Sports Injuries

Champion System Pro Cycling 2012 - Beijing Great Wall Ride

2012-01-20T14:07:00.001-05:00

I am back from my trip to China with Champion Systems Pro Cycling team what a great trip and fantastic organization to work with. I will be posting some more videos and pictures from camp but here is a nice video of the guys on a training ride to the Great Wall!

Champion System pro Cycling team & Recovery Doc in China!

2012-01-10T01:30:00.001-05:00

We are a few days into training camp here in Hong Kong and are packing up the team for our next leg of the trip in Beijing. We all are having a great time mixing cultures from Asia, Europe and the US. We had a Great team building exercise learning the dance of the dragon yesterday. For me it has been fantastic to learn about this great culture and all of its traditions. Looking forward to getting the team issued there RestWise device for recovery management in a few days and teaching the team about all of my advanced Recovery Technique. This post is from my phone so forgive me for any mistakes..

Champion Systems Pro cycling team names Dr. Rosa Team Chiropractor and Recovery Specialist!

2012-01-04T13:19:00.000-05:00

World's First Asian-based Professional Continental

Team name's Dr. Rosa Team Chiropractor and

Recovery consultant.

The new year brings a new cycling team that has asked me to work with them utilizing my state of the art recovery techingues to help their athletes recover faster and train harder. One of my primary tools will be the use of RestWise a monitoring system that uses physiological markers to help monitor the the athletes from any location that has internet access. I am looking forward to meeting everyone on the team this weekend in China.

Champion System, a leader in custom technical apparel, is proud to launch a new UCI Professional Continental Team registered in the People's Republic of China (PRC) in the 2012 season.

This 18-25 member team will be the first Asian-based UCI Professional Continental Team featuring Asia's best cyclists on an international roster. The team will be composed of top riders from China & Asia as well as experienced European & Anglo professionals.

One of the primary goals of the team is to allow Asia's top cyclists to compete at the highest level of the sport. Until now opportunities for Asian racers to compete in major international competitions have been rare. Champion System Pro Cycling Team will now pave the way. We are convinced Asian racers have the potential to be competitive in international premier races if given the opportunity.

Besides racing in the major UCI tours in Asia, the team will also compete in professional tours in Europe and the U.S. with the goal to develop Asian-based World and Olympic champions.

Ankle braces on Injury rates in Football Players

2011-12-31T09:58:00.000-05:00

The Effect of Lace-up Ankle Braces on Injury Rates in High School Football Players

Timothy A. McGuine, PhD, ATC (tmcguine@uwhealth.org)

University of Wisconsin-Madison, Madison, Wisconsin

Scott Hetzel, MS

University of Wisconsin-Madison, Madison, Wisconsin

John Wilson, MD, MS

University of Wisconsin-Madison, Madison, Wisconsin

Alison Brooks, MD, MPH

University of Wisconsin-Madison, Madison, Wisconsin

Abstract

Background: Although ankle injuries occur frequently in high school football players, no prospective studies have been performed to determine if wearing lace-up ankle braces will reduce the incidence and severity of ankle and other lower extremity injuries in these athletes.

Purpose: This study was conducted to determine if lace-up ankle braces reduce the incidence and severity of lower extremity injuries sustained by high school football players.

Design: Randomized controlled trial; Level of evidence, 1.

Methods: A total of 2081 players from 50 high schools were randomly assigned to a braced or control group. Braced group players wore lace-up ankle braces during the 2010 football season. Athletic trainers recorded brace compliance, athlete-exposures, and injuries. Cox proportional hazards models were utilized to compare injury rates between groups. Injury severity (days lost) was tested with Wilcoxon rank sum.

Results: The rate of acute ankle injury (per 1000 exposures) was 0.48 in the braced group compared with 1.12 in the control group (Cox hazard ratio [HR] = 0.39; 95% confidence interval [CI], 0.24-0.65; P < .001). The severity (median days lost) of acute ankle injuries was the same (5 days) in both groups (P = .985). The rate of acute knee injury was 0.70 in the braced group compared with 0.69 in the control group (HR = 0.92; 95% CI, 0.57-1.47; P = .721). There was no difference (P= .242) in the severity of knee injuries between the groups (controls = 11.5 days, braced = 17 days). The rate of other lower extremity injuries was 0.95 in the braced group and 1.32 in the control group (HR = 0.72; 95% CI, 0.48-1.09; P = .117), while the severity was similar in both groups (6 days vs 7 days; P = .295).

Conclusion: Players who used lace-up ankle braces had a lower incidence of acute ankle injuries but no difference in the incidence of acute knee or other lower extremity injuries. Braces did not reduce the severity of ankle, knee, or other lower extremity injuries.

