Evaluation of adolescent sport specialization and injury mechanism by sex: A secondary analysis

ObjectivesThe purpose of this study was to compare the association of sport specialization with previous overuse and acute injuries between male and female adolescent athletes.DesignCross-sectional study.MethodsQuestionnaires were completed by adolescent athletes from various sports at sport club summer events in the state of Wisconsin. Adolescent athletes (12–18 years old) who were active in organized sports in the previous year were recruited. The questionnaire contained demographics, sport participation, sport specialization classification, and previous injury history. Sport specialization classification was determined using common methods in sport specialization research. Previous injury was restricted to athletic injuries that occurred in the past year.ResultsTwo-thousand and eleven participants (age = 13.7 ± 1.6 years, females = 989) completed the questionnaire. Highly specialized athletes were more likely to report both acute and overuse injuries compared to low specialization athletes. However, this relationship differed by sex, with only moderate and highly specialized females being more likely (Moderate: OR [95%CI] = 1.74 [1.18–2.58], p = 0.005; High: OR [95%CI] = 1.69 [1.14–2.53], p = 0.010) to report an overuse injury compared to low specialization females. Highly specialized female athletes were more likely to report an acute injury (High: OR [95%CI] = 1.46 [1.06–2.02], p = 0.022) compared to low specialization females. Highly specialized male athletes were not associated with overuse or acute injuries.ConclusionsHighly specialized athletes were more likely to report acute and overuse injuries. However, when this analysis was separated by sex, only highly specialized females were more likely to report a previous overuse or acute injury.     

Socioeconomic status of parents with children participating on youth club sport teams

ObjectivesTo describe the socioeconomic status, measured by household income and educational attainment, of parents with children participating on youth club sport teams.DesignCross-sectional survey.SettingLocal sport events.Participants949 parents (571 female) of youth athletes between 10 and 18 years old were recruited at club team events and practices to complete an anonymous questionnaire.Main Outcome MeasuresSES variables included total household income (THI) and educational attainment. Sport specialization was classified as low, moderate, or high using a previously utilized 3-point specialization scale. Chi-square tests were used to compare frequencies SES categories with child specialization.ResultsParents reported spending a median of 1500 [500-3000] USD per year on their children's club sports activities. Most parents reported a THI greater than 100,000 USD per year and a bachelor's degree or higher level of education. Parents in the higher THI categories were more likely to have a child that is highly specialized in one sport.ConclusionThe current youth sports system in the United States, which emphasizes year-round participation on club teams, may be limiting the participation of families without the resources to participate in this system.     

The association between early specialization and performance level with injury and illness risk in youth elite athletes

A trend is observed towards more specialized training and selection into talent programs at an early age for youth athletes. Little is known how this might influence the risk of illness and injury. The aim of the study was to assess whether, in a group of youth elite athletes, those specializing early or performing best were at increased risk of incurring injury or illness after entering a specialized Sport Academy High School program. We enrolled 259 16‐year‐old elite athletes. They completed a baseline web‐based questionnaire covering their age at specialization, single‐ versus multi‐sport involvement during the previous 2 years and current performance level (rated by themselves and their coach). Subsequently, the Oslo Sports Trauma Research Centre (OSTRC) questionnaire on health problems was used to self‐report injuries and illnesses weekly for 26 weeks from October to May. In this specialized Sport Academy High School program, 39% of the athletes reported early specialization (at 12 years or younger). However, early specialization did not increase the risk of injury or illness during the 26 weeks, nor did being a single‐sport athlete the previous two years increase this risk. The best performing athletes at the time of enrollment were not at greater risk of becoming injured or ill during the 26 weeks. In conclusion, in a group of youth elite athletes entering a specialized Sport Academy High School program neither early single‐sport specialization nor performance level appears to represent risk factors for injury or illness after enrollment.     

Specialization patterns across various youth sports and relationship to injury risk

Objectives: Current trends among young athletes towards earlier specialization age and year-round training on multiple teams has raised concern for increased injury risk. Our previous analyses showed higher risk for injury in highly specialized young athletes. The goal of this research was to determine whether sports specialization and injury patterns vary by sports type.

