear deformation that occurs during rotational acceleration of the brain during injury. The injury effects on axonal molecular and functional events are not fully characterized. We have developed a strain injury model that maintains the three dimensional cell architecture and neuronal networks found in vivo with the ability to visualize individual axons and their response to a mechanical injury. The advantage of this model is that it can apply uniaxial strains to axons that make functional connections between two organotypic slices and injury responses can be observed in real-time and over long term. This uniaxial strain model was designed to be capable of applying an array of mechanical strains at various rates of strain, thus replicating a range of modes of axonal injury. Long term culture, preservation of slice and cell orientation, and slice-slice connection on the device was demonstrated. The device has the ability to strain either individual axons or bundles of axons through the control of microchannel dimensions. The fidelity of the model was verified by observing characteristic responses to various strain injuries which included axonal beading, delayed elastic effects and breakdown in microtubules. Microtubule breakdown was shown to be dependent on the degree of the applied strain field, where maximal breakdown was observed at peak strain and minimal breakdown is observed at low strain. This strain injury model could be a powerful tool in assessing strain injury effects on functional axonal connections. PMID:23233120
Dollé, Jean-Pierre; Morrison, Barclay; Schloss, Rene S; Yarmush, Martin L
OBJECTIVE: To test the hypothesis that increasing the hamstrings and quadriceps (H:Q) isokinetic strength ratio will, in the short term, improve the functional ability of an anterior cruciate ligament (ACL) deficient knee. METHODS: The isokinetic muscular characteristics at a speed of 60 degrees s-1 and 180 degrees s-1 of 46 recreational athletes with an arthroscopically confirmed ACL tear were determined using the Cybex II+ isokinetic dynamometer. The variables tested included peak torque, endurance ratio, total work output, and explosive power. Functional ability was scored with the Cincinnati rating system, measuring the severity of pain and swelling, the degree of giving way, and the overall ability to walk, run, ascent and descent stairs, jump and twist. RESULTS: Among all muscular characteristics, the H:Q ratio at 180 degrees s-1 at 30 degrees of knee flexion was shown to have the highest correlation to the functional score (r = 0.6249, P < 0.001). All variables involving hamstring strength were shown to be significantly correlated to the functional ability score (P < 0.01), while none of the variables involving quadriceps strength showed significant correlation with the functional ability of the injured knee. CONCLUSIONS: The H:Q ratio is strongly correlated to the functional ability of ACL deficient knees in Chinese recreational athletes. It could be used as an additional measure to guide in the decision making process in the management of ACL deficient knees.
Li, R C; Maffulli, N; Hsu, Y C; Chan, K M
Persons with cerebral palsy frequently walk with a crouched, internally rotated gait. Spastic medial hamstrings or adductors are presumed to contribute to excessive hip internal rotation in some patients; however, the capacity of these muscles to produce internal rotation has not been adequately investigated. The purpose of this study was to determine the hip rotation moment arms of the medial
Allison S. Arnold; Scott L. Delp
Context: An in-season groin injury may be debilitating for the athlete. Proper diagnosis and identification of the pathology are paramount in providing appropriate intervention. Furthermore, an adductor strain that is treated improperly can become chronic and career threatening. Any one of the 6 muscles of the adductor muscle group can be involved. The degree of injury can range from a minor strain (grade 1), where minimal playing time is lost, to a severe strain (grade 3), in which there is complete loss of muscle function. Persistent groin pain and muscle imbalance may lead to athletic pubalgia. Evidence Acquisition: Relevant studies were identified through a literature search of MEDLINE and the Cochrane database from 1990 to 2009, as well as a manual review of reference lists of identified sources. Results: Ice hockey and soccer players seem particularly susceptible to adductor muscle strains. In professional ice hockey and soccer players throughout the world, approximately 10% to 11% of all injuries are groin strains. These injuries have been linked to hip muscle weakness, a previous injury to that area, preseason practice sessions, and level of experience. This injury may be prevented if these risk factors are addressed before each season. Conclusion: Despite the identification of risk factors and strengthening intervention for athletes, adductor strains continue to occur throughout sport. If groin pain persists, the possibility of athletic pubalgia needs to be explored, because of weakening or tears in the abdominal wall muscles. A diagnosis is confirmed by exclusion of other pathology.
Tyler, Timothy F.; Silvers, Holly J.; Gerhardt, Michael B.; Nicholas, Stephen J.
This chapter examines the issue of unintentional injuries and focuses on a selected number of cause-specific unintentional injuries. Injuries have traditionally been defined as damage to a person caused by an acute transfer of energy (mechanical, thermal, electrical, chemical, or radiation) or by the sudden absence of heat or oxygen. Unintentional injuries consist of that subset of injuries for which
Robyn Norton; Adnan A. Hyder; David Bishai; Margie Peden
The purposes of this study were twofold: (a) to examine the test-retest reproducibility and concurrent validity of the horizontal hip joint angle test (H-HJA) and vertical hip joint angle test (V-HJA) for estimating hamstring flexibility measured with an inclinometer during the passive straight-leg raise test (PSLR) and (b) to determine whether the H-HJA cutoff scores may be used for V-HJA for the detection of short hamstring flexibility in active recreationally young adults. Fifty young men underwent the H-HJA, V-HJA, and PSLR on the right and left legs 3 times in a randomized order with a 4-week interval between trials under a controlled laboratory environment. Reproducibility was examined using coefficient of variation (CV) and intraclass correlation coefficient (ICC3,1) and their respective confidence limits. Regression and kappa correlation analyses were performed to examine the association of H-HJA and V-HJA with the PSLR test, and the 95% limits of agreement between H-HJA and V-HJA were calculated to check if there were differences in the raising scores. The results demonstrated acceptable reproducibility measures for the H-HJA (4.12% CV; 0.93 ICC), V-HJA (4.99% CV; 0.92 ICC), and PSLR (4.83% CV; 0.88 ICC). The H-HJA (R = 0.62) and V-HJA (R = 0.63) results were significantly associated with those of the PSLR. The 95% limits of agreement between the H-HJA and V-HJA reported systematic bias (+7.12 cm) and a wide 95% random error ( ±13.72 cm). This study concluded that the test-retest reproducibility of the H-HJA, V-HJA, and PSLR is acceptable and that the validity of H-HJA and V-HJA is moderate. Furthermore, the H-HJA cutoff scores should not be used for V-HJA for the detection of short hamstring muscles in young adults. PMID:22105048
Ayala, Francisco; Sainz de Baranda, Pilar; De Ste Croix, Mark; Santonja, Fernando
Randomized prospective study of ACL reconstruction with interference screw fixation in patellar tendon autografts versus femoral metal plate suspension and tibial post fixation in hamstring tendon autografts: 5-year clinical and radiological follow-up results
Patellar tendon graft has been the most frequently used material in anterior cruciate ligament (ACL) reconstruction, but the\\u000a hamstring tendons have been increasingly used as well; however, which graft is to be preferred is not adequately supported\\u000a by existing clinical studies. In this prospective randomized clinical trial, the study hypothesis was that the hamstring tendons\\u000a are equally good graft material
Arsi Harilainen; Eric Linko; Jerker Sandelin
We report a case of lateral meniscal tear resulting from the femoral cross-pin used for hamstring graft fixation in anterior cruciate ligament (ACL) reconstruction. A 29 year old man presented with symptoms of knee pain, catching and locking, 13 months following an ACL reconstruction. Magnetic resonance imaging (MRI) and arthroscopy confirmed the broken femoral cross-pin abutting the lateral meniscus and the resulting meniscal tear. Removal of the broken femoral cross-pin and repair of the lateral meniscal tear resulted in resolution of symptoms. Distal femoral cross-pin fracture and its intra-articular position are postulated as the cause of this lateral meniscal tear. Hence, we recommend a low threshold to investigate with a MRI scan any new symptoms following ACL reconstruction with cross-pin fixation. PMID:22520571
Dudhniwala, A G; Rath, N; Forster, M C
Drilling of femoral tunnel by transtibial technique is widely used in arthroscopic anterior cruciate ligament (ACL) reconstruction. Recent studies suggest in this technique graft is placed in non-anatomical position leading to instability. If the femoral tunnel is drilled through an anteromedial portal (transportal technique), graft can be placed more anatomically leading to better knee stability theoratically. The purpose of this study is to compare the clinical outcome of transtibial technique and transportal technique for drilling of femoral tunnel in arthroscopic ACL reconstruction using hamstring tendon autograft. All patients operated between January 2009 and September 2011 were approached for eligibility. Blinded assessment of IKDC score, Lachman test, pivot shift test, time of recovery from surgery were obtained from both the transtibial and transportal groups. The transportal group shows significantly better IKDC score, higher anteroposterior knee stability by Lachman test and lower recovery time from surgery. PMID:23785908
Mandal, Ananda; Shaw, Ranjit; Shaw, Ranjit Kumar; Biswas, Debasis; Basu, Anindya
The accuracy of video analysis of the passive straight-leg raise test (PSLR) and the validity of the sit-and-reach test (SR) were tested in 60 men and women. Computer software measured static hip-joint flexion accurately. High within-session reliability of the PSLR was demonstrated (R > .97). Test-retest (separate days) reliability for SR was high in men (R = .97) and women R = .98) moderate for PSLR in men (R = .79) and women (R = .89). SR validity (PSLR as criterion) was higher in women (Day 1, r = .69; Day 2, r = .81) than men (Day 1, r = .64; Day 2, r = .66). In conclusion, video analysis is accurate and feasible for assessing static joint angles, PSLR and SR tests are very reliable methods for assessing flexibility, and the SR validity for hamstring flexibility was found to be moderate in women and low in men. PMID:22276403
Mier, Constance M
Lightning strikes may cause a constellation of injuries. Blunt head trauma, neurologic injury, and cardiac injury are common in these patients. In contrast to high-voltage electrocutions, blunt trauma after a lightning strike is common. Thorough evaluation of all organ systems is crucial. This report discusses mechanism of injury and describes initial evaluation and treatment of lightning strike victims. PMID:12540003
Whitcomb, Darren; Martinez, Jorge A; Daberkow, Dayton
Objective: The purpose of this chapter is to review the distribution and determinants of injury rates as reported in the pediatric gymnastics injury literature, and to suggest measures for the prevention of injury and directions for further research. Data sources: An extensive search of Pubmed was conducted using the Text and MeSH words ’gymnastics’ and ’injury’ and limited to the
D. Caine; L. Nassar
The purpose of this study was to investigate for possible relationships between knee flexion to extension peak torque ratios (F1/Ext(rat)) and low-back injuries in highly active males and females. Forty-eight male (age 25.9 +/- 4.5 years) and 41 female (age 27.3 +/- 2.6 years) competitive rowers, and 20 male (age 26.6 +/- 6.0 years) professional ballet dancers volunteered for the study. Each subject performed a test of lumbar and knee flexor flexibility, isokinetic dynamometry and completed a self-administered questionnaire. Flexibility was assessed by using the sit-and-reach test. Knee flexion to extension peak torques were bilaterally monitored at the angular velocities of 1.04 and 4.19 rad x s(-1). The questionnaire was designed to obtain information regarding the number of days off action (e.g., training, competition, and rehearsals), due to low-back injuries, for the 12-month period prior to testing. Results revealed significant negative correlation coefficients between knee F1/Ext(rat), obtained at 1.04 rad x s(-1), and days off physical activity for oarsmen (r = - 0.69; p < 0.01), oarswomen (r = -0.62; p < 0.01) and male dancers (r = -0.57; p < 0.05). No such correlations were found for either knee F1/ Ext(rat) obtained at the angular velocity of 4.19 rad x s(-1) or between the sit-and-reach test results and low-back injuries. A sub-group of 22 female rowers was re-tested after a 6-8 month period, during which a special hamstring strength training programme was introduced. The main conclusions were: a) the lower the F1/Ext(rat) the greater the degree of low-back injury, b) at least in female rowers, 6-8 months of hamstring strength training can contribute to a reduction of the incidence of low-back injury, and c) isokinetic assessment of quadriceps and hamstrings obtained at lower compared to higher angular velocities is more prognostic of low back injury. PMID:9231847
Koutedakis, Y; Frischknecht, R; Murthy, M
The aim of the study was to examine whether the peak torque of the hamstring and quadriceps muscles affects the anterior\\u000a knee laxity measurements in male patients. The study comprised 45 male patients who had a chronic unilateral anterior cruciate\\u000a ligament (ACL) rupture. Preoperatively, one experienced physiotherapist performed all the KT-1000 examinations. The anterior\\u000a displacement was registered at 89 Newton.
Ninni Sernert; Jüri Kartus; Kristina Köhler; Lars Ejerhed; Sveinbjörn Brandsson; Jon Karlsson
Background: The choice of graft material for anterior cruciate ligament reconstruction is believed to play a major role in outcome, but most comparisons of graft choice have not been well controlled.Hypothesis: The choice of graft material (patellar tendon or hamstring tendon) does affect clinical outcome after anterior cruciate ligament reconstruction.Study Design: Prospective, nonrandomized clinical trial.Methods: Two groups of 90 patients
Leo A. Pinczewski; David J. Deehan; Lucy J. Salmon; Vivianne J. Russell; Amanda Clingeleffer
Purpose To compare the short term clinical results of anterior cruciate ligament (ACL) reconstruction with autologous hamstring tendon between Rigid-fix and PINN-ACL Cross Pin for femoral side fixation. Materials and Methods 127 patients who underwent arthroscopic ACL reconstruction using autologous hamstring tendon and had been followedup for over than one year were enrolled for the present study. Rigid-fix was used in 71 cases (group 1), and PINN-ACL Cross Pin was used in 56 cases (group 2). Clinical and radiological results, operation time, and perioperative complications were compared amongst the two groups. Results The International Knee Documentation Committee subjective score and Lysholm score were 94 and 95 in group 1 and 87 and 91 in group 2, with no statistical difference (p=0.892, p=0.833), respectively. However, significant difference was observed in one-leg hop test between the two groups (p=0.032). Five cases in group 1 and 40 cases in group 2 were found to be associated with perioperative complications with statistical difference (p<0.0001). Conclusions There was no resultant difference between the employment of PINN-ACL Cross Pin and Rigid-fix as femoral graft fixation for ACL reconstruction with hamstring tendon. However, PINN-ACL Cross Pin led to complications with extensive operation times. Hence, it needs further improvement of tools for minimization of complications.
Seo, Seung-Suk; Nam, Tae-Seok; Choi, Sang-Yeong
\\u000a Colorectal injuries are caused by penetrating trauma, less often by blunt trauma, or by accidental iatrogenic injuries. Colorectal\\u000a injuries endanger the patient due to infectious complications. Prognosis is improving if treatment is initiated early. Simple\\u000a suturing may be indicated in serosal and stabbing injuries. In high velocity trauma such as gun shot wounds or intestinal\\u000a rupture following blunt trauma, resection
Alexander Woltmann; Christian Hierholzer
Objectives: The purpose of this chapter is to review critically the existing studies on the epidemiology of pediatric rugby injuries and discuss suggestions for injury prevention and further research. Data Sources: Data were sourced from the sports medicine and science literature mainly since 1990, and from a prospective injury surveillance project in rugby undertaken by the University of New South
Jet skiing is a rapidly growing sport. The craft incorporate safety features and the manufacturers issue detailed safety instructions. Racing is conducted with adequate attention to clothing, safety and insurance. However, casual use is widespread and is sometimes irresponsible. Serious injuries to riders are uncommon: dental and knee injuries are described. A case of renal contusion and a head injury were caused by other riders and two potentially fatal injuries illustrate the risk for other water users. The number of injuries associated with the use of personal watercraft is likely to increase and may be influenced by appropriate organization or regulation. Images Figure 2 Figure 3 Figure 4
Jeffery, R S; Caiach, S
Head injury is one of the commonest injuries in sport. Most are mild but some can have serious outcomes. Sports medicine doctors should be able to recognise the clinical features and evaluate athletes with head injury. It is necessary during field assessment to recognise signs and symptoms that help in assessing the severity of injury and making a decision to return-to-play. Prevention of primary head injury should be the aim. This includes protective equipment like helmets and possible rule changes. PMID:20533694
Hureibi, K A; McLatchie, G R
Bicycling injuries can be classified into bicycle contact, traumatic, and overuse injuries. Despite the popularity of cycling, there are few scientific studies regarding injuries. Epidemiological studies are difficult to compare due to different methodologies and the diverse population of cyclists studied. There are only three studies conducted on top level professionals. Ninety-four percent of professionals in 1 year have experienced at least one overuse injury. Most overuse injuries are mild with limited time off the bike. The most common site of overuse injury is the knee, and the most common site of traumatic injury is the shoulder, with the clavicle having the most common fracture. Many overuse and bicycle contact ailments are relieved with simple bike adjustments. PMID:24030309
Silberman, Marc R
Hockey, Canada's national sport, is probably the world's fastest team sport. The nature of the game makes injuries a common occurence. This article reviews the literature on hockey injuries and identifies some of the changing trends over the past 15 years. Severity and incidence of injuries increase with the age and skill level of the player. There are fewer lacerations, eye injuries, and head injuries since helmets and facial protectors have become mandatory in minor hockey. However, there has been an increase in spinal cord injuries. Physicians who provide medical coverage for older adolescent and adult competitive élite hockey players should be proficient at assessment and acute care of patients with life-threatening injuries.
Sproule, James R.
While injuries of the upper extremity are widely discussed in rock climbers, reports about the lower extremity are rare. Nevertheless almost 50 percent of acute injuries involve the leg and feet. Acute injuries are either caused by ground falls or rock hit trauma during a fall. Most frequently strains, contusions and fractures of the calcaneus and talus. More rare injuries, as e.g., osteochondral lesions of the talus demand a highly specialized care and case presentations with combined iliac crest graft and matrix associated autologous chondrocyte transplantation are given in this review. The chronic use of tight climbing shoes leads to overstrain injuries also. As the tight fit of the shoes changes the biomechanics of the foot an increased stress load is applied to the fore-foot. Thus chronic conditions as subungual hematoma, callosity and pain resolve. Also a high incidence of hallux valgus and hallux rigidus is described.