2011-12-28T10:58:00.002-05:00

We are always looking for ways to determine the level of inflammation of an athlete as it relates to recovery. If the athlete is suffering from some type of pathology then inflammatory markers will help define the illness. When comes to recovery from various levels of training the jury is still out on that one. Take a look at this study:

Medicine & Science in Sports & Exercise:

January 2012 - Volume 44 - Issue 1 - p 50–56

doi: 10.1249/MSS.0b013e318229d2e9

Basic Sciences

Effect of Resistance, Endurance, and Concurrent Training on TNF-α, IL-6, and CRP

by LIBARDI, CLEITON AUGUSTO; DE SOUZA, GIOVANA VERGÍNIA; CAVAGLIERI, CLAUDIA REGINA; MADRUGA, VERA APARECIDA; CHACON-MIKAHIL, MARA PATRÍCIA TRAINA

Purpose: The aim of the present study was to evaluate the effects of 16 wk of resistance training (RT), endurance training (ET), and concurrent training (CT) on inflammatory markers, C-reactive protein (CRP), and functional capacity in sedentary middle-age men.

Methods: Healthy subjects were randomized into RT (n = 11), ET (n = 12), CT (n = 11), and a control group (n = 13). The subjects performed three weekly sessions lasting about 60 min for 16 wk. Maximal strength was tested in bench press and leg press. The peak oxygen uptake (V˙O2peak) was measured in an incremental exercise test. Plasma tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and CRP levels were determined by an enzyme-linked immunosorbent assay.

Results: Maximal strength was increased after 16 wk, with no differences between RT and CT. V˙O2peak increased in ET and CT comparing before and after training. There were no significant differences in TNF-α, IL-6, and CRP comparing before and after training.

Conclusions: Sixteen weeks of RT, ET, or CT in middle-age healthy men has not affected low and moderate IL-6, TNF-α, and CRP levels. CT performed in the same weekly frequency and session duration of ET and RT was effective in increasing both maximal strength and V˙O2peak, in addition to improvements in lipid profile.

Acute Effects of Verbal Feedback on Upper-Body Performance in Elite Athletes

2011-12-21T15:46:00.002-05:00

Journal of Strength & Conditioning Research:

December 2011 - Volume 25 - Issue 12 - pp 3282-3287

doi: 10.1519/JSC.0b013e3182133b8c

Original Research

Acute Effects of Verbal Feedback on Upper-Body Performance in Elite Athletes

Argus, Christos K; Gill, Nicholas D; Keogh, Justin WL; Hopkins, Will G

Abstract

Argus, CK, Gill, ND, Keogh, JWL, and Hopkins, WG. Acute effects of verbal feedback on upper-body performance in elite athletes. J Strength Cond Res 25(12): 3282–3287, 2011—Improved training quality has the potential to enhance training adaptations. Previous research suggests that receiving feedback improves single-effort maximal strength and power tasks, but whether quality of a training session with repeated efforts can be improved remains unclear. The purpose of this investigation was to determine the effects of verbal feedback on upper-body performance in a resistance training session consisting of multiple sets and repetitions in well-trained athletes. Nine elite rugby union athletes were assessed using the bench throw exercise on 4 separate occasions each separated by 7 days. Each athlete completed 2 sessions consisting of 3 sets of 4 repetitions of the bench throw with feedback provided after each repetition and 2 identical sessions where no feedback was provided after each repetition. When feedback was received, there was a small increase of 1.8% (90% confidence limits, ±2.7%) and 1.3% (±0.7%) in mean peak power and velocity when averaged over the 3 sets. When individual sets were compared, there was a tendency toward the improvements in mean peak power being greater in the second and third sets. These results indicate that providing verbal feedback produced acute improvements in upper-body power output of well-trained athletes. The benefits of feedback may be greatest in the latter sets of training and could improve training quality and result in greater long-term adaptation.

Which On-field Signs/Symptoms Predict Protracted Recovery From Sport-Related Concussion Among High School Football Players?

2011-12-20T20:22:00.000-05:00

Which On-field Signs/Symptoms Predict Protracted Recovery From Sport-Related Concussion Among High School Football Players?

+Author Affiliations

^†University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
^‡University of Pittsburgh Medical Center, Department of Orthopaedic Surgery, Sports Medicine Concussion Program, Pittsburgh, Pennsylvania
^§University of Pittsburgh Medical Center, Centers for Rehab Services, Pittsburgh, Pennsylvania
Investigation performed at University of Pittsburgh Medical Center, Center for Sports Medicine, Pittsburgh, Pennsylvania

↵* Brian C. Lau, MD, 3200 South Water Street, Pittsburgh, PA 15203 (e-mail:blau10@gmail.com).