Methods: In this clinical case-control study, injured athletes (aged 7–18 years) were recruited from sports medicine clinics and compared to similarly aged uninjured athletes recruited from primary care clinics. Participants completed a survey reporting age, gender, sport type, specialization patterns, and details regarding sports-related injuries in the previous 6 months. Clinical diagnoses were collected from patients’ medical records. Injuries were classified as acute, overuse, or serious overuse.

Results: Of 1,190 athletes enrolled, 26% (313) were single-sport specialized (reported participation in one sport and trained >8 months/year). Sports with the highest proportion of single-sport specialized athletes were tennis (46.7%), gymnastics (30.1%), and dance (26.3%). Single-sport specialized athletes in individual sports started specializing at a younger age (11.2 ± 2.4 vs. 12.0 ± 2.7, p = 0.05) and reported higher training volumes (11.8 vs. 10.3 h/week, p = 0.04) than those in team sports. Sports with the youngest specialization age were gymnastics (8.9 ± 1.7), dance (10.8 ± 3.0), and soccer (10.9 ± 2.4). Single-sport specialized athletes in individual sports accounted for a higher proportion of overuse injuries (44.3% vs 32.2%, OR = 1.67, p = 0.037) and serious overuse injuries (23.4% vs 11.6%, OR = 2.38, p = 0.011), but a lower proportion of acute injuries (28.8% vs 13.8%, OR = 0.37, p = 0.001) compared to single-sport specialized athletes involved in team sports.

Conclusions: Athletes in individual sports may be more likely to specialize in a single sport than team sport athletes. Single-sport specialized athletes in individual sports also reported higher training volumes and greater rates of overuse injuries than single-sport specialized athletes in team sports.     

Rehabilitation duration and time of starting sport-related activities associated with return to the previous level of sports after anterior cruciate ligament reconstruction

ObjectivesTo determine predictors for return to previous level of sports after anterior cruciate ligament reconstruction (ACLR).DesignCross-sectional;SettingAthletic teams.ParticipantsNinety-one athletes who had ACLR with hamstring-tendon autograft within 1–5 years participated in this study. Athletes indicated their sport participation levels, injury profile, rehabilitation duration, and time to start sport-related activities (running, cutting-pivoting) after ACLR. Athletes answered whether they returned to the same previous level of frequency, duration, and intensity of sports.Main outcome measuresAthletes’ characteristics, injury and surgical factors, duration of post-operative rehabilitation program, and time to start sport-related activities after ACLR were evaluated by univariate logistic regression to determine predictors for return to previous level of sports.ResultsNine athletes (10%) returned to their self-described previous level of sports. Predictors for returning to previous level of sports were rehabilitation duration >4 months (OR:6.78; p = .011), time to start running ≤4 months (OR:8.62; p = .047) and cutting-pivoting <6 months after surgery (OR:5.02; p = .030).ConclusionLonger post-operative rehabilitation duration and time to start sport-related activities after ACLR predicted return to previous level of sports. Spending adequate time in post-operative rehabilitation program and time-based resumption of sports-related activities after ACLR might be key factors for returning to previous sports level.     

Association of sport participation in preterm and full term born children and body and fat mass indices from age 3 to 14 years

ObjectivesTo assess the association of gestational age groups (VP: <32 weeks, MP: 32–33 weeks, LP: 34–36 weeks and FT: ≥37 weeks of gestation) and club sport participation in childhood on body mass index (BMI), fat free mass index (FFMI) and fat mass index (FMI).DesignLongitudinal, cross sectional.MethodsBMI (age 3, 5, 7, 11 and 14 years; N = 10581–14702) and FFMI/FMI (age 7, 11 and 14 years; N = 10446–12996) and consistent club sport participation at age 5, 7 and 11 years (ranging from never participating to participating at all three ages) were assessed prospectively. These were compared by gestational age and their associations with BMI and FMI were investigated, while controlling for confounders (socio-economic, maternal obesity, child related, diet).ResultsBMI and FFMI was lower in VP or MP until age 7, but no differences were found in BMI, FFMI or FMI after age 11 with regard to gestational age. Consistent club sport participation from age 5–11 was unrelated to BMI at ages 3–7. However, FT children with club sport participation had lower BMI and FMI at ages 11 and 14; but this association was not found in VP or MP.ConclusionsDuring adolescence body composition of VP and MP become similar to FT born peers. Consistent sport participation reduces BMI and FMI in FT only. In VP or MP children modifying effects of sport on body composition might not be detected due to the catch-up growth in weight, height and fat mass at the same time.     

