PREVALENCE OF MUSCULOSKELETAL PAIN IN MARATHON RUNNERS WHO COMPETE AT THE ELITE LEVEL

Background

Musculoskeletal pain can be an important sign of overuse injury in elite athletes. However, its prevalence and whether it is associated with aspects of training in marathon runners who compete at the elite level is still not clear.

Purpose

The purpose of this research was to assess the prevalence, location and intensity of running-related musculoskeletal pain over the previous 12 months in marathon runners who compete at the elite level and to verify whether certain training characteristics are associated with musculoskeletal pain.

Design

Cross sectional study.

Methods

One hundred and ninety-nine elite marathon runners were verbally interviewed regarding their personal demographics, training routines, and the presence, location and intensity of musculoskeletal pain.

Results

The prevalence of any running-related musculoskeletal pain in elite distance runners was 75%, and the most frequently reported location was the lower leg (19.1%). The presence of pain was independent of age, experience, and volume of training.

Conclusions

Running-related musculoskeletal pain is highly prevalent in marathon runners who compete at the elite level.

Clinical Relevance

Studies about prevalence and location of musculoskeletal pain and factors-related in this population are important to contribute to the development of educational and preventive strategies.

Evidence Level

2     

宁养照护中性别差异对癌痛的药物止痛疗效的影响

目的:比较性别差异对宁养服务患者的药物止痛疗效的影响。方法:3,153例宁养患者,总共6,886人次接受药物止痛治疗,根据性别分为男性组1,824例和女性组1,329例,回顾性分析他们的临床资料,判断不同性别患者的止痛效果的差异。结果 :两组患者年龄、入院时QOL评分和疼痛NRS评分无明显差异。宁养服务前,更多的女性患者已选择药物止痛,但两组患者对强阿片类药物的选择无明显差异。宁养服务中,两组患者的平均调药时间、每次调药不同性别人次比例、每次调药时主要止痛药物中强阿片类药物所占比例、每次调药时强阿片类药物的使用量、每次调药止痛有效率和总有效率均无差异。结论 :性别因素不足以影响宁养患者止痛药物的疗效。     

江苏省自然人群高血压患病率及相关因素分析

目的 :调查江苏省 15岁以上自然人群高血压患病率及相关因素。方法 :采用分层随机抽样法 ,对江苏省 11市 15岁以上 85 34人进行高血压患病率及相关因素调查分析。结果 :江苏省自然人群高血压患病率为 19 43% (男性 2 1 2 7% ,女性17 35 % ) ,标化患病率为 16 65 % (男性 18 70 % ,女性 15 19% )。单因素分析和多因素logistic回归分析显示与高血压患病相关的危险因素有 :年龄、体质指数 (BMI)、腰臀围比 (WHR)、高血压家族史、血糖、文化程度、婚姻状况、吸烟、饮酒、体力锻炼。结论 :高血压是由多基因遗传和多种环境不良因素交互作用而成。针对高血压的危险因素在人群中开展高血压一级预防具有重要意义     

KNOWLEDGE OF INJURY PREVENTION AND PREVALENCE OF RISK FACTORS FOR THROWING INJURIES IN A SAMPLE OF YOUTH BASEBALL PLAYERS

Background

Information on baseball injury prevention and pitch count recommendations is growing, however, the incidence of throwing injuries continues to rise. This study is the first to assess knowledge of safe throwing guidelines and risk factors from the perspective of youth athletes.

Purpose

The purpose of this study is two‐fold: (1) to evaluate knowledge of safe throwing guidelines and (2) to assess the reporting of risk factors for throwing injuries in a sample of youth baseball players.

Study Design

Survey study of 98 overhead athletes between the ages of 4 and 18.

Methods

A 35‐question survey was developed with questions related to knowledge of injury prevention, presence of risk factors associated with throwing injuries, and understanding and compliance with USA Baseball Medical & Safety Advisory Committee (USA BMSAC) overhead throwing guidelines.