Schoffl, Volker; Kupper, Thomas
The direction of fiber alignment within a muscle is known to influence the effectiveness of muscle contraction. However, most of the commonly used clinical gluteus maximus (GM) exercises do not consider the direction of fiber alignment within the muscle. Therefore, the purpose of this study was to investigate the influence of hip abduction position on the EMG (electromyography) amplitude and onset time of the GM and hamstrings (HAM) during prone hip extension with knee flexion (PHEKF) exercise. Surface EMG signals were recorded from the GM and HAM during PHEKF exercise in three hip abduction positions: 0°, 15°, and 30°. Thirty healthy subjects voluntarily participated in this study. The results show that GM EMG amplitude was greatest in the 30° hip abduction position, followed by 15° and then 0° hip abduction during PHEKF exercise. On the other hand, the HAM EMG amplitude at 0° hip abduction was significantly greater than at 15° and 30° hip abduction. Additionally, GM EMG onset firing was delayed relative to that of the HAM at 0° hip abduction. On the contrary, the GM EMG onset occurred earlier than the HAM in the 15° and 30° hip abduction positions. These findings indicate that performing PHEKF exercise in the 30° hip abduction position may be recommended as an effective way to facilitate the GM muscle activity and advance the firing time of the GM muscle in asymptomatic individuals. This finding provides preliminary evidence that GM EMG amplitude and onset time can be modified by the degree of hip abduction. PMID:23312068
Kang, Sun-Young; Jeon, Hye-Seon; Kwon, Ohyun; Cynn, Heon-Seock; Choi, Boram
We prospectively studied knee proprioception following ACL reconstruction in 40 patients (34 men and six women; mean age 31 years). The patients were allocated into two equal groups; group A underwent reconstruction using hamstrings autograft, and group B underwent reconstruction using bone-patellar tendon-bone autograft. Proprioception was assessed in flexion and extension by the joint position sense (JPS) at 15°, 45° and 75°, and time threshold to detection of passive motion (TTDPM) at 15° and 45°, preoperatively and at 3, 6 and 12 months postoperatively. The contralateral healthy knee was used as internal control. No statistical difference was found between the ACL-operated and the contralateral knees in JPS 15°, 45° and 75° at 6 and 12 months, in both study groups. No statistical difference was found between the ACL-operated and the contralateral knees in TTDPM 15° at 6 and 12 months, nor regarding TTDPM 45° at 3, 6 and 12 months, in group A. No statistical difference was found in JPS and TTDPM between the two grafts, at any time period. Knee proprioception returned to normal with ACL reconstruction at 6 months postoperatively, without any statistically significant difference between the autografts used. PMID:20149662
Angoules, A G; Mavrogenis, A F; Dimitriou, R; Karzis, K; Drakoulakis, E; Michos, J; Papagelopoulos, P J
In an animal model of Anterior Cruciate Ligament reconstruction by hamstring tendons and 8mm diameter biodegradable interference screws, we aimed to investigate whether pull out forces and failure modes were influenced by changing tendon and bone tunnel diameters. Three groups of 10 calf tibiae each were prepared with 8, 9 and 10mm diameter proximal tunnels fitted respectively with 8, 9 and 10mm diameter tendon grafts. Mean +/- SD pull out force was 607.9 +/- 191.5N in the 8mm group, 494.2 +/- 206.2N in the 9mm group and 530.4 +/- 212.5N in the 10mm group. These differences were not significant at t-test. 8mm specimens failed by tendon rupture, 10mm specimens failed by screw pull out and 9mm specimens failed in both ways. In this ACL reconstruction model, safe pull out forces were achieved by fixing tendon grafts to bone by 8 mm absorbable interference screws regardless of tendon and bone tunnel diameter. PMID:16681105
Teli, M; Chiodini, F; Sottocasa, R; Villa, T
OBJECTIVES: To obtain more information about injuries of West End performers. METHODS: A retrospective survey of 269 performers appearing in 20 West End productions (12 dramas and eight musicals). RESULTS: In current productions, 46% of all performers sustained at least one injury for an average of 0.87 injuries per performer. Lower extremity injuries were the most common for dancers (52.2% of injuries) and actors (43.2%) with neck and back injuries the second most common. Sprains and strains were the most common diagnoses. 61% of performers thought that their injuries were preventable. Most performers consulted nonphysician healthcare providers. Factors significantly influencing the risk of injuries for performers include female sex, a history of previous injuries, missed performances due to previous injuries, more physically demanding roles, and performing on raked (angled) stages. CONCLUSION: West End performers commonly sustain injuries. Although primary prevention of most theatrical injuries is not possible, modification of raked stages may reduce the incidence. This study may be helpful to the growing number of healthcare providers who practice performing arts medicine and may stimulate additional concern and research in the medical and theatrical communities about the performance injuries of professionals, amateurs, and theatrical students worldwide.
Evans, R. W.; Evans, R. I.; Carvajal, S.
Background: Wakeboarding is a popular water sport that has the potential to produce serious injuries. To date, there has been only one article describing an injury caused by wakeboarding.Hypothesis: Wakeboarding injuries are common.Study Design: Analysis of data obtained from physician and patient questionnaires.Methods: Analysis of questionnaire data obtained from 156 orthopaedic surgeons and 86 wakeboarders.Results: Of 156 orthopaedic surgeons completing
William G. Carson
In the broad spectrum of orthopedic skiing injuries, ‘second aid’ on the mountain and at the base by the physician is very important. All skiing physicians should carry minimal medical supplies, including narcotic medication. Diagnosis and treatment of injuries at the hospital are outlined. Most ski fractures of the tibia can be treated by conservative methods. A more aggressive approach to diagnosis and treatment of ligamentous injuries of the knee is recommended.
Bartlett, L. H.
Catastrophic injuries and illnesses create great financial strains on patients who require lifetime care. Families, health care providers and insurers recognise that individual patient care needs require a closer look at the prudent allocation of health care benefit dollars. Blue Cross Blue Shield of Michigan has initiated an approach to this problem called ‘case management’. Two ventilator dependent quadriplegics were
S I Weingarden; J P Kuric; J G Helen; P M Graham
The purpose of this study was to elucidate the most successful feed-forward strategies responsible for enhancing dynamic restraint following anterior cruciate ligament (ACL) injury and ACL reconstruction (ACLR). Ten male ACL deficient (ACLD) subjects (18-35 years) together with 27 matched males who had undergone ACLR (14 using a patella tendon graft and 13 using a combined semitendinosus and gracilis graft) and 22 matched-control subjects were recruited. After their knee functionality (0- to 100-point scale) was rated using the Cincinnati Knee Rating System, each subject performed a maximal, countermovement hop for distance on their involved limb while EMG data were collected from the vastus lateralis (VL), vastus medialis (VM), semitendinosus (ST) and biceps femoris (BF) muscles. Acceleration transients at the proximal tibia were recorded using a uniaxial accelerometer mounted at the level of the tibial tuberosity. Whilst pre-programmed muscle activation strategies and tibial acceleration transients when landing from a single-leg long hop for distance were not contingent upon ACL status, a number of significant correlations were identified between neuromuscular variables and knee functionality of ACLD and ACLR subjects. Increased hamstring preparatory activity together with a greater ability to control tibial motion during dynamic deceleration was associated with higher levels of knee functionality in the ACLD subjects. Successful feed-forward strategies following ACLR were related to graft selection; STGT subjects with superior knee function activated their quadriceps earlier and were better able to synchronise peak hamstring muscle activity closer to initial ground contact whilst more functional PT subjects demonstrated enhanced tibial control despite a lack of evidence supporting modified pre-programmed muscular activation patterns. Our conclusion was that more functional individuals used sensory feedback to build treatment-specific, feed-forward strategies to enhance dynamic restraint when performing a task known to stress the ACL. PMID:18656383
Bryant, Adam L; Newton, Robert U; Steele, Julie
Traumatic injury to neurons, initiated by high strain rates, consists of both primary and secondary damage, yet the cellular tolerances in the acute post-injury period are not well understood. The events that occur at the time of and immediately after an insult depend on the injury severity as well as inherent properties of the cell and tissue. We have analyzed
Michelle C. LaPlaca; Gustavo R. Prado; D. Kacy Cullen; Crystal M. Simon
This epidemiologic survey of the literature on the factors contributing to the high number of high school football injuries consolidates the current information on the characteristics and risk factors associated with these injuries. To reduce the incidence of knee sprains and strains, the most common injuries to this population, the following preventive recommendations are pre sented : 1) optimum maintenance
Brian Halpern; Nancy Thompson; Walton W. Curl; James R. Andrews; Stephen C. Hunter; John R. Boring
Injuries to the quadriceps muscle group occur frequently in sports and athletic activities. Muscle strains and contusions\\u000a constitute the majority of these injuries. The clinical presentation and assessment of quadriceps strains and contusions are\\u000a reviewed along with discussion of appropriate imaging used in diagnosis. Treatment protocols for acute injuries are reviewed\\u000a including rehabilitation techniques frequently utilized during recovery. Special consideration
Joel M. Kary
Lightning strikes the earth millions of times every day. Lightning causes serious injuries in 1000- 1500 individuals and over 1000 people death every year worldwide. Lightning causes damage to a wide range of body systems including cardiopulmonary, neurological, vascular, cutaneous burns, ophthalmic, and otological injuries. The most common cause of death in lightning strikes is cardiop- ulmonary arrest. If multiple
Hsien-Tsung Hsu; Tzong-Luen Wang
The purpose of this study was to determine differences in hamstrings-to-quadriceps (H/Q) peak torque ratios evaluated at different angular velocities between men and women who participate in judo, handball or soccer. A total of 166 athletes, including 58 judokas (26 females and 32 males), 39 handball players (22 females and 17 males), and 69 soccer players (17 females and 52 males), were evaluated using an isokinetic dynamometer. The H/Q isokinetic peak torque ratios were calculated at angular velocities of 1.05 rad · s?¹ and 5.23 rad · s?¹. In the analysis by gender, female soccer players produced lower H/Q peak torque ratios at 1.05 rad · s?¹ than males involved in the same sport. However, when H/Q peak torque ratio was assessed at 5.23 rad · s?¹, there were no significant differences between the sexes. In the analysis by sport, there were no differences among females at 1.05 rad · s?¹. In contrast, male soccer players had significantly higher H/Q peak torque ratios than judokas (66 ± 12% vs. 57 ± 14%, respectively). Female handball players produced significantly lower peak torque ratios at 5.23 rad · s?¹ than judokas or soccer players, whereas males presented no ratio differences among sports At 5.23 rad · s?¹. In the analysis by velocity, women's muscular ratios assessed at 1.05 rad · s?¹ were significantly lower than at 5.23 rad · s?¹ for all sports; among men, only judokas presented lower ratios at 1.05 rad · s?¹ than at 5.23 rad · s?¹. The present results suggest that sport modality and angular velocity influence the isokinetic strength profiles of men and women. PMID:22364375
Andrade, Marilia Dos Santos; De Lira, Claudio Andre Barbosa; Koffes, Fabiana De Carvalho; Mascarin, Naryana Cristina; Benedito-Silva, Ana Amélia; Da Silva, Antonio Carlos
This study examines year-to-year (1965, 1976 to 1977) and state-to-state (six western United States) cost variations in relation to injury site, severity, and repetition of high school football injuries. Data were collected from the files of the largest single insurer of secondary school students in these states. Analysis was made through a specially programmed Qantel 1300 computer. The average claim cost in 1965 was $34.72 in 1976 was $149.93, and, in 1977, it was $177.95. The average cost was lowest in Utah and highest in California. In the 1976 to 1977 season, 3,501 claims from 15,252 players were reported. Over 25% of the claims filed were from players who had more than come claim per season. Relatively minor injuries (sprains, strains, contusions, and abrasions) accounted for 72.3% of all injuries but only 42.4% of medical costs. Lower extremity injuries accounted for one-third of the injuries and one-half of the costs. Knee injuries alone accounted for 12.7% of all injuries and 31.8% of all medical costs paid by the insurance company. It is proposed that trainers and coaches not only know how to care for minor injuries but also that they are more rigid in their criteria for fitness, agility, stamina, and psychologic factors so that players predisposed to injury and repeated injuries will not contribute to the escalating medical costs of high school football injuries. PMID:7377453
Pritchett, J W
Introduction. Preoperative identification of patients with inadequate hamstring grafts for anterior cruciate ligament reconstruction is still a subject of interest. Purpose. The purpose of this study was to determine whether the semitendinosus tendon length is adequate for four-strand graft harvested by common technique (without bone plug) and whether there is correlation of gracilis and semitendinosus tendon grafts length and diameter of quadrupled graft with anthropometric parameters. Materials and Methods. In this retrospective study, 61 patients (45 males, 16 females) undergoing ACL reconstruction using four-strand hamstring autograft tendons were included. Results. The length of semitendinosus tendon, harvested by the common technique, was in 21% of our cases inadequate in order to be used alone as a four-strand graft especially in females (43%). There was moderate correlation between semitendinosus and gracilis graft diameter and patient's height and weight and fair correlation to BMI. We found no statistically important predictor for graft diameter in female patients. Conclusions. The length of semitendinosus tendon, harvested by common technique, is usually inadequate to be used alone as a four-strand graft especially in females. The most reliable predictor seems to be patient's height in males. In female patients, there is no statistically important predictor.
Stergios, Papastergiou G.; Georgios, Konstantinidis A.; Konstantinos, Natsis; Efthymia, Papathanasiou; Nikolaos, Koukoulias; Alexandros, Papadopoulos G.
In a prospective study of 302 adolescent players in three ball games (soccer, handball and basketball), 119 incurred injuries. The injury incidence (number of injuries per 1000 playing hours) was 5.6 in soccer, 4.1 in handball and 3.0 in basketball. Ankle sprains accounted for 25 per cent of the injuries, finger sprains 32 per cent, strains in the thigh and
J Yde; A B Nielsen
Details of the sports injuries occurring in 6799 children between the ages of 10 and 18 were recorded during the course of one academic year (September to June). One hundred sixteen injuries were noted: 29 sprains, 20 fractures, 18 strains, 14 contusions, 10 wounds, 7 dislocations, and 18 other injuries. On average these injuries resulted in 0.47 days of hospitalization,
A. W. S. Watson
Injuries sustained by male and female professional basketball teams were compared. Injuries from two consecutive seasons were coded, and computer-based cross-tabulations comparing sex, body part, and type of injury were performed. The women's injury frequency was 1.6 times that of men. The body part most frequently injured on both teams was the ankle. Women sustained significantly more knee and thigh injuries as well as sprains, strains, and contusions. Men had significantly more muscle spasms. Other injuries occurred in similar patterns in both sexes. Alterations in training programs are suggested with emphasis on women's strengthening and men's flexibility. PMID:6814271
Zelisko, J A; Noble, H B; Porter, M
influência do número de Séries e tempo de alongamento Estático Sobre a Flexibilidade dos Músculos isquiotibiais em Mulheres Sedentárias influence of the number of Sets and time of Static Stretching on the Flexibility of hamstring Muscles in Sedentary Women
Introduction and objective: Stretching exercises are largely used in rehabilitation programs, but the ideal duration and the number of sets have not been determined yet. The purpose of this study was to evaluate the effects of 10 sets-30 seconds and 3 sets-3 minutes of static stretch on flexibility of hamstring muscles, comparing different volumes within 10 minutes. Moreover, to verify
Mariana Vita Milazzotto; Luciana Gruba Corazzina; Richard Eloin Liebano
Quadriceps muscle strains frequently occur in sports that require repetitive kicking and sprinting, and are common in football in its different forms around the world. This paper is a review of aetiology, mechanism of injury and the natural history of rectus femoris injury. Investigating the mechanism and risk factors for rectus femoris muscle injury aims to allow the development of a framework for future initiatives to prevent quadriceps injury in football players. PMID:22864009
Mendiguchia, Jurdan; Alentorn-Geli, Eduard; Idoate, Fernando; Myer, Gregory D
A case of high-voltage electrical injury with massive retroperitoneal muscle necrosis, focal hepatic coagulation necrosis, acute pancreatitis, and an acute coagulopathy with factor V, factor X, and platelet deficits occurred. Visceral involvement by elect...
K. Eurenius P. W. Curreri T. W. Newsome
\\u000a Considerable, complex forces are exerted through the knee during sporting activity making the joint vulnerable to a wide variety\\u000a of acute and chronic injuries. Particularly in athletes, knee injury is common. Clinical assessment alone can be unreliable,\\u000a imaging allows full evaluation of the joint and supporting structures. Knowledge of pathology, knee anatomy, imaging findings\\u000a and common pitfalls is essential to
Melanie A. Hopper; Andrew J. Grainger
\\u000a Sports-related elbow injuries have increased over the last decade. With one in every four members of a household participating\\u000a in sports, both clinics and radiology departments are seeing more patients with elbow injuries. The most common clinical presentation\\u000a is lateral elbow pain. Familiar terms such as “tennis elbow,” “golfer’s elbow,” and “little leaguer’s elbow,” are mostly due\\u000a to the popularity
Kenneth S. Lee; Michael J. Tuite; Humberto G. Rosas
\\u000a The shoulder plays a vital role in many sporting activities and is vulnerable to injury both through direct acute trauma and\\u000a through chronic repetitive injury. These are particularly seen in overhead throwing athletes. The shoulder joint is dependent\\u000a on both the rotator cuff and the labroligamentous complex to maintain its stability and these structures are important in\\u000a the pathophysiology of
Andrew J. Grainger; Phillip F. J. Tirman
There are two categories of cold injury. The first is hypothermia, which is a systemic injury to cold, and the second is frostbite, which is a local injury. Throughout history, entire armies, from George Washington to the Germans on the Russian Front in World War II, have fallen prey to prolonged cold exposure. Cold injury is common and can occur in all seasons if ambient temperature is lower than the core body temperature. In the 1985 Boston Marathon, even though it was 76 degrees and sunny, there were 75 runners treated for hypothermia. In general, humans adapt poorly to cold exposure. Children are at particular risk because of their relatively greater surface area/body mass ratio, causing them to cool even more rapidly than adults. Because of this, the human's best defense against cold injury is to limit his/her exposure to cold and to dress appropriately. If cold injury has occurred and is mild, often simple passive rewarming such as dry blankets and a warm room are sufficient treatment. PMID:17630517
Kruse, R J
The aim of the present study was to analyze the injury patterns in professional world cup windsurfing. The one handed jumps and loops are combined with a high risk of injury. 49 world cup professional windsurfers (39 men, 10 women) could be asked regarding their injuries in their professional career. Questionnaires were used in German, English or French. Furthermore the windsurfers were asked about prophylaxis against injuries. 260 injuries could be stated: 43 injuries of the head (17%), 40 injuries of the trunk (15%), 23 injuries of the upper extremity (9%). The majority of the injuries were stated at the lower extremity (n = 154, 59%). As far as the lower extremity is concerned, the strain of the ankle joint was dominating (n = 57). With 22% of all mentioned injuries this was the most common injury and 61% of the windsurfers claimed about an injury of the ankle joint. An injury of the knee was stated in 30 windsurfers, whereby 80% of these injuries were severe injuries of the ligaments or the meniscus. Only 10% of the professionals used a helmet to prevent injuries of the head. The cause of the head injuries are the spectacular jumps like loopings or table tops. The cumulation of injuries of the lower extremity is due to the fixation of the feet in the footstraps. The fixation on the feet leads to extreme rotatory forces in the knee joint in case of a fall. Furthermore the fixation of the feet leads to a high rate of ankle joint strain. In order to prevent injuries a helmet should be used and special footstraps should be developed, which ensure a release of the foot in the danger area. PMID:11475622
Gosheger, G; Jägersberg, K; Linnenbecker, S; Meissner, H J; Winkelmann, W
Exposure to cold can produce a variety of injuries that occur as a result of man's inability to adapt to cold. These injuries can be divided into localized injury to a body part, systemic hypothermia, or a combination of both. Body temperature may fall as a result of heat loss by radiation, evaporation, conduction, and convection. Hypothermia or systemic cold injury occurs when the core body temperature has decreased to 35 degrees C (95 degrees F) or less. The causes of hypothermia are either primary or secondary. Primary, or accidental, hypothermia occurs in healthy individuals inadequately clothed and exposed to severe cooling. In secondary hypothermia, another illness predisposes the individual to accidental hypothermia. Hypothermia affects multiple organs with symptoms of hypothermia that vary according to the severity of cold injury. The diagnosis of hypothermia is easy if the patient is a mountaineer who is stranded in cold weather. However, it may be more difficult in an elderly patient who has been exposed to a cold environment. In either case, the rectal temperature should be checked with a low-reading thermometer. The general principals of prehospital management are to (1) prevent further heat loss, (2) rewarm the body core temperature in advance of the shell, and (3) avoid precipitating ventricular fibrillation. There are two general techniques of rewarming--passive and active. The mechanisms of peripheral cold injury can be divided into phenomena that affect cells and extracellular fluids (direct effects) and those that disrupt the function of the organized tissue and the integrity of the circulation (indirect effects). Generally, no serious damage is seen until tissue freezing occurs. The mildest form of peripheral cold injury is frostnip. Chilblains represent a more severe form of cold injury than frostnip and occur after exposure to nonfreezing temperatures and damp conditions. Immersion (trench) foot, a disease of the sympathetic nerves and blood vessels in the feet, is observed in shipwreck survivors or in soldiers whose feet have been wet, but not freezing, for long periods. Patients with frostbite frequently present with multisystem injuries (e.g., systemic hypothermia, blunt trauma, substance abuse). The freezing of the corneas has been reported to occur in individuals who keep their eyes open in high wind-chill situations without protective goggles (e.g., snowmobilers, cross-country skiers). PMID:15715518
Long, William B; Edlich, Richard F; Winters, Kathryne L; Britt, L D
Injuries to the quadriceps muscle group occur frequently in sports and athletic activities. Muscle strains and contusions constitute the majority of these injuries. The clinical presentation and assessment of quadriceps strains and contusions are reviewed along with discussion of appropriate imaging used in diagnosis. Treatment protocols for acute injuries are reviewed including rehabilitation techniques frequently utilized during recovery. Special consideration is given to discussing the criteria for return to sports for athletes after injury. Myositis ossificans is a potentially disabling complication from quadriceps contusions and risk factors, prevention, and treatment are reviewed.