Monitoring of sport participation and injury risk in young athletes

ObjectivesCareful modulation of training characteristics in high-level sports optimizes performance and avoids inappropriate workloads and associated sports injury risk. The aims of this study were to compare sport participation characteristics in different youth sport categories and to investigate their relationship with injury.DesignProspective cohort follow-up.MethodsYoung (12–19 years) high-level athletes (n = 154) from a regional sport school were followed during 41 weeks regarding sport participation characteristics and traumatic and overuse sports injuries (time-loss definition). All data were self-recorded by the athletes in an electronic system “TIPPS” (Training and Injury Prevention Platform for Sports) and subject to a systematic data quality control. Volume and intensity (self-rated perceived exertion) of each sport session were used to compute weekly load, monotony and strain. Sport categories were defined as team, racket, and individual sports.ResultsAll sport participation characteristics were dependent on sport category (p < 0.05). Weekly intensity, load and strain were dependent on age (p < 0.05). Racket and individual sports were associated with lower injury risk (HR = 0.37 and 0.34, p = 0.001 and p < 0.001, respectively) compared to team sports. Average sport participation characteristics were not related to injury according to the survival analysis. However, intensity during the week prior to injury was significantly higher (p < 0.01) compared to that of the 4 preceding weeks.ConclusionsThis study investigated for the first time the relationship between sport participation pattern and injury risk in young athletes. The monitoring method was sensitive to variations according to pertinent variables and might help identify athletes with increased sports injury risk.     

Assessing implementation,limited efficacy,and acceptability of the BEAST tool: A rehabilitation and return-to-sport decision tool for nonprofessional athletes with anterior cruciate ligament reconstruction

ObjectivesTo assess the implementation, limited efficacy, and acceptability of the BEAST (better and safer return to sport) tool – a rehabilitation and return-to-sport (RTS) decision tool after anterior cruciate ligament reconstruction (ACLR) in nonprofessional athletes.DesignProspective cohort.Participants43 nonprofessional pivoting sport athletes with ACLR.Main outcomeClinician- and athlete-experienced implementation challenges (implementation), changes in quadriceps power, side hop and triple hop performance from 6 to 8 months after ACLR (limited efficacy), athletes’ beliefs about the individual rehabilitation and RTS plans produced by the BEAST tool (acceptability).ResultsThe BEAST tool was developed and then implemented as planned for 39/43 (91%) athletes. Hop and quadriceps power performance improved significantly, with the largest improvement in involved quadriceps power (standardised response mean 1.4, 95% CI:1.1–1.8). Athletes believed the rehabilitation and RTS plan would facilitate RTS (8.2 [SD: 2.0]) and reduce injury risk (8.3 [SD: 1.2]; 0 = not likely at all, 10 = extremely likely).ConclusionThe BEAST tool was implemented with few challenges and adjustments were rarely necessary. Athletes had large improvements in quadriceps power and hop performance on the involved leg. Athletes believed that the individual rehabilitation and RTS plans produced by the tool would facilitate RTS and reduce injury risk.     

