Sports Injury Management- The first 72 hours- What to do

Functional Performance Testing: An Assessment Necessity

As a sports physiotherapist, it is important that you not only rehabilitate athletes but ensure that they are fully fit to return to play. As many of you are fully aware, objective measures such us a full active range of motion does not determine an athlete’s readiness to RTP. Accordingly, a comprehensive assessment of an athlete’s function, via functional performance testing, becomes an absolute assessment necessity. This article will discuss current research on the the role and implementation of functional performance testing, as well as some tests that you may use in your own clinical practice.

For detailed article, visit-
http://www.thesportsphysiotherapist.com/functional-performance-testing/ 

Risk factors for groin/hip injuries in field-based sports

Groin/hip injuries occur frequently in the athletic population, particularly in sports requiring kicking, twisting, turning and rapid acceleration and deceleration. Chronic hip, buttock and groin pain make up 10% of all attendances to sports medicine centres. Understanding risk factors for field-based sports (FBS) players is important in developing preventive measures for injury. The objective of this systematic review was to identify and examine the evidence for groin/hip injury risk factors in FBS. 14 electronic databases were searched using keywords. Studies were included if they met the inclusion criteria and investigated one or more risk factors with relation to the incidence of groin/hip injuries in FBS. Studies were accumulated and independently analysed by two reviewers under a 12-point quality assessment scale (modified CASP (for cohort study design) assessment scale). Because of the heterogeneity of studies and measures used, a meta-analysis could not be conducted. As a result risk factors were pooled for analysis and discussion. Of the 5842 potentially relevant studies, 7 high-quality studies were included in this review. Results demonstrated that previous groin/hip injury was the most prominent risk factor, identified across four studies (OR range from 2.6 (95% CI 1.1 to 6.11) to 7.3, (p=0.001)), followed by older age (OR 0.9, p=0.05) and weak adductor muscles (OR 4.28, 95% CI 1.31 to 14.0, p=0.02) each identified in two studies. Eight other significant risk factors were identified once across the included studies.

This study identified 11 significant risk factors for groin/hip injury for FBS players. The most prominent risk factor observed was previous groin/hip injury. Future research should include a prospective study of a group of FBS players to confirm a connection between the risk factors identified and development of groin/hip injuries.


For detailed study, kindly visit-
http://www.ncbi.nlm.nih.gov/pubmed/24795341

Why Do Some Runners Overuse Rectus Femoris?

The answer with detailed reasons can be found at-

http://www.kinetic-revolution.com/qa-why-do-runners-overuse-rectus-femoris/

By- James Dunne, a Sports Rehab. Specialist & Running Coach.

The effectiveness of exercise interventions to prevent sports injuries

Physical activity is important in both prevention and treatment of many common diseases, but sports injuries can pose serious problems.

To determine whether physical activity exercises can reduce sports injuries and perform stratified analyses of strength training, stretching, proprioception and combinations of these, and provide separate acute and overuse injury estimates, a research was done.

You can have full access to the study here-

http://bjsm.bmj.com/content/48/11/871.short

Overuse Injuries and Burnout in Youth Sports

There are many children and young athletes are affected by overuse injuries. Adolescent girls are most prone to such injuries. Early specialization in sports may put young athletes at risk for overuse injuries, and doesn't necessarily lead to long term success in their sport.

Parents, coaches, teachers, trainers, and doctors can work together to encourage young athletes to listen to their bodies and to rest and cross-train, that can decrease the phenomenon of overuse injuries and burnout in youth sports.

Overuse injuries - causes

Organized youth sports: Left to themselves, children engaged spontaneous and unstructured sport and recreational activity are generally free of overuse injury. It is when adults step into the picture that "injury free" status seems to change.

Elite-level travel teams: Increased emphasis on competitive success, often driven by goals of elite-level travel team selection, collegiate scholarships, Olympic and National team membership, and even professional contracts, has become widespread, resulting in increased pressure to begin high-intensity training at young ages. Excessive focus on early intensive training and competition at young ages rather than skill development can lead to overuse injury and burnout.

