Sports-related eye injuries: floorball endangers the eyes of young players

The objectives of this study were to determine the distribution of different sports-related eye injuries and to identify injury types to enable recommendations to be made about the use of protective eyewear. The study population comprises all 565 eye trauma patients examined at the Ophthalmology Emergency Clinic of the Helsinki University Central Hospital over a 6-month period. Data were collected from patient histories and questionnaires. In addition, three severe floorball eye injury cases are presented. Of the 565 eye traumas, 94 (17%) were sports related. Of these, 42 (45%) were associated with floorball. Countrywide, in Finland, estimated over 300 (+95% CI 228-415) floorball eye injuries occur annually. The mean age of floorball patients was 22 years. The most common finding (55%) in sports injury patients was hyphema. Clinically severe eye injuries during this period accounted for one-fourth of all cases. During the study period, no eye injury was found in an organized junior ice hockey, where facial protection is mandatory. Floorball is estimated to belong to the highest risk group in sports, and thus, the use of protective eyewear is strongly recommended. We conclude that national floorball federations should make protective eyewear mandatory.     

A prospective study of injuries in licensed floorball players

Injuries occuring among 457 licensed floorball players in teh Swedish National League were analysed prospectively during the season from 1993 to 1994. Fifty-one (11%) players sustained 58 injuries. The majority (76%) of the injuries were due to trauma mostly during the game (55%). Twenty-three (52%) of the traumatic injuries were caused by an opponent or a stick. Ankle sprain (35%) was the most common diagnosis. Injury severity classified with regard to time of absence from sport participation were similarly distributed for minor (36%), moderate (29%) and major (35%) injuries. The total rate of injury was 2.5 per 1000 hours for female and 2.6 for male players. Although this rate is lower than for contact sports like soccer and ice-hockey, we feel that further investigation of floorball injuries and improvement of protection devices would be valuable.     

Acute injuries in Finnish junior floorball league players

Objectives

To investigate the incidence and characteristics of acute time-loss injuries in Finnish junior floorball league players.

Functional movement screen test: A reliable screening test for young elite ice hockey players

ObjectivesTo determine inter-rater and intra-rater reliability of the Functional Movement Screen (FMS) test among young elite hockey players.DesignReliability study.SettingInter-rater reliability was evaluated by two raters in the field. All performances were videotaped. Two other raters evaluated the videos once and then again 6 weeks later to determine intra-rater reliability. A weighted kappa statistic was used to analyze intra-rater and inter-rater reliability of each FMS sub-test, while an intra-class correlation coefficient (ICC) was calculated for the total score.ParticipantsTwenty-eight male hockey players aged 13–16.Main OutcomeFMS total and sub-tests scores.ResultsThe video raters demonstrated excellent intra-rater reliability for the total score, with an ICC of 0.96 (95% CI; 0.92–0.98) and 0.96 (95% CI; 0.91–0.98). The field raters achieved excellent inter-rater reliability for the total score, with an ICC of 0.96 (95% CI; 0.92–0.98). Sub-test analysis showed good agreement among all four raters for five of the seven main sub-tests.ConclusionFMS is a reliable test for young elite hockey players. Further research should be done to assess the predictive validity of the FMS test within this population so that physiotherapists may eventually use it as an injury prevention tool.     

Previous-day hypohydration impairs skill performance in elite female field hockey players

The purpose of this study was to determine the effects of 2% hypohydration on skill performance in elite female field hockey players following intermittent exercise in the heat. Eight elite female field hockey players performed 50 min of a field hockey-specific intermittent treadmill running protocol (FHITP) in hot environmental conditions (33 °C, 60% relative humidity) in different hydration states: euhydrated (EUH) and hypohydrated by 2% body mass (HYPO). Hydration status was manipulated via a period (121±10 min) of passive hyperthermia (40 °C, 75% relative humidity) and controlled fluid intake 1 day preceding testing. Ad libitum fluid intake was permitted throughout both trials. Field hockey skill tests were performed pre- and post-FHITP. Skill performance time increased (P=0.029) in the HYPO trial compared with the EUH trial, which may be attributed to an increase in penalty time (P=0.024). Decision-making time increased (P=0.008) in the HYPO trial and was significantly impaired compared with EUH (P=0.016) pre-FHITP. Ad libitum drinking appeared to be sufficient to maintain decision-making performance as no interaction effects were evident post-FHITP. Players who commence match-play in a state of hypohydration may be susceptible to decrements in skill and decision-making performance.     

