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1.
    
The etiology of running‐related injury is important to consider as the effectiveness of a given running‐related injury prevention intervention is dependent on whether etiologic factors are readily modifiable and consistent with a biologically plausible causal mechanism. Therefore, the purpose of the present article was to present an evidence‐informed conceptual framework outlining the multifactorial nature of running‐related injury etiology. In the framework, four mutually exclusive parts are presented: (a) Structure‐specific capacity when entering a running session; (b) structure‐specific cumulative load per running session; (c) reduction in the structure‐specific capacity during a running session; and (d) exceeding the structure‐specific capacity. The framework can then be used to inform the design of future running‐related injury prevention studies, including the formation of research questions and hypotheses, as well as the monitoring of participation‐related and non‐participation‐related exposures. In addition, future research applications should focus on addressing how changes in one or more exposures influence the risk of running‐related injury. This necessitates the investigation of how different factors affect the structure‐specific load and/or the load capacity, and the dose‐response relationship between running participation and injury risk. Ultimately, this direction allows researchers to move beyond traditional risk factor identification to produce research findings that are not only reliably reported in terms of the observed cause‐effect association, but also translatable in practice.  相似文献   

2.

Objective

To compare injury risk in elite football played on artificial turf compared with natural grass.

Design

Prospective two‐cohort study.

Setting

Male European elite football leagues.

Participants

290 players from 10 elite European clubs that had installed third‐generation artificial turf surfaces in 2003–4, and 202 players from the Swedish Premier League acting as a control group.

Main outcome measure

Injury incidence.

Results

The incidence of injury during training and match play did not differ between surfaces for the teams in the artificial turf cohort: 2.42 v 2.94 injuries/1000 training hours and 19.60 v 21.48 injuries/1000 match hours for artificial turf and grass respectively. The risk of ankle sprain was increased in matches on artificial turf compared with grass (4.83 v 2.66 injuries/1000 match hours; rate ratio 1.81, 95% confidence interval 1.00 to 3.28). No difference in injury severity was seen between surfaces. Compared with the control cohort who played home games on natural grass, teams in the artificial turf cohort had a lower injury incidence during match play (15.26 v 23.08 injuries/1000 match hours; rate ratio 0.66, 95% confidence interval 0.48 to 0.91).

Conclusions

No evidence of a greater risk of injury was found when football was played on artificial turf compared with natural grass. The higher incidence of ankle sprain on artificial turf warrants further attention, although this result should be interpreted with caution as the number of ankle sprains was low.  相似文献   

3.
    
Groin injuries represent a considerable problem in male football, accounting for 4%‐19% of all time‐loss injuries. The Adductor Strengthening Programme is the first groin‐specific prevention program shown to reduce the risk of groin problems. We aimed to use the RE‐AIM framework to examine the players’ experiences with the implementation of the program and player attitude toward groin injury prevention in football. Of the 632 players involved in the trial examining the effect of the Adductor Strengthening Programme, 501 agreed to participate in a survey at the end of the season. Most players thought that footballers are at moderate to high risk for groin injuries (87%) and that there is a need for preventive measures (96%). They also believed that a preventive program with strengthening exercises would reduce the risk of groin injuries (91%). Majority of the players reported using <5 minutes to complete the program (73%), and only 11% wanted additional exercises. However, only 46% reported to have performed the program as recommended, and an even smaller proportion (31%) planned to continue using it as recommended the next season. Our results suggest that footballers believe that prevention of groin injuries is needed. Attitude toward implementation of the Adductor Strengthening Programme was positive, and the single‐exercise approach was considered an important facilitator. However, in future dissemination of the program, the players’ reluctance to maintain the exercise protocol may be a potential barrier to implementation that should be addressed.  相似文献   

4.
Objectives: Achilles tendon (AT) ruptures are a potentially career-altering and ending injury. Achilles tendon ruptures have a below average return-to-play rate compared to other common orthopaedic procedures for National Football League (NFL) players. The objective of this study was to monitor the incidence and injury rates (IR) of AT ruptures that occurred during the regular season in order to evaluate the influence of player position, time of injury, and playing surface on rupture rates.