Abstract

Background: There has been increasing attention and understanding of sport-related concussions. Recent studies show that neurocognitive testing and symptom clusters may predict protracted recovery in concussed athletes. On-field signs and symptoms have not been examined empirically as possible predictors of protracted recovery.

Purpose: This study was undertaken to determine which on-field signs and symptoms were predictive of a protracted (≥21 days) versus rapid (≤7 days) recovery after a sports-related concussion. On-field signs and symptoms included confusion, loss of consciousness, posttraumatic amnesia, retrograde amnesia, imbalance, dizziness, visual problems, personality changes, fatigue, sensitivity to light/noise, numbness, and vomiting.

Study Design: Cohort study (prognosis); Level of evidence, 2.

Methods: The sample included 107 male high school football athletes who completed computerized neurocognitive testing within an average 2.4 days after injury, and who were followed until returned to play as determined by neuropsychologists using international clinical concussion management guidelines. Athletes were then grouped into rapid (≤7 days, n = 62) or protracted (≥21 days, n = 36) recovery time groups. The presence of on-field signs and symptoms was determined at the time of injury by trained sports medicine professionals (ie, ATC [certified athletic trainer], team physician). A series of odds ratios with χ² analyses and subsequent logistic regression were used to determine which on-field signs and symptoms were associated with an increased risk for a protracted recovery.

Results: Dizziness at the time of injury was associated with a 6.34 odds ratio (95% confidence interval = 1.34-29.91, χ² = 5.44, P = .02) of a protracted recovery from concussion. Surprisingly, the remaining on-field signs and symptoms were not associated with an increased risk of protracted recovery in the current study.

Conclusion: Assessment of on-field dizziness may help identify high school athletes at risk for a protracted recovery. Such information will improve prognostic information and allow clinicians to manage and treat concussion more effectively in these at-risk athletes.

Keywords:

Am J Sports Med November 2011 vol. 39 no. 11 2311-2318

Prevalence of Septic Arthritis After Anterior Cruciate Ligament Reconstruction Among Professional Athletes

2011-12-17T09:17:00.002-05:00

Prevalence of Septic Arthritis After Anterior Cruciate Ligament Reconstruction Among Professional Athletes

+Author Affiliations

^†Centre Orthopédique Santy, Lyon, France
^‡Agence Régionale de Santé Rhône-Alpes, Annecy, France
^§Clinica Hilario Maldonado, Marilia, Brazil
Investigation performed at The Centre Orthopédique Santy, Lyon, France

↵* Bertrand Sonnery-Cottet, MD, Centre Orthopédique Santy, 24 Avenue Paul Santy, 69008 Lyon, France (e-mail: sonnerycottet@aol.com).

Abstract

Background: Septic arthritis of the knee after anterior cruciate ligament (ACL) reconstruction is a rare complication. Its prevalence and characteristics have never been reported among professional athletes.

Purpose: To report the prevalence and the characteristics of septic arthritis after ACL reconstruction in professional athletes and a general population of patients.

Study Design: Case control study; Level of evidence, 3.

Methods: A retrospective analysis of a consecutive series of 1957 patients who underwent an ACL reconstruction between 2003 and 2008 was performed; 88 patients were professional athletes. The patient demographics, the prevalence of infection, the involved organism, and the method of treatment were reviewed. Three potential risk factors for infection—level of sporting participation, indoor/outdoor sports, and the presence or not of a combined lateral tenodesis—were assessed using univariate and multivariate logistic regression analysis.

Results: The prevalence of septic arthritis was 0.37% in the nonprofessional group and 5.7% in the professional athlete population. Being a professional athlete (odds ratio [OR], 16.0; 95% confidence interval [CI], 3.9-59.8; P = .0001) or having a combined lateral tenodesis (OR, 4.8; 95% CI, 1.04-18.04; P = .02) was found to be significantly correlated with septic arthritis after ACL reconstruction. A significant correlation exists between being a professional athlete and having a combined lateral tenodesis (χ² = 16.7; P = 4 × 10⁻⁵), suggesting a potential confounding role is played by one of these variables. All the cases of infection in the professional athletes occurred in those who participated in outdoor sports, although this was not found to be statistically significant (P = .17).

Conclusion: Participation in professional sports and having a combined lateral tenodesis are risk factors for the development of infection after ACL reconstruction. We hypothesize that professional athletes may be part of a specific group of patients at higher risk of infection after ACL reconstruction.

Keywords:

Watch Dr. Rosa on Sports Talk show with Glenn Harris

2011-12-09T12:57:00.001-05:00

Dr. Rosa Will be on the Sports Talk tonight at 9:00 with Glenn Harris check it out!