ACTN3 R577X polymorphism does not influence explosive leg muscle power in elite volleyball players

We examined the association of R577X polymorphism (rs1815739) in the α‐actinin‐3 (ACTN3) gene with “explosive” leg muscle power performance in a group of male and female elite volleyball players (n=66, 31 men, 35 women) and in a group of non‐athletic male and female young adults (n=334, 243 men, 91 women). We assessed power performance by means of the vertical squat and counter‐movement jump tests. We also determined whether the genotypic frequencies of the ACTN3 R577X genotypes differed between groups. We did not observe any effect of the ACTN3 R577X polymorphism on study phenotypes in both groups, regardless of gender (all P>0.05). Genotype frequencies were similar between volleyball and control groups (P=0.095). Moreover, we did not find an association between the ACTN3 R577X polymorphism and the likelihood of being an elite volleyball player using the dominant (RR vs RX+XX) and the recessive model (RR+RX vs XX). In summary, these findings suggest that the ACTN3 R577X polymorphism does not influence explosive leg muscle power in elite volleyball players.     

MRI does not effectively diagnose ulnar-sided wrist pain in elite tennis players

ObjectivesUlnar-sided injuries of the non-dominant wrist are common in elite tennis players using a double-handed backhand technique. This study investigated the radiological changes of the non-dominant wrist in elite symptomatic and asymptomatic players using this technique as well as healthy controls. We compared clinical findings to radiological abnormalities.DesignCross-sectional design with blinded radiological assessment, and contemporaneous clinical assessment of symptomatic players.MethodsMagnetic resonance images (MRI) of wrists related to non-dominant ulnar-sided pain, were taken in 14 symptomatic tennis players, 14 asymptomatic tennis players, and 12 healthy controls which were then independently reviewed for abnormalities by blinded radiologists. Total abnormalities and global between-group differences in the triangular fibrocartilage complex (TFC), ulnar collateral ligament (UCL), extensor carpi ulnaris (ECU) and supporting structures, osseous-articular lesions and ganglia were assessed. These were then compared to clinical examinations of the symptomatic players to assess agreement.ResultsSymptomatic players reported a mean 3.64 abnormalities, being exactly 1 abnormality greater than asymptomatic players (2.64) and controls (2.50), suggesting similar asymptomatic lesions in all three groups. Players with pain reported significantly more osseous-articular lesions, ECU tendon and dorsal radio-ulnar ligament abnormalities, while changes to the UCL may reflect an isolated problem in specific wrists. There were no between-group differences in the presence of ganglia, most TFC structures nor ECU subsheath tear and subluxation.ConclusionsClinicians should carefully consider radiological changes alongside their clinical diagnosis of non-dominant wrist pain in tennis players due to possible tennis-related changes and/or asymptomatic findings.     

The standing knee lift test is not a useful screening tool for time loss from low back pain in youth basketball and floorball players

ObjectivesThe aim of this study was to investigate the association between pelvic kinematics during the standing knee lift (SKL) test and low back pain (LBP) in youth floorball and basketball players.DesignA prospective cohort study.SettingFinnish elite youth floorball and basketball players.ParticipantsFinnish elite youth female and male floorball and basketball players (n = 258, mean age 15.7 ± 1.8).Main outcome measuresLBP resulting in time loss from practice and games was recorded over a 12-month period and verified by a study physician. Associations between LBP and sagittal plane pelvic tilt and frontal plane pelvic obliquity during the SKL test as measured at baseline were investigated. Individual training and game hours were recorded, and Cox’s proportional hazard models with mixed effects were used for the analysis.ResultsCox analyses revealed that sagittal plane pelvic tilt and frontal plane pelvic obliquity were not associated with LBP in floorball and basketball players during the follow-up. The hazard ratios for pelvic tilt and pelvic obliquity ranged between 0.93 and 1.08 (95% CIs between 0.91 and 1.07 and 0.83 and 1.29), respectively.ConclusionsPelvic movement during the SKL test is not associated with future LBP in youth floorball and basketball players.     

Altered hip control during a standing knee-lift test is associated with increased risk of knee injuries

A few prospective studies have investigated hip and pelvic control as a risk factor for lower extremity (LE) injuries. The purpose of this study was to investigate whether deficits in hip and lumbopelvic control during standing knee-lift test are associated with increased risk of acute knee and LE injuries in youth team sports. At baseline, 258 basketball and floorball players (aged 12-21 years) participated in a standing knee-lift test using 3-dimensional motion analysis. Two trials per leg were recorded from each participant. Peak sagittal plane pelvic tilt and frontal plane pelvic drop/hike were measured. Both continuous and categorical variables were analyzed. New non-contact LE injuries, and match and training exposure, were recorded for 12 months. Seventy acute LE injuries were registered. Of these, 17 were knee injuries (eight ACL ruptures) and 35 ankle injuries. Risk factor analyses showed that increased contralateral pelvic hike was significantly associated with knee injury risk when using categorical variable (HR for high vs low group 4.07; 95% CI 1.32-12.6). Furthermore, significant association was found between high lateral pelvic hike angles and ACL injury risk in female players (HR for high vs low group 9.10; 95% CI 1.10-75.2). Poor combined sensitivity and specificity of the test was observed. In conclusion, increased contralateral pelvic hike is associated with non-contact knee injury risk among young team sport players and non-contact ACL injuries among female players. More research to determine the role of pelvic control as a risk factor for knee injuries is needed.     

