Open Access Journal of Sports Medicine最新文献

Introduction: Elbow ulnar collateral ligament (UCL) injuries in gymnastics have not been well documented in the literature, in comparison to UCL injuries in baseball. Few studies have examined the mechanism and nonoperative management of this injury, and no studies to date have been published on incidence of injury and return to play recommendations in gymnastics.

Patient case review: A literature search was performed using PubMed to review articles from 1980 to 2016 that addressed the biomechanics of UCL injury in baseball and gymnastics, the anatomy of the elbow, injury rates, surgical vs non-surgical management, rehabilitation, and return to play recommendations for the sport of gymnastics. Five female collegiate gymnasts sustained UCL injury over a 3-year period. Electronic medical records for each case were thoroughly reviewed including imaging, surgical and non-surgical management, rehabilitation, and the progressive return to gymnastics.

Discussion: Four UCL injuries were confirmed by MRI to be avulsions at the distal insertion of the UCL and one was an avulsion at the proximal origin. While less than half of baseball players can return to competition with conservative management of these types of injuries, four out of five gymnasts were able to return to competition with nonoperative management. One gymnast opted to have reconstruction after a successful competition season. Time to return to play varied seemingly dependent on the severity of UCL injury and event.

Conclusion: In our case series, collegiate female gymnasts were able to return to participation with nonoperative treatment of the UCL. Their success in returning to competitive gymnastics may also depend on the event(s) in which they are trying to participate.

Strength of recommendation taxonomy: C.

Treatment of symptomatic meniscal tears continues to evolve as we improve our understanding of the biomechanical role of the meniscus and its long-term importance to the health of the knee joint. Suture repair of meniscal tears is challenging and continues to rise as we aim to preserve meniscal tissue. Outside-in meniscal suture techniques may involve using expensive equipment that is not readily available for immediate use in most operating rooms. Aware of the different techniques available, the authors describe a fast and reproducible technique that does not require the use of specific material or equipment.

Introduction: The stability of hematological status indices is a key determinant of optimal sport performance. The capacity to monitor hematological behaviors of elite soccer players may better explain the stresses placed upon physiological systems and the potential decrements in performance and physical capacity. The primary aim of this investigation was to examine the post-seasonal hematological status of professional top-level soccer players in response to seasonal match-play and training demands, in terms of the training practices, intensity, and loadings that they experience before, during, and after each season.

Methods: Seventeen male elite European soccer players participated in the study (mean±SD: age 26.8±4.6 years, weight 78.1±5.7 kg, height 182.4±4.8 cm, body fat 9.8%±2.9%, and maximal aerobic capacity 56.5±4.2 mL kg^-1 min^-1). The season culminated in 74 competitive matches including domestic, Champions League, and UEFA Cup matches. Blood samples were collected between 9:00 and 10:30 am after an overnight fast (~10 hours), 72 hours post conclusion of the final match of the competitive season.

Results: Near-perfect correlations between white blood cells, neutrophils, the period of season, training availability, and total competitive minutes were found. When adjusting for all the confounding variables, a stability of the hematological profile was noticed. Only mean cell volume and mean cell hemoglobin values were associated with the requirement for elite European soccer teams to fulfill excessive competitive loadings. The reported lower mean cell volume and mean cell hemoglobin values may highlight the accumulative effects of seasonal training and match-play demands.

Conclusion: Regular blood testing could identify the need for both squad rotation and the implementation of interventions to assist in stabilizing transient hematological behaviors in order to optimize performance and sports output.

Background: Current knowledge of the effect of changes in posture and the way cam morphology of the hip joint may affect hip range of motion (ROM) is limited.

Purpose: To determine the effect of changes in pelvic tilt (PT) on hip ROM and with/without the presence of cam.

Study design: This was a cross-sectional study.

Materials and methods: The hip ROM of 87 subjects (n=61 young elite skiers, n=26 nonathletes) was examined using a goniometer, in three different seated postures (flexed, neutral, and extended). The hips of the subjects were further subgrouped into cam and no-cam morphology, based on the magnetic resonance imaging findings in the hips.