WJLA/NewsChannel 8

Enhancing Jump Performance After Combined vs. Maximal Power, Heavy-Resistance, and Plyometric Training Alone

2011-12-02T09:53:00.001-05:00

Enhancing Jump Performance After Combined vs. Maximal Power, Heavy-Resistance, and Plyometric Training Alone

by de Villarreal, Eduardo Sáez Sáez; Izquierdo, Mikel; Gonzalez-Badillo, Juan J

Sáez Sáez de villarreal, E, Izquierdo, M, and Gonzalez-Badillo, JJ. Enhancing jump performance after combined vs. maximal power, heavy-resistance, and plyometric training alone. J Strength Cond Res 25(12): 3274–3281, 2011—

The purpose of this study was to examine the effects of 5 different stimuli on jumping ability and power production after 7 weeks of training. Sixty-five (47 men and 18 women) physical education students were randomly assigned to 5 experimental groups that performed: combination of all training methods (A); heavy-resistance training using full-squat exercise (i.e., 56–85% of 1 RM for 3–6 repetitions) (B); power-oriented strength training using a parallel-squat exercise (i.e., 100–130% of load that maximizes power output for 2–6 repetitions) (C); power-oriented strength training using a loaded countermovement jumping (i.e., 70–100% of load that maximizes power output for 2–5 repetitions; countermovement jump [CMJ]) (D); and plyometric jumping (E). The CMJ (cm), loaded CMJ (cm), maximum rate of force development (RFDmax) during early concentric phase of loaded CMJ (N·s−1) and power output during early concentric phase of loaded CMJ (watts) were measured before and after 7 weeks of training. Significant improvements in CMJ (from 7.8 to 13.2%) were observed in all groups.

Significantly greater increases in power output during loaded jumps were observed in A (10–13%) and D (8–12%) groups compared with in the other groups.

Significant increases in RFDmax were observed in A (20–30%), C (18–26%), and D (20–26%) groups. The results of this study provide evidence to suggest that if training program is designed and implemented correctly, both traditional slow velocity training and faster power-oriented strength training alone, or in combination with plyometric training, would provide a positive training stimulus to enhance jumping performance.

Journal of Strength & Conditioning Research:

December 2011 - Volume 25 - Issue 12 - pp 3274-3281

doi: 10.1519/JSC.0b013e3182163085

Do Compression Garments Enhance the Active Recovery Process after High-Intensity Running?

2011-11-30T12:37:00.001-05:00

Do Compression Garments Enhance the Active Recovery Process after High-Intensity Running?

by Lovell, Dale I; Mason, Dale G; Delphinus, Elias M; McLellan, Christopher P

Lovell, DI, Mason, DG, Delphinus, EM, and McLellan, CP. Do compression garments enhance the active recovery process after high-intensity running? J Strength Cond Res 25(12): 3264–3268, 2011—

This study examined the effect of wearing waist-to-ankle compression garments (CGs) on active recovery after moderate- and high-intensity submaximal treadmill running.

Twenty-five male semiprofessional rugby league players performed two 30-minute treadmill runs comprising of six 5-minute stages at 6 km·h−1, 10 km·h−1, approximately 85% V̇O2max, 6 km·h−1 as a recovery stage followed by approximately 85% V̇O2max and 6 km·h−1 wearing either CGs or regular running shorts in a randomized counterbalanced order with each person acting as his own control. All stages were followed by 30 seconds of rest during which a blood sample was collected to determine blood pH and blood lactate concentration [La−]. Expired gases and heart rate (HR) were measured during the submaximal treadmill tests to determine metabolic variables with the average of the last 2 minutes used for data analysis.

The HR and [La−] were lower (p ≤ 0.05) after the first and second 6 km·h−1 recovery bouts when wearing CGs compared with when wearing running shorts. The respiratory exchange ratio (RER) was higher and [La−] lower (p ≤ 0.05) after the 10 km·h−1 stage, and only RER was higher after both 85% V̇O2max stages when wearing CGs compared with when wearing running shorts.

There was no difference in blood pH at any exercise stage when wearing the CGs and running shorts. The results of this study indicate that the wearing of CGs may augment the active recovery process in reducing [La−] and HR after high-intensity exercise but not effect blood pH. The ability to reduce [La−] and HR has important consequences for many sports that are intermittent in nature and consist of repeated bouts of high-intensity exercise interspersed with periods of low-intensity exercise or recovery.

