Hypermobility and sports injuries in junior netball players

Objective: To evaluate the incidence of hypermobility in young female netball players and to determine the relation between hypermobility, previous injuries sustained in netball or other sports, and the use of protective equipment. Methods: Under 16 year old female netball players from a local suburban netball association were assessed for joint hypermobility using the validated Beighton score (0–9, with higher scores indicating increasing hypermobility). Player profiles and details of sporting injuries, both netball and non-netball, and the use of protective equipment were gathered by means of a self completed questionnaire. Parental and child consent was obtained. Results: Two hundred netball players were recruited for the study. Twenty one percent of the subjects with a Beighton hypermobility score of 0–2 had sustained previous netball injuries compared with 37% with Beighton scores of 3–4, and 43% with scores of 5–9. These differences were significant (p<0.025). Injuries were most common in the ankle (42%), knee (27%), and fingers (15%). Thirty nine players (19%) wore protective equipment, and within this group 30 (77%) had sustained previous injuries. No association was detected between hypermobile joints and non-netball sporting injuries. Conclusions: In this study hypermobility was significantly associated with an increased prevalence of injuries in junior netball players. A targeted interventional approach may help to reduce injuries in this susceptible group.     

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.     

Somatotype, role and performance in elite volleyball players.

BACKGROUND: The purpose of the present study was to examine the importance of the somatometric components of elite male and female volleyball players in relation to their different game roles and levels of performance. METHODS: Two hundred and thirty-four male athletes (aged 24.7+/-4.4 years) and 244 female athletes (aged 23.1+/-4.4 years) from the Italian A1 and A2 volleyball leagues underwent anthropometric measurements during the 1992-1993 and 1993-1994 seasons. Somatotypes were estimated with the Heath-Carter method. RESULTS: Marked sexual dimorphism in somatotype was observed in the total sample. The average somatotype for men was 2.2-4.2-3.2 (SD 0.7-0.9-0.9), and for women it was 3.0-3.3-2.9 (SD 0.8-1.0-0.9). The somatotype was significantly different in players at different levels of performance (A1 vs A2 leagues), as it follows: 2.1-4.1-3.3 (SD 0.6-0.8-0.7) vs 2.3-4.3-3.0 (SD 0.7-1.0-0.8) in males; 2.9-3.1-3.0 (SD 0.8-1.0-0.9) vs 3.1-3.5-2.7 (SD 0.8-0.9-0.8) in females. The somatotype was also significantly different in players in different roles. In male sex the mean somatotypes for setters were 2.4-4.5-2.8 (SD 0.7-0.9-0.8), for centres they were 2.0-4.0-3.5 (SD 0.6-1.0-0.8), for spikers they were 2.2-4.3-3.0 (SD 0.6-0.9-0.7), for opposites they were 2.2-4.3-3.1 (SD 0.6-0.9-0.8). In female sex the mean somatotypes for setters were 3.1-3.6-2.5 (SD 0.8-1.0-1.0), for centres they were 2.8-3.1-3.1 (SD 0.8-0.9-0.7), for spikers they were 3.0-3.5-2.8 (SD 0.9-1.0-0.9) and for opposites they were 3.0-3.2-3.0 (SD 0.7-0.9-0.8). CONCLUSIONS: The physique of athletes in the A1 league is characterized by higher ectomorphy and lower endomorphy and mesomorphy. There is also a slight tendency of male players to a greater homogeneity in somatotype within the group at the maximum level of performance. Moreover somatotype differs in relation to game role in volleyball players of both sexes: the mesomorphic component is maximal in setters, while the ectomorphic component is maximal in centres.     

Somatotype, size and body composition of competitive female volleyball players

The aim of this study was to describe the morphological characteristics of competitive female volleyball players. For this purpose, body weight and height, breadths and girths as well as skinfold thickness at various body sites were assessed in 163 elite female volleyball players (age: 23.8 ± 4.7 years, years of playing: 11.5 ± 4.2, hours of training per week: 11.9 ± 2.9, means ± S.D.). Seventy-nine of these players were from the A1 division and the rest from the A2 division of the Greek National League. Two-way ANOVA was used to compare the differences in these characteristics between competition level and playing position. Body height ranged from 161 cm to 194 cm, and the mean value (177.1 ± 6.5 cm) was not inferior to that of international players of similar calibre. Adiposity of these players (sum of 5 skinfolds: 51.8 ± 10.2 mm, percent body fat: 23.4 ± 2.8) was higher than that reported in other studies in which, however, different methodology was used. Volleyball athletes of this study were mainly balanced endomorphs (3.4-2.7-2.9). The A1 division players were taller and slightly leaner with greater fat-free mass than their A2 counterparts. Significant differences were found among athletes of different playing positions which are interpreted by their varying roles and physical demands during a volleyball game. The volleyball players who play as opposites were the only subgroup of players differing between divisions; the A2 opposites had more body fat than A1 opposites. These data could be added in the international literature related to the anthropometric characteristics of competitive female volleyball players.     

