Physician and Sportsmedicine最新文献

Objectives: Long-term trends in the use of oral contraceptives or progestin preparations in elite female athletes and the types of hormonal preparations are unclear. This study aimed to examine longitudinal changes in the prevalence and types of hormonal preparations used by Japanese female Olympians over 16 years.

Methods: This retrospective cohort study analyzed pre-participation medical examination questionnaires, including age, sport, and whether participants were taking prescribed hormonal preparations, from all Japanese female athletes selected for nine consecutive Olympic Games (Beijing 2008-Paris 2024). Data on the use and specific type of oral contraceptives (OCs) and progestin-only preparations were extracted. Temporal trends were assessed using weighted logistic regression models.

Results: The total number of female athletes who competed in the past nine Olympic Games was 1,227. The prevalence of hormonal preparation use increased more than six-fold, from 4.7% at Beijing 2008 to a peak of 36.0% at Beijing 2022 (29.3% at Paris 2024). A weighted logistic regression confirmed a significant trend, with the odds of use increasing 1.67-fold per four-year Olympic cycle (95% CI 1.48-1.89, p < 0.001). A significant shift occurred from OCs containing ≥30 µg of ethinylestradiol (EE) to those containing 20 µg of EE, and from desogestrel-based OCs to those containing drospirenone and norethisterone. Progestin-only preparations were first reported at Rio 2016, with their use increasing thereafter.

Conclusion: The number of elite-level female athletes in Japan using hormone preparations has increased significantly over the past 16 years, and the types of preparations used have also diversified. This trend highlights the growing importance of gynecological support in elite sports. Future research should focus on the potential performance and health effects of the newer-generation formulations that are now predominantly used.

Introduction: As the use of electric scooters (e-scooters) has significantly increased in the past decade, there has been a concomitant rise in e-scooter related injuries. This study aims to analyze trends and mechanisms of e-scooter fractures in the US pediatric population. We hypothesized that there would be a significant increase in pediatric e-scooter fractures particularly from 2020 to 2023, with forearm fractures being the most prominent.

Methods: The National Electronic Injury Surveillance System (NEISS) was queried for pediatric (age ≤18) e-scooter fractures reported at US EDs between 1 January 2014, and 31 December 2023. The mechanisms of injury and specific bone(s) that were fractured were identified using the injury narrative. Trends in fracture patterns were analyzed using linear regression analysis.

Results: A total of 669 pediatric e-scooter fractures (NE = 18,103) were included. There was a significant increase in pediatric fractures from 2014 to 2023 (p = .011). In addition, there was a 2.7-fold increase in the annual average fracture incidence from pre-COVID (2017-2019) to post-COVID (2021-2023). The most common body part fractured was the lower arm (NE = 5,047, 27.9%) and wrist (NE = 4,765, 26.3%). The most common bone fractured was the radius (NE = 3,681, 33.8%) followed by the clavicle (NE = 952, 8.7%). The most common mechanisms of injury were falling off of the e-scooter (NE = 14,513, 80.2%) followed by impact with stationary obstacles (NE = 1,721; 9.5%).

Conclusion: The prevalence of fractures in the pediatric population due to e-scooter use has risen significantly in the past decade, particularly since COVID-19. The lower arm and wrist were the most commonly affected, with the radius being the most frequently fractured bone. These findings highlight the need for enhanced regulation and safety measures to prevent fractures in young riders.

Background: American football has traditionally been male-dominated, but female participation in youth football is increasing, especially with the rise of flag football. This study aimed to (1) describe the epidemiology of injured body parts and diagnoses in female youth football athletes, and (2) compare injury patterns between pre-high school (≤14 years) and high school (≥15 years) players.

Methods: American football-related injury data were obtained from the National Electronic Injury Surveillance System (NEISS) from 2012-2021, representing U.S. emergency department visits. All participants were female and ≤18 years. Injuries were classified by body part and diagnosis, then compared between pre-high school and high school groups. Descriptive statistics summarized injury characteristics. Chi-square tests assessed group differences, with odds ratios (OR), 95% confidence intervals (CI), and p-values for significance. NEISS data lack detail on injury context, which may limit interpretation.

