Patellar tendinopathy (PT) is a common overuse injury of the patellar tendon in jumping athletes. In a recent large cross-sectional study from 2008 several factors were identified that may be associated with the etiology of PT. However, because of the study design no conclusions could be drawn about causal relations. The primary aim of the current study is to investigate whether the factors identified in the previous 2008 study can also be prospectively recognized as predictors of symptomatic PT in 2011. Nine hundred twenty-six Dutch elite and non-elite basketball and volleyball players from the previous study were invited again to complete an online survey about knee complaints and risk factors for PT in 2011. The logistic regression included 385 athletes of which 51 (13%) developed PT since 2008. Male gender [odds ratio (OR) 2.0, 95% confidence interval (CI) 1.1–3.5] was found to be a risk factor for developing PT. No sports-related variables could be identified to increase the risk of developing PT, but some evidence was found for performing heavy physically demanding work, like being a nurse or a physical education teacher (OR 2.3, 95% CI 0.9–6.3). These findings indicate that, when considering preventive measures, it is important to take into account the total tendon load.
The systematic review and meta-analysis by Taylor et al is the most current evaluation of injury prevention efforts in basketball. Basketball originated as a noncontact, finesse sport. However, it has evolved into a very physical contest emphasizing total body strength and leverage at the collegiate and professional ranks. Players often use their bodies to jostle for an advantageous position both on offense and defense. The girth and bulk of today’s elite players hints at the demands of today’s game. Contact mechanisms now account for the majority (69.2%) of acute injuries in basketball. It is a vertical and horizontal sport that combines jumping and rapid changes in direction. The axial rotation and lateral movement of the lower extremity is constant, along with the rapid momentum shifts. The vertical and horizontal movements of the game present many lower extremity opportunities for injury as torques and sheer forces are applied to the ankle, knee, and hip. Those physical features and basketball’s global popularity and participation generate many opportunities to study basketball injury epidemiology.
To survey injury/illness in the National Basketball Association over a 25-year period and examine the relationship of injury/illness to team performance.
A retrospective correlational design.
Trends were examined in reported numbers of players injured/ill during a season and games missed due to injury/illness from seasons ending in 1986 through 2005. This period was compared to years 2006-2010, when NBA teams were allowed to increase the total number ofplayers on the team from 12 to 15.
There was a highly significant trend (p<0.0001) of increasing numbers of playersinjured/ill and games missed from 1986 through 2005. After the team expansion in 2006, these rates fell abruptly by 13% and 39% respectively (both p<0.0001 compared to the previous 5-year period). We also found a significant inverse association between games missed due to injury/illness and percent games won (r=-0.29, p<0.0001).
Results demonstrate an increased rate of injury in the National Basketball Association up until the expansion of team size in 2006. Following 2006, team expansion was positively associated with decreased injury/illness rates. The latter finding suggests the importance of maintaining a healthy roster with respect to winning outcomes.
In jump-landing sports, the injury mechanism that most frequently results in an injury is the jump-landing movement. Influencing the movement patterns and biomechanical predisposing factors are supposed to decrease injury occurrence.
To evaluate the influence of a 3-mo coach-supervised jump-landing prevention program on jump-landing technique using the jump-landing scoring (JLS) system.
Randomized controlled trial.
116 athletes age 15-41 y, with 63 athletes in the control group and 53 athletes in the intervention group.
The intervention program in this randomized control trial was administered at the start of the basketball season 2010-11. The jump-landing training program, supervised by the athletic trainers, was performed for a period of 3 mo.
MAIN OUTCOME MEASURES:
The jump-landing technique was determined by registering the jump-landing technique of all athletes with the JLS system, pre- and postintervention.
After the prevention program, the athletes of the male and female intervention groups landed with a significantly less erect position than those in the control groups (P < .05). This was presented by a significant improvement in maximal hip flexion, maximal knee flexion, hip active range of motion, and knee active range of motion. Another important finding was that postintervention, knee valgus during landing diminished significantly (P < .05) in the female intervention group compared with their control group. Furthermore, the male intervention group significantly improved (P < .05) the scores of the JLS system from pre- to postintervention.
Malalignments such as valgus position and insufficient knee flexion and hip flexion, previously identified as possible risk factors for lower-extremity injuries, improved significantly after the completion of the prevention program. The JLS system can help in identifying these malalignments.
LEVEL OF EVIDENCE:
Therapy, prevention, level 1b.