Prevalence of sport specialisation and association with injury history in youth football

ObjectivesThe aims of this study were to determine the prevalence of sport specialisation in youth football, and to investigate the associations of sport specialisation and volume of sport participation with injury history.DesignCross-sectional questionnaire.SettingNew Zealand youth football teams.Participants414 youth football players aged 10–15 years.Main outcome measuresThe level of specialisation, average weekly sport participation and free-play volume were recorded. 12-month injury history was captured and grouped by injury type. Associations between level of specialisation and demographic variables were analysed using chi square tests. Logistic regression was used to investigate associations between injury history, level of specialisation, and volume of participation.ResultsParticipants were classified as high (43%), moderate (38%), or low (19%) specialised (n = 399 complete). High specialisation was more likely in boys, older participants, and those from large schools. Highly specialised participants were more likely to report a history of gradual onset injury than those who were low specialised (n = 340 with complete injury data). Odds of reporting a gradual onset injury also increased with greater weekly and annual sport participation volume.ConclusionsThere is a high prevalence of sport specialisation in youth football, and it is associated with increased incidence of gradual onset injury.     

Shoulder functional status in rugby union players with and without history of shoulder problems

ObjectivesTo assess the effects of (1) rugby union practice, (2) history of injury managed nonoperatively, and (3) history of injury managed operatively on shoulder functional status in male rugby union players.DesignCross sectional study.SettingClinical.Participants86 male athletes were assigned into four groups: multisport athletes, rugby union players without shoulder problems, with history of shoulder injury managed nonoperatively and with history of shoulder injury managed operatively.Main outcome measuresSI-RSI questionnaire, maximal isometric glenohumeral internal and external rotator strength, unilateral seated shot put test, upper quarter Y balance test.ResultsHealthy players presented higher internal (p = 0.03) and external (p = 0.04) rotator strength than multisport athletes. History of shoulder injury managed nonoperatively did not impair physical abilities but limited player’s psychological readiness (p < 0.001). After 4.5-months, shoulder stabilization surgery impaired maximal muscle strength and upper quarter body stability and mobility (p < 0.001 for all).ConclusionsThe shoulder functional status in rugby union player presented increased glenohumeral rotator strength when compared to non-collision sport athletes. In rugby union players, psychological concerns remained in the long-term after a shoulder injury managed nonoperatively, and psychological and physical readiness seemed not be reached at 4.5 months postoperatively to respond to rugby union practice demand.     

Fear of re-injury in people who have returned to sport following anterior cruciate ligament reconstruction surgery

ObjectivesTo examine fear of re-injury in athletes who had returned to regular sports participation following anterior cruciate ligament reconstruction surgery.DesignCross-sectional case series.MethodsA self-report questionnaire was used to collect data 2–7 years following surgery. Key inclusion criteria were regular participation in sport prior to injury and participation in sport at the time of the study.ResultsA sample of 209 (88 females, 121 males) at a mean of 39.6 ± 13.8 months post surgery participated. Overall, participants did not express fear of re-injury, scoring >6/10 (where 10 was the most positive response) on all questions. In terms of the total score and for six out of eight questions, participants who returned to their pre-injury sports level had significantly less fear of re-injury than those who had not returned to their pre-injury level. Females had significantly more concern than males about the environmental conditions experienced while playing (mean 6.1 compared to 7.5). On three out of eight questions, individuals who had surgery more than 3 months after injury had a greater fear of re-injury than those who had their surgery closer to the time of injury.ConclusionsAthletes participating in sport 2–7 years following their anterior cruciate ligament reconstruction generally appear to do so without fear of re-injury. However, gender, the timing of surgery following injury and the level of sport the athletes returned to may be associated with fear of re-injury following surgery.     

Characterization of hip passive stiffness of volleyball,basketball and futsal young athletes

Objectives(1) To establish the reference values of the test of ‘Position of hip passive resistance against gravity’ (PHPR) in young athletes; (2) To investigate differences between the values of PHPR test according to athlete's sex, age and sport practiced.DesignCross-sectional.SettingSports club.Participants282 Volleyball, basketball and futsal athletes aged between 10 and 18 years.Main outcome measuresHip passive stiffness was measured through PHPR test, which provides indirect information regarding this tissue property; high stiffness means low corresponding test values.ResultsThe mean values of PHPR test ranged from 0.41 to 1.06°/kg. The test results were different among all age categories and the values were lower in older athletes (p < 0.001). The PHPR test values of futsal players were lower than basketball players only in the intermediate age category (p = 0.001). The female volleyball athletes had higher values than the male ones (p < 0.001).ConclusionThis study established reference values for PHPR test in young athletes, which allow therapists to obtain information regarding hip passive stiffness by means of a clinical test. Hip passive stiffness in young athletes increases with age, and female volleyball players showed lower values of this property compared with males.     