Results: A total of 3,348 injuries were identified: 2,342 in pre-high school and 1,006 in high school athletes. The most common injury sites for both groups were the upper extremity (pre-high school: 57.9%; high school: 43.1%), followed by the lower extremity (22.1% vs. 30.6%) and head/trunk (18.7% vs. 25.1%). Pre-high school athletes sustained proportionally more finger injuries (38.8% vs. 27.1%, p=0.001) and fractures (31.8% vs. 20.4%, p=0.001). High school athletes had higher proportions of head (20.5% vs. 14.1%), ankle (12.7% vs. 10.2%), and knee injuries (10.3% vs. 5.3%) (all p<0.05), as well as more sprains/strains (39.3% vs. 33.9%, p=0.003) and concussions (11.1% vs. 7.4%, p=0.001).

Conclusion: Injury patterns differ by age among female youth football players. Pre-high school athletes more often sustain finger injuries and fractures, while high school athletes experience more head, ankle, and knee injuries, along with higher rates of sprains/strains and concussions. These differences may reflect variations in physiology and style of play, and findings may inform age-specific injury prevention strategies and guide future research on female football athletes.

Objective: The aim of this prospective cohort study was to examine the incidence and characteristics of injuries in professional ballet dancers across multiple seasons.

Methods: Hundred-and-sixteen ballet dancers (median age 24; range 18-40, females 53%) from a professional ballet company agreed to participate and were followed for up to five ballet seasons. All dance-related injuries requiring a visit to a medical doctor were recorded by in-house physiotherapists. Injury rates per 100 dancer seasons were calculated and injury characteristics (i.e. anatomical location, tissue type, severity, and mechanism) were described.

Results: Hundred-and-sixty injuries occurred in 311 dancer-seasons, comprising an injury rate (IR) of 51.5 injuries (95% CI 45.9 to 57.0) per 100 dancer-seasons. Eighty-three percent of the injuries affected the lower limbs (IR 42.4, 95% CI 37.0 to 47.9). The ankle was the most injured body region (IR 15.4, 95% CI 11.4 to 19.5), followed by lower leg (IR 8.4, 95% CI 5.3 to 11.4), and knee (IR 6.1, 95% CI 3.5 to 8.8). Thirty-nine percent of injuries involved muscle/tendon structures, and 29% involved ligaments/joints. Fifty-seven percent of injuries were severe, causing more than 28 days absence from dance. Of all injuries, 57% were sudden onset, and 43% were gradual onset injuries.

Conclusion: Results highlight the need for effective interventions to reduce the high incidence of lower limb injuries, including ankle sprains, tendon issues, muscle strains, and stress fractures in professional ballet dancers.

Objectives: Socioeconomic status (SES) may be associated with time to return to play (RTP) after sport-related concussion (SRC), but the literature is limited and has yielded mixed results. The purpose of our study was to determine the association between SES and concussion recovery in high school and middle school athletes.

Methods: High school and middle school athletes from 24 schools in southeast Minnesota who sustained a SRC between 2020 and 2023 were included in this study. Data obtained for each concussion included date of injury and date of clearance to complete a RTP protocol. A validated measure of SES, HOUSES (HOUsing-based index of SES), was used to determine SES by pairing home addresses to publicly available property data. SES was divided into four quartiles determined for the region (Q1 = lowest SES quartile, Q4 = highest SES quartile). A negative-bimodal regression model was used to analyze the relationship between SES and RTP time.

Results: A total of 132 athletes (mean age 15.9 ± 1.5 years, 75.0% male) were included in the study. Among the total cohort, median RTP time was 12.0 days. Within each HOUSES quartile, median RTP time was 16 days in Q1, 12 days in Q2, 13 days in Q3, and 11 days in Q4. After adjusting for sex, race, ethnicity, and prior diagnosis of migraines, attention deficit/hyperactivity disorder, learning disorder, and mood disorder, athletes were estimated to have 23.9% fewer recovery days for each 1-unit increase in HOUSES quartile (p < 0.001).

Conclusion: RTP time after concussion may be related to SES in young athletes, with higher SES associated with shorter RTP timelines.

Purpose: Pickleball's rapid rise in popularity in the U.S. has led to a surge in injuries, particularly as younger players have begun engaging in the sport at greater rates. Understanding injury trends across age groups is critical for guiding prevention strategies. This study aims to examine pickleball-related injuries in different age groups, specifically comparing injury mechanisms and types between older (≥65 years) and younger players to identify age-specific risk factors.