Methods: A thorough online review was completed to identify published injury reports and public information regarding AT ruptures sustained during regular season and post-season games in the National Football League (NFL) during the 2009–10 to 2016–17 seasons. Team schedules, player position details and stadium information was used to determine period of the season of injury and playing surface. IRs were calculated per 100 team games (TG). Injury rate ratios (IRR) were utilized to compare IRs.

Results: During eight monitored seasons, there were 44 AT ruptures in NFL games. A majority of AT ruptures were sustained in the first eight games of the regular season (n = 32, 72.7%). There was a significant rate difference for the first and second four-game segments of the regular season compared to the last two four-game segments of the regular season. Defensive players suffered a majority of AT ruptures (n = 32, 72.7%). The IR on grass was 1.00 per 100 TG compared to 1.08 per 100 TG on artificial turf (IRR: 0.93, p = .80).

Conclusion: A significant increase in AT ruptures occurred in the first and second four game segments of the regular season compared to the last two-four game segments of the regular season. Defensive players suffered a majority of AT ruptures compared to offensive or specialist players. There was no difference between AT rupture rates and playing surface in games.  相似文献   


5.
    
The main objective was to investigate whether the cumulative load of the lower limbs, defined as the product of external load and step rate, could be predicted using spatiotemporal variables gathered with a commercially available wearable device in running. Therefore, thirty-nine runners performed two running tests at 10 and 12 km/h, respectively. Spatiotemporal variables (step rate, ground contact time, and vertical oscillation) were collected using a commercially available wearable device. Kinetic variables, measured with gold standard equipment (motion capture system and instrumented treadmill) and used for the calculation of a set of variables representing cumulative load, were peak vertical ground reaction force (peak vGRF), vertical instantaneous loading rate (VILR), vertical impulse, braking impulse, as well as peak extension moments and angular impulses of the ankle, knee and hip joints. Separate linear mixed-effects models were built to investigate the prediction performance of the spatiotemporal variables for each measure of cumulative load. BMI, speed, and sex were included as covariates. Predictive precision of the models ranged from .11 to .66 (R2m) and .22 to .98 (R2c), respectively. Greatest predictive performance was obtained for the cumulative peak vGRF (R2m = .66, R2c = .97), VILR (R2m = .43, R2c = .97), braking impulse (R2m = .52, R2c = .98), and peak hip extension moment (R2m = .54, R2c = .90). In conclusion, certain variables representing cumulative load of the lower limbs in running can be predicted using spatiotemporal variables gathered with a commercially available wearable device.  相似文献   

6.
Scase E  Cook J  Makdissi M  Gabbe B  Shuck L 《British journal of sports medicine》2006,40(10):834-8; discussion 838

Objective

To evaluate the effectiveness of a preseason physical training programme that taught landing and falling skills in improving landing skills technique and preventing injury in junior elite Australian football players.

Methods

723 male players who participated in an under 18 elite competition were studied prospectively in a non‐randomised controlled trial over two consecutive football seasons. There were 114 players in the intervention group and 609 control players. The eight session intervention programme taught players six landing, falling, and recovery skills, which were considered fundamental for safe landing in Australian football. Landing skills taught in these sessions were rated for competence by independent and blinded assessors at baseline and mid‐season.

Results

Evaluation of landing skills found no significant differences between the groups at baseline. Evaluation after the intervention revealed overall improvement in landing skills, but significantly greater improvement in the intervention group (z  =  −7.92, p  =  0.001). Players in the intervention group were significantly less likely (relative rate 0.72, 95% confidence interval 0.52 to 0.98) to sustain an injury during the season than the control group. In particular, the time to sustaining a landing injury was significantly less for the intervention group (relative rate 0.40, 95% confidence interval 0.17 to 0.92) compared with the control group.