The influence of soccer shoe design on player performance and injuries

Although soccer is the most popular sport in the world, little research has been published in the field of soccer biomechanics, particularly on the importance of footwear for the game. The traction properties of soccer shoes on natural and artificial turf have been speculated to be responsible for acute and chronic injuries in soccer. This article reviewed the current knowledge on how soccer shoes influence the risk of injuries and how they may serve to improve player performance. Comfort is the highest priority that players want from their shoes, followed by traction and stability. Cleat design and arrangement are important shoe features that allow for fast accelerations and stops, rapid cuts, and turns. Soccer shoe design can influence shooting speed and, even more important for the game of soccer, kicking accuracy. To combine shoe characteristics for injury prevention and better performance will be a challenge for future research on optimizing soccer shoes.     

Head injuries in the female football player: incidence, mechanisms, risk factors and management

Although all injuries in sports are a concern for participants, head injuries are particularly troublesome because of the potential for long-term cognitive deficits. To prevent any specific injury, it is important to understand the basic frequency and incidence of injury and then the mechanism of injury. Once these are established, prevention programmes can be tested to see if the rate of injury changes. A primary problem with head injuries is recognising that the injury has occurred. Many athletes are not aware of the seriousness of concussive injury, thus this type of injury is probably under-reported. Once the diagnosis of a concussion is made, the next difficult decision is when to return a player to the game. These two management issues dominate the continuing development of understanding of concussive head injury. This paper explores the known gender differences between head injuries and highlights the areas that need to be considered in future research.     

Previous injuries and persisting symptoms in female soccer players

One hundred and fifty players in a female senior soccer division, starting up a new season, were examined for past injuries and persisting symptoms. An incidence of 0.18 injury/player/year was found, which is not significantly different from previously reported injury rates for male soccer. Sprains to the lower extremity and shin-splints were the most common previous injuries. Forty-three percent of the players had some kind of persistent symptom as a result of a past injury. Symptoms from previous ankle and knee sprains and from overuse injuries were the most common. Players who had sustained an ankle joint injury were more prone to have persistent symptoms (p less than 0.05) if they had persistent mechanical instability. Compared to previous retrospective studies on men's soccer, the women showed a higher rate of previous patellar dislocations. These injuries often caused persistent symptoms. The women showed fewer serious knee injuries. This might depend on a real difference in incidence or is just a reflection of female players ceasing to play soccer after a severe knee injury.     

Sectional neuroanatomy of the lower limb I: lower back and hip

This series of two articles is structured to provide anatomically accurate functional schematics of the motor and sensory innervation of the lower back, hip, and lower limb. This first paper provides radiographically oriented schematic axial sections of the lower back and hip in which the muscles are appropriately color-coded to match the peripheral nerves. A companion color-coded summary table allows prediction of unique patterns of denervation from 25 lesion sites. These are divided into three categories (roots T12 to S4, four plexal quadrants, and 11 sectional levels). Correlation between an imaging abnormality at one of these lesion sites and the predicted denervation pattern ensures the lesion is, in fact, clinically significant. The next article will continue this color-coded approach into the lower limb.     

Catastrophic injuries in high school and college baseball players

BACKGROUND: There are few epidemiologic studies of catastrophic baseball injuries. PURPOSE: To develop a profile of catastrophic injuries in baseball players and to describe relevant risk factors. STUDY DESIGN: Retrospective cohort study. METHODS: The authors reviewed 41 incidents of baseball injuries reported to the National Center for Catastrophic Sports Injury Research from 1982 until 2002. RESULTS: There were an estimated 1.95 direct catastrophic injuries per year, or 0.43 injuries per 100,000 participants. The most common mechanisms of injury were a collision of fielders (9) or of a base runner and a fielder (8), a pitcher hit by a batted ball (14), and an athlete hit by a thrown ball (4). Catastrophic injuries included 23 severe head injuries, 8 cervical injuries, 3 cases of commotio cordis, and 2 cases each of a collapsed trachea and facial fractures. Three athletes sustained a severe head injury and facial fractures. Ten of the 41 injuries were fatalities. CONCLUSIONS: Suggestions for reducing catastrophic injuries in baseball include teaching proper techniques to avoid fielding and baserunning collisions, protecting the pitcher via a combination of screens and/or helmets with faceguards, continued surveillance and modifications of the bat and ball, eliminating headfirst slides, and continued analysis of chest protectors and automatic external defibrillators for commotio cordis.     