Methods: Using the National Electronic Injury Surveillance System (NEISS), we identified pickleball-related injuries from 2012 to 2021. Cases were stratified by age, and analyses included demographics, injury types, mechanisms, and emergency department dispositions. Comparative risk analyses were performed to assess differences between older and younger players.

Results: 53,649 weighted cases (95% CI: 28518 -78,780) were recorded. Older players accounted for 83% of injuries, though the younger group experienced a higher annual rate of increase (older: 50.08%, younger: 69.93%). The most common injury mechanisms were slips, trips, falls, and dives (64.3%, 95% CI: 34.17%-94.42%), with older players three times more likely to sustain fractures (OR 2.96; 95% CI: 2.79-3.15) compared to younger players, and nearly three times as likely to be injured by a slip, fall, trip, or dive (OR 2.75; 95% CI: 2.63-2.88). Younger players were more likely to sustain strains or sprains (OR 1.86; 95% CI: 1.78-1.95) from 'otherspecified mechanisms' such as sudden stops and lunging (OR 2.13; 95% CI:2.03-2.23).

Conclusions: Distinct injury patterns between younger and older players suggest the need for age-specific prevention strategies. Older players face higher fracture risks, while younger players are more prone to strains and sprains from dynamic movements.

Objectives: The objectives of this study were to (1) assess whether the Pitch Timer was associated with the incidence of upper extremity injury (UEI) in Major League Baseball (MLB) Pitchers and (2) assess the association between UEI and Pitcher 'Tempo' between 2021 and 2024 in the MLB.

Methods: This study was a retrospective review of all MLB Pitchers who pitched in at least three out of four seasons between 2021 and 2024. Players were assessed for time spent on the injury list (IL) due to shoulder and/or forearm/elbow-associated pathology. With the Pitch Timer starting in the 2023 season, the incidence of UEI was calculated in pre- and post-Timer cohorts. Games missed per injury were also assessed pre- and post-Timer. Average Pitching Tempo was assessed in pitchers with shoulder injuries, forearm/elbow injuries, and uninjured pitchers. Continuous variables were compared using two-tailed t-tests, and categorical variables were compared using the chi-squared test with a statistical significance set at p < 0.05.

Results: There were no significant differences in the incidence of shoulder injuries (p = 0.94) or forearm/elbow injuries (p = 0.24) in MLB pitchers between any year from 2021 to 2024. Pitchers who sustained shoulder injuries in 2023-2024 missed significantly more games per injury than pitchers who sustained shoulder injuries in 2021-2022 (p = 0.007). The same trend did not exist in the elbow (p = 0.57). Average Pitch Tempo was similar between pitchers with shoulder and forearm/elbow injuries versus uninjured pitchers (16.72-17.09 s, p = 0.14-0.20).

Conclusions: The incidence of UEI did not increase in MLB Pitchers following the implementation of the Pitch Timer prior to the 2023 MLB season. Following the introduction of the Pitch Timer in 2023, MLB Pitchers averaged significantly greater games missed per shoulder injury than previous seasons, suggesting there may be a link between the Pitch Timer and shoulder injury severity. Pitching Tempo was not associated with UEI.

Objective: Overuse injuries are more associated with highly specialized youth athletes in individual sports than those in team sports; however, as baseball, softball, and volleyball involve frequent repetitive motions, these repetitive motion team sports (RMTS) may see a greater proportion of overuse injuries than non-repetitive motion team sports (non-RMTS). The objective of the present study is to compare the distribution of injuries (overuse vs. acute) in RMTS to non-RMTS and individual sports among highly specialized youth athletes.

Methods: We conducted a retrospective review of 805 highly specialized athletes (aged 12.00-17.92 years) who presented with a sports-related injury between January 2015 and June 2022. The injury distribution (proportion of overuse vs. acute injuries) for each sport type group (Individual, RMTS, non-RMTS) was compared to each of the other two via chi-square, and linear regression was used to evaluate the relative odds of any given injury being overuse for sport type and various demographic and sports participation variables.