Preventive effect of tailored exercises on patellar tendinopathy in elite youth athletes: A cohort study

ObjectiveTo investigate the effects of an intervention with tailored exercises on the incidence of patellar tendinopathy (PT) in elite youth jumping athletes.DesignProspective crossover cohort.SettingOne sport club facility.Participants271 elite youth basketball and volleyball player were followed in the first year of the study (Observation year) and 270 athletes were followed in the second year (intervention year).Main outcome measureIncidence rates of PT per 1,000h of exposure. Cox survival analysis was used to verify the effects of the intervention (exercises implemented according to the findings of a preseason assessment) on PT incidence.ResultsThe exercise prevention program significantly reduced the number of cases of PT, with athletes submitted to the intervention showing 51% less risk of developing PT. The overall PT incidence in the Observation year (5.9 per 1,000h of exposure) was significantly higher than that in the intervention year (2.8 per 1,000h of exposure) (P = .037). Twenty-six athletes developed PT in the observation year, whereas 13 athletes developed PT in the intervention year.ConclusionsA tailored preventive program may be able to reduce the incidence of patellar tendinopathy, especially in male youth volleyball athletes. Randomized controlled trials are encouraged to confirm these findings.     

Comparison of shoulder range of motion,strength, and upper quarter dynamic balance between NCAA division I overhead athletes with and without a history of shoulder injury

ObjectiveTo determine differences in shoulder range of motion, strength, and upper quarter dynamic balance between collegiate overhead athletes with and without a history of a shoulder injury.DesignCross-sectional study.SettingAthletic training clinic.Participants58 overhead athletes who were fully participating in NCAA Division I overhead sports (baseball, softball, volleyball, and tennis) and free of any current shoulder injury were included. Participants were divided into a shoulder injury history group (n = 25) and uninjured group (n = 33). Participants in the shoulder injury history group had a previously resolved shoulder injury.Main outcome measuresActive range of motion assessments for shoulder internal rotation, external rotation, and horizontal adduction. Isometric strength assessments for shoulder IR and ER. The Upper Quarter Y-Balance Test.ResultsThe shoulder injury history group demonstrated a lower Upper Quarter Y-Balance Test mean score in the superolateral direction (p = .03, d = 0.56), but no group differences existed for other results (p > .05).ConclusionsOverhead athletes with a history of shoulder injury had worse upper quarter dynamic balance versus those without the history. From a clinical perspective, the findings may have significant implications for developing shoulder re-injury prevention and rehabilitation protocols in relation to their shoulder injury history.     

Injury risk is different in team and individual youth sport

ObjectivesThis study compared sports injury incidence in young high-level athletes from various team and individual sports and investigated if sport participation patterns are linked to injuries.DesignProspective cohort follow-up.MethodsPupils from a public sports school (12–19 years) were recruited over two separate school years (2008–2009: 42 weeks, n = 199 athletes; 2009–2010: 40 weeks, n = 89 athletes). Training and competition volume and intensity were recorded via a personal sports diary. Sports injuries (time-loss definition) were registered by medical staff members using a standardized questionnaire.ResultsInjury incidence was significantly higher in team compared with individual sports (6.16 versus 2.88 injuries/1000 h, respectively), as a result of a higher incidence of both traumatic (RR = 2.17; CI95% = 1.75–2.70; p < 0.001), and overuse injuries (RR = 2.06; CI95% = 1.46–2.91; p < 0.001). A Cox proportional hazards regression revealed that team sports participation had a hazard ratio of 2.00 (CI95% = 1.49–2.68; p < 0.001) compared to individual sports, with additionally previous injury being a risk and age a protective factor. The number of competitions per 100 days was significantly higher in team sports, whereas the number of intense training sessions per 100 days was significantly lower. In team sports, the number of competitions per 100 days was positively associated with injuries (HR = 1.072; CI95% [1.033; 1.113]; p < 0.001), while in individual sports the number of competitions per 100 days had a protective effect (HR = 0.940; CI95% [0.893; 0.989]; p = 0.017).ConclusionsTeam sports participation entailed a higher injury risk, whatever the injury category. Further research should elucidate the role of characteristics related to sport participation in injury causation.     