Results: There was a significant correlation between the hip ROM and the seated posture in both extended and flexed postures compared with the neutral posture. There was a significant decrease in internal hip rotation when the subjects sat with an extended posture with maximum anterior PT (p<0.0001). There was a significant increase in internal hip rotation when the subjects sat with a flexed posture with maximum posterior PT (p<0.001). External rotation was significantly decreased in an extended posture with maximum anterior PT (p<0.0001), but there was no difference in flexed posture with maximum posterior PT. The hips with cam morphology had reduced internal hip rotation in all three positions, but they responded to the changes in position in a similar manner to hips without cam morphology.

Conclusion: Dynamic changes in PT significantly influence hip ROM in young people, independent of cam or no-cam morphology.

The sub-2-hour marathon is a new barrier in endurance running performance, and it has been widely debated in the scientific community. In this review we present a mathematical model to estimate the possible year when a male could break through the sub-2-hour barrier, and also an estimation of when a female could break Paula Radcliffe's marathon running record. Further, we present several aspects (ie, physiology, nationality, age, biomechanics, pacing, and drafting) that are associated with marathon running performance in elite runners and, finally, the possible characteristics of the male to break the sub-2-hour barrier. In summary, with the results of the developed equations, it is possible that a male athlete can break through the sub-2-hour barrier in the next decade (with Nike^® Breaking2 performance 1920-2018 [NBP]: y =0.0417x²-14.18x +3,128; year of 2026; without NBP 1920-2018: y =0.045x²-15.12x +3,194; year of 2027). This marathoner will possibly have a maximal oxygen uptake >85 mL∙kg^-1∙min^-1 and should perform the race at a pacing higher than 85% of maximal oxygen uptake. In addition, this runner should pay more attention to strength training, endurance strength, speed training, and focus on running training at an intensity above the anaerobic threshold. Most likely, this runner originates from East Africa (especially from Ethiopia) and will have an age of ~27 years. For the females, there is poor evidence regarding the physiological profile of the female marathoner who will break Radcliffe's record, but the available literature suggests that it will not happen any time soon.

With the growing popularity of water-based sports, cases of swimming-induced pulmonary edema (SIPE) are becoming increasingly recognized. SIPE, a potentially life-threatening condition, is an acute cause of breathlessness in athletes. It has been described frequently in scuba divers, swimmers, and triathletes and is characterized by symptoms and signs of pulmonary edema following water immersion. It is important to recognize that athletes' symptoms can present with a spectrum of severity from mild breathlessness to severe dyspnea, hemoptysis, and hypoxia. In most cases, there is rapid resolution of symptoms within 48 hours of exiting the water. Recent advances in the understanding of the pathophysiology of SIPE, particularly regarding exaggerated pulmonary vascular pressures, have begun to explain this elusive condition more clearly and to distinguish its predisposing factors. It is essential that event organizers and athletes are aware of SIPE. Prompt recognition is required not only to prevent drowning, but also to implement appropriate medical management and subsequent advice regarding return to swimming and the risk of recurrence. This manuscript provides a current perspective on SIPE regarding the incidence rate, the current understanding of the pathophysiology, clinical presentation, medical management, recurrence rates, and advice on return to sport.

Purpose: The age of peak performance (APP) has been studied extensively in various endurance and ultra-endurance sports; however, less information exists in regard to duathlon (ie, Run1, Bike, and Run2). The aim of the present study was to assess the APP of duathletes competing either in a short (ie, 10 km Run1, 50 km Bike, and 5 km Run2) or a long distance (ie, 10 km Run1, 150 km Bike, and 30 km Run2) race.

Participants and methods: We analyzed 6,671 participants (women, n=1,037, age 36.6±9.1 years; men, n=5,634, 40.0±10.0 years) in "Powerman Zofingen" from 2003 to 2017.

Results: Considering the finishers in 5-year age groups, in the short distance, a small main effect of sex on race time was observed (p<0.001, η² =0.052) with men (171.7±20.9 min) being faster than women (186.0±21.5 min) by -7.7%. A small main effect of age group on race was shown (p<0.001, η² =0.049) with 20-24 years being the fastest and 70-74 years the slowest. No sex × age group interaction was found (p=0.314, η² =0.003). In the long distance, a small main effect of sex on race time was observed (p<0.001, η² =0.021) with men (502.8±56.8 min) being faster than women (544.3±62.8 min) by -7.6%. A large main effect of age group on race time was shown (p<0.001, η² =0.138) with age group 25-29 years the fastest and age group 70-74 years the slowest. A small sex × age group interaction on race time was found (p<0.001, η² =0.013) with sex difference ranging from -22.4% (15-19 age group) to -6.6% (30-34 age group).