Results: Among 805 patients, 487 (60.5%) were individual sport athletes, 83 (10.3%) were RMTS athletes, and 235 (29.2%) were non-RMTS athletes. The proportions of overuse injury were 67.1%, 57.5%, and 40.0% in the individual, RMTS, and non-RMTS groups, respectively. Overuse injury proportion was higher in RMTS than non-RMTS (p = 0.0105), though it was not significantly different between RMTS and individual sports (p = 0.098). Patients participating in individual sports (Odds Ratio = 2.93, 95% CI = 2.00-4.29) or RMTS (OR = 2.28, 95% CI = 1.31-3.97) had greater odds of overuse injury relative to acute injury when compared to those in non-RMTS.

Conclusions: Among highly specialized youth athletes, individual sport and RMTS athletes had similar proportions of overuse injuries, and both had a higher proportion of overuse injuries than non-RMTS athletes. Preliminary evidence suggests that RMTS athletes may share some risk characteristics with individual sport athletes, which may help guide future research into injury patterns in this group to help better inform clinicians in counseling highly specialized youth athletes regarding overuse injuries.

Objectives: To describe thepattern of injuries in the second division of men's professional football in Argentina.

Methods: This descriptive prospective multicentric study included 195players from six teams. The methods adhered to the football extension of theinternational olympic committee (IOC) consensus statement on injurysurveillance. A time-loss injury definition was used. Primary outcomes includedinjury incidence rates, types of common injuries and time loss.

Results: Theoverall injury incidence rate was 3.67 injuries per 1000 hours(h) of footballexposure (95% CI: 2.6 - 4.6). In matches, the incidence rate was 26.42/1,000 h(95% CI: 21.55 to 32.08) and in training it was 1.91/1,000 h (95% CI:  1.54 to 2.33). The overall injury burden was84.10 days lost per 1000 h (95% CI 45.81; 122.4). The injury types with the highest time-lossburden were muscle injury (31.56 per 1000 h 95% CI 27.660; 35.630) and ligamentsprains (32.799 per 1000 h 95% CI 17.370; 51.080).

Conclusion: Thisstudy is one of the first surveillance studies of professional men's footballin South America, demonstrating the feasibility of surveillance in the ArgentinianFootball Association (AFA), and providing valuable insights into theepidemiology of injuries in this region. The results highlight several notablefindings, including the relatively high rates of anterior cruciate ligament(ACL) injuries and training-related injuries, suggesting the presence of a distinctive injury pattern in AFA league compared to other regions worldwide,emphasizing the need for region-specific prevention and management strategies.These findings can inform future policies and practices aimed at reducinginjury rates and improving player health and team performance.

Objectives: To describe the injury profile of a Portuguese professional football team over one competitive season, focusing on the type, severity, mechanism, timing, and management of time-loss injuries.

Design: This is a retrospective, observational study based on a single professional team from the Portuguese first football league. The study was conducted over one full competitive season (2024/2025).

Methods: All time-loss injuries resulting in missed official matches were included. Collected data included player demographics, injury type, anatomical location, mechanism (traumatic or overuse), recurrence, time-loss duration, and the use of image-guided interventional procedures. Injuries were diagnosed using clinical evaluation and confirmed by imaging (ultrasound, X-ray or Magnetic Resonance Imaging). Descriptive statistics were used.

Results: A total of 26 injuries were recorded, corresponding to an overall incidence of 2.1 injuries per 1000 hours of player exposure (training: 1.5/1000 h; match: 13.5/1000 h; incidence rate ratio = 9.0). Muscle injuries of the hip and thigh were most common (n = 14, 53.8%), particularly hamstring (n = 6) and adductor strains (n = 4). Traumatic mechanisms accounted for 92.3% (n = 24) of cases, while 2 were overuse injuries. Sixteen injuries (61.5%) occurred during training and 8 (30.8%) during matches. The mean time-loss was 20.8 days, corresponding to 4.2 matches missed per injury. Injury peaks were observed in February and April. Defenders were the most affected (n = 15, 57.7%). Four players underwent ultrasound-guided procedures, including three platelet-rich plasma (PRP) injections and one corticosteroid plus hyaluronic acid injection, all with favorable outcomes and return to play.

Conclusions: This study reinforces the importance of context-specific surveillance to guide injury prevention and treatment. The predominance of traumatic training injuries and successful application of image-guided interventions highlight key considerations for elite football medical teams.