Elite golfers' kinematic sequence in full-swing and partial-swing shots

2011-11-18T09:08:00.001-05:00

Elite golfers' kinematic sequence in full-swing and partial-swing shots

Sports Biomechanics

Volume 9, Issue 4, 2010

Fredrik Tinmark^a^b^*, John Hellström^c, Kjartan Halvorsen^d^e &Alf Thorstensson^a^b

pages 236-244

Abstract

The aim of this study was to investigate whether kinematic proximal-to-distal sequencing (PDS) and speed-summation are common characteristics of both partial and full-swing shots in golf players of different skill levels and genders. A total of 45 golfers participated, 11 male tournament professionals, 21 male and 13 female elite amateurs. They performed partial shots with a wedge to targets at three submaximal distances, 40, 55 and 70 m, and full-swing shots with a 5 iron and a driver for maximal distance. Pelvis, upper torso and hand movements were recorded in 3D with an electromagnetic tracking system (Polhemus Liberty) at 240 Hz and the magnitude of the resultant angular velocity vector of each segment was computed.

The results showed a significant proximal-to-distal temporal relationship and a concomitant successive increase in maximum (peak) segment angular speed in every shot condition for both genders and levels of expertise. A proximal-to-distal utilization of interaction torques is indicated. Using a common PDS movement strategy in partial and full-swing golf shots appears beneficial from mechanical and control points of view and could serve the purpose of providing both high speed and accuracy.

Sport-Related Concussions in United States High Schools

2011-11-16T13:43:00.001-05:00

Assessment and Management of Sport-Related Concussions in United States High Schools

by Meehan, W. P., d'Hemecourt, P., Collins, C. L., Comstock, R. D.

Background: Little existing data describe which medical professionals and which medical studies are used to assess sport-related concussions in high school athletes.

Purpose: To describe the medical providers and medical studies used when assessing sport-related concussions. To determine the effects of medical provider type on timing of return to play, frequency of imaging, and frequency of neuropsychological testing.

Study Design: Descriptive epidemiology study.

Methods: All concussions recorded by the High School Reporting Information Online (HS RIO) injury surveillance system during the 2009 to 2010 academic year were included. ² analyses were conducted for categorical variables. Fisher exact test was used for nonparametric data. Logistic regression analyses were used when adjusting for potential confounders. Statistical significance was considered for P < .05.

Results: The HS RIO recorded 1056 sport-related concussions, representing 14.6% of all injuries. Most (94.4%) concussions were assessed by athletic trainers (ATs), 58.8% by a primary care physician. Few concussions were managed by specialists. The assessment of 21.2% included computed tomography. Computerized neuropsychological testing was used for 41.2%. For 50.1%, a physician decided when to return the athlete to play; for 46.2%, the decision was made by an AT. After adjusting for potential confounders, no associations between timing of return to play and the type of provider (physician vs AT) deciding to return the athlete to play were found.

Conclusion: Concussions account for nearly 15% of all sport-related injuries in high school athletes. The timing of return to play after a sport-related concussion is similar regardless of whether the decision to return the athlete to play is made by a physician or an AT. When a medical doctor is involved, most concussions are assessed by primary care physicians as opposed to subspecialists. Computed tomography is obtained during the assessment of 1 of every 5 concussions occurring in high school athletes.

Am J Sports Med November 2011 vol. 39 no. 11 2304-2310

Two Federal Studies Undertaken by the University of South Florida Point to Chiropractic Engagement to Aid in Injury Prevention

2011-11-15T08:57:00.001-05:00

Two Federal Studies Undertaken by the University of South Florida Point to Chiropractic Engagement to Aid in Injury Prevention

The Federal government has awarded the University of South Florida (USF), School of Physical Therapy & Rehabilitation Sciences $1.42 million to research the effectiveness of specific exercise interventions for reducing the risk of back injuries amongst some of the nation’s most vulnerable — firefighters and military personnel.

“Back injury is a primary condition that dramatically affects our nation’s heroes — cited as a top reason for disability and early retirement amongst firefighters, and a top non-combat reason for service men and women being displaced from active duty,” says John Mayer, D.C., Ph.D, associate professor and Lincoln College Endowed Chair in Biomechanical and Chiropractic Research at USF, and lead researcher in the $715,000 Department of Defense (DOD) and $701,000 Federal Emergency Management Agency (FEMA) studies. “These studies will be the first to be led by a Doctor of Chiropractic at a major university that will attempt to identify the preventive outcomes of applying specific exercise interventions amongst firefighters and soldiers.”

Each study will be conducted in several phases carried out over the next few years.

With research already in progress, the FEMA study will include 106 participants headquartered at a Tampa, Fla., fire department. Participants will undergo 24 weeks of bi-weekly supervised training sessions consisting of particular stability and resistance exercises with the goal of improving back muscular endurance — commonly documented as a direct link to back pain.