Oakley, ET, Pardeiro, RB, Powell, JW, and Millar, AL. The effects of multiple daily applications of ice to the hamstrings on biochemical measures, signs, and symptoms associated with exercise-induced muscle damage. J Strength Cond Res 27(10): 2743-2751, 2013-There is inconclusive evidence for the effectiveness of cryotherapy for the treatment of exercised-induced muscle damage (EIMD). Small sample sizes and treatment applications that did not correspond to evidence-based practice are limitations in previous studies that may have contributed to these equivocal findings. The purpose of this study was to examine the effectiveness of daily multiple applications of ice on EIMD throughout the 72-hour recovery period, an icing protocol that more closely resembles current clinical practice. Thirty-three subjects were assigned to either the cryotherapy group (n = 23) or control group (n = 10). The EIMD was induced through repeated isokinetic eccentric contractions of the right hamstring muscle group. The experimental group received ice immediately after induction of EIMD and continued to ice thrice a day for 20 minutes throughout the 72 hours; the control group received no intervention. Isometric torque, hamstring length, pain, and biochemical markers (creatine kinase [CK], alanine aminotransferase, and aspartate aminotransferase [AST]) were assessed at baseline, 24, 48, and 72 hours. Both groups demonstrated a significant change (p < 0.05) in all dependent variables compared with that at baseline, but there was no difference between groups except for pain. The cryotherapy group had significantly (p = 0.048) less pain (3.0 ± 2.1 cm) compared with the control (5.35 ± 2.5 cm) at 48 hours. Although not statistically significant, the cryotherapy group had a greater range of motion and lower CK and AST means at 72 hours compared with that of the control group. Repeated applications of ice can decrease the pain associated with EIMD significantly at 48 hours post EIMD. Although the results may not be unique, the methodology in this study was distinctive in that we used a larger sample size and an icing protocol similar to current recommended treatment practice. PMID:23364294
Oakley, Elizabeth T; Pardeiro, Rafael B; Powell, Joseph W; Millar, Audrey L
As the popularity of trampolines has increased during the past 10 years, so has the number of injuries sustained using them. Whether there is an actual increase in the risk associated with the use of a trampoline for the same number of exposure hours is not known. The marked increase in emergency room visits related to trampoline injuries might reflect only the increased number of trampolines now available for recreational use or the creative manner in which they are being used. The complex factors related to trampolines, their use, and the possible injuries will be discussed. A liberal use of Internet references will be used because this is where much of the advertising and information available to the public regarding trampolines currently is disseminated. PMID:12671484
Esposito, Paul W
Thoracolumbar injuries represent an unique neurologic injury. In light of the potential for recovery in the roots of the cauda equina, an aggressive plan of management should be undertaken, to absolutely ensure an adequate decompression of the spinal canal and neural elements, but in addition to accomplish a simultaneous bony reduction and fusion of the injury site. Traditional laminectomy alone has minimal benefit in most of these cases, since compression is usually anterior and decompression is best achieved through a posterolateral or anterior transthoracic approach. The best avenue of decompression is dictated by a careful and complete preoperative radiographic evaluation, including polytomography and CT scanning. Utilization of this aggressive plan of management can then offer an optimum milieu for neurologic recovery and at the same time produce solid, pain-free bony healing with a minimum of spinal deformity. PMID:6667592
Seljeskog, E L
The shock wave generated by an explosion ("blast wave") may cause injury in any or all of the following: (1) direct impact on the tissues of variations in environmental pressure; (2) flying glass and other debris set in motion by it; (3) propulsion of the body. Injuries in the first category affect gas-containing organs (ears, lungs and intestines), and acute death is attributed to air forced into the coronary vessels via damaged pulmonary alveoli. It is estimated that overpressure sufficient to cause lung injury may occur up to five miles from a 20-megaton nuclear explosion. The greatest single hazard from blast is, however, flying glass, and serious wounding from this cause is possible up to 12 miles from an explosion of this magnitude. PMID:6015742
de Candole, C A
The shock wave generated by an explosion (“blast wave”) may cause injury in any or all of the following: (1) direct impact on the tissues of variations in environmental pressure; (2) flying glass and other debris set in motion by it; (3) propulsion of the body. Injuries in the first category affect gas-containing organs (ears, lungs and intestines), and acute death is attributed to air forced into the coronary vessels via damaged pulmonary alveoli. It is estimated that overpressure sufficient to cause lung injury may occur up to five miles from a 20-megaton nuclear explosion. The greatest single hazard from blast is, however, flying glass, and serious wounding from this cause is possible up to 12 miles from an explosion of this magnitude.
de Candole, C. A.
Purpose The purpose of this study was to compare the anterior tibial translation (ATT) of the anterior cruciate ligament (ACL) reconstructed-knee between single-bundle and double-bundle ACL reconstruction under cyclic loading. Methods Single-bundle and double-bundle reconstructions of the knee were performed sequentially in randomized order on the same side using eight human amputated knees. After each reconstruction, the reconstructed-knee was subjected to 500-cycles of 0 to 100-N anterior tibial loads using a material testing machine. The ATT before and after cyclic loading and “laxity increase”, which indicated a permanent elongation of the graft construct, was also determined. Results The ATT after cyclic loading increased in both single-bundle and double-bundle reconstruction techniques compared to that without cyclic loading. Changes in ATT before and after cyclic loading were 3.9?±?0.9 mm and 2.9?±?0.6 mm respectively, and were significantly different. Laxity increase was also significantly different (4.3?±?0.9 mm and 3.2?±?0.8 mm respectively). Although no graft rupture or graft fixation failure was found during cyclic loading, the graft deviated into an eccentric position within the tunnel. Conclusions Although ATT was significantly increased in both single-bundle and double-bundle reconstruction with hamstring tendon after cyclic loading test, there was significant difference. Double-bundle reconstruction might be superior to prevent increasing ATT under cyclic loading. Deformation of hamstring tendon after cyclic loading might result in deterioration of knee stability after ACL reconstruction, and is one of disadvantages of soft tissue graft.
Objectives: To conduct a detailed analysis of preseason football injuries sustained in English professional football over two competitive seasons. Methods: Club medical staff at 91 professional football clubs annotated player injuries. A specific injury audit questionnaire was used together with a weekly form that documented each club's current injury status. Results: 17% (1025) of the total number of injuries over the two seasons were sustained during the preseason, the mean number of days absent per injury was 22.3 days. Younger age groups (17–25 yrs) were more likely to sustain a preseason injury than more experienced players (26–35+) (p<0.01). There were relatively more "slight" and "minor" injuries (as defined in the methodology), overuse, and tendon related injuries sustained during preseason compared to the in season (p<0.01). The thigh (23%), knee (17%), and ankle (17%) were the most common locations for injuries during the preseason, there was a relatively greater number of lower leg injuries (15%) during the preseason (p<0.05). Achilles tendonitis was most prevalent in the preseason, with 33% of all Achilles related injuries sustained during this period (p<0.01). Muscle strains were the most common injury during preseason (37%). Rectus femoris muscle strains were observed twice as frequently during the preseason relative to the in season (p<0.01). Ligament sprains were the second most common injury during preseason (19%). Non-contact mechanisms were the cause of significantly more injuries during the preseason (p<0.01), with relatively more preseason injuries sustained while running or shooting (p<0.01). For 70% of the injuries reported during the preseason, the ground condition was described as dry. Conclusions: Players are at a greater risk of slight and minor injuries, overuse injuries, lower leg injuries (especially the Achilles tendon) and rectus femoris strains during the preseason period. Prevention of preseason injury is important to ensure availability of players for the commencement of the season and to decrease the risk of injury later in the season, we recommend the implementation of a risk management policy for this purpose. Areas requiring further investigation include methods of prevention for the common preseason injuries that have been identified, a detailed analysis of preseason and closed season training programmes, and a smaller study involving exposure data.
Woods, C; Hawkins, R; Hulse, M; Hodson, A; Andersen, T; Bahr, R
Increased levels of oxidants and compromised compensatory response are associated with CVD susceptibility. We hypothesized that rat strains demonstrating genetic CVD will have lower levels of antioxidants and greater ozone-induced pulmonary injury relative to healthy strains. Mal...
Electrical trauma can be caused by low-voltage current (from 60 to 1000 V, usually 220 or 360 V), high-voltage (more than 1000 V) current, lightning, and voltaic arc. Often victims are little children, teenagers, and working-age adults. Electrical injuries and clinical manifestations can vary a lot and range from mild complaints not demanding serious medical help to life-threatening conditions. Lightning causes serious injuries in 1000-1500 individuals every year worldwide. The case fatality rate is about 20-30%, with as many as 74% of survivors experiencing permanent injury and sequela. The primary cause of death in victims of lightning strike or other electrical trauma is cardiac or respiratory arrest. That is why appropriate urgent help is essential. Subsequently electrical burns, deep-tissue and organ damage caused by electricity, secondary systemic disorders often demand intensive care and prompt, usually later multistage surgical treatment; therefore, prevention of electrical trauma, which would help to reduce electrical injuries in children and working-age population, is very actual. The most important is to understand the possible danger of electricity and to avoid it. PMID:17413256
Adukauskiene, Dalia; Vizgirdaite, Venta; Mazeikiene, Sandra
... and treat. WHY DO OVERUSE INJURIES OCCUR? The human body has a tremendous capacity to adapt to physical stress. In fact, many positive changes occur as a result of this. With exercise and activity, bones, muscles, tendons, and ligaments get stronger and more functional. ...
... impingement is an overuse injury that causes achy pain on the front or side of the shoulder. The pain is felt most when the arm is overhead ... extremity and trunk strengthening. Strength in the legs, hips, and trunk is crucial for ... IV Restore function Resume overhead motion ...
The purpose of this research was to use vehicle impact test data and parametric finite element analysis to study the contribution of translational accelerations (TransAcc) and rotational accelerations (RotAcc) on strain-induced head injuries. Acceleration data were extracted from 33 non-contact vehicle crash tests conducted by the US Department of Transportation, National Highway Traffic Safety Administration. A human finite element head model was exercised using head accelerations from the nine accelerometer package placed inside the driver dummy in these tests. Three scenarios were parameterized: both TransAcc and RotAcc, only TransAcc, and only RotAcc to demonstrate the contribution of these accelerations on brain injury. Brain strains at multiple elements, cumulative strain damage, dilatation damage, and relative motion damage data were compared. Rotational accelerations contributed to more than 80% of the brain strain. Other injury metrics also supported this finding. These findings did not depend on the crash mode, peak amplitude of translational acceleration (29 to 120 g), peak amplitude of rotational acceleration (1.3 to 9.4 krad/s ( 2 ) ) or HIC (68-778). Rotational accelerations appeared to be the major cause of strain-induced brain injury. PMID:16968626
Zhang, Jiangyue; Yoganandan, Narayan; Pintar, Frank A; Gennarelli, Thomas A
In order to identify the specific risk and injury factors related to rail freight/transport, road haulage/transport, and business conveyance, the INAIL data/memory bank was searched for occupational diseases and injuries/accidents. In road haulage and business conveyance, osteoarticular diseases prevail, while in rail freight asbestos diseases are predominant. The permanent disability is more severe in road haulage than in business conveyance. Occupational injuries are more frequent in road transport and business conveyance in northern regions of Italy and consisted mainly in sprains/strains and dislocations. More frequently the workers recovered without serious hangovers. PMID:23405648
Neurologic running injuries account for a small number of running injuries. This may be caused by misdiagnosis or underdiagnosis. Nerve injuries that have been reported in runners include injuries to the interdigital nerves and the tibial, peroneal, and sural nerves. In this article, the etiology, symptoms, diagnosis, and treatment of these injuries are reviewed. Differences between nerve injury and more common musculoskeletal injury have been presented to aid in differential diagnosis. PMID:18295096
McKean, Kelly A
Neurologic running injuries account for a small number of running injuries. This may be caused by misdiagnosis or underdiagnosis. Nerve injuries that have been reported in runners include injuries to the interdigital nerves and the tibial, peroneal, and sural nerves. In this article, the etiology, symptoms, diagnosis, and treatment of these injuries are reviewed. Differences between nerve injury and more common musculoskeletal injury have been presented to aid in differential diagnosis. PMID:19084775
McKean, Kelly A
Objectives—To undertake a prospective epidemiological study of the injuries sustained in English professional football over two competitive seasons. Methods—Player injuries were annotated by club medical staff at 91 professional football clubs. A specific injury audit questionnaire was used together with a weekly form that documented each club's current injury status. Results—A total of 6030 injuries were reported over the two seasons with an average of 1.3 injuries per player per season. The mean (SD) number of days absent for each injury was 24.2 (40.2), with 78% of the injuries leading to a minimum of one competitive match being missed. The injury incidence varied throughout the season, with training injuries peaking during July (p<0.05) and match injuries peaking during August (p<0.05). Competition injuries represented 63% of those reported, significantly (p<0.01) more of these injuries occurring towards the end of both halves. Strains (37%) and sprains (19%) were the major injury types, the lower extremity being the site of 87% of the injuries reported. Most injury mechanisms were classified as being non-contact (58%). Re-injuries accounted for 7% of all injuries, 66% of these being classified as either a strain or a sprain. The severity of re-injuries was greater than the initial injury (p<0.01). Conclusions—Professional football players are exposed to a high risk of injury and there is a need to investigate ways of reducing this risk. Areas that warrant attention include the training programmes implemented by clubs during various stages of the season, the factors contributing to the pattern of injuries during matches with respect to time, and the rehabilitation protocols employed by clubs. Key Words: football; injuries; prevention
Hawkins, R; Hulse, M; Wilkinson, C; Hodson, A; Gibson, M
We undertook this study to determine the types and frequency of injuries sustained in the sport of luge. Before this study, no data were available in the medical literature on luge injuries. We performed a retrospective analysis between the years 1985 and 1992 using data obtained from the athlete injury and illness report forms at the US Training Center Sports Medicine Clinic in Lake Placid, New York. During the 7 years examined, 1043 athletes took 57,244 track runs and sustained 407 injuries. The risk of sustaining an injury was 0.39 per person per year, and the risk of an injury causing the loss of more than 1 day of practice was 0.04 per person per year. Contusions were the major injury (51%), followed by strains (27%). Strains of the neck muscles and contusions of extremities, especially the hands, were characteristic injuries sustained by athletes. The most serious injuries were concussions (2%) and fractures (3%). Crashes were responsible for 64% of injuries. Luge appears to be a relatively safe sport with injury rates comparable with recreational alpine skiing. PMID:9240985
Cummings, R S; Shurland, A T; Prodoehl, J A; Moody, K; Sherk, H H
Injury costs strain the finances of many dance companies. The objectives of this study were to analyze the effect of comprehensive management on injury patterns, incidence, and time loss and examine its financial impact on workers compensation premiums in a modern dance company. In this retrospective-prospective cohort study, injury was defined as any physical insult that required financial outlay (workers compensation or self insurance) or caused a dancer to cease dancing beyond the day of injury (time-loss injury). Injury data and insurance premiums were analyzed over an eight-year period. Injuries were compared using a mixed linear model with phase and gender as fixed effects. It was found that comprehensive management resulted in 34% decline in total injury incidence, 66% decrease in workers compensation claims, and 56% decrease in lost days. These outcomes achieved substantial savings in workers compensation premiums. Thus, this study demonstrates the effectiveness of an injury prevention program in reducing injury-related costs and promoting dancers' health and wellness in a modern dance company. PMID:22040757
Ojofeitimi, Sheyi; Bronner, Shaw
There has been a decrease in the overall injury rate, particularly the rate of lower-extremity injuries, for alpine skiing, with a resultant increase in the ratio of upper-extremity to lower-extremity injuries. The upper extremity is injured nearly twice as often during snowboarding than alpine skiing, with approximately half of all snowboarding injuries involving the upper extremity. Shoulder injuries are likely under-reported, as many patients seek evaluation for minor shoulder injuries with their local physicians, and not at the ski medical clinic, where most epidemiology studies obtain their data. Shoulder injuries account for 4 to 11% of all alpine skiing injuries and 22 to 41% of upper-extremity injuries. During snowboarding, shoulder injuries account for 8 to 16% of all injuries and 20 to 34% of upper-extremity injuries. Falls are the most common mechanism of shoulder injury, in addition to pole planting during skiing and aerial manoeuvres during snowboarding. Common shoulder injuries during skiing and snowboarding are rotator cuff strains, glenohumeral dislocations, acromioclavicular separations and clavicle fractures. It is still unclear, when comparing snowboarding and skiing injury data, which sport has the higher incidence of shoulder injuries. Stratifying shoulder injuries by type allows better delineation as to which sport has an increased incidence of certain injury patterns. The differing mechanisms of injury combined with distinct equipment for each sport plays a role in the type and frequency of shoulder injuries seen in these two subgroups. With the increased ratio of upper- to lower-extremity injuries during alpine skiing and the boom in popularity of snowboarding, shoulder injuries are seen with increasing frequency by those who care for alpine sport injuries. According to recent epidemiological data, only clavicle and humerus fractures have shown increased rates of incidence among alpine skiers. Over the past 30 years, there has been a general decrease in both upper- and lower-extremity injuries which can be attributed to improved designs of protective equipment, increased awareness of injury patterns and emphasis on prevention. In the future, physicians and therapists who treat this population must be comfortable and confident in their treatment algorithms to help keep skiers and snowboarders conditioned and ready for the slopes and develop strategies for the prevention of upper-extremity injuries associated with these activities. PMID:19945981
McCall, D; Safran, M R
This retrospective longitudinal study aims to describe reported Taekwondo injuries and to examine associations between competitor experience level, age and gender, and the type, location, and mechanism of injury sustained. Additionally, we examined whether recent rule changes concerning increased point value of head shots in adult Taekwondo competition had affected injury incidence. This study was a summation of 9 years of data of competition injury reports, which included 904 injury reports spanning 58 individual competitions. The data was collected on standardized injury reports at time of injury during competition. Care was provided to the athletes, but the type of care provided was not included in the study. Participants included athletes injured during competition who sought care by the health care team, and for whom an injury report was filled out. The data analysis was performed at the Canadian Memorial Chiropractic College. The three most common locations of presenting injury were the head (19%), foot (16%), and thigh (9%). The most common mechanism of presenting injury was found to be a defensive kick (44%), followed by an offensive kick (35%). The most commonly diagnosed injuries were contusions (36%), sprains (19%), and strains (15%). Coloured belts had a higher incidence of contusions, while black belts sustained more joint irritation injuries. Black belts were more likely to suffer multiple injuries. Colored belts suffered more injuries while receiving a kick, while black belts had a larger influence of past history of injury. We found no significant difference in location or type of injury when comparing pre versus post rule change. The most common locations of injury are head, foot, and thigh respectively, and are areas for concern when considering preventative measures. Colour belt competitors are more likely to sustain contusions, which the authors believe is due to more aggressive tactics and lack of control. Those more likely to be injured tend to be younger than 18 years. Recent rule changes have no significant effect on head injuries.