Neuromuscular training reduces lower limb injuries in elite female basketball players. A cluster randomized controlled trial

The study was a two‐armed, parallel group, cluster randomized controlled trial in which 15 teams (160 players) were assigned to either an experimental group (EG , 8 teams n = 86), which warmed‐up with bodyweight neuromuscular exercises, or a control group (CG , 7 teams, n = 74) that performed standard tactical‐technical exercises before training. All injuries during the 2015‐2016 regular season were counted. Epidemiologic incidence proportion and incidence rate were also calculated. Countermovement jump (CMJ ) and composite Y‐Excursion Balance test (YBT ) were used to assess lower limb strength and postural control. A total of 111 injuries were recorded. Chi‐square test detected statistically significant differences between EG and CG (32 vs 79, P  = .006). Significant differences in the injuries sustained in the EG (21 vs 11, P  = .024) and CG (52 vs 27, P  = .0001) during training and matches, respectively, were observed. Significant differences in post‐intervention injuries were observed between in EG and CG during training (21 vs 52, P  < .0001) and matches (11 vs 27, P  = .006). Significant differences in epidemiologic incidence (0.37 vs 1.07, P  = .023) and incidence rate (1.66 vs 4.69, P  = .012) between the EG and the CG were found. Significant improvement in CMJ (+9.4%, P  < .0001; d  = 1.2) and composite YBT (right: +4.4%, P  = .001, d  = 1.0; left: +3.0%, P  = .003; d  = 0.8) for the EG was noted. Significant differences in post‐intervention CMJ (+5.9%, P  = .004) and composite YBT scores (right, +3.7%, P  = .012; left, +2.3%, P  = .007) between the EG and the CG were observed. Including bodyweight neuromuscular training into warm‐up routines reduced the incidence of serious lower limb injuries in elite female basketball players.     

Utility of the anterior reach Y-BALANCE test as an injury risk screening tool in elite male youth soccer players

ObjectivesExamine growth and maturation trends in dynamic balance using the anterior reach Y-Balance test, and its utility as an injury risk screening tool.DesignCross sectional and prospective cohort.SettingElite male youth soccer players.Participants346 players grouped as pre, circa or post peak height velocity (PHV).Main outcome measuresPre-season anterior reach absolute and relative Y-Balance test scores and seasonal prospective lower extremity injury monitoring.ResultsAbsolute reach distances were greatest post-PHV (p < 0.05). Relative to leg length, pre-PHV achieved the highest scores and increased between-limb differences. Significant associations between injury and anterior reach scores were present in pre (OR: 0.94, CI: 0.91–0.98, p < 0.05) and circa-PHV (OR: 1.05, 95% CI: 1.05–1.10, p < 0.05). Increased age (OR: 1.49, 95% CI: 1.04–2.13, p < 0.05) and height (OR: 1.06, 95% CI: 0.99–1.13, p = 0.82) were risk factors post-PHV. No differences in injury occurrence were shown between players with absolute reach difference >4 cm in any group.ConclusionsAnterior reach scores increased injury risk, but associations were small and inconsistent. The Y-Balance should be used with caution as a screening tool in this cohort.     

Ice slurry ingestion does not enhance self‐paced intermittent exercise in the heat

This study aimed to determine if ice slurry ingestion improved self‐paced intermittent exercise in the heat. After a familiarisation session, 12 moderately trained males (30.4 ± 3.4 year, 1.8 ± 0.1 cm, 73.5 ± 14.3 kg, O_2max 58.5 ± 8.1 mL/kg/min) completed two separate 31 min self‐paced intermittent protocols on a non‐motorised treadmill in 30.9 ± 0.9 °C, 41.1 ± 4.0% RH. Thirty minutes prior to exercise, participants consumed either 7.5 g/kg ice slurry (0.1 ± 0.1 °C) (ICE) or 7.5 g/kg water (23.4 ± 0.9 °C) (CONTROL). Despite reductions in T_c (ΔT_c: ?0.51 ± 0.3 °C, P < 0.05) and thermal sensation prior to exercise, ICE did not enhance self‐paced intermittent exercise compared to CONTROL. The average speed during the walk (CONTROL: 5.90 ± 1.0 km, ICE: 5.90 ± 1.0 km), jog (CONTROL: 8.89 ± 1.7 km, ICE: 9.11 ± 1.5 km), run (CONTROL: 12.15 ± 1.7 km, ICE: 12.54 ± 1.5 km) and sprint (CONTROL: 17.32 ± 1.3 km, ICE: 17.18 ± 1.4 km) was similar between conditions (P > 0.05). Mean T_sk, T_b, blood lactate, heart rate and RPE were similar between conditions (P > 0.05). The findings suggest that lowering T_c prior to self‐paced intermittent exercise does not translate into an improved performance.     