Catastrophic head injuries in high school and college football players

BACKGROUND: Catastrophic head injuries in football are rare but tragic events. PURPOSE: To update the profile of catastrophic head injuries in high school and college football players and to describe relevant risk factors. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: We reviewed 94 incidents of severe football head injuries reported to the National Center for Catastrophic Sports Injury Research during 13 academic years (September 1989 through June 2002). RESULTS: In the study period there were an average of 7.23 (standard deviation = 2.05) direct high school and college catastrophic head injuries in scholastic football participants per year. There were 0.67 injuries per 100 000 (95% confidence interval: 0.54, 0.81 per 100 000) high school and 0.21 injuries per 100 000 (95% confidence interval: 0.0, 0.49 per 100 000) college participants for a risk ratio of 3.28 (95% confidence interval: 0.81, 13.3). The injuries resulted in subdural hematoma in 75 athletes, subdural hematoma with diffuse brain edema in 10 athletes, diffuse brain edema in 5 athletes, and arteriovenous malformation or aneurysm in 4 athletes. Fifty-nine percent of the contacts reported that the athlete had a history of a previous head injury, of which 71% occurred within the same season as the catastrophic event. Thirty-nine percent of the athletes (21 of 54) were playing with residual neurologic symptoms from the prior head injury. There were 8 (9%) deaths as a result of the injury, 46 (51%) permanent neurologic injuries, and 36 (40%) serious injuries with full recovery. Most players sustained a major impact to the head either from tackling or being tackled. CONCLUSION: The incidence of catastrophic head injuries in football has remained low since the advent of the modern day football helmet in the early 1970s. The incidence of catastrophic head injuries in football is dramatically higher at the high school level than at the college level. Although the reason for this discrepancy is unclear, an unacceptably high percentage of high school players were playing with residual symptoms from a prior head injury. Coaches, athletes, athletic trainers, and medical personnel need to adhere to the guideline that an athlete with any neurologic symptoms from a head injury should be strongly discouraged from returning to play.     

The incidence and differential diagnosis of acute groin injuries in male soccer players

This prospective cohort study evaluated the incidence of acute groin injuries and estimated the distribution of differential diagnoses in male soccer players. Two senior male soccer divisions (21 teams, 326 players) were followed for 1 year. Patients with groin injuries were examined clinically as well as by herniography, sonography and by plain x-ray of the pelvic bones. Groin injuries accounted for 8% of all injuries. The incidence of groin injury was 0.8/1000 h of exposure. Thirteen (52%) of the 25 patients were clinically considered to have a muscle/tendon injury. However, when using sonography, muscle/tendon injury was only verified in 1 patient. Clinical suspicion of hernia or incipient hernia was evident in 4 (16%) of the patients, while 14 (56%) had a pathological finding at herniography. Clinical and paraclinical (i.e. diagnostic methods using imaging and other advanced techniques) diagnoses do not correspond very well in acute groin injury.     

Thermal pants may reduce the risk of recurrent hamstring injuries in rugby players.

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. RESULTS--In the group who wore warmers some of the time, the injury rate was significantly lower when using the warmers (3 injuries/1000 playing hours) than when not (57/1000 playing hours). There was no difference in injury rates between groups who either wore warmers all the time or none of the time, probably because the number who wore the warmers all the time was small (n = 5). Eighteen percent of the injuries recurred at exactly the same site in the muscle and within 12 d of returning to rugby after the initial injury. The incidence of injury was high in the first three weeks of the season and again in the same period after the mid-season break. More than 80% of all match and practice time lost by these players during the study was a direct result of their hamstring injuries. CONCLUSIONS--Thermal pants may have a role in preventing recurrent hamstring injuries but other factors such as inadequate preseason training and incomplete rehabilitation after injury are likely to be more significant risk factors for injury.     

Propensity for osteoarthritis and lower limb joint pain in retired professional soccer players

OBJECTIVE: To quantify the prevalence of osteoarthritis and the severity of pain in the lower limb joints of players retired from English professional soccer. METHOD: An anonymous self administered questionnaire was distributed to 500 former players registered with the English Professional Footballers' Association. The questionnaire was designed to gather information on personal details, physical activity loading patterns, history of lower limb joint injury, and current medical condition of the lower limb joints. RESULTS: Of 500 questionnaires distributed, 185 (37%) were returned. Nearly half of the respondents (79: 47%) retired because of injury; 42% (33) were acute injuries and 58% (46) chronic injuries. Most of the acute injuries that led to early retirement were of the knee (15: 46%), followed by the ankle (7: 21%) and lower back (5: 15%). Most of the chronic injuries that led to early retirement were also of the knee (17: 37%), followed by the lower back (10: 22%) and the hip (4: 9%). Of all respondents, 32% (59) had been medically diagnosed with osteoarthritis in at least one of the lower limb joints. More respondents had been diagnosed with osteoarthritis in the knee joints than either the ankle or the hip joints. Significantly (p<0.001) more respondents reported pain in one lower extremity joint during one or more daily activities than those who did not (joint pain: 137, 80%; no joint pain: 35, 20%). CONCLUSION: The risk for professional soccer players of osteoarthritis in at least one of the lower extremity joints is very high and significantly greater than for the general population. The results support the suggestion that professional soccer players should be provided with health surveillance during their playing career.     

Long-term followup of knee injuries in high school football players

Twenty-three American football participants were studied 20 years after high school competition, as well as 11 age-matched controls, to assess the development of knee osteoarthritis. No statistically significant increase in osteoarthritis could be demonstrated radiographically, subjectively, or objectively. A significant increase in knee joint osteoarthritis was found in the subgroup of football players who had sustained a knee injury.