Physician and Sportsmedicine最新文献

Introduction: There is a growing percentage of elite female athletes who choose to start a family during their athletic careers. Current guidelines to manage postpartum elite athletes returning to sport are weakly rooted in athlete-centered evidence and/or are restricted by small sample sizes. The purpose of this review was to collect and compare existing protocols and guidelines for elite athletes returning to sport following childbirth and to highlight the current culture surrounding postpartum athletes.

Methods: Online databases including PubMed and BioMed Central were searched from September 2023 to May 2024. Studies of any design were included if they contained information on pregnancy and postpartum. Peer-reviewed research studies, systematic reviews, case reports, and data from organizational websites (American College of Obstetricians and Gynecologists, the World Health Organization, and the Official Olympics) were included.

Results: Athlete-mothers face numerous challenges in their transition back to competitive sport following childbirth, including the societal expectations of a 'good' mother, potential loss of financial sponsorships, and limited guidance on postpartum training. Additionally, the healthcare community historically managed postpartum athletes in a reactionary manner by treating symptoms from pregnancy and childbirth as they arise. Recent literature is pointing toward adopting a preventive and proactive model of care to optimize an athlete's health prior to pregnancy and therefore support their safe return to sport postpartum.

Conclusion: Increased support for female participation in sports must also be met by increased support for pregnant and postpartum athletes. There is a continued need for research regarding return-to-sport guidelines for postpartum athletes, and their proper implementation.

Surfer's neurapraxia is a rare surfing injury of the saphenous nerve secondary to persistent compression of the saphenous nerve along the medial thigh by the surfboard when paddling prone and while sitting upright on the board waiting for a wave. Symptoms may be nonspecific and consist of pain in the medial thigh with or without radiation along the saphenous nerve distribution (medial leg, medial ankle, medial arch of the foot). The saphenous nerve tension test can be utilized to reproduce the symptoms of surfer's neurapraxia. Treatment consists of conservative management while refractory cases may benefit from injection with local anesthetic. The authors propose the Obana Plan (WATER) for prevention of surfer's neurapraxia, consisting of Wetsuits, Abduction, Timing, Exercise, and Rest. Overall, surfer's neurapraxia is a benign condition that can be prevented and managed conservatively.

Objective: To evaluate the role of parental influence on youth SSS and to characterize parental perceptions of SSS.

Data sources: Embase.com, Ovid-Medline All, CINAHL Plus, APA PsycInfo, Scopus, Web of Science, and PubMed Central (PMC) since database inception.

Study selection: Primary studies that assessed reasons for youth SSS that included parental influence as a factor and/or studies that investigated the nature or extent of parental influence on SSS were included.

Data extraction: A single author extracted data, focusing on definitions and measures of SSS and parental influence, findings concerning primary reasons for SSS, any quantitative or qualitative findings on the extent of parental influence on SSS, and findings concerning various associations between parental influence, SSS, and other themes.

Data synthesis: 61 articles were assessed in total, with 23 meeting criteria for inclusion. Parental influence plays a limited direct role in SSS, accounting for approximately 10.6% of the overall influence. Athlete self-influence or self-enjoyment of sport was found to be the predominant reason to pursue SSS, accounting for 82.3% of the overall influence. However, parents indirectly influence SSS by modulating athlete motivation and providing financial, practical, and emotional support.

Conclusions: Athlete self-motivation primarily drives SSS directly, while parents indirectly influence SSS by modulating athlete self-motivation and offering financial, practical, and emotional support. Misconceptions persist regarding parental perceptions of SSS-related injury risks, scholarship attainment, and athletic development. Communication with parents regarding the risks associated with SSS and their role in monitoring their children's sports participation is crucial for mitigating adverse outcomes in youth athletes.

Older Fighters are defined as combat sports athletes older than 35 years, based on heightened medical risks and historical classification. Age-related changes to the neurological, cardiopulmonary, endocrinological, thermoregulatory, osmoregulatory, and musculoskeletal systems increase these athletes' risks for injury and may prolong their recovery. These age-related risks warrant special considerations for competition, licensure, prefight medical clearance, in-fight supervision, post-fight examination, and counseling regarding training practices and retirement from combat sports. Neurological considerations include increased risk of intracranial lesions, intracranial hemorrhage, and sequelae from traumatic brain injury (TBI), warranting more comprehensive neurological evaluation and neuroimaging. Increased risk of myocardial ischemia and infarction warrant careful assessment of cardiac risk factors and scrutiny of cardiovascular fitness. Older fighters may take longer time to recover from musculoskeletal injury; post-injury clearance should be individualized.