The FADIR test accuracy for screening cam and pincer morphology in youth ice hockey players

Objectives

Aim of this study was to evaluate the flexion-adduction-internal rotation (FADIR) test accuracy for screening cam and pincer morphology in youth male ice hockey players without diagnosed hip disorders.

The potential of head acceleration measurement to augment current best practice in concussion screening in professional Australian football players

ObjectiveTo explore the potential utility of head acceleration event (HAE) measurements to augment identification of players for further concussion screening in non-helmeted contact sport.DesignProspective observational pilot study.Participants210 (118 female) professional Australian football players in 2017 season.MethodsPlayers wore the X-Patch® accelerometer for one match each with data collected across 14 matches. Players with HAEs above thresholds associated with concussion, 95 g (males) or 85.5 g (females), were compared to players identified to have suspected concussion by club personnel during the inspected matches. Video review of matches was undertaken by a physician blinded to HAEs to identify players with concussive signs.ResultsAmong 26 players (50% female) with HAEs above threshold, two players were screened for concussion. Of the remaining 24 players, nine were not visible on video at the HAE time, six sustained verifiable head impacts, and nine sustained verifiable body impacts with no head impacts. Among 184 players with HAEs below threshold, five players were screened.ConclusionPlayers were identified to have head impacts and suspected concussion in the absence of HAEs above threshold. Use of X-Patch® was not sufficiently reliable for identifying players for further concussion screening in professional Australian football. Video review of head impacts remains essential in concussion screening.     

The incidence,prevalence, severity,mechanism and body region of injury in elite junior Australian football players: A prospective cohort study over one season

Objectives

To describe the incidence, prevalence, severity, mechanism and body region of injuries in elite junior Australian football (AF) players over one competitive season in order to help inform injury prevention interventions.

The effect of overhead target on the lower limb biomechanics during a vertical drop jump test in elite female athletes

The purpose of the study was to investigate the effect of an overhead target on the jump height and lower limb biomechanics in all three planes of motion in a vertical drop jump (VDJ) task among elite female handball and football (soccer) players. The hypothesis was that adding an overhead target to the VDJ task improves jump height, increases joint loading, and decreases frontal plane knee control. Five hundred and twenty-three female handball and football players (mean ± SD: 21 ± 4 years, 168 ± 6 cm, 65 ± 8 kg) completed the test. The overhead target increased jumping height by 5.8%. Furthermore, the overhead target led to statistically significant changes in many of the lower limb biomechanical variables examined. However, all the changes in kinematics and kinetics were clinically insignificant, as indicated by the small effect sizes. Strong to moderate positive Spearman's rank correlations were found between the two conditions. Therefore, an overhead target is unlikely to increase the range of responses in biomechanical variables in elite female handball and football athletes.     

The 11+ Kids warm-up programme to prevent injuries in young Iranian male high-level football (soccer) players: A cluster-randomised controlled trial

ObjectiveTo assess the effectiveness of the 11+ Kids warm-up programme regarding injury reduction in male high-level children’s football players.DesignCluster-randomised controlled trial.MethodMale youth football teams of Iran’s high-level football schools were invited to participate. Inclusion criteria were: teams are competing in the highest league of their province; players are between 7 and 14 years old; regular training takes place at least twice per week. Teams were excluded if they used an injury prevention measure.Participating clubs were randomised to an intervention (INT, N = 20 teams) and a control group (CON, N = 22 teams), stratified by the number of teams and the age group. The groups were blinded against each other. The follow-up period was one season (9 months). INT replaced their warm-up by 11+ Kids. CON performed a standard warm-up programme. The primary outcome was the injury incidence density (injuries per 1000 h of football exposure), compared between groups by incidence rate ratios (RR).ResultsIn total, 64,047 h of football exposure of 962 players (INT = 443 players, 31,934 h of football, CON = 519 players, 32,113 h of football) were recorded. During the study, 90 (INT = 30; CON = 60) injuries occurred. The overall injury incidence density in INT was reduced by 50% compared to CON (RR 0.50; 95%-CI 0.32, 0.78). No injuries occurred during the execution of the intervention exercises.ConclusionsThe 11+ Kids reduces injuries in high-level children’s football players, thus supporting player health and potentially performance and player development.