Expected to begin in spring 2012, the DOD study will include 600 active duty US Army soldiers and will provide a perspective that complements traditional directions of treatment-focus. Instead, the study will assess preventive methods by implementing and evaluating targeted high intensity exercise interventions designed to strengthen the back extensor muscles.

“Chiropractic engagement with regards to specific exercise interventions and their potential to prevent back conditions has continued to gain momentum,” says Mayer. “Federal agencies are now recognizing the skills of Doctors of Chiropractic to address prevention and treatment of back injury for our national heroes.”

To learn more about either study, visit www.health.usf.edu.

Functional Knee Brace after Anterior Cruciate Ligament Reconstruction not recommended.

2011-11-14T09:13:00.001-05:00

I have often expressed my personal dislike of the over use of bracing in general and feel that in most cases it is over utilized. This study supports my previous statements that functional knee brace's are not helpful and we should focus on Rehabilitation not bracing.

A Randomized Controlled Trial Comparing the Effectiveness of Functional Knee Brace and Neoprene Sleeve Use After Anterior Cruciate Ligament Reconstruction

Trevor B. Birmingham, PhD†,‡,*,

Dianne M. Bryant, PhD†,‡,

J. Robert Giffin, MD, FRCS(C)†,‡,

Robert B. Litchfield, MD, FRCS(C)†,‡,

John F. Kramer, PhD‡,

Allan Donner, PhD‡, and

Peter J. Fowler, MD, FRCS(C)†,‡

+Author Affiliations

From the ^†Fowler Kennedy Sport Medicine Clinic, and the ^‡University of Western Ontario, London Ontario, Canada

Address correspondence to Trevor B. Birmingham, PhD, School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada N6G 1H1 (e-mail: tbirming@uwo.ca).

Abstract

Background: Despite a lack of evidence for their effectiveness, functional knee braces are commonly prescribed to patients after anterior cruciate ligament (ACL) reconstruction.

Purpose: This trial was conducted to compare postoperative outcomes in patients using an ACL functional knee brace and patients using a neoprene knee sleeve.

Hypothesis: Patients using a brace will have superior outcomes than those using a sleeve.

Study Design: Randomized controlled clinical trial; Level of evidence, 1.

Methods: One hundred fifty patients were randomized to receive a brace (n = 76) or neoprene sleeve (n = 74) at their 6-week postoperative visit after primary ACL reconstruction with hamstring autograft. Patients were assessed preoperatively, then 6 weeks and 6, 12, and 24 months postoperatively. Outcome measures included disease-specific quality of life (Anterior Cruciate Ligament–Quality of Life [ACL-QOL] Questionnaire), anterior tibial translation (KT-1000 arthrometer side-to-side difference), the single-limb forward hop test (limb symmetry index), and Tegner Activity Scale. Outcomes at 1 and 2 years were compared after adjusting for baseline scores. Subjective ratings of how patients felt while using the brace/sleeve were also collected for descriptive purposes using a questionnaire. Four a priori directional subgroup hypotheses were evaluated using tests for interactions.

Results: There were no significant differences between brace (n = 62) and sleeve (n = 65) groups for any of the outcomes at 1- and 2-year follow-ups. Adjusted mean differences at 2 years were as follows: −0.94 (95% confidence interval [CI], −7.52 to 5.64) for the ACL-QOL Questionnaire, −0.10 mm (95% CI, −0.99 to 0.81) for KT-1000 arthrometer side-to-side difference, −0.87% (95% CI, −8.89 to 7.12) for hop limb symmetry index, and −0.05 (95% CI, −0.72 to 0.62) for the Tegner Activity Scale. Subjective ratings of confidence in the knee provided by the brace/sleeve were higher for the brace group than the sleeve group. Subgroup findings were minimal. Adverse events were few and similar between groups.

Conclusions: A functional knee brace does not result in superior outcomes compared with a neoprene sleeve after ACL reconstruction. Current evidence does not support the recommendation of using an ACL functional knee brace after ACL reconstruction.

Keywords:

anterior cruciate ligament (ACL) reconstruction

functional knee brace

neoprene sleeve, randomized clinical trial (RCT)

Footnotes

Blood Donation, Recovery and Peak Aerobic Power.

2011-11-09T14:08:00.002-05:00

Interesting little study!