Conclusions

Landing and falling ability can be taught to junior elite Australian football players. Players in the intervention group were protected against injury, particularly injuries related to landing and falls.  相似文献   

7.
In brief: Abnormal blood chemistry values may be a normal physiological response to marathon running and training. This was shown by elevations in creatine phosphokinase, high density lipoproteins, lactate dehydrogenase, and WBCs after a marathon run. Significant changes(p <.05) were noted in all blood parameters except globulin and high density lipoproteins from subjects before the race to immediately after the race and two to three weeks after the race. Insignificant differences in blood chemistry values were observed in runners with different running speeds, previous marathon experience, age, body weight, and average training miles per week.  相似文献   

8.
    
Patellar tendinopathy is the most common knee injury incurred in volleyball, with its prevalence in elite athletes more than three times that of their sub‐elite counterparts. The purpose of this study was to determine whether patellar tendinopathy risk factors differed between elite and sub‐elite male volleyball players. Nine elite and nine sub‐elite male volleyball players performed a lateral stop–jump block movement. Maximum vertical jump, training history, muscle extensibility and strength, three‐dimensional landing kinematics (250 Hz), along with lower limb neuromuscular activation patterns (1500 Hz), and patellar tendon loading were collected during each trial. Multivariate analyses of variance (P < 0.05) assessed for between‐group differences in risk factors or patellar tendon loading. Significant interaction effects were further evaluated using post‐hoc univariate analysis of variance tests. Landing kinematics, neuromuscular activation patterns, patellar tendon loading, and most of the previously identified risk factors did not differ between the elite and sub‐elite players. However, elite players participated in a higher training volume and had less quadriceps extensibility than sub‐elite players. Therefore, high training volume is likely the primary contributor to the injury discrepancy between elite and sub‐elite volleyball players. Interventions designed to reduce landing frequency and improve quadriceps extensibility are recommended to reduce patellar tendinopathy prevalence in volleyball players.  相似文献   

9.
    
Athletes exposed to rapid maneuvers need a high level of dynamic knee stability and robustness, while also controlling whole body movement, to decrease the risk of non‐contact knee injury. The effects of high‐level athletic training on such measures of movement control have not, however, been thoroughly evaluated. This study investigated whether elite athletes (who regularly perform knee‐specific neuromuscular training) show greater dynamic knee robustness and/or different movement strategies than non‐athletic controls, in relation to overall knee function. Thirty‐nine women (19 athletes, 20 controls) performed standardized rebound side hops (SRSH) while a motion capture system synchronized with two force plates registered three‐dimensional trunk, hip, and knee joint angles and moments. Dynamic knee robustness was evaluated using finite helical axis (FHA) inclination angles extracted from knee rotation intervals of 10°, analyzed with independent t tests. Angle and moment curves were analyzed with inferential methods for functional data. Athletes had superior knee function (less laxity, greater hop performances, and strength) but presented similar FHA inclination angles to controls. Movement strategies during the landing phase differed; athletes presented larger (a) hip flexion angles (during 9%‐29% of the phase), (b) hip adduction moments (59%‐99%), (c) hip internal rotation moments (83%‐89%), and (d) knee flexion moments (79%‐93%). Thus, elite athletes may have a greater ability than non‐athletes to keep the knee robust while performing SRSH more efficiently through increased engagement of the hip. However, dynamic knee robustness associated with lower FHA inclination angles still show room for improvement, thus possibly decreasing knee injury risk.  相似文献   

10.
Groin injuries cause major problems in sports and particularly in football. Exercise is effective in treating adductor‐related groin pain, but no trials have been published regarding the specific prevention of groin pain or prevention specifically targeting overuse injuries in sport using exercise programs. We performed a cluster‐randomized trial including 55 football clubs representing 1211 players. The clubs were randomized to an exercise program aimed at preventing groin injuries (n=27) or to a control group training as usual (n=28). The intervention program consisted of six exercises including strengthening (concentric and eccentric), coordination, and core stability exercises for the muscles related to the pelvis. Physiotherapists assigned to each club registered all groin injuries. Twenty‐two clubs in each group completed the study, represented by 977 players. There was no significant effect of the intervention (HR=0.69, 95% CI 0.40–1.19). The risk of a groin injury was reduced by 31%, but this reduction was not significant. A univariate analysis showed that having had a previous groin injury almost doubles the risk of developing a new groin injury and playing at a higher level almost triples the risk of developing a groin injury.  相似文献   

11.
    