Background: In 2023, Major League Baseball (MLB) implemented the pitch clock. The effects of the pitch clock on player injury rates is largely unknown, and some, including the major league baseball players association, have suggested that pitchers may be at an increased risk of injury with its implementation. Position players have received little attention in these discussions, even though they may be at the same theorized risk of injuries. The aim of this study is to determine if implementation of the 2023 MLB pitch clock influenced the incidence of injuries in position players. It is hypothesized that implementation of the MLB pitch clock will lead to a rise in injuries due to a reduction of time for the primary biological energy system used by baseball to restore to normal levels.

Methods: Injury data was collected from the fangraphs.com injury database, the most comprehensive MLB data and statistical database website, for the 2021, 2022, and 2023 MLB seasons. The incidence rate ratio was calculated and used to compare the injury rate for the 2023 season to the 2021 and 2022 seasons for both major anatomical categories and anatomical subcategories. A z-test for proportions was used to determine significance.

Results: Incidence rate ratio comparison of the 2023 MLB pitch clock season versus the 2021 MLB season showed a decrease in the total incidence of injuries (p < .001), lower extremity injuries (p < .001), and hamstring injuries (p = .032). Incidence rate ratio comparison of the 2023 MLB pitch clock season versus the 2022 MLB season showed a decrease in the total incidence of injuries (p = .010), undisclosed injuries (p < .001), and knee injuries (p = .035).

Conclusions: Following the implementation of the pitch clock during the 2023 MLB season, the total number of injuries and several lower extremity injury categories decreased. Due to a decrease in the overall time spent on the field in a single game and over a season, it could be hypothesized that the pitch clock decreased the workload for position players, leading to this drop in injuries. Further longitudinal investigation must be done to investigate if this influence of the MLB pitch clock persists overtime.

Objective: To prospectively describe the incidence, severity, and burden of injuries in the youth divisions of an Argentinian professional soccer club during a competitive season.

Methods: Two hundred and twelve male soccer academy players were grouped by age categories and maturity offset as pre-peak height velocity (PHV), circa-PHV and post-PHV. Injury characteristics were recorded as the International Olympic Committee suggests.

Results: A total of 235 time-loss injuries were sustained by 101 different players. The overall injury incidence rate was of 5.8 injuries per 1000 hours (h), with a training and match injury incidence rate of 4.9 and 9.7 injuries per 1000 h, respectively. The prevalence over the season was 47%. Most of the injuries (202) affected the lower limbs (86.6%) and most of them were classified as muscle/tendon injuries (n = 117, 49.8%). Hamstring structural injury was the diagnosis with the highest burden in both circa and post-PHV groups.

Conclusions: The incidence, prevalence, and injury burden reported in this study would add valuable information to Argentinians' youth soccer institutions. Post-PHV players had higher incidence, severity, and burden compared to circa-PHV. Structural/functional injuries to the muscle/tendon represented the highest burden for type of injuries (41.1 per 1000 h), suggesting a need for implementing preventive measures.

Objectives: Nearly 3 million children participate in youth soccer annually in the United States. Popularity of youth soccer within recent years has prompted investigation describing youth-soccer concussion trends presenting to United States emergency departments (EDs).

Methods: Data from National Electronic Injury Surveillance System were analyzed for soccer players 2-18 years old sustaining concussions from January 2013 to December 2022. Patient data included age, sex, mechanism of injury, setting (practice vs. game), diagnosis, loss of consciousness, and disposition. Raw data were used to calculate national estimates based on assigned statistical sample weight of each hospital.

Results: A total of 80,582 youth soccer concussions were diagnosed in US EDs (51.0% female, 49.0% male). The most common mechanism of injury was head to ball (31.0%). On average, overall concussions decreased by 572 per year (p = 0.02). Head to body concussions decreased by 169 per year (p < 0.01) and head to ground concussions decreased by 155 per year (p < 0.01). No changes per year in concussion trends for head to ball, head to head, not specified, and other mechanisms. Exclusion of years 2020 and 2021 (COVID), demonstrated decreases in concussions for head to body by 125 (p = 0.01) and head to ground mechanisms by 135 per year (p = 0.01).

Conclusion: There is a decreasing trend in youth soccer head injuries and concussions presenting to US emergency departments from 2013 to 2022. The trends from this study indicate that heading may be the most important aspect of soccer-related concussions presenting to US emergency departments. This study contributes to the growing literature regarding concussions in youth soccer athletes.

Background: Dancesport is performed in high-heeled shoes. Dancesport athletes may have a higher prevalence and incidence of ankle sprains, which can affect their performance. However, the occurrence of ankle sprains among dancesport athletes remains unclear. This study aimed to determine the prevalence and incidence of ankle sprains among elite dancesport athletes and to investigate the related information.

Method: We conducted a mixed descriptive epidemiological study (cross-sectional and longitudinal) involving 198 elite adolescent dancesport athletes, using past medical records and questionnaires administered to the participants. Data on the occurrence of ankle sprains among all participants were compiled using medical records and information on injury mechanisms, missed days, severity types, and countermeasures for ankle sprains were collected. The prevalence of chronic ankle instability (CAI) among the participants was assessed using a questionnaire. Following the initial survey, we conducted a one-year follow-up study to investigate the incidence of ankle sprains, incidence rate per 1000 exposure hours, and recurrence of ankle sprains.