Time Course for Recovery of Peak Aerobic Power After Blood Donation

by Judd, Tyler B; Cornish, Stephen M; Barss, Trevor S; Oroz, Irina; Chilibeck, Philip D

Judd, TB, Cornish, SM, Barss, TS, Oroz, I, and Chilibeck, PD. Time course for recovery of peak aerobic power after blood donation. J Strength Cond Res 25(11): 3035–3038, 2011—

Peak aerobic power (V̇O2peak) is decreased after blood donation, but the time course for full recovery is unknown. We measured V̇O2peak and exercise time to fatigue before and weekly for 4 weeks after 450-ml blood donation at a blood donor clinic, to determine the time course of recovery. Twelve moderately active individuals (2 women, 10 men; 24.3 ± 5.2 years) of average aerobic fitness (based on their V̇O2peak relative to normative values) completed V̇O2peak exercise tests before donation, the day after donation, and at weekly intervals for 4 weeks after donation. V̇O2peak was determined by an incremental exercise test on a cycle ergometer. At baseline, mean absolute and relative V̇O2peak values were 4.06 ± 0.92 L·min−1 and 46.6 ± 7.0 ml·kg−1·min−1, respectively. V̇O2peak was significantly decreased on day 1 (3.85 ± 0.89 L·min−1; 44.0 ± 6.5 ml·kg−1·min−1) and during week 2 (3.91 ± 0.97 L·min−1; 44.5 ± 7.2 ml·kg−1·min−1) after blood donation (p < 0.05), and recovered at week 3 after donation. Time to fatigue and peak heart rate were not significantly affected by blood donation.

We conclude that blood donation causes a significant decrease in V̇O2peak for between 2 and 3 weeks. The practical application of this study is that aerobic power in people of average fitness will be decreased, up to 3 weeks after donating blood. Despite this, there is no effect of blood donation on performance as measured by time to fatigue during an incremental test on a cycle ergometer.

NFL and Hamstring injuries why so many this year?

2011-11-07T10:00:00.001-05:00

Why so many Hamstring injuries in NFL this Year? Most of these types of injuries occur in players that are at high speed positions and during the the short preseason. Now if you take away access to proper training during the off season by the trainers on their teams and sprinkle in almost no off season preparation and a shorted preseason you have a recipe for disaster. I would also add that the injury rate has increased overall this season compared to previous season for the very same reason. The body does not like it when it is rushed in its development. For those of you that have heard me lecture on this topic you are familiar with the concept that it take a greater amount of time for ligaments and tendon insertions to increase in tensile strength then for muscles to gain in power and strength. So if this process is rushed you will see that either the tendon or ligaments begin to fail with micro tears that can develop into more serious injuries. This study was published in April of this year take a look!

Hamstring Muscle Strains in Professional Football Players

A 10-Year Review

^*Peak Performance Project, Santa Barbara, California
^†Department of Orthopaedic Surgery, Children’s Hospital Boston, Harvard Medical School, Boston, Massachusetts
^‡Graduate Athletic Training Program, Michigan State University, East Lansing, Michigan
Investigation performed at Peak Performance Project, Santa Barbara, California

§↵Charles D. Kenyon, Peak Performance Project, 110 Santa Barbara Street, Santa Barbara, CA 93101 (e-mail: charlie.kenyon@gmail.com).

Abstract

Background: Investigations into hamstring strain injuries at the elite level exist in sports such as Australian Rules football, rugby, and soccer, but no large-scale study exists on the incidence and circumstances surrounding these injuries in the National Football League (NFL).

Hypothesis: Injury rates will vary between different player positions, times in the season, and across different playing situations.

Study Design: Descriptive epidemiology study.

Methods: Between 1989 and 1998, injury data were prospectively collected by athletic trainers for every NFL team and recorded in the NFL’s Injury Surveillance System. Data collected included team, date of injury, activity the player was engaged in at the time of injury, injury severity, position played, mechanism of injury, and history of previous injury. Injury rates were reported in injuries per athlete-exposure (A-E). An athlete-exposure was defined as 1 athlete participating in either 1 practice or 1 game.

Results: Over the 10-year study period 1716 hamstring strains were reported for an injury rate (IR) of 0.77 per 1000 A-E. More than half (51.3%) of hamstring strains occurred during the 7-week preseason. The preseason practice IR was significantly elevated compared with the regular-season practice IR (0.82/1000 A-E and 0.18/1000 A-E, respectively). The most commonly injured positions were the defensive secondary, accounting for 23.1% of the injuries; the wide receivers, accounting for 20.8%; and special teams, constituting 13.0% of the injuries in the study.

Conclusion: Hamstring strains are a considerable cause of disability in football, with the majority of injuries occurring during the short preseason. In particular, the speed position players, such as the wide receivers and defensive secondary, as well as players on the special teams units, are at elevated risk for injury. These positions and situations with a higher risk of injury provide foci for preventative interventions.

Keywords:

Am J Sports Med April 2011vol. 39 no. 4 843-850
www.recoverydoc.net

Aging and Running Economy Whats happens?