Results

Respondents demonstrated variability in their knowledge of the USA BMSAC guidelines related to throwing frequencies. The 13‐16 year old age group displayed the least knowledge of USA BMSAC guidelines. The 9‐10 and 11‐12 year old age groups demonstrated the greatest knowledge of recommended BMSAC guidelines. Eighty‐five (82/98) percent of the respondents reported that they had never heard of the USA BMSAC guidelines. Sixty‐two percent (59/98) disagreed with the statement, “The more you throw, the more likely you are to get an injury”. Fifty‐seven percent of respondents (39/98) indicated that they would not seek medical help if they experienced a tired or sore arm during a game.

Conclusion

The results of this study suggest that young baseball players demonstrate the need for education on the following topics: the USA Baseball Medical and Safety Advisory Committee throwing guidelines, risk factors for developing throwing‐related injuries, the long‐term implications of playing with an injured or fatigued arm, and the benefit of seeking medical help when fatigue or soreness is experienced in the throwing arm.

Level of Evidence

Level 3     

体表镇痛剂对深部炎症痛缓解作用机制探讨

目的:本研究通过行为学和电生理学等方法 ,探索表面镇痛剂缓解机体深部组织疼痛的作用机制。方法:成年SD大鼠(雌雄各半),用完全佐剂(complete Freund’s adjuvant,CFA)构建左侧胫骨前肌炎症痛模型。随机分为2组:实验组(镇痛剂贴敷)和对照组(普通透气胶布贴敷)。分别观察大鼠的痛行为学;用伊文氏蓝的渗出测定血管渗透性;用电生理方法记录皮和肌肉的神经纤维放电情况,并观察去神经后的纤维放电情况。结果:表面镇痛剂有缓解肌肉炎症痛的作用,且具有药物特异的潜伏期(从10分钟到1~2小时)和作用时程。镇痛剂作用的皮肤区表现为血管渗出通透性增加。神经的纤维活动记录发现镇痛剂对A-纤维的兴奋性没有影响,也不能诱发其自发电活动;但却可以提高皮肤C-纤维的兴奋性,诱发C-纤维的自发电活动。电生理实验中潜伏期和作用时程与行为学实验中药物起效时间的对比证实药物对肌肉的镇痛作用与皮肤C-纤维的自发电活动相关。来自炎症肌肉的C-纤维传入电活动记录证明,表面镇痛剂可有效的抑制肌肉C-纤维的自发传入电活动;若去除药物作用的皮肤区的神经支配,则药物对深部组织的炎症痛的缓解作用消失。结论:表面镇痛剂可能通过激活皮肤的痛觉感受器,反射性减弱深部炎症肌肉的损害性传入活动。     

江干区临床护理人员医疗锐器伤情况调查

目的了解杭州市江干区医疗机构临床护理人员医疗锐器伤情况,为制定预防锐器伤措施提供参考。方法采用问卷调查方式,对江干区所属部分医疗机构护理人员锐器伤情况进行了调查。结果此次共调查临床护士363名,其中有280名护士自参加工作以来至少发生过一次锐器伤,锐器伤的发生率为77.13%。锐器伤发生率最高的科室是治疗室和输液室。护士在实习期锐器伤年发生率61.5%。结论临床护理人员是医疗锐器伤主要群体,应加强对护理人员特别是年轻护士预防锐器伤知识教育,采取有效的防护措施。     

首钢地区癌痛普查及社区医护人员癌痛知识调查

目的：对首钢地区的肿瘤现患者生活质量及癌痛发生情况进行基线摸底；较全面地调查现患肿瘤病人的数量及癌痛发生率、社区医师的癌痛知识和对癌痛三阶梯方案的认识情况。方法：采用自制问卷调查的方法进行普查。结果：全地区约13万人口中共普查出397位现存癌症患者，现患率30．5／万；其中112人曾存在疼痛，占所有癌症现患者的28．2％，61人仍有疼痛，占总疼痛人数的55％；癌症分期越晚，疼痛发生率越高；总体疼痛控制率低。结论：疼痛患者对癌痛控制的错误认识较多；社区医护人员对癌痛知识的了解较少，缺乏控制癌痛的能力。     

AN ASSESSMENT OF THE CONTRACTILE PROPERTIES OF THE SHOULDER MUSCULATURE IN ELITE VOLLEYBALL PLAYERS USING TENSIOMYOGRAPHY