Conclusion: Based on these findings, it was concluded an older APP in the long than in the short distance was seen in "Powerman Zofingen." This indicates that APP in duathlon follows a similar trend as in endurance and ultra-endurance running and triathlon, ie, the longer the distance, the older the APP.

Introduction: Psychological distress is increasing among adolescents and clusters with other mental health problems such as eating problems. The aim of this study was to investigate the prevalence of psychological distress among young elite athletes and age-matched controls and whether prevalence figures may be attributed to perfectionism and eating problems.

Methods: First-year athletes from all Norwegian elite sport high schools (n=711) and 500 students from randomly selected ordinary high schools were eligible for this cross-sectional study. In total, 611 athletes and 355 student controls provided self-report data about psychological distress, perfectionism, and eating problems (ie, body dissatisfaction and a drive for thinness), as well as their physical training/activity.

Results: A significantly higher proportion of controls scored above the cutoff point for marked psychological distress. Physical activity above the recommended levels for this age group predicted psychological distress among the controls, while the opposite was found in the student elite athlete sample. In both samples, perfectionistic concerns, ie, concern over mistakes, predicted overall psychological distress. However, among elite athletes, perfectionistic concerns were particularly associated with clinically significant psychological distress. Moreover, the impact of eating problems was negligible.

Conclusion: Results from this study highlight the need to target the maladaptive perfectionistic concerns to prevent psychological distress among young athletes as well as among their age-matched nonathlete counterparts.

Background: The aim of this study was to compare the effect of different soccer-specific maximal actions (Continuous run, Sprint, Sprint with change of direction [Sprint COD], Jump and Shot) upon physiological (oxygen uptake and heart rate) and perceptual (rating of perceived exertion [RPE]) responses and accelerometer load.

Materials and methods: Ten moderately to well-trained male soccer players volunteered to serve as subjects in this study. A repeated within-subject design was used in which each subject was tested on five occasions on different days, one test each day, during a period of 2 weeks. Each of the five tests had a distance of 900 m and lasted 5 minutes, thus the mean speed for all five tests was 3 m/s. During the test, oxygen uptake, heart rate and accelerometer load were measured. Immediately after each test, RPE was recorded, and after the test, oxygen uptake was measured for 5 minutes while the subject sat in an upright position on a chair.

Results: In the comparison of different soccer-specific maximal actions upon physiological and perceptual responses and accelerometer load, this study found that the total accelerometer load was lowest in Sprint and Sprint COD conditions, although the physiological (oxygen uptake and heart rate) and perceptual (RPE) responses were highest in the respective conditions. The Jump condition experienced lower RPE than Sprint and Sprint COD but achieved the highest accelerometer load.

Conclusion: Accelerometer load is not a valid measurement for energy costs or RPE but may function as a complementary tool to investigate the player loads during matches and training.

The potential factors associated with overuse injuries and pain in cyclists that are supported by evidence remain unclear. Our study aimed at assessing, using a systematic search of the most updated evidence, the main factors related to overuse knee-related pain and/or injuries in cyclists. The search assessed any potential mechanism related to knee pain or injury that could be used in the clinical practice. Databases were searched (i.e., PubMed, Scopus, Web of Science, and EBSCO). Studies were included if they presented results from original studies. They had to include, preferably but not limited to, recreational and/or competitive cyclists with or without knee pain. Quality of articles was assessed. Eleven articles were deemed eligible for full text appraisal. Studies involved generally the assessment of biomechanical outcomes associated with knee pain in cyclists. Overall, studies showed that cyclists with knee pain present larger knee adduction and larger ankle dorsiflexion and differences in activation for hamstrings and quadriceps muscles. Unclear results were observed for knee moments and no differences were observed for knee flexion angle, tibiofemoral and patellofemoral forces. It is important to state that varied types of knee pain were mixed in most studies, with 2 focused on anterior-related pain. Cyclists with overuse-related pain or injuries on their knees presented an increased medial projection of their knees and an altered activation of the Vastus Medialis and Vastus Lateralis muscles. However, this limited evidence is based on retrospective studies comparing cyclists with and without pain, which limits the conclusion on how cyclists develop knee pain and what are the main options for treatment of knee pain.