Kazemi, Mohsen; Chudolinski, Artur; Turgeon, Matt; Simon, Aaron; Ho, Eric; Coombe, Lianne
This retrospective longitudinal study aims to describe reported Taekwondo injuries and to examine associations between competitor experience level, age and gender, and the type, location, and mechanism of injury sustained. Additionally, we examined whether recent rule changes concerning increased point value of head shots in adult Taekwondo competition had affected injury incidence.This study was a summation of 9 years of data of competition injury reports, which included 904 injury reports spanning 58 individual competitions. The data was collected on standardized injury reports at time of injury during competition. Care was provided to the athletes, but the type of care provided was not included in the study. Participants included athletes injured during competition who sought care by the health care team, and for whom an injury report was filled out. The data analysis was performed at the Canadian Memorial Chiropractic College.The three most common locations of presenting injury were the head (19%), foot (16%), and thigh (9%). The most common mechanism of presenting injury was found to be a defensive kick (44%), followed by an offensive kick (35%). The most commonly diagnosed injuries were contusions (36%), sprains (19%), and strains (15%). Coloured belts had a higher incidence of contusions, while black belts sustained more joint irritation injuries. Black belts were more likely to suffer multiple injuries. Colored belts suffered more injuries while receiving a kick, while black belts had a larger influence of past history of injury. We found no significant difference in location or type of injury when comparing pre versus post rule change. The most common locations of injury are head, foot, and thigh respectively, and are areas for concern when considering preventative measures. Colour belt competitors are more likely to sustain contusions, which the authors believe is due to more aggressive tactics and lack of control. Those more likely to be injured tend to be younger than 18 years. Recent rule changes have no significant effect on head injuries. PMID:20037692
Kazemi, Mohsen; Chudolinski, Artur; Turgeon, Matt; Simon, Aaron; Ho, Eric; Coombe, Lianne
The authors report the case of a 38-year-old male who presented to the accident and emergency department with a locked knee after falling from a height. The knee was locked at 35° of flexion without any signs of instability in clinical examination. The patient was operated within 6 h from injury. During arthroscopy bucket-handle tears of both medial and lateral menisci were found. The bucket-handle fragments were displaced into the intercondylar notch causing the knee to lock. Additionally, tears of the anterior cruciate ligament (ACL) and the medial collateral ligament (MCL) were also found. The patient underwent ACL reconstruction with hamstrings autograft, medial subtotal meniscectomy and lateral meniscus repair. The MCL was treated conservatively. The postoperative period was uneventful and the patient returned to the preinjury level of activity within 8 months. The patient remains asymptomatic 2 years postoperatively.
Koukoulias, Nikolaos E; Kyparlis, Dimitris; Koumis, Panagiotis; Lola, Despoina; Papastergiou, Stergios G
Objective: To review the current evidence for the epidemiology of pediatric injuries in martial arts. Data sources: The relevant literature was searched using SPORT DISCUS (keywords: martial arts injuries, judo injuries, karate injuries, and taekwondo injuries and ProQuest (keywords: martial arts, taekwondo, karate, and judo), as well as hand searches of the reference lists. Main results: In general, the absolute
This study evaluated the effects of competitive intensity, represented by the variables time in competition, phase of play, and field location, on injury severity in U.S. high school football. The injury rate was higher in competition than practice (RR?=?4.75, 95% CI: 4.34–5.20). Mild and moderate injuries were frequently lower leg\\/foot\\/ankle sprains\\/strains and concussions. Severe injuries were frequently knee Sprains\\/strains and
Ellen E. Yard; R. Dawn Comstock
Background/Objective: Children with spinal cord injury (SCI) are at risk for musculoskeletal and cardiovascular complications. Stationary cycling using functional electrical stimulation (FES) or passive motion has been suggested to address these complications. The purpose of this case series is to report the outcomes of a 6-month at-home cycling program for 4 children with SCI. Methods: Two children cycled with FES and 2 cycled passively at home for 1 hour, 3 times per week. Outcome Measures: Data collected included bone mineral density of the left femoral neck, distal femur, and proximal tibia; quadriceps and hamstring muscle volume; stimulated quadriceps and hamstring muscle strength; a fasting lipid profile; and heart rate and oxygen consumption during incremental upper extremity ergometry testing. Results: The 2 children cycling with FES and 1 child cycling passively exhibited improved bone mineral density, muscle volume, stimulated quadriceps strength, and lower resting heart rate. For the second child cycling passively, few changes were realized. Overall, the lipid results were inconsistent, with some positive and some negative changes seen. Conclusions: This case series suggests that cycling with or without FES may have positive health benefits and was a practical home exercise option for these children with SCI.
Johnston, Therese E; Smith, Brian T; Oladeji, Oluwabunmi; Betz, Randal R; Lauer, Richard T
Background Prospective measures of high knee abduction moment during landing identify female athletes at high risk for non-contact anterior cruciate ligament injury. Biomechanical laboratory measurements predict high knee abduction moment landing mechanics with high sensitivity (85%) and specificity (93%). The purpose of this study was to identify correlates to laboratory-based predictors of high knee abduction moment for use in a clinic-based anterior cruciate ligament injury risk prediction algorithm. The hypothesis was that clinically obtainable correlates derived from the highly predictive laboratory-based models would demonstrate high accuracy to determine high knee abduction moment status. Methods Female basketball and soccer players (N=744) were tested for anthropometrics, strength and landing biomechanics. Pearson correlation was used to identify clinically feasible correlates and logistic regression to obtain optimal models for high knee abduction moment prediction. Findings Clinical correlates to laboratory-based measures were identified and predicted high knee abduction moment status with 73% sensitivity and 70% specificity. The clinic-based prediction algorithm, including (Odds Ratio: 95% confidence interval) knee valgus motion (1.43:1.30–1.59 cm), knee flexion range of motion (.98:0.96–1.01 deg), body mass (1.04:1.02–1.06 kg), tibia length (1.38:1.25–1.52 cm) and quadriceps to hamstring ratio (1.70:1.06–2.70) predicted high knee abduction moment status with C statistic 0.81. Interpretation The combined correlates of increased knee valgus motion, knee flexion range of motion, body mass, tibia length and quadriceps to hamstrings ratio predict high knee abduction moment status in female athletes with high sensitivity and specificity.
Myer, Gregory D.; Ford, Kevin R.; Khoury, Jane; Succop, Paul; Hewett, Timothy E.
|Over a two-year period this study evaluated the condition of 65 athletes with nerve injuries. These injuries represent the spectrum of nerve injuries likely to be encountered in sports medicine clinics. (Author/MT)|
Collins, Kathryn; And Others
Avulsion injuries of the apophysis is a problem in young athletes. A correct diagnosis is necessary for establishing the appropriate treatment and the rehabilitation program. However, it is often difficult to distinguish between a simple muscle strain and an avulsion fracture. The X-ray examination is helpful only when an ossification center of the apophysis exists. Ultrasonography is considered the suitable
D. Lazovi?; U. Wegner; G. Peters; F. Gossé
The aim of this study was to investigate accidents which occur in connection with horse-riding. The material was found in a data base covering 14% of all case registered in Casualty Departments in Denmark. The number of horse-riding accidents has increased by 150% from 1986 to 1996. The majority of these were girls. The age group 10-19 years accounted for 61% of the accidents. The majority of injuries occurred on falling from the horse and particularly involved the upper part of the body. Out of 1250 injuries, 24% sustained a fracture: 64% were located to the upper extremities, and 19% lower extremities. One hundred patients required hospitalization: 29 for observation for concussion; 51 for reduction of fractures and osteosynthesis; 13 for contusion. Forty-five percent of the accidents happened in a riding arena and 25% in a stable. It is concluded that the proportion of horse-riding accidents is strongly on the increase in Ribe County. PMID:9846094
Houshian, S; Freund, K G
An innovative technique for anterior cruciate ligament (ACL) reconstruction has been developed in 1998 which allows the grafts to be fixed by press-fit to the femoral and tibial tunnel without any hardware. The semitendinosus (ST) and gracilis tendons (GT) are built into a sling by tying a knot with the tendon ends and securing the knot after conditioning by sutures. For the femoral tunnel the anteromedial porta is used. The correct anatomic position of the single femoral tunnel is checked using intraoperative lateral fluoroscopy by placing the tip of a K-wire to a point between the anteromedial and posterolateral bundle insertion sites. A femoral bottleneck tunnel is drilled to receive the knot of the tendons. The tendon loops filled the tibial tunnel without any suture material. The loops are fixed at the tibial tunnel outlet with tapes over a bone bridge. Between 1998 and 1999 a prospective randomized study (level 1) was conducted comparing this technique with a technique using bone-patellar-tendon graft and press-fit fixation without hardware. In conclusion it was found that implant-free press-fit ACL reconstruction using bone-patella-tendon (BPT) and hamstring tendon (HT) grafts proved to be an excellent procedure to restore stability and function of the knee. Using hamstring tendons (ST and GT) significantly lower donor site morbidity was noted. Kneeling and knee walking pain persisted to be significantly more intense in the BPT up to 9 years after the operation. Re-rupture rates, subjective findings, knee stability and isokinetic testing showed similar results for both grafts. This is the first level I study which demonstrates cartilage protection by ACL reconstruction as long as the meniscus is intact at index surgery, shown by bilateral MRI analysis 9 years post-operation. There was no significant difference in the average grade of chondral and meniscus lesions between BPT and HT and in comparison of the operated to the intact knee, except for grade 3-4 lesions found at the 9 year follow-up, which were significantly higher in the BPT group. PMID:20607509
Pässler, H H
The objective of this study was to describe the number, types and locations of known injuries occurring across different age categories and levels of competition in female ice hockey within the Ontario Women's Hockey Association from 2004/05 to 2007/08. We further examined under which aforementioned factors and combination of factors an unusually high or low number of injuries was recorded. Secondary analysis of anonymized injury data was conducted. The most common known injury type was strain/sprain, followed by concussion while the most frequent injury location was head/face/mouth. Analysis of deviance indicated that a significantly higher than expected number of sprain/strain, concussion and laceration injuries were recorded compared to all other injury types. In addition, there were a higher number of injuries recorded at the AA level compared to all other levels of competition. Finally, the age categories of Peewee, Midget and Intermediate within the AA level of competition, as well as Senior/Adult within the Houseleague level of competition also recorded a significantly higher number of injuries compared to other combinations of descriptive factors. Further research with female youth is needed to better understand the high number of injuries, including concussions, reported overall. PMID:23516144
Keightley, M; Reed, N; Green, S; Taha, T
The author describes common sports injuries involving the ear. Such injuries include hematoma, lacerations, foreign bodies (tattoo), and thermal injuries. Ear canal injuries include swimmer's ear and penetrating injuries. Tympanum injuries include tympanic membrane perforations, ossicular discontinuity, eustachian tube dysfunction, temporal bone fractures and traumatic facial nerve palsy. Inner ear injuries include traumatic sensorineural deafness. The author emphasizes the management of these injuries.
Wagner, G. A.
Background Prospective measures of high knee abduction moment (KAM) during landing identify female athletes at high risk for anterior cruciate ligament injury. Laboratory-based measurements demonstrate 90% accuracy in prediction of high KAM. Clinic-based prediction algorithms that employ correlates derived from laboratory-based measurements also demonstrate high accuracy for prediction of high KAM mechanics during landing. Hypotheses Clinic-based measures derived from highly predictive laboratory-based models are valid for the accurate prediction of high KAM status, and simultaneous measurements using laboratory-based and clinic-based techniques highly correlate. Study Design Cohort study (diagnosis); Level of evidence, 2. Methods One hundred female athletes (basketball, soccer, volleyball players) were tested using laboratory-based measures to confirm the validity of identified laboratory-based correlate variables to clinic-based measures included in a prediction algorithm to determine high KAM status. To analyze selected clinic-based surrogate predictors, another cohort of 20 female athletes was simultaneously tested with both clinic-based and laboratory-based measures. Results The prediction model (odds ratio: 95% confidence interval), derived from laboratory-based surrogates including (1) knee valgus motion (1.59: 1.17-2.16 cm), (2) knee flexion range of motion (0.94: 0.89°-1.00°), (3) body mass (0.98: 0.94-1.03 kg), (4) tibia length (1.55: 1.20-2.07 cm), and (5) quadriceps-to-hamstrings ratio (1.70: 0.48%-6.0%), predicted high KAM status with 84% sensitivity and 67% specificity (P < .001). Clinic-based techniques that used a calibrated physician’s scale, a standard measuring tape, standard camcorder, ImageJ software, and an isokinetic dynamometer showed high correlation (knee valgus motion, r = .87; knee flexion range of motion, r = .95; and tibia length, r = .98) to simultaneous laboratory-based measurements. Body mass and quadriceps-to-hamstrings ratio were included in both methodologies and therefore had r values of 1.0. Conclusion Clinically obtainable measures of increased knee valgus, knee flexion range of motion, body mass, tibia length, and quadriceps-to-hamstrings ratio predict high KAM status in female athletes with high sensitivity and specificity. Female athletes who demonstrate high KAM landing mechanics are at increased risk for anterior cruciate ligament injury and are more likely to benefit from neuromuscular training targeted to this risk factor. Use of the developed clinic-based assessment tool may facilitate high-risk athletes’ entry into appropriate interventions that will have greater potential to reduce their injury risk.
Myer, Gregory D.; Ford, Kevin R.; Khoury, Jane; Succop, Paul; Hewett, Timothy E.
Anti-vehicular (AV) landmines and improvised explosive devices (IED) have accounted for more than half of the United States military hostile casualties and wounded in Operation Iraqi Freedom (OIF) (Department of Defense Personnel & Procurement Statistics, 2009). The lower extremity is the predominantly injured body region following an AV mine or IED blast accounting for 26 percent of all combat injuries in OIF (Owens et al., 2007). Detonations occurring under the vehicle transmit high amplitude and short duration axial loads onto the foot-ankle-tibia region of the occupant causing injuries to the lower leg. The current effort was initiated to develop lower extremity injury criteria for occupants involved in underbelly blast impacts. Eighteen lower extremity post mortem human specimens (PMHS) were instrumented with an implantable load cell and strain gages and impacted at one of three incrementally severe AV axial loading conditions. Twelve of the 18 PMHS specimens sustained fractures of the calcaneus, talus, fibula and/or tibia. The initiation of skeletal injury was precisely detected by strain gages and corresponded with local peak axial tibia force. Survival analysis identified peak axial tibia force and impactor velocity as the two best predictors of incapacitating injury. A tibia axial force of 5,931 N and impactor velocity of 10.8 m/s corresponds with a 50 percent risk of an incapacitating injury. The criteria may be utilized to predict the probability of lower extremity incapacitating injury in underbelly blast impacts. PMID:20058557
McKay, Brian J; Bir, Cynthia A
Objective: To describe the epidemiology of work related injury in a group of small scale, independent commercial fishers. Design: Cross sectional survey (baseline instrument of a prospective cohort study). Setting and subjects: Commercial fishers in eastern North Carolina. Results: A cohort of 219 commercial fishers was established and 215 subjects completed an injury questionnaire. The main types of fishing conducted by the cohort were finfishing (159/215) and crabbing (154/215). Of the 215 fishers, 83 reported that they had suffered an injury event in the previous 12 months, a retrospective recall incidence proportion of 38.6 per 100 workers (95% confidence interval 32.1 to 45.1). The 83 injury events resulted in 94 injuries; 47% were penetrating wounds and 24% were strains/sprains. Half of injuries were to the hand/wrist/digits and 13% were to the back. Of the penetrating wounds, 87% were to the hand/wrist/digits, 32% became infected, and 80% were caused by contact with finfish, shellfish, or other marine animal. Of the strains/sprains, 48% were to the back and 26% were to the shoulder. Seventy percent of strains/sprains were caused by moving heavy objects, mainly either while hauling in nets, pots, or lines or loading/unloading the boat. Conclusion: In this group of small scale, independent fishers, the most common reported injuries were penetrating wounds to the hand/wrist/digits from marine animals and strains/sprains to the back while moving heavy objects.