This prospective cohort study investigated the influence of an artificial playing surface on injury risk and perceptions of muscle soreness in elite English Premiership Rugby Union players. Time loss (from 39.5 matches) and abrasion (from 27 matches) injury risk was compared between matches played on artificial turf and natural grass. Muscle soreness was reported over the 4 days following one match played on each surface by 95 visiting players (i.e., normally play on natural grass surfaces). There was a likely trivial difference in the overall injury burden relating to time‐loss injuries between playing surfaces [rate ratio = 1.01, 90% confidence interval (CI): 0.73–1.38]. Abrasions were substantially more common on artificial turf (rate ratio = 7.92, 90% CI: 4.39–14.28), although the majority of these were minor and only two resulted in any reported time loss. Muscle soreness was consistently higher over the 4 days following a match on artificial turf in comparison with natural grass, although the magnitude of this effect was small (effect sizes ranging from 0.26 to 0.40). These results suggest that overall injury risk is similar for the two playing surfaces, but further surveillance is required before inferences regarding specific injury diagnoses and smaller differences in overall injury risk can be made.  相似文献   

12.
中国女子足球运动员运动损伤规律及防治的初步研究   总被引：25，自引：1，他引：25  
1997年春训时,对国家队等8支女子足球队共175名运动员进行了运动损伤调查及病因分析,结果显示女子足球运动损伤发生率为235.4％,其中急性损伤占41.8％,慢性损伤占58.2％。发病率列前6位的运动损伤依次为踝关节扭伤、膝关节韧带损伤、大腿后肌群拉伤、颈椎劳损、踝部骨关节病、腰肌劳损。损伤原因为训练水平不足、训练缺乏科学性、人为因素、客观原因。针对病因,我们以广东队等4队93名运动员作为防治组(陕西队等3队58人作为自然对照组),采取了综合防治措施。1998年春训时调查结果显示防治组运动损伤发生率为105.4％,而对照组运动损伤发生率为229.3％,二者有显著性差异(P＜0.05),表明在目前条件下,采取本文综合性防治措施是行之有效的。  相似文献   

13.
    
Although the 11+ program has been shown to reduce injuries in sub‐elite football, program compliance is typically poor, suggesting that strategies to optimize delivery are necessary. This study investigated the effect of rescheduling Part 2 of the three‐part 11+ program on program effectiveness. Twenty‐five semi‐professional football clubs were randomly allocated to either a Standard‐11+ (n = 398 players) or P2post group (n = 408 players). Both groups performed the 11+ program at least twice a week throughout the 2017 football season. The Standard‐11+ group performed the entire 11+ program before training activities commenced, whereas the P2post group performed Parts 1 and 3 of the 11+ program before and Part 2 after training. Injuries, exposure, and individual player 11+ dose were monitored throughout the season. No significant between group difference in injury incidence rate (P2post vs Standard‐11+ = 11.8 vs 12.3 injuries/1000 h) was observed. Severe time loss injuries > 28 days (33 vs 58 injuries; P < .002) and total days lost to injury (4303 vs 5815 days; P < .001) were lower in the P2post group. A higher 11+ program dose was observed in the P2post (29.1 doses; 95% CI 27.9‐30.1) versus Standard‐11+ group (18.9 doses; 95% CI 17.6?20.2; P < .001). In semi‐professional football, rescheduling Part 2 of the 11+ program to the end of training maintained the effectiveness of the original 11+ program to reduce injury incidence. Importantly, rescheduling Part 2 improved player compliance and reduced the number of severe injuries and total injury burden, thereby enhancing effectiveness of the 11+ program.  相似文献   

14.
    