Result: The cross-sectional study and longitudinal study included 198 participants and 92 elite dancesport athletes, respectively. The prevalence of ankle sprains and CAI was 49.5% and 45.1%, respectively. Of all ankle sprains, 88% were medial injuries. The most common injury mechanisms were turning (46.9%) and jumping (46.9%). The average number of missed days due to ankle sprains was 11.2 days. Most injuries were managed with rest, and only one male athlete underwent surgery due to an ankle sprain sustained during dancing. During the one-year follow-up, the incidence of ankle sprains, incidence rate per 1000 exposure hours, and recurrence rate of ankle sprains were 46.6% (male, 41.2%; female, 48.8%), 0.65 ankle sprains/1000 h, and 35.3%, respectively. No sex-related differences were observed.

Conclusion: It is crucial to focus on the occurrence of ankle sprains and CAI in dancesport athletes with high heels. Future research should clarify the impact of ankle sprains on dancesport performance and develop preventive measures to reduce the incidence and recurrence of these associated injuries.

Background: Injuries to the ulnar collateral ligament (UCL) are commonly reported in traditional overhead sports. Conversely, there is a lack of evidence outlining management and return to play (RTP) outcomes for gymnasts. This study aimed to evaluate RTP and patient reported outcomes (PROs) in gymnasts after operative and non-operative treatment of UCL injuries.

Methods: Gymnasts who presented with UCL injury and underwent operative and non-operative treatment were evaluated. Patient reported outcomes were collected via telephone: Conway-Jobe Scale, Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow (KJOC) Score, Mayo Elbow Performance (MEP) Score, and quick DASH (qDASH) and Timmerman-Andrews (TA) Elbow Score.

Results: Nine patients met inclusion criteria and were available for follow-up. Five were initially treated operatively and four were initially treated non-operatively. The operative group initially consisted of three ulnar collateral ligament reconstructions (UCLR) and two UCL repairs with internal bracing. One patient crossed over to the operative group after failing non-operative treatment and underwent UCLR four months post injury. Overall, 66.7% and 100% of operatively and non-operatively treated gymnasts were able to return to play, respectively. At final follow-up, the operative groups' mean KJOC, MEP, TA, and qDASH scores were: 68.4 ± 7.7, 97.5 ± 2.7, 90.8 ± 10.7, and 1.9 ± 3.0, respectively. For the non-operative group, the mean scores were 67.4 ± 9.0, 71.7 ± 5.8, 71.7 ± 14.4, and 11.4 ± 9.9, respectively. Treatment satisfaction for the operative group was 81.7 ± 27.5 compared to 80.6 ± 34.5 in the non-operative group. Odds ratios indicated no differences between groups.

Conclusion: Both operative and non-operative interventions for UCL injuries in gymnasts can provide favorable outcomes with respect to return to play and subjective patient-reported outcomes. Further research is warranted to determine optimal treatment, especially regarding indications for operative vs. nonoperative treatment, of UCL injury based on injury severity and location in gymnasts.

Level of evidence: Case series; Level III Evidence.

Objectives: Exposure to bullying and high levels of anxiety are important determinants of the quality and duration of athletes' experiences of success. The aim of this study was to determine which behaviors are most commonly perceived as bullying by para athletes and whether the exposure to bullying or levels of trait anxiety differ between para athletes and non-disabled athletes.

Methods: It is a cross-sectional study. Two groups consisting of professional para athletes (n = 104) and non-disabled athletes (n = 129) between the ages of 18-45 affiliated to the national athletics federation were included in the study. The questionnaire included information about demographics and the two scales, the Negative Acts Questionnaire-Revised (NAQ-R) and the Sport Anxiety Scale-2 (SAS-2).

Results: Withholding information that could affect performance and spreading rumors (item 1,5) were the most frequently reported bullying behaviors. No statistically significant difference was found between para athletes and non-disabled athletes or between male and female genders in terms of total or any subdimension NAQ-R scores (p > 0.05). SAS-2 total and SAS-2-worry subdimension scores were significantly lower in the para athletes (p = 0.018 and p = 0.020). Total and all SAS-2 subdimension scores were significantly higher in female athletes (p < 0.05).

Conclusion: The knowledge about bullying exposure in para-athletes is quite limited. The para-athlete group has fewer opportunities than the non-disabled group in terms of financial opportunities, physical conditions, media coverage and many other aspects. However, in our study, they reported bullying exposure at a similar rate with the non-disabled group. Although there is a similar level of exposure, it is clear that the results will not be similar in the two groups due to the different psychological bases. According to the results of this study, it is thought that stakeholders who have responsibility for the para-athlete group should be further educated.