Marshall, S; Kucera, K; Loomis, D; McDonald, M; Lipscomb, H
Household interviews were used to survey 21,105 persons living in 431 urban and rural sites in Ghana, to determine the nature and extent of their occupational injuries. Annual occupational injury rates were 11.5 injuries/1000 persons in the urban areas and 44.9/1000 in the rural areas. Occupational injuries had higher mortality, longer disability, and higher treatment costs than non-occupational injuries. There were substantial occupational injury rates among children, especially in rural areas. In the urban areas, the largest numbers of injuries were to drivers (12.7% of urban occupational injuries) and traders (19.4%), most of which were road-traffic-related. In the rural areas, most injuries (71.6%) were to farm workers. Occupational injuries are a substantial burden in Ghana. Priorities include improving road safety and improving the prevention and treatment of injuries from nonmechanized farming. PMID:16130964
Mock, Charles; Adjei, Samuel; Acheampong, Frederick; Deroo, Lisa; Simpson, Kate
Injury of test cultures was quantitated by differences in colony counts obtained with a complete medium and those obtained on conventional selective media. Staphylococcus aureus, Streptococcus faecalis, and several strains of Escherichia coli were injured when exposed to the quaternary ammonium compound methylalkyltrimethyl ammonium chloride. Representative hypochlorite sanitizers also caused injury of E. coli ML30. Sanitizer concentration appeared to be the main factor in the cause of death and injury, a higher concentration being needed to cause death. Increases in temperature did not result in substantial increases in injury; however, the lethal effect was greater at higher temperatures. Varying the cell concentration from 107 to 109 cells per ml did not change the fraction of cell population killed or injured. The inability or failure of common selective media to detect injured bacteria in food could have serious public health consequences.
Scheusner, D. L.; Busta, F. F.; Speck, M. L.
As with any athlete, the dancer has a high risk for injury. Most studies carried out relate to classical and modern dance; however, there is a lack of reports on injuries involving other dance techniques. This study is an attempt to determine the differences in the incidence, the exposure-related rates, and the kind of injuries in three different dance techniques. A prospective study about dance injuries was carried out between 2004 and 2007 on students of modern, Mexican folkloric, and Spanish dance at the Escuela Nacional de Danza. A total of 1,168 injuries were registered in 444 students; the injury rate was 4 injuries/student for modern dance and 2 injuries/student for Mexican folkloric and Spanish dance. The rate per training hours was 4 for modern, 1.8 for Mexican folkloric, and 1.5 injuries/1,000 hr of training for Spanish dance. The lower extremity is the most frequent structure injured (70.47%), and overuse injuries comprised 29% of the total. The most frequent injuries were strain, sprain, back pain, and patellofemoral pain. This study has a consistent medical diagnosis of the injuries and is the first attempt in Mexico to compare the incidence of injuries in different dance techniques. To decrease the frequency of student injury, it is important to incorporate prevention programs into dance program curricula. More studies are necessary to define causes and mechanisms of injury, as well as an analysis of training methodology, to decrease the incidence of the muscle imbalances resulting in injury. PMID:20795335
Echegoyen, Soledad; Acuña, Eugenia; Rodríguez, Cristina
Background International sports bodies should protect the health of their athletes, and injury surveillance is an important pre-requisite for injury prevention. The Fédération International de Football Association (FIFA) has systematically surveyed all football injuries in their tournaments since 1998. Aims Analysis of the incidence, characteristics and changes of football injury during international top-level tournaments 1998–2012. Methods All newly incurred football injuries during the FIFA tournaments and the Olympic Games were reported by the team physicians on a standardised injury report form after each match. The average response rate was 92%. Results A total of 3944 injuries were reported from 1546 matches, equivalent to 2.6 injuries per match. The majority of injuries (80%) was caused by contact with another player, compared with 47% of contact injuries by foul play. The most frequently injured body parts were the ankle (19%), lower leg (16%) and head/neck (15%). Contusions (55%) were the most common type of injury, followed by sprains (17%) and strains (10%). On average, 1.1 injuries per match were expected to result in absence from a match or training. The incidence of time-loss injuries was highest in the FIFA World Cups and lowest in the FIFA U17 Women's World Cups. The injury rates in the various types of FIFA World Cups had different trends over the past 14?years. Conclusions Changes in the incidence of injuries in top-level tournaments might be influenced by the playing style, refereeing, extent and intensity of match play. Strict application of the Laws of the Games is an important means of injury prevention.
Junge, Astrid; Dvorak, Jiri
The use of platelet-rich plasma (PRP) as an adjuvant to tissue repair is gaining favour in orthopaedic surgery. Tunnel widening after anterior cruciate ligament (ACL) reconstruction is a recognised phenomenon that could compromise revision surgery. The purpose of this study was to determine whether PRP might prevent tunnel widening in ACL reconstruction.Patients undergoing ACL reconstruction using a hamstring graft were randomly allocated either to have PRP introduced into the tunnels peri-operatively or not. CT scanning of the knees was carried out on the day after surgery and at three months post-operatively and the width of the tunnels was measured. Patients were also evaluated clinically at three months, when laxity was also measured.Each group comprised 25 patients, and at three months post-operatively all were pain-free with stable knees, a negative Lachman test and a good range of movement. Arthrometric results had improved significantly in both groups (p < 0.001). Despite slightly less tunnel widening in the PRP group, there was no significant difference between the groups at the femoral opening or the mid-tunnel (p = 0.370 and p = 0.363, respectively) nor at the tibial opening or mid-tunnel (p = 0.333 and p = 0.177, respectively).We conclude that PRP has no significant effect in preventing tunnel widening after ACL reconstruction. PMID:23307675
Mirzatolooei, F; Alamdari, M T; Khalkhali, H R
Medial patellofemoral ligament (MPFL) reconstruction is used to treat patellar instability and recurrent patellar dislocation. Anatomical studies have found the MPFL to be a double-bundle structure. We carried out a meta-analysis of studies reporting outcomes of patellofemoral reconstruction using hamstring tendon autograft in a double-bundle configuration and patellar fixation via mediolateral patellar tunnels. A literature search was undertaken with no language restriction in various databases from their year of inception to July 2012. The primary outcome examined was the post-operative Kujala score. We identified 320 MPFL reconstructions in nine relevant articles. The combined mean post-operative Kujala score was 92.02 (standard error (se) 1.4, p = 0.001) using a fixed effects model and 89.45 (se 37.9, p = 0.02) using random effect modelling. The reported rate of complications with MPFL reconstruction was 12.5% (40 of 320) with stiffness of the knee being the most common. High-quality evidence in assessing double-bundle MPFL reconstruction is lacking. The current literature consists of a mixture of prospective and retrospective case series. High-quality randomised trials evaluating this procedure are still awaited. PMID:23814240
Singhal, R; Rogers, S; Charalambous, C P
The costs and circumstances of low-back strains, low-back impact injuries, and non-low-back injuries among field employees of an offshore petroleum drilling company, 1979-1985, were compared. The objectives were to identify worker and workplace factors associated with low-back injuries, to identify factors differentially associated with lost-time injuries, and to formulate recommendations for the control of low-back injuries. Low-back-impact injuries resulted largely from falls. Efforts to prevent falls would have a potential to reduce other serious consequences as well as back injuries. Workers performing the heaviest physical labor were at highest risk of low-back strains. Based on activities precipitating the injury, modifications of work site, equipment, and procedures to help reduce low-back strains are recommended. Only job was a predictor of whether a low-back strain was likely to be associated with lost time. Even this association was lacking for low-back impact injuries. Cost control by preventing the small proportion of high cost injuries may not be feasible. Rather, subsets of low-back injuries defined, for example, by work site or activity can suggest options for intervention. PMID:1833829
Clemmer, D I; Mohr, D L; Mercer, D J
Background: Stingray injuries with potentially lethal outcomes have been described in the medical literature, but a stingray injury to a surfer does not belong to the injuries treated daily in Germany.Patients: We report on a stingray injury to a 31-year-old female with an uncommon course.Results: Diagnostics of and therapy for stingray injuries are described.Conclusion: Stingray stings are painful injuries. In addition to the pain-relieving heat deactivation of the stingray toxin, the wound has to be cleaned to avoid secondary infection. Non-radiopaque foreign bodies should be ruled out by MRI. Stingray bites can cause severe injuries to water sportsmen and women with the need for surgical intervention. PMID:23784807
Kauther, M D; Wedemeyer, C; Lendemans, S; Hussmann, B; Waydhas, C; Jäger, M
Acquired brain injury in childhood is not uncommon and arises from trauma, metabolic conditions, CNS tumours and infection, toxins or as a result of treatment. Injury to the brain can occur any time from just after conception onwards. Age of injury is a critical variable in determining outcome, as is the mechanism of injury. When the brain is in a
Judith A Middleton
School nurses play a crucial role in injury prevention and initial treatment when injuries occur at school. The role of school nurses includes being knowledgeable about the management of head injuries, including assessment and initial treatment. The school nurse must be familiar with the outcomes of a head injury and know when further evaluation…
This prospective trial collected all cases where injuries had resulted from the hand passing through or striking glass and had been referred to a hand injury service during 1 year. Eighty-seven cases were referred and the factors relating to these injuries were examined. A record was made of the structures damaged, the surgery performed and prevailing socioeconomic factors. These injuries
L. R. Irwin; J. C. Daly; J. H. James; C. L. Muwanga; L. Williams
Although airbags measurably reduce the overall risk of injury to adults (including eye injury), and death from motor vehicle accidents, injuries attributed to airbag deployment have been reported. To identify reported cases of ocular trauma related to airbag deployment, a MEDLINE search from 1991 to 2000 was performed. A total of 263 injuries in 101 patients were identified. Patient demographics,
Joel A Pearlman; K. G. Au Eong; Ferenc Kuhn; Dante J Pieramici
Injuries to the head and neck are the most frequent catastrophic sports injury, and head injuries are the most common direct athletic cause of death. Although direct compressive forces may injure the brain, neural tissue is particularly susceptible to injury from shearing stresses, which are most likely to occur when rotational forces are applied to the head. The most common
R C Cantu
... risk for severe injuries to the head and neck with damage to the brain or spinal cord. Catastrophic injuries have been reported ... developed for each sport to prevent head and neck injury. Concussion Concussions are mild traumatic brain injuries. They are caused by a blow to ...
Pediatric burns comprise a major mechanism of injury, affecting millions of children worldwide, with causes including scald injury, fire injury, and child abuse. Burn injuries tend to be classified based on the total body surface area involved and the depth of injury. Large burn injuries have multisystemic manifestations, including injuries to all major organ systems, requiring close supportive and therapeutic measures. Management of burn injuries requires intensive medical therapy for multi-organ dysfunction/failure, and aggressive surgical therapy to prevent sepsis and secondary complications. In addition, pain management throughout this period is vital. Specialized burn centers, which care for these patients with multidisciplinary teams, may be the best places to treat children with major thermal injuries. This review highlights the major components of burn care, stressing the pathophysiologic consequences of burn injury, circulatory and respiratory care, surgical management, and pain management of these often critically ill patients.
Krishnamoorthy, Vijay; Ramaiah, Ramesh; Bhananker, Sanjay M
Closed head injuries vary from the very minor to the catastrophic. It is often difficult to differentiate the severity at initial presentation. Serial assessment is very valuable. Awareness of facial injuries is aided by familiarity with facial bone anatomy and the clinical presentation of orbital, zygomatic, maxillary, and mandibular fracture. Functional injury such as concussion may coexist with other injuries. This article will discuss closed head trauma and outline specific injuries to the face, brain, skull, and its surroundings. PMID:23522509
Kerr, Hamish A
Despite progress in the management of esophageal perforations by early diagnosis, antibiotics, monitoring, and respiratory and nutritional support, it still remains as a disasterous condition. The most common cause of esophageal perforation is iatrogenic disruption. The result in the management of esophageal perforation is influenced by several factors: localization and size of the rupture, length of delay in diagnosis, age, extent of mediastinal and pleural contamination, the presence of underlying esophageal diseases, and inflammation or tumor at the perforation localization. In this study, 7 cases of esophageal perforations in the last six years have been analysed retrospectively. In study group, there were 5 males and 2 females, and the mean age was 36 (12-75). The most common cause of perforation was gunshot injury (3 cases), and stab wound (1 case), foreign body (1 case), iatrogenic distruption (2 cases). Three patients died and four patients were discharged from hospital with recovery. Esophageal perforation is a life-threatening condition. Early diagnosis and repair reduces the morbidity and mortality. PMID:11705168
Ertekin, C; Yanar, H T; Gülo?lu, R; Tavilo?lu, K; Dilege, S
Despite advances in the therapy for acute lung injury and adult respiratory distress syndrome, mortality remains high. The iatrogenic risk of ventilator-induced lung injury might contribute to this high mortality because the lungs are hyperinflated. Low tidal volume and inspiratory pressure are surrogates for the stress and strain concept; but lung compliance, transpulmonary pressure, and chest wall elastance might differ in individual patients. In previous published studies, an increasing number of patients were treated successfully with extracorporeal support. Extracorporeal membrane oxygenation and interventional lung assist allow ultraprotective ventilation strategies. However, these assists have different technical aspects and different indications. PMID:23089499
von Dossow-Hanfstingl, Vera
The work of the goldsmiths consists in the manufacture of jewelry. The piece, be it an earring, bracelet or necklace, is hand-assembled. This task requires precision, skill, kindness and patience. In this work, we make use of tools such as cuticle clippers and rounded tip, beads or precious stones and also pieces of metal. This type of activity requires a biomechanical stress of hands and wrists. In order to quantify the biomechanical stress, we performed a case study to measure the movements performed by an assembly of pieces of jewelry. As method for research, filming was done during assembly of parts to a paste, using a Nikon digital camera, for 1 (one) hour. The film was edited by Kinovea software, and the task was divided into cycles, each cycle corresponds to a complete object. In one cycle, there are four two movements of supination and pronation movements of the forearm. The cycle lasts approximately sixteen seconds, totaling 1800 cycles in eight hours. Despite the effort required of the wrists, the activity shows no complaints from the employees, but this fact does not mischaracterizes the ability of employees to acquire repetitive strain injuries and work-related musculoskeletal disorders. PMID:22317096
Cândido, Paula Emanuela Fernandes; Teixeira, Juliana Vieira Schmidt; Moro, Antônio Renato Pereira; Gontijo, Leila Amaral
This paper proposes a new technology,``a bodygraphic injury surveillance system (BISS)'' that not only accumulates accident situation data but also represents injury data based on a human body coordinate system in a standardized and multilayered way. Standardized and multilayered representation of injury enables accumulation, retrieval, sharing, statistical analysis, and modeling causalities of injury across different fields such as medicine, engineering, and industry. To confirm the effectiveness of the developed system, the authors collected 3,685 children's injury data in cooperation with a hospital. As new analyses based on the developed BISS, this paper shows bodygraphically statistical analysis and childhood injury modeling using the developed BISS and Bayesian network technology.
Tsuboi, Toshiki; Kitamura, Koji; Nishida, Yoshihumi; Motomura, Yoichi; Takano, Tachio; Yamanaka, Tatsuhiro; Mizoguchi, Hiroshi
Golf is a global sport enjoyed by an estimated 60 million people around the world. Despite the common misconception that the risk of injury during the play of golf is minimal, golfers are subject to a myriad of potential pathologies. While the majority of injuries in golf are attributable to overuse, acute traumatic injuries can also occur. As the body's direct link to the golf club, the upper extremities are especially prone to injury. A thorough appreciation of the risk factors and patterns of injury will afford accurate diagnosis, treatment, and prevention of further injury. PMID:24032581
Cohn, Michael A; Lee, Steven K; Strauss, Eric J
A review of all penetrating eye injuries treated at the Manchester Royal Eye Hospital over four years (1 January 1982-31 December 1985) was undertaken. A total of 202 penetrating eye injuries were seen of which 68 (34%) were in children under the age of 15 years. Airgun, dart, and knife injuries accounted for 28 (41%) of the injuries. Thirty seven patients (54%) achieved a good visual result (6/12 or better) and eight (12%) had enucleations. The period of inpatient treatment ranged from two to 18 days. From the analysis of the activities at the time of the injury, many of the injuries can be considered to be preventable.
Patel, B C
Objective: To review 15 years of National Collegiate Athletic Association (NCAA) injury surveillance data for women's soccer and identify potential areas for injury prevention initiatives. Background: The number of NCAA schools sponsoring women's soccer has grown tremendously, from 271 in 1988– 1989 to 879 schools in 2002–2003. During that time, the NCAA Injury Surveillance System has collected game and practice injury data for women's soccer across all 3 NCAA divisions. Main Results: The rate of injury was more than 3 times higher in games than in practices (16.44 versus 5.23 injuries per 1000 athlete-exposures, rate ratio = 3.2, 95% confidence interval = 3.1, 3.4, P < .01), and preseason practices had an injury rate that was more than 3 times greater than the rate for in-season practices (9.52 versus 2.91 injuries per 1000 athlete-exposures, rate ratio = 3.3, 95% confidence interval = 3.1, 3.5, P < .01). Approximately 70% of all game and practice injuries affected the lower extremities. Ankle ligament sprains (18.3%), knee internal derangements (15.9%), concussions (8.6%), and leg contusions (8.3%) accounted for a substantial portion of game injuries. Upper leg muscle-tendon strains (21.3%), ankle ligament sprains (15.3%), knee internal derangements (7.7%), and pelvis and hip muscle strains (7.6%) represented most of the practice injuries. Injuries were categorized as attributable to player contact, “other contact” (eg, contact with the ball, ground, or other object), or no contact. Player-to-player contact accounted for more than half of all game injuries (approximately 54%) but less than 20% of all practice injuries. The majority of practice injuries involved noncontact injury mechanisms. Knee internal derangements, ankle ligament sprains, and concussions were the leading game injuries that resulted in 10 or more days of time lost as a result of injury. Recommendations: Ankle ligament sprains, knee internal derangements, and concussions are common injuries in women's soccer. Research efforts have focused on knee injuries and concussions in soccer, and further epidemiologic data are needed to determine if preventive strategies will help to alter the incidence of these injuries. Furthermore, the specific nature of the player contact leading to concussions and lower extremity injuries should be investigated. Preventive efforts should continue to focus on reducing knee injuries, ankle injuries, and concussions in women collegiate soccer players.
Dick, Randall; Putukian, Margot; Agel, Julie; Evans, Todd A; Marshall, Stephen W
The 1994 Australian Universities Games represents a multi-sport event which featured 5106 participants competing in nineteen sports. Injury surveillance was conducted by means of the injury Surveillance Form, which recorded time, mechanism, site, type and severity of injury, as well as initial treatment and referral patterns. Over six days of competition, 1177 presentations with injury were recorded, sustained by 994 athletes or 19.5% of all participating athletes. Tae kwon do and hockey were the sports with the greatest incidence of injury. Haematomas, muscle strains and ligament sprains were the most common injuries, with contact and overuse the most common mechanisms of injury. Mild injuries dominated and severe injuries were uncommon. 75% of injuries were initially assessed and treated by a nurse, first aid officer or sports trainer; 15% by a physiotherapist and 10% by a doctor. The authors' recommendation is that such a team of medical staff should be an integral part of any large sporting event, whether participants are professionals or amateurs. Additionally, they need to be supported by facilities and services such as central clinics, a nearby x-ray centre, a nearby hospital and an ambulance/first aid transport network. PMID:8836476
Cunningham, C; Cunningham, S
The objective is to describe the one year incidence rate of self-reported injuries, their causes, where they happened, and their consequences within the age group 11-15 years. Four thousand and forty-six students from a random sample of 45 schools answered a standardized questionnaire about health and health behaviour. This report regards injuries treated by a doctor or a nurse. During one year, 28% were injured, 12% more than once; 12% needed medical treatment such as a plaster cast, stitches, surgery or staying in a hospital; 16% missed at least one full day in school. The injury incidence rate increases with age among boys but not among girls. The proportion with more than one injury increases by age among girls but not boys. The proportion who receive hospital treatment is higher among boys than girls. The proportion who stay home from school because of the injury increases with age among both girls and boys. Five percent are injured at home, 5% at school, 9% are injured at a sport facility, and 4% in the street/road. Ten percent report a sports injury, 4% an injury by falling, and 3% by riding a bicycle. Most common injuries are sprain/strain/pull of a muscle (9%), broken or dislocated bone (6%), and cuts (3%). In conclusion, the incidence of self-reported injuries is much higher than the hospital-reported. More research about injury-mechanisms and more preventive efforts are needed. PMID:10778316
Holstein, B E; Due, E P
... NAICS and SOC Hours-based fatal injury rates Corrections to "Nonfatal Occupational Injuries and Illnesses Requiring Days ... about Census of Fatal Occupational Injuries Database (FI) Correction to news release "Nonfatal Occupational Injuries and Illnesses ...