The aim of this study was to evaluate the influence of the fatigue on the machine scrum pushing sagittal forces during repeated scrums and to determine the origin of the knee extensor fatigue. Twelve elite U23 rugby union front row players performed six 6-s scrums every 30 s against a dynamic scrum machine with passive or active recovery. The peak, average, and the standard deviation of the force were measured. A neuromuscular testing procedure of the knee extensors was carried out before and immediately after the repeated scrum protocol including maximal voluntary force, evoked force, and voluntary activation. The average and peak forces did not decrease after six scrums with passive recovery. The standard deviation of the force increased by 70.2 ± 42.7% (P < 0.001). Maximal voluntary/evoked force and voluntary activation decreased (respectively 25.1 ± 7.0%, 14.6 ± 5.5%, and 24 ± 9.9%; P < 0.001). The standard deviation of the force did not increase with active recovery and was associated with lower decrease of maximal voluntary/evoked force and voluntary activation (respectively 12.8 ± 7.9%, 4.9 ± 6.5%, and 7.6 ± 4.1%; all P < 0.01). As a conclusion repeated scrummaging induced an increased machine scrum pushing instability associated with central and peripheral fatigue of the knee extensors. Active recovery seems to limit all these manifestations of fatigue.  相似文献   

15.
Competitive swimming is one of the most demanding and time-consuming sports. Swimmers at elite level practice 20–30 h per week. During 1 year's practice, the average top level swimmer performs more than 500,000 stroke revolutions per arm. These innumerable repetitions over many years of hard training together with an increasing muscular imbalance around the shoulder girdle seem to be the main etiological factors in the development of the overuse syndrome swimmer's shoulder. Shoulder pain in swimmers has in general been regarded as synonymous with coracoacromial impingement, i.e. anterior shoulder pain due to rotator cuff tendinitis, but new knowledge suggests that a concomitant glenohumeral instability plays an additional role. The diagnostic complexity of the problem is as challenging as the search for the gold standard of treatment. The condition should ideally be diagnosed as early as possible, and intensive functional rehabilitation of the shoulder girdle including the scapular muscles should be started in order to restore muscle balance. The surgical possibilities include subacromial decompression in cases of purely mechanical impingement. If a painful glenohumeral instability persists after intensive functional rehabilitation, anterior capsulolabral reconstruction can be performed. Still, however, short- and long-term results show that surgery is less successful in elite athletes involved in overhead sports. Prevention protocols include education of coaches in primary injury prophylaxis and the institution of resistance strength training in prepubescent swimmers. Emphasis should be made to improve muscular balance around the glenohumeral and scapulothoracic joints.  相似文献   

16.
    
Excessive knee abduction loading is a contributing factor to anterior cruciate ligament (ACL) injury risk. The purpose of this study was to determine whether a double‐leg landing training program with real‐time visual feedback improves frontal‐plane mechanics during double‐ and single‐leg landings. Knee abduction angles and moments and vertical ground reaction forces (GRF) of 21 recreationally active women were quantified for double‐ and single‐leg landings before and after the training program. This program consisted of two sessions of double‐leg jump landings with real‐time visual feedback on knee abduction moments for the experimental group and without real‐time feedback for the control group. No significant differences were found between training groups. In comparison with pre‐training data, peak knee abduction moments decreased 12% post‐training for both double‐ and single‐leg landings; whereas peak vertical GRF decreased 8% post‐training for double‐leg landings only, irrespective of training group. Real‐time feedback on knee abduction moments, therefore, did not significantly improve frontal‐plane knee mechanics during landings. The effect of the training program on knee abduction moments, however, transferred from the double‐leg landings (simple task) to single‐leg landings (more complex task). Consequently, ACL injury prevention efforts may not need to focus on complex tasks during which injury occurs.  相似文献   

17.
brief reports     
Hypertrophic cardiomyopathy (HCM) is a rare cause of death among the many participants in sports and recreational athletics, but it attracts widespread attention because the deaths occur in young, apparently healthy people. Differentiating HCM from conditioning hypertrophy (athlete's heart) remains a challenge. Routine detection of HCM patients is most commonly done with family history, physical examination, electrocardiography, and echocardiograhy. Keys to the differential diagnosis include evidence of heterogenous left ventricle hypertrophy, left atrial enlargement, unusual ECG patterns, and family history or gene mutations. Molecular detection methods for known defective genes in HCM have not yet become routine clinical tools. Athletes with unequivocal HCM should not participate in competitive sports, except for perhaps some low-intensity ones.  相似文献   

18.
    