Sternoclavicular (SC) dislocation is a rare injury of the upper extremity. Treatment of posterior SC dislocation ranges from conservative (closed reduction) to operative (open reduction with or without surgical reconstruction of the SC joint). To date, we are unaware of any literature that exists pertaining to this injury or its treatment in elite athletes. The purpose of this case report is to describe a posterior SC joint dislocation in a professional American football player and to illustrate the issues associated with its diagnosis and treatment and the athlete's return to sports. To our knowledge, this case is the first reported in a professional athlete. He was treated successfully with closed reduction and returned to play within 5 weeks of injury.
Concussion is common in many sports, and the incidence is increasing. The medical consequences after a sport-related concussion have received increased attention in recent years since it is known that concussions cause axonal and glial damage, which disturbs the cerebral physiology and makes the brain more vulnerable for additional concussions. This study reports on a knocked-out amateur boxer in whom cerebrospinal fluid (CSF) neurofilament light (NFL) protein, reflecting axonal damage, was used to identify and monitor brain damage. CSF NFL was markedly increased during 36 weeks, suggesting that neuronal injury persists longer than expected after a concussion. CSF biomarker analysis may be valuable in the medical counselling of concussed athletes and in return-to-play considerations. Level of evidence IV.
A common sequela of concussions is impaired reaction time. Computerized neurocognitive tests commonly measure reaction time. A simple clinical test for reaction time has been studied previously in college athletes; whether this test is valid and reliable when assessing younger athletes remains unknown. Our study examines the reliability and validity of this test in a population of high school athletes.
Two American High Schools.
High school athletes (N = 448) participating in American football or soccer during the academic years 2011 to 2012 and 2012 to 2013.
All study participants completed a computerized baseline neurocognitive assessment that included a measure of reaction time (RT comp), in addition to a clinical measure of reaction time that assessed how far a standard measuring device would fall prior to the athlete catching it (RT clin).
MAIN OUTCOME MEASURES:
Validity was assessed by determining the correlation between RT clin and RT comp. Reliability was assessed by measuring the intraclass correlation coefficients (ICCs) between the repeated measures of RT clin and RT comp taken 1 year apart.
In the first year of study, RT clin and RT comp were positively but weakly correlated (rs = 0.229, P < 0.001). In the second year, there was no significant correlation between RT clin and RT comp (rs = 0.084, P = 0.084). Both RT clin [ICC = 0.608; 95% confidence interval (CI), 0.434-0.728] and RT comp (ICC = 0.691; 95% CI, 0.554-0.786) had marginal reliability.
In a population of high school athletes, RT clin had poor validity when compared with RT comp as a standard. Both RT clin and RT comp had marginal test-retest reliability. Before considering the clinical use of RT clin in the assessment of sport-related concussions sustained by high school athletes, the factors affecting reliability and validity should be investigated further.
Reaction time impairment commonly results from concussion and is among the most clinically important measures of the condition. The device evaluated in this study has previously been investigated as a reaction time measure in college athletes. This study investigates the clinical generalizability of the device in a younger population.
A video abstract showing how the RT clin device is used in practice is available as Supplemental Digital Content 1, http://links.lww.com/JSM/A43.
Linemen are at high risk for knee cartilage injuries and osteoarthritis. High-intensity movements from squatting positions (eg, 3-point stance) may produce high joint loads, increasing the risk for cartilage damage. We hypothesized that knee moments and joint reaction forces during lineman-specific activities would be greater than during walking or jogging. Data were collected using standard motion analysis techniques. Fifteen NCAA linemen (mean ± SD: height = 1.86 ± 0.07 m, mass = 121.45 ± 12.78 kg) walked, jogged, and performed 3 unloaded lineman-specific blocking movements from a 3-point stance. External 3-dimensional knee moments and joint reaction forces were calculated using inverse dynamics equations. MANOVA with subsequent univariate ANOVA and post hoc Tukey comparisons were used to determine differences in peak kinetic variables and the flexion angles at which they occurred. All peak moments and joint reaction forces were significantly higher during jogging than during all blocking drills (all P < .001). Peak moments occurred at average knee flexion angles > 70° during blocking versus < 44° in walking or jogging. The magnitude of moments and joint reaction forces when initiating movement from a 3-point stance do not appear to increase risk for cartilage damage, but the high flexion angles at which they occur may increase risk on the posterior femoral condyles.