Incorrect bicycle configuration may predispose athletes to injury and reduce their cycling performance. There is disagreement within scientific and coaching communities regarding optimal configuration of bicycles for athletes. This review summarizes literature on methods for determining bicycle saddle height and the effects of bicycle saddle height on measures of cycling performance and lower limb injury risk. Peer-reviewed journals, books, theses and conference proceedings published since 1960 were searched using MEDLINE, Scopus, ISI Web of Knowledge, EBSCO and Google Scholar databases, resulting in 62 references being reviewed. Keywords searched included 'body positioning', 'saddle', 'posture, 'cycling' and 'injury'. The review revealed that methods for determining optimal saddle height are varied and not well established, and have been based on relationships between saddle height and lower limb length (Hamley and Thomas, trochanteric length, length from ischial tuberosity to floor, LeMond, heel methods) or a reference range of knee joint flexion. There is limited information on the effects of saddle height on lower limb injury risk (lower limb kinematics, knee joint forces and moments and muscle mechanics), but more information on the effects of saddle height on cycling performance (performance time, energy expenditure/oxygen uptake, power output, pedal force application). Increasing saddle height can cause increased shortening of the vastii muscle group, but no change in hamstring length. Length and velocity of contraction in the soleus seems to be more affected by saddle height than that in the gastrocnemius. The majority of evidence suggested that a 5% change in saddle height affected knee joint kinematics by 35% and moments by 16%. Patellofemoral compressive force seems to be inversely related to saddle height but the effects on tibiofemoral forces are uncertain. Changes of less than 4% in trochanteric length do not seem to affect injury risk or performance. The main limitations from the reported studies are that different methods have been employed for determining saddle height, small sample sizes have been used, cyclists with low levels of expertise have mostly been evaluated and different outcome variables have been measured. Given that the occurrence of overuse knee joint pain is 50% in cyclists, future studies may focus on how saddle height can be optimized to improve cycling performance and reduce knee joint forces to reduce lower limb injury risk. On the basis of the conflicting evidence on the effects of saddle height changes on performance and lower limb injury risk in cycling, we suggest the saddle height may be set using the knee flexion angle method (25-30°) to reduce the risk of knee injuries and to minimize oxygen uptake. PMID:21615188
Bini, Rodrigo; Hume, Patria A; Croft, James L
The current study, using a sample of 294 university students, examined the effects of key strains, negative emotions, and conditioning factors on various types of deviance. Eight key strains most likely to lead to deviance, but largely ignored in the previous research on the general strain theory (GST), such as teachers' emotional punishment and race\\/gender discrimination, were measured. Overall, the
Byongook Moon; Kraig Hays; David Blurton
... Soft Tissue Injuries Severed or Constricted Limbs or Digits Merck Manual > Patients & Caregivers > Injuries and Poisoning > First ... Previous: Wounds Next: Severed or Constricted Limbs or Digits Audio Figures Photographs Pronunciations Sidebar Tables Videos Copyright © ...
Injuries are a major cause of morbidity and mortality among adolescents. Adolescents routinely experiment with high-risk behaviors, increasing their risk of injury. Major modes of injury in adolescents include motor vehicle collisions, drowning, suicide and homicide. This article reviews the risk factors for fatal injuries in adolescents and discusses current prevention strategies. Previous research identifies many risk factors associated with adolescent injuries. Practitioners can help prevent teen injuries by screening all adolescent patients and identifying those at high risk of injury. Patients at high risk need preventive counseling and evaluation for possible referral to other services. Current strategies are useful in preventing many injuries; however, further research is needed to evaluate these strategies and to design new prevention programs. PMID:11220192
McIntosh, G; Moreno, M
... Prevention & Control : Traumatic Brain Injury Traumatic Brain Injury Concussion & Mild TBI Recognition Response Feeling Better Prevention Clinical ... Patient Care Return to Activities Support and Resources Concussion in Sports Recognition Response Prevention Baseline Test Survivor ...
... Immunity Laws by State Search Strategy Heads Up: Concussion in Sports Falls – Older Adults Get the Facts ... playground-related injuries are severe–fractures, internal injuries, concussions, dislocations, and amputations (Tinsworth 2001). About 75% of ...
This text integrates basic concepts and relative scientific information to provide a foundation in all aspects of sports injury. It covers: prevention; recognition; assessment; management; disposition; and rehabilitation of a range of injuries from life threatening to minor.
Marcia K. Anderson; Susan J. Hall
In order to provide data on human tolerance to blunt abdominal impact a literature study and laboratory tests were carried out to determine the major causes of abdominal injury, injury mechanisms, a quantitative relationship between input and occurrence o...
D. L. Beckman J. H. McElhaney R. L. Stalnaker V. L. Roberts
... from that shoulder. Brachial plexus injuries are common in contact sports, but they frequently result from auto or motorcycle ... with no apparent shoulder injury. Risk factors Participating in contact sports, particularly football and wrestling, or being involved in ...
Football is one of the most popular sports in the United States and is the leading cause of sports-related injury. A large focus in recent years has been on concussions, sudden cardiac death, and heat illness, all thought to be largely preventable health issues in the young athlete. Injury prevention through better understanding of injury mechanisms, education, proper equipment, and practice techniques and preseason screening may aid in reducing the number of injuries. Proper management of on-field injuries and health emergencies can reduce the morbidity associated with these injuries and may lead to faster return to play and reduced risk of future injury. This article reviews current concepts surrounding frequently seen football-related injuries. PMID:23531977
Olson, David E; Sikka, Robby Singh; Hamilton, Abigail; Krohn, Austin
Pantibial ligamentous injury including knee dislocation and tibiotalar joint subluxation is an uncommon severe rotational injury. A 21-year-old male injured his right knee falling from a motorcycle. Physical examination revealed effusion on the right knee and ankle, and posterior translation of the tibia as well. The MRI of the right knee and ankle demonstrated the following findings: a complete disruption
Huseyin S. Yercan; Guvenir Okcu; Serkan Erkan; Ugur Ozic
Background Global systolic strain has been described previously in patients with chronic aortic insufficiency (AI). This study explored regional differences in contractile injury. Methods Tagged magnetic resonance images of the left ventricle (LV) were acquired and analyzed to calculate systolic strain in 42 patients with chronic AI. Multiparametric systolic strain analysis was applied to relate cardiac function in AI patients to a normal strain database (N = 60). AI patients were classified as having normal or poor function based on their results. A two-way repeated-measures analysis of variance was applied to analyze regional differences in injury. Results The mean and standard deviation of raw strain values (circumferential strain, longitudinal strain, and minimum principal strain angle) are presented over the entire LV in our normal strain database. Of the 42 patients with AI, 15 could be defined as having poor function by multiparametric systolic strain analysis. In AI patients with poor function, statistical analysis showed significant differences in injury between standard LV regions (F369,44.33 = 3.47, p = 0.017) and levels (F1.49,17.88 = 4.41, p = 0.037) of the LV, whereas no significant differences were seen in the group with normal cardiac function. Conclusions Patients with poor function, as defined by multiparametric systolic strain z scores, exhibit a consistent, heterogeneous pattern of contractile injury in which the septum and posterior regions at the base are most injured.
Knutsen, Andrew K.; Ma, Ningning; Taggar, Ajay K.; Brady, Beckah D.; Cupps, Brian P.; Pasque, Michael K.
Impacts in sport can cause severe and fatal head, spinal and thoracic injuries. As sports have developed during the last half\\u000a century, methods have been developed to control injury risks, such as rule modifications, helmets, padded clothing and training.\\u000a The biomechanics of severe injury is well understood through investigations of motor vehicle accident trauma. Research into\\u000a sports injury can assist
Andrew S. McIntosh
\\u000a Injury to the adolescent shoulder poses a unique challenge to the sports medicine team. To determine best practice patterns,\\u000a the team must utilize an evidenced-based approach. These young athletes sustain injuries caused by both acute, traumatic events\\u000a and chronic overuse patterns. These injuries affect both osseous and soft-tissue structures. Some of the injuries encountered\\u000a are unique to this age group.
John A. Guido; Treg Brown
Background: There are few epidemiologic studies of cheerleading injuries.Purpose: To develop a profile of catastrophic injuries in cheerleading and to describe relevant risk factors.Study Design: Retrospective cohort study.Methods: We reviewed 29 of 39 incidents of cheerleading injuries reported to the National Center for Catastrophic Sports Injury Research from 1982 to 2002.Results: Twenty-seven of the injured cheerleaders were women. There were
Barry P. Boden; Robin Tacchetti; Frederick O. Mueller
Lightning is an uncommon but potentially devastating cause of injury in patients presenting to burn centers. These injuries feature unusual symptoms, high mortality, and significant long-term morbidity. This paper will review the epidemiology, physics, clinical presentation, management principles, and prevention of lightning injuries. PMID:18395987
Ritenour, Amber E; Morton, Melinda J; McManus, John G; Barillo, David J; Cancio, Leopoldo C
|School nurses are faced with the challenge of identifying and treating ankle injuries in the school setting. There is little information guiding the assessment and treatment of these children when an injury occurs. It is essential for school nurses to understand ankle anatomy, pathophysiology of the acute ankle injury, general and orthopedic…
Mai, Nicholas; Cooper, Leslie
Very concise description of what constitutes a traumatic brain injury and the cost to society in hospitalizations, injuries and deaths resulting from traumatic brain injury. It also looks very concisely at new understandings of the nature of TBIs and the research being done to find better treatments.
Dr. Leslie Nader (MSMR)
Background: Blunt traumatic aortic injury (TAI) is clini- cally difficult to diagnose, as signs and symptoms are unreliable and variable. The identification of TAI may be obscured by other injuries that are more apparent. Furthermore, radiologic evaluation of the mediastinum for this injury is not well defined. Most patients with TAI die immediately. Survivors have a contained rupture which requires
Joseph Yuk; Sang Ting
Background: Blunt traumatic aortic injury (TAI) is clinically difficult to diagnose, as signs and symptoms are unreliable and variable. The identification of TAI may be obscured by other injuries that are more apparent. Furthermore, radiologic evaluation of the mediastinum for this injury is not well defined. Most patients with TAI die immediately. Survivors have a contained rupture which requires crucial
Joseph Yuk Sang Ting; Sang Ting
Injury occurs when body tissues are subjected to levels of energy outside the normal tolerance bands. Excessive energy damages tissues, potentially beyond repair, and disrupts normal physiologic functioning. Injury may also occur when inadequate energy is available, such as extreme cold leading to frostbite injury, or disruption of normal cellular energy systems such as asphyxiation. Energy may be in the
STEPHEN A. MCCURDY
The popularity of paintball as an extreme sport has gained momentum in recent years. Injuries related to paintball are growing as the number of participants increases. An increasing percentage of paintball-related injuries have occurred in noncommercial settings, such as backyards. We report distinctive follicular stippling and annular scars resulting from paintball injuries in 2 males. Dermatologists may encounter paintball-related injuries during routinely scheduled visits for acne or nevi surveillance. Patients should be verbally reminded to use protective gear to prevent injuries. PMID:17725065
Ambay, Aparna R; Stratman, Erik J
The running portion of the triathlon represents the final leg of the competition and, by some reports, the most important part in determining a triathlete's overall success. Although most triathletes spend most of their training time on cycling, running injuries are the most common injuries encountered. Common causes of running injuries include overuse, lack of rest, and activities that aggravate biomechanical predisposers of specific injuries. We discuss the running-associated injuries in the hip, knee, lower leg, ankle, and foot of the triathlete, and the causes, presentation, evaluation, and treatment of each. PMID:23147090
Spiker, Andrea M; Dixit, Sameer; Cosgarea, Andrew J
Objective To create a basis for prevention of modern skydiving injuries. Design Descriptive epidemiological study. Setting National total material. Patients Data on all reported injury events (n?=?257) in Swedish skydiving 1999–2003 (total 539 885 jumps) were retrieved from the Swedish Parachute Association. Non?fatally injured skydivers were sent a questionnaire asking for event and injury details (response rate 89%), and supplementary hospital records were retrieved for the most serious injuries (n?=?85). Human, equipment and environmental factors were assessed for risk. Main Outcome Measurements Frequency and severity of injuries. Results Incidence of non?fatal injury events was 48 per 100?000 jumps. The lower extremities, spine and shoulders were important regions of injury. The most serious injuries were experienced by licensed skydivers, but students in training had a higher injury rate and more often left the sport because of the injury. Of two student?training systems, one had an incidence less than half that of the other. Conclusions A basis for prevention was created, showing a potential for reduction of frequency and severity of injuries with training and technical interventions.
Westman, Anton; Bjornstig, Ulf
Injuries in triathletes are common and are mostly overuse injuries. Rotator cuff tendinitis is the most common complaint from swimming, but the incidence of tendinopathy and rotator cuff tears on magnetic resonance imaging is comparable in triathletes without and with shoulder pain. Cycling injuries are mainly to the knee, including patellar tendinosis, iliotibial band syndrome, and patellofemoral stress syndrome, and to the Achilles tendon and the cervical and lumbar spine. Running is associated with most injuries in triathletes, during both training and racing, causing the athlete to discontinue the triathlon. In addition to knee injuries from running, triathletes may also develop foot and ankle, lower leg, and hip injuries similar to single-sport distance runners. Some injuries in triathletes may be mainly symptomatic during one of the three sports but are exacerbated by one or both of the other disciplines. PMID:21094402
Tuite, Michael J
Typical injuries of highly professional classical ballet dancers were evaluated in 108 members of German opera companies. We demonstrated the predominance of overuse-syndromes to acute injuries related to the excessive training-extends. Disorders of the feet, particularly tendinitis followed by low-back pain, chondromalacia patellae, jumpers knee, shin splints and muscle strains are most frequent. Considerable time often elapsed before diagnosing was made because complaints were ignored by dancers. Our inquiry includes range of motion of the spine and the extremities, serial x-rays and a systematic review of ballet-related injuries, training-programs and techniques. PMID:2566215
Goertzen, M; Ringelband, R; Schulitz, K P
Nonsteroidal antiinflammatory drugs (NSAIDs) are frequently used in the treatment of acute athletic injuries, often for analgesic purposes as the evidence to support enhanced healing is limited. However, the current evidence on NSAID use in athletic injury is slowly growing. On the basis of animal models and limited human studies, some practical management guidelines can be drawn to assist the sports physician. Specifically, NSAIDs are not recommended in the treatment of completed fractures, stress fractures at higher risk of nonunion, or in the setting of chronic muscle injury. The only exception may be very short-term use (eg, a few days) for analgesic purposes only. Judicious use of NSAIDs may be more appropriate in the management of acute ligament sprains, muscle strains, tendinitis, and eccentric muscle injury. However, length of treatment should always be kept as short as possible, with consideration of the specific type of injury, level of dysfunction, and pain. PMID:16603889
Mehallo, Christopher J; Drezner, Jonathan A; Bytomski, Jeffrey R
A strain gage comprising a strained-layer superlattice crystal exhibiting piezoelectric properties is described. A substrate upon which such a strained-layer superlattice crystal has been deposited is attached to an element to be monitored for strain. A light source is focused on the superlattice crystal and the light reflected from, passed through, or emitted from the crystal is gathered and compared with previously obtained optical property data to determine the strain in the element. 8 figs.
Noel, B.W.; Smith, D.L.; Sinha, D.N.
A strain gage comprising a strained-layer superlattice crystal exhibiting piezoelectric properties is described. A substrate upon which such a strained-layer superlattice crystal has been deposited is attached to an element to be monitored for strain. A light source is focused on the superlattice crystal and the light reflected from, passed through, or emitted from the crystal is gathered and compared with previously obtained optical property data to determine the strain in the element.