There is strong evidence linking an athlete's movement technique during sidestepping with anterior cruciate ligament (ACL) injury risk. However, it is unclear how these injurious postures are influenced by prior movement. We aim to describe preparatory trunk and thigh kinematics at toe-off of the penultimate-step and flight-phase angular momenta, and explore their associations with frontal-plane risk factors during unplanned sidestepping maneuvers. We analyzed kinematic and kinetic data of 33 male Australian Football players performing unplanned sidestepping tasks (103 trials). Linear mixed models tested for reliable associations between ACL injury risk during weight acceptance of the execution-step, with preparatory kinematics and angular momenta of the trunk and thigh during the penultimate-step. Multi-planar flight-phase trunk momenta along with hip abduction angle at penultimate-step toe-off were significantly associated with peak knee valgus moments during the execution-step (R2 = .21, P < .01). Execution-step trunk lateral flexion was significantly predicted by frontal and sagittal-plane preparatory trunk positioning at toe-off of the penultimate-step (R2 = .44, P < .01). Multi-planar flight-phase trunk momenta as well as multi-planar trunk and hip positioning at penultimate-step toe-off were associated with hip abduction during the execution-step (R2 = .53, P < .01). Preparatory positioning of the trunk and hip, along with flight-phase trunk momentum adjusting this positioning are linked to known ACL injury risk factors. We recommend that during the penultimate-step athletes maintain an upright trunk, as well as minimize frontal-plane trunk momentum and transverse-plane trunk momentum toward the sidestep direction to reduce risk of ACL injury during unplanned sidesteps.  相似文献   

19.
    
We investigated the effect of a “PreBind” engagement protocol on the biomechanics of contested Rugby Union scrummaging at different playing levels. “PreBind” requires front‐row props to take a bind on opposing players prior to the engagement, and to maintain the bind throughout the scrum duration. Twenty‐seven teams from five different playing levels performed live scrums under realistic conditions. Video analysis, pressures sensors, and inertial measurement units measured biomechanical outcomes as teams scrummaged following different engagement protocols: the CTPE (referee calls “crouch‐touch‐pause‐engage”), the CTS (“crouch‐touch‐set”), and the PreBind (“crouch‐bind‐set”) variants. PreBind reduced the set‐up distance between the packs (?27%) and the speed at which they came into contact by more than 20%. The peak biomechanical stresses acting on front rows during the engagement phase were decreased in PreBind by 14–25% with respect to CTPE and CTS, without reducing the capability to generate force in the subsequent sustained push. No relevant main effects were recorded for playing level due to within‐group variability and there were no interaction effects between playing level and engagement protocol. Pre‐binding reduced many mechanical quantities that have been indicated as possible factors for chronic and acute injury, and may lead to safer engagement conditions without affecting subsequent performance.  相似文献   

20.
    
The purpose of this study was to compare the effects of Mulligan's tape (MT) and kinesio tape (KT) with no tape (NT) on hip and knee kinematics and kinetics during running. Twenty‐nine female recreational runners performed a series of ‘run‐throughs’ along a 10‐m runway under the three taping conditions. Two force plates and a 14‐camera Vicon motion analysis system (Oxford Metrics, Inc., Oxford, UK) captured kinematic and kinetic data for each dependent variable from ground contact to toe off. Comparisons of each dependent variable under three taping conditions were assessed through Statistical Package for the Social Sciences (SPSS; SPSS, Inc., Chicago, Illinois, USA; P‐value < 0.01) using repeated measure analyses of variance. For each dependent variable with a P‐value < 0.01, repeated measures with pairwise comparisons and Bonferroni adjustment were conducted to compare the three taping conditions. MT induced a significant reduction in anterior and posterior hip forces, knee flexion angular velocity, knee extensor moments, and hip flexion and extension moments compared with NT and KT (P = 0.001). There was no difference in hip or knee, kinematics or kinetics, between KT and NT (P = 1.000). MT appears to influence hip and knee biomechanics during running in an asymptomatic sample, whereas KT appeared to be biomechanically not different from NT.  相似文献   

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