Background:In volleyball, offensive (Hitters) and defensive players (Non-Hitters) perform differing actions that vary both kinematically and in terms of intensity. This may impose contrasting demands on the musculature involved in performing these actions. Previous research has identified differences in the muscle activation and contractile properties of the lower-body musculature between positions. Additionally, asymmetries between dominant and non-dominant limbs of the upper-body musculature has been observed in athletes performing overhead movements.Purpose:The aim of this study was to use Tensiomyography (TMG) to examine the contractile properties of the shoulder musculature in elite volleyball players.Study Design:Cross-sectional studyMethods:Thirty-one elite volleyball players participated in this study (Age: 23 ± 2 yrs, Body Mass: 76.5 ± 9.8 kg, Stature: 181 ± 9.3 cm), 26 of which displayed right-limb dominance and five displayed left-limb dominance. Contractile properties of the shoulder musculature including the anterior deltoid (AD), biceps brachii (BB), posterior deltoid (PD), and the upper trapezius (UT) were assessed bilaterally using TMG measures on one occasion prior to any training or exercise. The contractile measures provided by TMG included the maximal displacement (Dm), contraction time (Tc), delay time (Td), sustain time (Ts), and the relaxation time (Tr).Results:No statistically significant differences were observed between positions or limbs, except that Hitters displayed a significantly lower Ts of the left AD compared to Non-hitters (p = 0.01, ES = 1.02), and significant differences between dominant and non-dominant sides in the Td of the UT in Non-hitters were present (p = 0.05, ES = 0.8).Conclusion:These data suggest that irrespective of playing position and limb dominance, contractile properties of the shoulder musculature in elite volleyball players, as measured using TMG, display few significant differences.Levels of Evidence:3b     

RECOGNITION AND MANAGEMENT OF TRAUMATIC SPORTS INJURIES IN THE SKELETALLY IMMATURE ATHLETE

Over the last decade, participation in organized youth sports has risen to include over 35 million contestants.¹ The rise in participation has brought about an associated increase in both traumatic and overuse injuries in the youth athlete, which refers to both children and adolescents within a general age range of seven to 17. Exposure rates alone do not account for the increase in injuries. Societal pressures to perform at high levels affect both coaches and athletes and lead to inappropriate levels of training intensity, frequency, and duration. In this environment high physiologic stresses are applied to the immature skeleton of the youth athlete causing injury. Typically, since bone is the weakest link in the incomplete ossified skeleton, the majority of traumatic injuries result in fractures that occur both at mid‐shaft and at the growth centers of bone. The following clinical commentary describes the common traumatic sports injuries that occur in youth athletes, as well as those which require rapid identification and care in order to prevent long term sequelae.     

LOWER EXTREMITY KINEMATICS IN RUNNING ATHLETES WITH AND WITHOUT A HISTORY OF MEDIAL SHIN PAIN

Purpose/Background:

Medial shin pain (MSP) is a common complaint that may stop an athlete from running. No previous study has identified deficits in pelvic, hip or knee motion as potential contributing factors to MSP. The purpose of this study was to investigate the differences in kinematics during running between uninjured athletes and those with MSP. Secondary analyses investigated differences in limbs between groups and differences between sexes.

Methods:

This case-control study investigated fourteen runners aged 18–40 years old with a history of unilateral MSP and fourteen runner controls. Three dimensional lower quarter kinematics were captured as runners ran on a treadmill. Specifically, peak hip internal rotation (IR), frontal plane pelvic tilt (PT) excursion, and knee flexion were examined.

Results:

Groups were similar in age, mass, height, and training mileage. Subjects with a history of MSP demonstrated significantly greater frontal plane PT (P = 0.002, Effect size = 0.55) and peak hip IR (P = 0.004, Effect size = 0.51); and less knee flexion (P = 0.02, Effect size = 0.46) than the control group. No significant difference was found in kinematics of the MSP group during their involved side stance phase as compared to their non-involved side.

Conclusions:

Runners with MSP displayed greater PT excursion, peak hip IR, and decreased knee flexion while running as compared to a control group. These results should help guide treatment for the running athlete that experiences MSP.

Level of Evidence:

3b