Noel, Bruce W. (Espanola, NM); Smith, Darryl L. (Los Alamos, NM); Sinha, Dipen N. (Los Alamos, NM)
It is estimated that 3.2 million children ages 6 to 14 years participated in organized youth football in the United States in 2007. Approximately 240,000 children play football in the nation's largest youth football organization, with tackle divisions starting at age 5 years. The number of children playing unsupervised football is much higher, and the overall number of children participating in American football is increasing. Sports are the leading cause of injury-related emergency room visits for teenagers, and football is a leading precipitating athletic activity for these visits. Football is also the most hazardous organized sports in the United States. Though most pediatric football-related injuries are minor, such as abrasions, sprains, and strains of the extremities, football accounts for more major and catastrophic injuries than any other sport. Given football's popularity with children in the United States, combined with the high rate of injury associated with participation in this activity, radiologists should be familiar with the imaging features and injury patterns seen in this patient population. PMID:19774374
Podberesky, Daniel J; Unsell, Bryan J; Anton, Christopher G
There is a discrepancy between males and females in regards to lower extremity injury rates, particularly at the knee [Agel, J., Arendt, E.A., Bershadsky, B., 2005. Anterior cruciate ligament injury in National Collegiate Athletic Association basketball and soccer: a 13-year review. American Journal of Sports Medicine 33, (4) 524–530]. Gender differences in neuromuscular recruitment characteristics of the muscles that stabilize
Jennifer M. Medina; Tamara C. Valovich McLeod; Suzanne K. Howell; Jackie J. Kingma
Investigated factors related to unintentional injuries in 50 children from summer day camps for economically underprivileged youth. Data were collected on parent reports of children's previous medically treated injuries, Eyberg Child Behavior Inventory (ECBI) scores, and the day camp's incident reports of injuries. One year later, parents completed a second questionnaire about medically and home-treated injuries. Multiple linear regression indicated that previous medically treated injury, ECBI opposition score, and injury at camp accounted for 50% of the variance of medically treated injuries in the year after camp. Previous medically treated injury accounted for 21% of the variance in frequent home-treated injuries during the year after camp. Children who have behavior problems may behave in ways that predispose them to common injuries. Conceptualizing injury as a behavioral process suggests behavior change strategies to reduce injury risk and ways to target children for injury prevention efforts. PMID:8151497
Jaquess, D L; Finney, J W
Objective—To provide epidemiological data on whitewater kayaking injuries using a descriptive study. Methods—A retrospective survey was distributed at whitewater events and club meetings, and made available and advertised on the world wide web, through postings and announcements to newsgroups, related sites, and search engines. Data on sex, age, experience, and ability were collected. Injury data collected included mechanism, activity, difficulty of rapid, and self reported severity. Results—Of the 392 kayaking respondents included in the final analysis, 219 suffered 282 distinct injury events. The number of days spent kayaking per season was the only independent predictor of injury. The overwhelming majority of injuries occurred while the kayaker was still in the boat (87%). Striking an object was the most common mechanism of injury (44%), followed by traumatic stress and overuse (25% each). The most common types of injury were abrasion (25%), tendinitis (25%), contusion (22%), and dislocation (17%). The upper extremity, especially the shoulder, was the most commonly injured area of the body. Although half of injured kayakers sought medical care for their injury, and almost one third missed more than one month of kayaking because of the injury, almost all (96%) reported a complete or good recovery. Conclusions—Factors relating to likelihood of injury appear to be connected with exposure, namely the number of days a year that the sport was pursued. Except for class V (extreme) kayakers, reports of injuries paralleled the number of participants. Kayakers reported injuries predominantly on rivers that they assessed to be at a level appropriate to their skills. Key Words: kayaking; whitewater; injuries
Fiore, D; Houston, J
Muscle strain injuries are some of the most frequent injuries in sports and command a great deal of attention in an effort to understand their etiology. These injuries may be the culmination of a series of subcellular events accumulated through repetitive lengthening (eccentric) contractions during exercise, and they may be influenced by a variety of variables including fiber strain magnitude, peak joint torque, and starting muscle length. To assess the influence of these variables on muscle injury magnitude in vivo, we measured fiber dynamics and joint torque production during repeated stretch-shortening cycles in the rabbit tibialis anterior muscle, at short and long muscle lengths, while varying the timing of activation before muscle stretch. We found that a muscle subjected to repeated stretch-shortening cycles of constant muscle-tendon unit excursion exhibits significantly different joint torque and fiber strains when the timing of activation or starting muscle length is changed. In particular, measures of fiber strain and muscle injury were significantly increased by altering activation timing and increasing the starting length of the muscle. However, we observed differential effects on peak joint torque during the cyclic stretch-shortening exercise, as increasing the starting length of the muscle did not increase torque production. We conclude that altering activation timing and muscle length before stretch may influence muscle injury by significantly increasing fiber strain magnitude and that fiber dynamics is a more important variable than muscle-tendon unit dynamics and torque production in influencing the magnitude of muscle injury. PMID:16397062
Butterfield, Timothy A; Herzog, Walter
Background: Internal oblique muscle injuries are common in professional baseball pitchers and may require a prolonged convalescence of up to 10 weeks. Most strains can be diagnosed clinically, but imaging can be helpful to assess the severity of injury, which may predict recovery and return to play.Hypothesis: Ultrasound-guided injection of steroid and local anesthetic into the muscle tear can speed
Kathryn J. Stevens; Jana M. Crain; Kenneth H. Akizuki; Christopher F. Beaulieu
The behavior and environment of individuals are key determinants of both unintentional and intentional injuries in childhood and adolescence. These two determinants often interact so that certain behaviors lead to different injury outcomes depending on the environmental context of the injury. For example, depression is more likely to lead to suicide in the presence of alcohol intoxication. Alcohol intoxication is much more likely to lead to the choice of a firearm in a suicide attempt. Children with poor pedestrian crossing skills are far more likely to be hit in a busy urban intersection than in a safer location. The science of injury control has attempted to learn more about both the behavioral, environmental, and agent characteristics that lead to injury. Each of these dimensions offers opportunities for injury prevention or amelioration of the outcome. Despite increasing knowledge about how certain behaviors are associated with specific types of injuries, there has been only limited success achieved by attempts to modify behavior, particularly by persuasion or education. More success has been derived by legislative mandates. The most success, particularly in the prevention of unintentional injury, has been achieved by modification of the environments and the agents that are most often associated with injury. Because intentional injuries involve extremely complex and aberrant behavior, there is a persistent concern that attempts to modify the environment (e.g., handgun control) will be overridden by those with a high level of intent, i.e., they will seek another method. Although this may be true for carefully premeditated acts, suicide attempts and assaults by youth are usually precipitated by an acute stressor that depends on the availability of a weapon at that immediate time. While we develop more sophisticated psychosocial epidemiologic models that accurately predict violent behavior, we must continue to analyze aspects of intentional injuries that offer an opportunity to reduce the injury severity after the injury has occurred. Pediatricians and other health providers of children have played three important historical roles in the field of injury control. As clinicians, we have a unique opportunity to discuss these concerns with our patients and use our influence to attempt to modify individual behavior and inform about risks. As investigators, pediatricians have been important advocates of research initiatives to use the same epidemiologic methods used to study infectious diseases and cancer and apply them to the study of injury. Finally, pediatricians have played a critical public policy role in the evolution of injury control. Pediatricians have been at the helm behind most legislative initiatives to reduce injury among all people.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:1574354
Grossman, D C; Rivara, F P
The present experimental study was designed to elucidate specific morphological features emerging from the destruction of diaphyses of long tubular bones undergoing a combined strain/stress impact. It is concluded that the species-specific signs of the injuries to the long tubular bones can be used for the purpose of their differential diagnosis from other types of injuries. PMID:22384700
Leonov, S V; Leonova, E N
Objective: To report the soft tissue injuries sustained by the members of four disabled sports organizations (DSOs) who competed as the USA Team at the 1996 Paralympic Games.Setting: 1996 Paralympic Games, Atlanta, Georgia.Methods: Soft tissue (strain, sprain, tendonitis, bursitis, or contusion) injury frequencies sustained by Disabled Sports USA (DSUSA, n = 66), the United States Association for Blind Athletes (USABA,
John Nyland; Susan L. Snouse; Mark Anderson; Trish Kelly; James C. Sterling
Women's basketball has changed over time. It is a faster paced game than it was 30 years ago. Greatplayers, like Anne Meyers,who was the first, and only, woman to be signed to an NBA contract, would agree today's game is different. The game is played mostly "below the rim" but with players like Candice Parker, Sylvia Fowles and Maya Moore able to dunk the ball, the game is still changing. The one thing that remains constant in basketball, especially women's basketball, is injury. The majority of injuries in women's basketball are similar to those in men's basketball. Studies at the high school and college level show similar injury rates between women and men. ACL injuries are one exception, with female athletes having atwo to four times higher rate ofACL injuries. In this article, we review the common injuries in women's basketball. We discuss treatment issues and possible preventive measures. PMID:18426181
Trojian, Thomas H; Ragle, Rosemary B
It is estimated that 30 million children in the US participate in organised sports programmes. As more and more children participate in sports and recreational activities, there has been an increase in acute and overuse injuries. Emergency department visits are highest among the school-age to young adult population. Over one-third of school-age children will sustain an injury severe enough to be treated by a doctor or nurse. The yearly costs have been estimated to be as high as 1.8 billion US dollars. There are physical and physiological differences between children and adults that may cause children to be more vulnerable to injury. Factors that contribute to this difference in vulnerability include: children have a larger surface area to mass ratio, children have larger heads proportionately, children may be too small for protective equipment, growing cartilage may be more vulnerable to stresses and children may not have the complex motor skills needed for certain sports until after puberty. The most commonly injured areas of the body include the ankle and knee followed by the hand, wrist, elbow, shin and calf, head, neck and clavicle. Contusions and strains are the most common injuries sustained by young athletes. In early adolescence, apophysitis or strains at the apophyses are common. The most common sites are at the knee (Osgood-Schlatter disease), at the heel (Sever's disease) and at the elbow (Little League Elbow). Non-traumatic knee pain is one of the most common complaints in the young athlete. Patellar Femoral Pain Syndrome (PFPS) has a constellation of causes that include overuse, poor tracking of the patellar, malalignment problems of the legs and foot problems, such as pes planus. In the child, hip pathology can present as knee pain so a careful hip exam is important in the child presenting with an insidious onset of knee pain. Other common injuries in young athletes discussed include anterior cruciate ligament injuries, ankle sprains and ankle fractures. Prevention of sports and recreation-related injuries is the ideal. There are six potential ways to prevent injuries in general: (i) the pre-season physical examination; (ii) medical coverage at sporting events; (iii) proper coaching; (iv) adequate hydration; (v) proper officiating; and (vi) proper equipment and field/surface playing conditions. PMID:12477379
Adirim, Terry A; Cheng, Tina L
Context: As the Asian Ice Hockey League gradually expands and becomes more competitive, ice hockey-related injuries may increase. However, no reports have been published on ice hockey injuries in Japan, including the method of injury and the daily supervision of the players during the regular season. Objective: To prospectively study the incidence, types, and mechanisms of ice hockey injuries in an elite Japanese ice hockey team. Design: Prospective observational cohort study design. Setting: An elite ice hockey team, Tokyo, Japan. Patients or Other Participants: Ninety-four players during the 2002–2005 seasons. Main Outcome Measure(s): Data were collected for 3 consecutive seasons using an injury reporting form. Results: The overall game injury rate was 74.3 per 1000 player-game hours and 11.7 per 1000 player-game hours for injuries resulting in any time loss. The overall practice injury rates were 11.2 per 1000 player-practice hours and 1.1 per 1000 player-practice hours for injuries resulting in any time loss. Forwards had the highest rate of injury, followed by defensemen and then goalkeepers. Contusions were the most common injury, followed by strains, lacerations, and sprains. Conclusions: Most injuries among Japanese ice hockey players occurred during games. Game or play intensity may influence the injury rate during games.
Kuzuhara, Kenji; Shimamoto, Hideki; Mase, Yasuyoshi
American football is one of the leading causes of athletic-related injuries. Injury rates in female elite players are mostly unknown. We hypothesized that the injury rates of female was comparable to those in men's football during practice, as well as games. From 2009 to 2011, injury data were collected from the German female national team during training camps, World Championship 2010 and International friendly matches. The injury was categorized by location on the body and recorded as fracture/dislocation, strain, concussion, contusion or other injury. Injury rates were determined based on the exposure of an athlete to a game or practice event. The injury rate was calculated as the ratio of injuries per 1000 athlete exposures (AE). The rate of injury was significantly higher during games (58.8/1000 AE) than practices [16.3/1000 AE, (P<0.01)]. Furthermore, the injury rate in the tryouts was significantly higher (24.05/1000 AE) compared to other training sessions with the national team (11.24/1000 AE). Our findings show that the injury rates in female elite American football players can be compared to those described for male players. Higher injury rates during matches than in training should also be underlined.
Ezechieli, Marco; Berger, Stephan; Siebert, Christian-Helge; Miltner, Oliver
Objectives: To study characteristics of injury events and injuries requiring treatment in a Vermont population. Method: A one year 30% prospective sample was studied of persons from 22 communities who received first physician care for injury at the Medical Center Hospital of Vermont. Results: Modal injuries were—superficial involving skin only among children below age 10, overexertion injuries among 10–59 year
Julian A. Waller; Joan M. Skelly; John H. Davis
|Presents statistics on injury patterns in youth sports, recommending that physicians who care for young athletes understand the kinds of injuries likely to be sustained. Awareness of injury patterns helps medical professionals identify variables associated with injury, anticipate or prevent injuries, plan medical coverage, and compare individual…
Background—Skateboarding injuries have increased with the rise in popularity of the sport, and the injury pattern can be expected to have changed with the development of both skateboard tricks and the materials used for skateboard construction. Objective—To describe the injury pattern of today. Methods—The pattern of injuries, circumstances, and severity were investigated in a study of all 139 people injured in skateboarding accidents during the period 1995–1998 inclusive and admitted to the University Hospital of Umeå. This is the only hospital in the area, serving a population of 135 000. Results—Three of the 139 injured were pedestrians hit by a skateboard rider; the rest were riders. The age range was 7–47 years (mean 16). The severity of the injuries was minor (AIS 1) to moderate (AIS 2); fractures were classified as moderate. The annual number of injuries increased during the study period. Fractures were found in 29% of the casualties, and four children had concussion. The most common fractures were of the ankle and wrist. Older patients had less severe injuries, mainly sprains and soft tissue injuries. Most children were injured while skateboarding on ramps and at arenas; only 12 (9%) were injured while skateboarding on roads. Some 37% of the injuries occurred because of a loss of balance, and 26% because of a failed trick attempt. Falls caused by surface irregularities resulted in the highest proportion of the moderate injuries. Conclusions—Skateboarding should be restricted to supervised skateboard parks, and skateboarders should be required to wear protective gear. These measures would reduce the number of skateboarders injured in motor vehicle collisions, reduce the personal injuries among skateboarders, and reduce the number of pedestrians injured in collisions with skateboarders. Key Words: skateboard; injury; prevention
Forsman, L; Eriksson, A
Injuries are an important health issue for children. Previous research, however, has presented confusing and conflicting results on the determinants of childhood injuries, particularly psychosocial predictors, largely due to methodologic problems. The purpose of this analysis, based on a prospective follow-up study of 532 children, was to identify factors related to injuries encountered in a prepaid group practice during a 12-month period. Using logistic regression, we found four factors independently associated with the risk of at least one treated injury: high activity level, high rate of pediatric utilization for non-injury-related visits during the follow-up period, occurrence of a treated injury during the year preceding the follow-up period, and negative attitude toward medical care providers by the child's mother. In addition, four factors were found to be independent predictors of injuries judged severe enough to always warrant medical care: occurrence of a treated injury in the preceding year, high rate of pediatric utilization for non-injury-related visits during the follow-up period, working more than 15 hours a week outside the home by the child's mother, and more life events reported by the mother for the year preceding the follow-up period. Since family stressors are related specifically to the risk of more severe injuries, which are unlikely to escape medical attention, we conclude that these factors probably are related to the occurrence of common injuries of early childhood and not exclusively to utilization behavior. We therefore suggest that children from families with these characteristics be targeted for injury prevention strategies. PMID:3369398
Horwitz, S M; Morgenstern, H; DiPietro, L; Morrison, C L
Summary \\u000a The article reports a new hypothesis of whiplash injury based on a series of experimental studies using isolated human cadaveric\\u000a specimens. Although the clinical symptoms of whiplash are widely known, the understanding of the underlying injury mechanism\\u000a is poor. The prevailing view of neck-hyperextension as the essential injury mechanisms was not supported by recent experiments.\\u000a In a series of
M. M. Panjabi; J. Cholewicki; K. Nibu; J. N. Grauer; L. B. Babat; J. Dvorak; H. F. Bär
\\u000a Head injuries are common among children, and they result in a significant number of visits to emergency departments and physicians’\\u000a offices each year. In children 15yr old and under, the estimated incidence of traumatic brain injury is 180 per 100,000 children\\u000a per year, totaling more than 1 million injuries annually in the United States and accounting for more than 10%
Pediatric head injury is a public health problem that exacts a high price from patients, their families and society alike.\\u000a While much of the brain damage in headinjured patients occurs at the moment of impact, secondary injuries can be prevented\\u000a by aggressive medical and surgical intervention. Modern imaging devices have simplified the task of diagnosing intracranial\\u000a injuries. Recent advances in
\\u000a In patients with multiple traumas urological injuries can be frequently found. The incidence is highest in renal injuries\\u000a although it is located safely in the retroperitoneum. Injuries of the ureter in trauma patients are rare, most of the ureteral\\u000a lacerations being iatrogenic. Gross hematuria can be a symptom of almost all kind of urological associated traumas. In most\\u000a patients the
David Pfister; Axel Heidenreich
Only one prospective, controlled study has compared the risk of accidental injury in persons with epilepsy to controls without seizures. A mildly increased risk in the epilepsy group was found, predominantly due to injuries that result directly from a seizure. With regard to injury type, this study found significantly higher rates of only head and soft tissue injury; however, most injuries were minor. Several retrospective, population-based studies have suggested increased rates of more serious injury types. Submersion injury has a high mortality; the risk of submersion in children with epilepsy is 7.5-13.9 fold higher than in the general population. The risk of fracture is elevated approximately twofold, either resulting directly from seizure-induced injury or predisposed by drug-induced reduction in bone mineral density. Burns due to seizures account for between 1.6% and 3.7% of burn unit admissions. The risk of motor vehicle accidents in drivers with epilepsy also appears increased, albeit marginally. Several factors predispose to a higher risk of injury among those with epilepsy. Seizures resulting in falls increase the risk of concussion and other injuries. Higher seizure frequency, lack of a prolonged seizure-free interval, comorbid attention deficit disorder, or cognitive handicap may also increase the risk of injury. While some restrictions are necessary to protect the safety of the person with epilepsy, undue limitations may further limit achievement of independence. Given the high morbidity and mortality of submersion injury, those with active epilepsy should bathe or swim only with supervision; however, showering is a reasonable option. Appropriate vitamin D and calcium supplementation and periodic measurement of bone mineral density in those at risk for osteopenia are recommended. PMID:17044832
Wirrell, Elaine C
Nonpenetrating abdominal injuries are commonly seen in a general hospital. High speed traffic accidents are responsible for the majority of these injuries. The mortality rate is high. Deaths were from associated injuries, failure to recognize abdominal trauma, hemorrhage and from acute renal insufficiency. Careful observation of every severely injured person, vigorous treatment of hemorrhagic shock with whole blood, and prompt surgical intervention when indicated will improve the mortality figures.
Brock, William; Cusick, George
Phase-dependent modulation of monosynaptic reflexes has been reported for several muscles of the lower limb of uninjured rats and humans. To assess whether this step-phase-dependent modulation can be mediated at the level of the human spinal cord, we compared the modulation of responses evoked simultaneously in multiple motor pools in clinically complete spinal cord injury (SCI) compared with noninjured (NI) individuals. We induced multisegmental responses of the soleus, medial gastrocnemius, tibialis anterior, medial hamstring, and vastus lateralis muscles in response to percutaneous spinal cord stimulation over the Th11-Th12 vertebrae during standing and stepping on a treadmill. Individuals with SCI stepped on a treadmill with partial body-weight support and manual assistance of leg movements. The NI group demonstrated phase-dependent modulation of evoked potentials in all recorded muscles with the modulation of the response amplitude corresponding with changes in EMG amplitude in the same muscle. The SCI group demonstrated more variation in the pattern of modulation across the step cycle and same individuals in the SCI group could display responses with a magnitude as great as that of modulation observed in the NI group. The relationship between modulation and EMG activity during the step cycle varied from noncorrelated to highly correlated patterns. These findings demonstrate that the human lumbosacral spinal cord can phase-dependently modulate motor neuron excitability in the absence of functional supraspinal influence, although with much less consistency than that in NI individuals. PMID:20357075
Dy, Christine J; Gerasimenko, Yury P; Edgerton, V Reggie; Dyhre-Poulsen, Poul; Courtine, Grégoire; Harkema, Susan J
Paintball sport-related ocular injuries represent an increasing problem as the popularity of the sport increases and the number of participants grows. Although eye protective devices designed specifically for paintball sports are extremely effective in preventing such injuries, the failure to properly wear these devices has resulted in an alarming number of severe ocular injuries. Recent trends have indicated that an increasing percentage of paintball sport-related ocular injuries have occurred in unsupervised, noncommercial settings (i.e., backyard games) where the use of eye protective devices is not required. Paintball industry standards for eye protection have recently been developed and should be implemented for all participants. PMID:11389344
Fineman, M S
Injuries to the head and neck are the most frequent catastrophic sports injury, and head injuries are the most common direct athletic cause of death. Although direct compressive forces may injure the brain, neural tissue is particularly susceptible to injury from shearing stresses, which are most likely to occur when rotational forces are applied to the head. The most common athletic head injury is concussion, which may very widely in severity. Intracranial haemorrhage is the leading cause of head injury death in sports, making rapid initial assessment and appropriate follow up mandatory after a head injury. Diffuse cerebral swelling is another serious condition that may be found in the child or adolescent athlete, and the second impact syndrome is a major concern in adult athletes. Many head injuries in athletes are the result of improper playing techniques and can be reduced by teaching proper skills and enforcing safety promoting rules. Improved conditioning (particularly of the neck), protective headgear, and careful medical supervision of athletes will also minimise this type of injury.