Overuse injuries - risk factors

Risk factors for overuse injuries are often grouped into two categories: intrinsic (e.g. individual biological characteristics and psychosocial traits) and extrinsic (e.g. external forces related to the sport type, the biomechanics of the activity, and the sporting environment), some of which are capable of being modified (e.g. strength, neuromuscular function) and others are not (age, gender).

IntrinsicPrior injury: is the strongest predictor of future overuse injury. Repeated overuse injury may occur as a result of inadequate rehabilitation of the injury and/or a failure to recognize the factors that contributed to the original injury.

Adolescent growth spurt: Overuse injuries may be more common during the adoloscent growth spurt.

Menstrual irregularity: a history of amenorrhea (irregular periods), especially in sports that emphasize leanness (e.g. gymnastics, figure skating, dance) is a significant risk factor for bone stress injury, although there is little data on younger adolescents.

Extrinsic

Workload:
Higher training volumes have consistently been shown to increase the risk of overuse injury in multiple sports.A study of high school athletes found a linear relationship between hours of sports participation and risk of injury, with training more than 16 hours per week associated with a significant increased risk of injury requiring medical care.

Volume (amount of activity in single session) and intensity (number of sessions per week/month/year) is correlated with overuse injury risk): i.e.- Number of pitches per game in youth baseball, More than 100 innings per year, Wrist pain in young gymnasts related to training intensity, as measured by skill level and number of hours training per week.

Year-round play. 42% increase in self-reported overuse injuries in high school athletes who participated all year versus 3 or less seasons per year. (Cuff, 2010).

More organized sports/less free play. There is emerging evidence to suggest that athletes who spend most of their time in organized sports and little time in free play or recreation are more likely to be injured. One study (Jayanthi, 2012), for instance, found that the athletes who suffered sport-related injuries spent an average of 12.6 hours per week in tennis and only 2.4 hours per week in free play or recreation, while the uninjured players spent only 9.7 hours per week in organized tennis and 4.3 hours in unstructured free play.

BurnOut- risk factors

Environmental-
Extremely high training volumes

Extremely high time demands

Demanding performance expectations (imposed by self or significant others)

Frequent intense competition

Inconsistent coaching practices

Personal characteristics-
Perfectionism

Need to pleases others

Nonassertiveness

Unidimensional self-conceptualization (focusing only on one's athletic involvement)

Low self-esteem

High perception of stress (high anxiety)

Early specialization-
Several studies have suggested that athletes who had early specialized training withdrew from their sport either due to injury or burnout.

A study of swimmers found that those who specialized early spent less time on the national team and retired earlier than those who specialized later.

Early specialization also seems to be correlated with reports of decreased general health and psychological well-being.

What We Don't Know

Incidence and prevalence: Research on overuse injuries in children and adolescents is sparse. Becauses aged-based data is lacking, recommendations for participation and training is often based on extrapolations derived from limited high school and college data, extrapolation which, says one expert (Roberts WO, 2014), is hazard."

Reasons kids drop out of sports: The issue is complicated issue, with a lack of reliable data hampering informed public opinion and sports polcies. "Ironically," says one Roberts, the source of the oft-quoted statistic that '80% of youth athletes drop out by age 13' is impossible to find."

Effect of tournaments and showcases: Despite the absence of data to link these activities with overuse injuries, longer rest periods between matches and games have been proposed in an effort to improve athlete safety and performance, enhance recovery, and minimize the "carryover" effects from previous competitions. In terms of overuse injuries, scheduling may simply be a marker for a high ratio of workload-to-recovery time.

The relationship between sports specialization and injuries: While there are both theoretical and measurable risks associated with intense, specialized training, the relationship has not been clearly demonstrated. A large study of competitive junior tennis players found that those who competed only in tennis were 1.5 times more likely to have reported an injury, but did not account for training intensity (e.g. weekly training hours). Early data from a clinical study comparing young athletes with sports-related injuries to healthy, uninjured athletes presenting for sports physicals suggests that more specialized athletes were more likely to be injured, but further research, both studies controlling for training intensity and year-round training and evaluating multi-sport athletes over time (e.g. longitudinally) compared to specialized athletes and stages of development to determine the effects of sports diversification with specialization, are needed.

