Injuries to Young Athletes

Introduction. High-intensity interval training (HIIT) is a time-efficient strategy shown to induce various cardiovascular and metabolic adaptations. Little is known about the optimal tolerable combination of intensity and volume necessary for adaptations, especially in clinical populations. Objectives: In a randomized controlled pilot design, we evaluated the effects of two types of interval training protocols, varying in intensity and interval duration, on clinical outcomes in overweight/obese men. Methods. Twenty-five men [body mass index (BMI) > 25 kg·m²] completed baseline body composition measures: fat mass (FM), lean mass (LM) and percent body fat (%BF) and fasting blood glucose, lipids and insulin (IN). A graded exercise cycling test was completed for peak oxygen consumption (VO₂peak) and power output (PO). Participants were randomly assigned to high-intensity short interval (1MIN-HIIT), high-intensity interval (2MIN-HIIT) or control groups. 1MIN-HIIT and 2MIN-HIIT completed 3 weeks of cycling interval training, 3 days/week, consisting of either 10 × 1 min bouts at 90% PO with 1 min rests (1MIN-HIIT) or 5 × 2 min bouts with 1 min rests at undulating intensities (80%–100%) (2MIN-HIIT). Results. There were no significant training effects on FM (Δ1.06 ± 1.25 kg) or %BF (Δ1.13% ± 1.88%), compared to CON. Increases in LM were not significant but increased by 1.7 kg and 2.1 kg for 1MIN and 2MIN-HIIT groups, respectively. Increases in VO₂peak were also not significant for 1MIN (3.4 ml·kg^-1·min^-1) or 2MIN groups (2.7 ml·kg^-1·min^-1). IN sensitivity (HOMA-IR) improved for both training groups (Δ-2.78 ± 3.48 units; p < 0.05) compared to CON. Conclusion. HIIT may be an effective short-term strategy to improve cardiorespiratory fitness and IN sensitivity in overweight males.     

Acute Knee Injuries

An athlete who has an acute knee injury should be assessed rapidly on the field and then more thoroughly on the sideline or in the training room. On-the-field assessment includes questions about the mechanism of injury and any similar previous injuries, a visual check for knee deformities and skin injuries, a neurovascular exam, and, ideally, tests for flexion and hyperextension. On the sideline or in the training room, standard physical tests are likely to reveal any significant injuries. These include the patellar apprehension, Lachman, posterior sag, quadriceps active, posterior drawer, posterolateral drawer, valgus and varus stress, pivot-shift, and dial tests.     

Nerve Injuries in Athletes

In brief: Nerve injuries in athletes may be serious and may delay or prevent an athlete's return to his or her sport. Over a two-year period, the authors evaluated the condition of 65 patients who had entrapments of a nerve or nerve root, documented with electromyography. They describe four case histories: Two patients had radial nerve entrapments, one caused by baseball pitching and the other by kayaking; one football player had combined suprascapular neuropathy and upper trunk brachial plexopathy; and one patient had carpal tunnel syndrome of a median nerve secondary to rowing. Sports-related peripheral nerve lesions of the lower extremity were not seen during the study period. Based on a literature review, the nerve injuries discussed represent the spectrum of nerve entrapments likely to be seen in US clinics. The authors conclude that peripheral nerve lesions should be considered in the differential diagnosis of sports injuries, particularly at the shoulder, elbow, and wrist.     

Knee Injuries in Sailboarding

Sailboarding is an exciting sport, but it does involve some risk for injury. In this study of 21 knee injuries that occurred during sailboarding over a 2-year period, 12 were isolated medial collateral ligament (MCL) sprains, 4 were meniscus tears, and 5 involved joint instability. The MCL sprains were directly related to the use of the foot straps on the sailboard. Conservative treatment was successful for the MCL sprains; the meniscus tears were treated with arthroscopic surgery. Improved foot straps designed to release the foot more readily may help reduce knee injuries.     

Diagnosing Kidney Injuries in Athletes

In brief: The University of Wisconsin in Madison has been a forerunner in the field of sports medicine. The initial goals of the program (education, research, and the establishment of a sports medicine clinic) have been reached. For example, residents in pediatrics, family practice, internal medicine, and physical medicine can now elect a rotation in sports medicine. Research activities have resulted in improved treatment and rehabilitation methods that have become the standard for sports and nonsports injuries alike. In addition, the University Hospital Sports Medicine and Fitness Center includes a clinic, a fitness evaluation center, a rehabilitation center, and a fitness center. The current goals of the sports medicine program are to anticipate and meet community needs, offer up-to-date educational programs, and provide optimal medical care for athletes.     

急性膝关节交叉韧带损伤的MRI表现

膝关节是人体的一个重要关节,既支撑全身重量,又是人体运动量最大的关节之一。如果运动不当或外伤暴力容易引起损伤。所以膝关节损伤是临床常见的外伤性疾病。而膝关节交叉韧带损伤又是膝关节损伤中常伴有的,有文献报道1/3为膝关节韧带损伤,其余为骨折、脱位[1]。交叉韧带的损伤为关节内损伤,以往主要靠临床检查和关节镜,前者是靠医生的临床经验,准确性受到限制。后者为创伤性检查。MR I检查方便且无创,可清晰显示交叉韧带的结构及其损伤程度、类型,为临床提供准确的依据。本文主要通过对25例膝关节交叉韧带损伤的病例分析来讨论交叉韧带…     

Hypermobility and Knee Injuries

In brief: The effect of knee joint hypermobility on knee injury is not fully clear. Inherited flexibility probably plays little role in the causes of most knee injuries. The exception is patellar dislocation, which is strongly associated with hypermobility. Discussions of hypermobility often reflect confusion over the difference between flexibility and laxity. In general, flexibility refers to a joint's range of motion and is a function of muscle and tendon tightness, while laxity refers to joint distraction and shear and is a function of ligament tightness. Research on hypermobility has focused on flexibility; the relationship between injury and joint laxity (ligament stability) has not been studied prospectively. Such research could yield information useful for injury prevention.