Cantu, R C
Once a child is determined to be at risk of having a cervical spine injury, clinicians must take appropriate precautions to avoid potential worsening of neurologic deficits. Occasionally these decisions are made in the absence of adequate cervical spine imaging when dealing with a child's unstable airway or other life-threatening injuries. Furthermore, clinicians have to make decisions regarding appropriate diagnostic testing to evaluate for potential injury. Decisions regarding testing should take into consideration the clinical presentation of the patient, aiming to order appropriate testing for those at risk and avoid unnecessary testing for those without signs of cervical spine injury. PMID:24093899
Leonard, Julie C
The optimal management sequence to treat avulsion injuries in children is particularly difficult because of the following problems: (1) Assessment of these rare but frequently massive injuries can be very difficult and treacherous, as the extent of the injury is often underestimated and treatment therefore considered inappropriate; (2) Avulsion injuries have a high risk of infection: lesions are always contaminated due to the mechanism of injury (mostly vehicle accidents) and subsequent long-term hospitalization adds an additional risk for nosocomial infections; (3) Children with avulsion injuries have an increased risk to develop functional deficits: although the body grows, scars and reconstructed tissues may not adapt sufficiently and this may lead to serious constraints. Because of these problems, avulsion injuries may lead to a high morbidity and even mortality, especially if the injury is mismanaged. Reviewing the most recent data regarding the management of avulsion injuries yields the following key points: (1) A scoring system may help to assess the primary dimension of the defect; (2) Innovative techniques such as the use of a Vacuum Assisted Closure system may lower the risk of infection; (3) Choosing a comprehensive, reconstructive approach taking the growth of the child into consideration, may reduce the development of serious functional deficits and improve cosmetic outcome. PMID:23982820
Boettcher-Haberzeth, Sophie; Schiestl, Clemens
Professional ballet dancers require an extraordinary anatomic, physiologic, and psychologic makeup to achieve and sustain their level of ability and activity. They are subject to a myriad of injuries as a result of the extreme demands of this profession. Tendon injuries are common and often coexist with other pathologies of the bone, ligaments, and psyche. It is critical that the dance doctor not examine the tendon injury in isolation, but rather the cause of the injury, either intrinsic from anatomic malalignment or from external sources, including poor form. PMID:18346542
Hodgkins, Christopher W; Kennedy, John G; O'Loughlin, Padhraigh F
Sports-related brain injuries are increasing in incidence and may affect athletes from many different sports. Concussion is the most common form of sports-related head injury and is a form of mild traumatic brain injury. Evaluations of concussed athletes should include careful history, focused neurologic examination, balance testing, and cognitive testing. Postinjury management consists of avoiding aggravating factors until symptoms resolve. Return to play should not begin until all symptoms resolve, and then this should be done in a graduated fashion that avoids recreating symptoms. Research is ongoing concerning the maximum safe number of concussive injuries and any possible long-term sequelae. PMID:23668643
Sills, Allen K
Although Taekwondo is becoming an increasingly popular sport, there is a lack of reliable epidemiologic data on Taekwondo injuries. To perform an epidemiologic study on the variety of types of injury in professional and amateur Taekwondo athletes and to find a relation between Taekwondo style, skill level, weight-class and warm-up routine and the occurrence of injuries, we analysed the injury data using a 7-page questionnaire from a total of 356 Taekwondo athletes who were randomly selected. Overall, we registered a total of 2,164 injuries in 356 athletes. Most traumas were contusions and sprains in the lower extremities. Professional Taekwondo athletes have an increased risk of injury in comparison to recreational athletes. Taekwondo style, weight class and tournament frequency have an influence on the athlete's injury profile. Warm-up routines were found to have a positive effect on injury rates. Overall, Taekwondo may be considered a rather benign activity, if injuries during Taekwondo tournaments can be avoided. If not, Taekwondo can result in serious musculoskeletal problems. PMID:21563037
Schlüter-Brust, K; Leistenschneider, P; Dargel, J; Springorum, H P; Eysel, P; Michael, J W-P
Athletic competition has long been a known source of spinal injuries. Approximately 8.7% of all new cases of spinal cord injuries in the United States are related to sports activities. The sports activities that have the highest risk of catastrophic spinal injuries are football, ice hockey, wrestling, diving, skiing, snowboarding, rugby, and cheerleading. Axial compression forces to the top of the head can lead to cervical fracture and quadriplegia in any sport. It is critical for any medical personnel responsible for athletes in team sports to have a plan for stabilization and transfer of an athlete who sustains a cervical spine injury. PMID:19084763
Boden, Barry P; Jarvis, Christopher G
Athletic competition has long been a known source of spinal injuries. Approximately 8.7% of all new cases of spinal cord injuries in the United States are related to sports activities. The sports activities that have the highest risk of catastrophic spinal injuries are football, ice hockey, wrestling, diving, skiing, snowboarding, rugby, and cheerleading. Axial compression forces to the top of the head can lead to cervical fracture and quadriplegia in any sport. It is critical for any medical personnel responsible for athletes in team sports to have a plan for stabilization and transfer of an athlete who sustains a cervical spine injury. PMID:18295084
Boden, Barry P; Jarvis, Christopher G
This article reviews the anatomy of the physis and the most common classification of injuries or fractures through the physis. The common apophyseal injuries of Osgood-Schlatter, Severs disease and iliac apophysitis, are reviewed in addition to a review of the most common osteochondritides, including Panner's disease and Osteochondritis Dessicans of the femur and talus. An understanding of these is key to diagnosis and treatment of adolescent musculoskeletal injuries. This article also reviews slipped capital femoral epiphysis, little leaguer's elbow, anterior cruciate and collateral ligament injuries, patella problems, ankle sprains and several common fractures in children. PMID:9469924
Kaeding, C C; Whitehead, R
OBJECTIVE: To define the causes of injuries to players in English professional football during competition and training. METHOD: Lost time injuries to professional and youth players were prospectively recorded by physiotherapists at four English League clubs over the period 1994 to 1997. Data recorded included information related to the injury, date and place of occurrence, type of activity, and extrinsic Playing factors. RESULTS: In all, 67% of all injuries occurred during competition. The overall injury frequency rate (IFR) was 8.5 injuries/1000 hours, with the IFR during competitions (27.7) being significantly (p < 0.01) higher than that during training (3.5). The IFRs for youth players were found to increase over the second half of the season, whereas they decreased for professional players. There were no significant differences in IFRs for professional and youth players during training. There were significantly (p < 0.01) injuries in competition in the 15 minute periods at the end of each half. Strains (41%), sprains (20%), and contusions (20%) represented the major types of injury. The thigh (23%), the ankle (17%), knee (14%), and lower leg (13%) represented the major locations of injury, with significantly (p < 0.01) more injuries to the dominant body side. Reinjury counted for 22% of all injuries. Only 12% of all injuries were caused by a breach of the rules of football, although player to player contact was involved in 41% of all injuries. CONCLUSIONS: The overall level of injury to professional footballers has been showed to be around 1000 times higher times higher than for industrial occupations generally regarded as high risk. The high level of muscle strains, in particular, indicates possible weakness in fitness training programmes and use of warming up and cooling down procedures by clubs and the need for benchmarking players' levels of fitness and performance. Increasing levels of injury to youth players as a season progresses emphasizes the importance of controlling the exposure of young players to high levels of competition. ???
Hawkins, R. D.; Fuller, C. W.
Strain caps are one of a series of microstructures that typically form during deformation of a softer matrix around hard objects. However—in contrast to other microstructures around porphyroblasts, for example pressure shadows—strain caps are rarely described in the literature. Here we describe strain caps with particular focus on strain caps associated with growth of a new phase, not elsewhere present in the paragenesis. Examples from foliated, amphibolite facies, metapelitic schists from Alaska, Sinai and Bhutan are discussed. All examples show chlorite growth exclusively in strain caps formed around porphyroblasts. Porphyroblasts around which the strain caps grow are muscovite, staurolite and garnet, respectively. In all of these examples strain caps formed synkinematically, but the chlorite grew statically at a later stage. Three mechanisms can explain the formation of new phases in the strain cap region: (a) the strain cap region may have experienced different P-T conditions from the matrix; (b) the strain cap region has a different effective bulk composition from the surrounding matrix; (c) fluid flow that is preferentially focused parallel to the foliation planes causing only local adjustment to retrograde metamorphism in the strain cap region. We show that the third hypothesis is the most preferable mechanism. Indeed, the absence of chlorite outside the strain cap region allows a quantification of the amount of fluid that infiltrated the rock. It is shown that for Bhutan sample about 8.5 mole% more water must have been added to the rock during fluid infiltration to cause the strain cap formation.
Abu-Alam, Tamer; Stüwe, Kurt
Objectives: To undertake a prospective epidemiological study of the injuries sustained in English youth academy football over two competitive seasons. Methods: Player injuries were annotated by medical staff at 38 English football club youth academies. A specific injury audit questionnaire was used together with a weekly return form that documented each club's current injury status. Results: A total of 3805 injuries were reported over two complete seasons (June to May) with an average injury rate of 0.40 per player per season. The mean (SD) number of days absent for each injury was 21.9 (33.63), with an average of 2.31 (3.66) games missed per injury. The total amount of time absent through injury equated to about 6% of the player's development time. Players in the higher age groups (17–19 years) were more likely to receive an injury than those in the younger age groups (9–16 years). Injury incidence varied throughout the season, with training injuries peaking in January (p<0.05) and competition injuries peaking in October (p<0.05). Competition injuries accounted for 50.4% of the total, with 36% of these occurring in the last third of each half. Strains (31%) and sprains (20%) were the main injury types, predominantly affecting the lower limb, with a similar proportion of injuries affecting the thigh (19%), ankle (19%), and knee (18%). Growth related conditions, including Sever's disease and Osgood-Schlatter's disease, accounted for 5% of total injuries, peaking in the under 13 age group for Osgood-Schlatter's disease and the under 11 age group for Sever's disease. The rate of re-injury of exactly the same anatomical structure was 3%. Conclusions: Footballers are at high risk of injury and there is a need to investigate ways of reducing this risk. Injury incidence at academy level is approximately half that of the professional game. Academy players probably have much less exposure to injury than their full time counterparts. Areas that warrant further attention include the link between musculoskeletal development and the onset of youth related conditions such as Sever's disease and Osgood-Schlatter's disease, the significant number of non-contact injuries that occur in academy football, and the increased rates of injury during preseason training and after the mid season break. This study has highlighted the nature and severity of injuries that occur at academy level, and the third part of the audit process now needs to be undertaken: the implementation of strategies to reduce the number of injuries encountered at this level.
Price, R; Hawkins, R; Hulse, M; Hodson, A
Background Over the past decade, there has been heightened interest in injury rates sustained by martial arts athletes, and more specifically, Taekwondo athletes. Despite this interest, there is a paucity of research on pre-competition habits and training of these athletes. The purpose of this pilot study was to assess training characteristics, competition preparation habits, and injury profiles of Taekwondo athletes. Methods A retrospective survey of Canadian male and female Taekwondo athletes competing in a national tournament was conducted. Competitors at a Canadian national level tournament were given a comprehensive survey prior to competition. Items on training characteristics, diet, and injuries sustained during training and competition were included. Questionnaires were distributed to 60 athletes. Results A response rate of 46.7% was achieved. Of those that responded, 54% dieted prior to competition, and 36% dieted and exercised pre-competition. Sixty-four percent of the athletes practised between 4–6 times per week, with 54% practicing 2 hours per session. Lower limb injuries were the most common (46.5%), followed by upper extremity (18%), back (10%), and head (3.6%). The majority of injuries consisted of sprains/strains (45%), followed by contusions, fractures, and concussions. More injuries occurred during training, including 59% of first injuries. Conclusion More research needs to be conducted to further illustrate the need for appropriate regulations on weight cycling and injury prevention.
Kazemi, Mohsen; Shearer, Heather; Su Choung, Young
Glenohumeral dislocation results in permanent deformation (nonrecoverable strain) of the glenohumeral capsule which leads to increased range of motion and recurrent instability. Minimal research has examined the effects of injury on the biomechanical properties of the capsule which may contribute to poor patient outcome following repair procedures. The objective of this study was to determine the effect of simulated injury on the stiffness and material properties of the AB-IGHL during tensile deformation. Using a combined experimental and computational methodology, the stiffness and material properties of six AB-IGHL samples during tensile elongation were determined before and after simulated injury. The AB-IGHL was subjected to 12.7 ± 3.2 % maximum principal strain which resulted in 2.5 ± 0.9 % nonrecoverable strain. The linear region stiffness and modulus of stress-stretch curves between the normal (52.4 ± 30.0 N/mm, 39.1 ± 26.6 MPa) and injured (64.7 ± 21.3 N/mm, 73.5 ± 53.8 MPa) AB-IGHL increased significantly (p = 0.03, p = 0.04). These increases suggest that changes in the tissue microstructure exist following simulated injury. The injured tissue could contain more aligned collagen fibers and may not be able to support a normal range of joint motion. Collagen fiber kinematics during simulated injury will be examined in the future. PMID:23054378
Rainis, Carrie A; Brown, Andrew J; McMahon, Patrick J; Debski, Richard E
Although mechanical ventilation (MV) is a life-saving intervention for patients with acute respiratory distress syndrome (ARDS), it can aggravate or cause lung injury, known as ventilator-induced lung injury (VILI). The biophysical characteristics of heterogeneously injured ARDS lungs increase the parenchymal stress associated with breathing, which is further aggravated by MV. Cells, in particular those lining the capillaries, airways and alveoli, transform this strain into chemical signals (mechanotransduction). The interaction of reparative and injurious mechanotransductive pathways leads to VILI. Several attempts have been made to identify clinical surrogate measures of lung stress/strain (e.g., density changes in chest computed tomography, lower and upper inflection points of the pressure–volume curve, plateau pressure and inflammatory cytokine levels) that could be used to titrate MV. However, uncertainty about the topographical distribution of stress relative to that of the susceptibility of the cells and tissues to injury makes the existence of a single ‘global’ stress/strain injury threshold doubtful.
Plataki, Maria; Hubmayr, Rolf D
This project is designed to investigate intracellular signaling mechanisms associated with neuronal cell injury. In the acute form, this injury accounts for neural injury following stroke and head trauma, while in the chronic phenotype, it may account for...
I. J. Reynolds
Twenty-nine soloist and principal dancers (mean age, 29.08 years) from America's two most celebrated ballet companies were administered questionnaires measur ing personality (API), occupational stress (OES), strain (PSQ), and coping mechanisms (PRQ), and injury pat terns. The results revealed that male dancers demon strated significantly more negative personality traits and psychological distress than female dancers or men in the general
Linda H. Hamilton; William G. Hamilton; James D. Meltzer; Peter Marshall; Marika Molnar
Background Despite the growing popularity of women's football and the increasing number of female players, there has been little research on injuries sustained by female football players. Purpose Analysis of the incidence, characteristics and circumstances of injury in elite female football players in top?level international tournaments. Study design Prospective survey. Methods Injuries incurred in seven international football tournaments were analysed using an established injury report system. Doctors of all participating teams reported all injuries after each match on a standardised injury reporting form. The mean response rate was 95%. Results 387 injuries were reported from 174 matches, equivalent to an incidence of 67.4 injuries/1000 player hours (95% CI 60.7 to 74.1) or 2.2 injuries/match (95% CI 2.0 to 2.4). Most injuries (84%; 317/378) were caused by contact with another player. The injuries most commonly involved the lower extremity (n?=?248; 65%), followed by injuries of the head and neck (n?=?67, 18%), trunk (n?=?33, 9%) and upper extremity (n?=?32, 8%). Contusions (n?=?166; 45%) were the most frequent type of injury, followed by sprains or ligament rupture (n?=?96; 26%) and strains or muscle fibre ruptures (n?=?31; 8%). The most common diagnosis was an ankle sprain. There were 7 ligament ruptures and 15 sprains of the knee. On average 1 injury/match (95% CI 0.8 to 1.2) was expected to result in absence from a match or training. Conclusion The injury rate in women's top?level tournaments was within the range reported previously for match injuries in elite male and female players. However, the diagnoses and mechanisms of injury among the female players differed substantially from those previously reported in male football players.
Junge, Astrid; Dvorak, Jiri
This study evaluated the effects of 4 different weekly stretching protocols on the rate of gain and decline in hamstring flexibility over an 8-week period, across sex. Using a randomized single-blind design, 53 healthy subjects aged 18-46 years were assigned to 1 of 4 stretching protocols or a control group. The stretching protocols consisted of either daily or 3 times per week stretching and performed once or twice each day. These protocols differed in terms of frequency and total weekly stretching time. All the subjects stretched their hamstring muscles for 4 weeks and were measured weekly for their hip range of motion (ROM). Stretching ceased the final 4 weeks as the weekly measurements continued. The results revealed no significant differences in the rate of gain or the rate of loss between the different stretching protocols (2-way analysis of variance, F = 2.60, p > 0.05). All the stretching groups gained in hip ROM from pre to week 4 (F = 269.24, p < 0.001). After cessation, the rate of loss was similar for all the 4 stretching groups (F = 102.86, p < 0.001); all the groups retained significant gains at the end of the study (p < 0.001). The control group did not change over time. Those who stretched at least 6 times per week gained more than those who stretched 3 times per week (24 and 16.8%, respectively, F = 5.20, p < 0.05). Subject sex did not influence ROM changes (p > 0.05). Stretching appears to be equally effective, whether performed daily or 3 times per week, provided individuals stretch at least 2 times each day. Moreover, although women are more flexible than men are, there was no sex difference in terms of stretching response. PMID:22027850
Cipriani, Daniel J; Terry, Megan E; Haines, Michelle A; Tabibnia, Amir P; Lyssanova, Olga
... strains are common. Many people get strains playing sports. Symptoms include pain, muscle spasms, swelling, and trouble moving the muscle. At first, treatment of both sprains and strains usually involves resting the injured area, icing it, wearing a bandage or device ...