The path forward

National research agenda needs to be developed to more carefully examine all aspects of youth sport programs;

Holistic approach needed which considers how youth sports either contributes to or detracts from the overall health of the child, physical/physiological, psychological, cognitive/academic, social and spiritual;

Future research needs to focus on age groups (6-10, 11-15, 16-18, 19-25 years); even better, group children by developmental stage (prepubuscent, pubescent, postpubuscent, and late-stage maturation), with different age groupings to account for earlier maturation of girls compared to boys.

Concerted effort from sports community to develop a funding stream to support research is needed.

Sources:

Cuff S, Loud K, O'Riordan MA. Overuse injuries in high school athletes. Clin Pediatr. 2010;49:731-736.

DiFiori JP, Benjamin HJ, Brenner J, Gregory A, Jayanthi N, Landry GL, Luke A. Overuse Injuries and Burnout in Youth Sports: A Position Statement from the American Medical Society for Sports Medicine. Clin J Sports Med. 2014;24(1):3-20.

DiFiori JP, Puffer JC, Mandelbaum BR, et al. Factors associated with wrist pain in the young gymnast. Am J Sports Med. 1996;24:9-14.

Dun S, Loftice J, Fleisig GS, et al. A biomechanical comparison of youth baseball pitches: is the curveball potentially harmful? Am J Sports Med. 2008;36:686-692.

Fleisig GS, Andrews JR, Cutter GR, et al. Risk of serious injury for young baseball pitchers: a 10-year prospective study. Am J Sports Med. 2011;39:253-257.

Jayanthi N. Injury risks of sport specialization and training in junior tennis players: a clinical study. Paper presented to the Society for Tennis and Medicine Science North American Regional Conference, Atlanta GA. December 2012.

Parks ED, Ray TR. Prevention of overuse injuries in young baseball pitchers. Sports Health. 2009;1:514-517.

Roberts WO. Overuse Injuries and Burnout in Youth Sports. Clin J Sports Med. 2014;24(1):1-2.

With ref. from Momsteam

Anxiety in Sports

It is often the case that we suffer from anxiety. Anxiety can be acute (short-term) or chronic (long-term). Anxiety can also be related to pre-match nerves or develops over time due to low self-confidence.

Stage Fright – Once we cross the line we are on STAGE.

If we are anxious of competition a number of things can occur.

There are two effects of anxiety:
1)   Psychological (in the head) (Cognitive)
2)   Physiological (in the stomach) (Somatic)

Performers who dwell on their anxiety will suffer from poor performance.

Performers will suffer from a range of:
1)   Restricted focus
2)   Poor concentration
3)   Limited control
4)   Lack of spatial awareness
5)   Negative thinking/thoughts
6)   Butterflies in the stomach
7)   Increased heart rate
8)   Tight muscles
9)   Sweaty palms
10)  Feelings of apprehension/sickness

In order to help our mind overcome our negative symptoms there are a range of strategies that need to be practiced on a regular basis.

Strategies:
10 steps to effective deep breathing – this method is crucial in reducing butterflies in the stomach. To benefit you must find a quiet place (at home) and lie down.
STEP 1) close your eyes and regulate your breathing by starting to feel the centre of your stomach.
STEP 2) put both hands on your stomach and feel it go up and down for twenty seconds.
STEP 3) control your breathing through your nose and out your mouth. This must be a smooth transition that flows as a rhythm.
STEP 4) think back to your best performance and recall all the positive feelings that you had. During this recall think of all the positive emotions and the impact they had on your body. You should now be relaxed.
STEP 5) concentrate on your stomach and feel it go up and down slowly.
STEP 6) try and imagine you are inside your stomach and see how it feels. If it is tight try and make it relax, imagine you are stroking it.
STEP 7) next, bring some colours into your thinking and make them float inside your stomach. Do this for ten seconds.
STEP 8) now tighten the muscles in and around your stomach and relax them after ten seconds.
STEP 9) reintroduce the colours into your stomach for ten seconds and see how you feel.
STEP 10) for the final three to five minutes imagine you are at the seaside, the sun is out, the sea is calm and you are relaxing in the sand. Keep this in your mind and smile.