Lower preseason reactive strength index scores are associated with injury in female collegiate volleyball players but not male collegiate basketball players

ObjectivesFunctional tests are used by sports medicine professionals to discriminate injury risk in athletes. One test that has shown promise is the drop vertical jump (DVJ); however, it is primarily used to evaluate measures associated with anterior cruciate ligament injury. The DVJ test can also be used to calculate the reactive strength index (RSI); a measure used to assess an athlete’s power. The ability of the RSI to discriminate injury risk is unknown. The purpose of this study was to prospectively evaluate the ability of preseason RSI scores to identify athletes at risk for a noncontact time-loss injury to the low back or lower extremities.DesignProspective cohort.MethodsOne hundred and fifty-five male collegiate basketball (BB) players and 117 female collegiate volleyball (VB) players were recruited for this study. DVJ tests were performed in a motion capture lab.ResultsFemale VB players with a RSI 0.9125 m/s or less (30.48 cm box) were 4 times (relative risk = 4.2 [95% CI: 1.0, 17.7]; p-value = 0.024) more likely to be injured. There was no association between preseason scores and injury in the male BB athletes.ConclusionRSI scores should be collected for female collegiate VB players as part of a preseason screen.     

Participation in pre-injury level sport one-year following sport-related concussion: A prospective,matched cohort study

ObjectivesTo estimate the times taken to receive clearance to return to sporting activity and to return to pre-injury level of sport competition following sport-related concussion, and to estimate the proportion of athletes who were participating at their pre-injury level of sport competition six months and one-year following sport-related concussion.DesignProspective cohort study.MethodsAmateur, adult athletes (16–38 years old) were diagnosed with sport-related concussion at a university-affiliated hospital emergency department. Participants were assessed within one-week, upon medical clearance to return to sporting activity, two weeks following return to sporting activity, six months, and 12 months following sport-related concussion. We assessed sex-, age-, and activity-matched non-injured, control participants at matched time-points. Participants were asked during each study assessment whether they were participating in any sport, in a different sport than before their sport-related concussion, in the same sport but at a lower level of competition than before their sport-related concussion, or in the same sport at the same level of competition than before their sport-related concussion.ResultsFifty concussed participants and 50 non-injured, control participants completed the study. The median times taken to receive clearance to return to sporting activity and to return to pre-injury level of sport competition following sport-related concussion were 13 days (95%CI = 12,16) and 31 days (95%CI = 28,32), respectively. One-year following sport-related concussion, 52% of participants reported that they were no longer participating in the same sport and at the same level of competition as they were before their sport-related concussion, compared with only 24% of participants in the non-injured, control group (p = 0.003).ConclusionsA greater percentage of athletes in the concussion group were not participating at their perceived pre-injury level of sport competition one-year following sport-related concussion compared with a non-injured control group. Factors that explain the lower proportion of amateur athletes participating at their pre-injury level of sport competition one-year after sport-related concussion are likely multifaceted and should be considered in future investigations.     

Factors influencing sport participation among athletes with spinal cord injury

OBJECTIVE: This exploratory study examined the relationships between pre- and post-injury sport participation among active individuals with spinal cord injury (SCI) in the United Kingdom. In particular, factors that influence individuals with SCI into sport were identified. METHODS: A total of 143 British individuals with SCI currently participating in wheelchair basketball, wheelchair rugby, wheelchair tennis, and wheelchair athletics were recruited. A total of 112 subjects were active prelesion, and 31 subjects were inactive preinjury. A Disability Sport Participation questionnaire developed by the authors was used for data collection. The questionnaire was distributed through the British Wheelchair Sport Associations. Personal, impairment, health and fitness, socialization, and participation data of athletes with SCI were collected. Groups of active preinjury and inactive preinjury were compared. RESULTS: For athletes who had been active pre-SCI, the in-hospital rehabilitation program and specialized sport club for people with disabilities were more important contexts for introducing the sport after injury to individuals. Friends and peers with disabilities were much more influential as initial and continuing socialization agents than rehabilitation therapists. The main reasons for athletes with SCI who participated in sports after injury were for fitness, fun, health, and competition, although many athletes noted that social aspects and rehabilitation also influenced their sport participation. CONCLUSION: This study identified social contexts, social agents, difficulties, sources of information, and reasons for sport participation of athletes with SCI. The results may offer some directions for the improvement of rehabilitation programs for people with SCI and also help the development of appropriate strategies to encourage people with SCI to participate in sports and leisure activities.     

Anatomical risk factors of lateral ankle sprain in adolescent athletes: A prospective cohort study

ObjectivesThe purpose of this study was to identify prospectively the anatomical and functional intrinsic risk factors for lateral ankle sprain (LAS) in adolescent athletes participating in team sports.DesignA prospective cohort study.SettingUniversity research laboratory.ParticipantsA total of 152 adolescent male athletes (age: 14.45 ± 2.96 years; height: 165.63 ± 15.33 cm; weight: 55.60 ± 16.56 kg; body mass index: 19.97 ± 3.58 kg/m²) participated in this study.Main outcome measuresThe participants were assessed during the preseason for previous ankle sprain history, navicular drop, tibia vara, Q angle, tibia torsion, knee recurvatum, and ankle ROM. LASs were prospectively recorded and diagnosed for two consecutive seasons (20 months).ResultsPrevious ankle sprain history (odds ratio [OR] = 60.911, p < 0.001), increased navicular drop (OR = 1.767, p < 0.001), and knee recurvatum (OR = 1.881, p = 0.002) were positively associated with the incidence of LAS. The receiver operating characteristic (ROC) analyses revealed the predictive potentials of previous ankle sprain history (the area under the ROC [AUROC] = 0.706, p < 0.001), navicular drop (AUROC = 0.906, p < 0.001), and knee recurvatum (AUROC = 0.724, p < 0.001).ConclusionAthletes with previous ankle sprain history, knee recurvatum, and especially navicular drop may have a greater risk of LAS injury. The data from this study can help therapists and trainers to identify people with a higher risk of LAS.     

Nearly 40% of adolescent athletes report anterior knee pain regardless of maturation status,age, sex or sport played

ObjectiveTo report point prevalence of anterior knee pain (AKP) in adolescent athletes by (1) maturation status, (2) chronological age, (3) sex, and (4) primary sport.DesignCross-sectional.MethodsMale and female participants aged 11–15 years were recruited from specialised sports programs for basketball, volleyball, Australian Rules Football and tennis. Standing height, sitting height, and body mass were measured and used to calculate maturity status. Past injury history, self-reported physical activity, and Victorian Institute of Sport Assessment Questionnaire Patellar Tendon (VISA-P) questionnaires were completed. Anterior knee pain was defined as any pain experienced on the anterior surface of the knee and recorded using a visual analogue scale (VAS). A single leg decline squat (SLDS) was performed for provocation of AKP.ResultsTwo hundred and seventeen male and female adolescent athletes participated in this study. Twenty participants were excluded from data analysis. Point prevalence of AKP was 39% (N = 76). Average self-reported physical activity/week was 7.9 ± 4.1 h of their specialised sport and 2.0 ± 2.0 h of other physical activity/week. Maturation status, chronological age, sex nor primary sporting program was statistically significant in explaining the presence or absence of AKP.ConclusionDue to the right-skewed maturation sample, the authors cannot state conclusively that maturation status was not associated with AKP. Nearly 40% of this cohort reported AKP during a pain provocation test. The presence of AKP was not explained by maturation status, age, sex or primary sport program. Given the chronic nature of AKP and future morbidity reported, this high prevalence provides rationale for intervention or prevention studies targeting younger athletes.