2011-11-04T06:10:00.000-04:00

Aging and Factors Related to Running Economy

Quinn, Timothy J1; Manley, Michelle J1; Aziz, Jason2; Padham, Jamie L3; MacKenzie, Allison M4

Abstract

Quinn, TJ, Manley, MJ, Aziz, J, Padham, JL, and MacKenzie, AM. Aging and factors related to running economy. J Strength Cond Res 25(11): 2971–2979, 2011—

The purpose of this study was to investigate the relationship that age has on factors affecting running economy (RE) in competitive distance runners. Fifty-one male and female subelite distance runners (Young [Y]: 18–39 years [n = 18]; Master [M]: 40–59 years [n = 22]; and Older [O]: 60–older [n = 11]) were measured for RE, step rate, lactate threshold (LT), V̇O₂max, muscle strength and endurance, flexibility, power, and body composition. An RE test was conducted at 4 different velocities (161, 188, 215, and 241 m·min⁻¹), with subjects running for 5 minutes at each velocity. The steady-state V̇O₂ during the last minute of each stage was recorded and plotted vs. speed, and a regression equation was formulated.

A 1 × 3 analysis of variance revealed no differences in the slopes of the RE regression lines among age groups (y = 0.1827x − 0.2974; R² = 0.9511 [Y]; y = 0.1988x − 1.0416; R² = 0.9697 [M]; y = 0.1727x + 3.0252; R² = 0.9618 [O]). The V̇O₂max was significantly lower in the O group compared to in the Y and M groups (Y = 64.1 ± 3.2; M = 56.8 ± 2.7; O = 44.4 ± 1.7 mlO₂·kg⁻¹·min⁻¹). The maximal heart rate and velocity @ LT were significantly different among all age groups (Y = 197 ± 4; M = 183 ± 2; O = 170 ± 6 b·min⁻¹ and Y = 289.7 ± 27.0; M = 251.5 ± 32.9; O = 212.3 ± 24.6 m·min⁻¹, respectively). The V̇O₂ @ LT was significantly lower in the O group compared to in the Y and M groups (Y = 50.3 ± 2.0; M = 48.8 ± 2.9; O = 34.9 ± 3.2 mlO₂·kg⁻¹·min⁻¹). The O group was significantly lower than in the Y and M groups in flexibility, power, and upper body strength. Multiple regression analyses showed that strength and power were significantly related to running velocity.

The results from this cross-sectional analysis suggest that age-related declines in running performance are associated with declines in maximal and submaximal cardiorespiratory variables and declines in strength and power, not because of declines in running economy.

Baseball Pitching injuries: Dont forget about the Latissimus Dorsi and Teres Major!

2011-11-02T17:34:00.003-04:00

Management and Outcomes of Latissimus Dorsi and Teres Major Injuries in Professional Baseball Pitchers

by Nagda, S. H., Cohen, S. B., Noonan, T. J., Raasch, W. G., Ciccotti, M. G., Yocum, L. A.

Background: Very little data exist on latissimus dorsi (LD) and teres major (TM) injuries in professional baseball pitchers.

Purpose: This review was undertaken to report on the management and outcomes of baseball pitchers with injury to 1 or both of these muscles.

Study Design: Case series; Level of evidence, 4.

Methods: A retrospective review of 16 professional baseball pitchers diagnosed and treated for an LD and/or TM tear between 2002 and 2008 was performed. Magnetic resonance imaging confirmed the diagnosis in all cases. The mean age was 28.1 years. All were treated nonoperatively with rest, rehabilitation, and return to pitching after a throwing program. The injuries included tendon avulsions in 6 athletes and strains in 10. Length of disabled time, return to prior level of pitching, and recurrences were noted.

Results: Fifteen of 16 pitchers (94%) returned to the same or higher level of play. The mean time to throwing was 35.6 days. Mean time to pitching was 61.9 days. Nine of 16 injuries (56%) were season-ending. Mean total time lost for athletes returning the same season was 82.4 days. Two of 16 pitchers (13%) sustained recurrent injuries. Prior shoulder and elbow injuries were noted in 75% (12 of 16).

Conclusion: Injury of the LD and/or TM can occur in pitchers. Nonoperative treatment is successful in allowing a return to high-level pitching.

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Stretching and Jump performance whats the best method? New Study takes a look.

2011-11-01T08:48:00.000-04:00

The Acute Effects of Different Stretching Exercises on Jump Performance

by Pacheco, Laura; Balius, Ramon; Aliste, Luisa; Pujol, Montse; Pedret, Carles

Pacheco, L, Balius, R, Aliste, L, Pujol, M, and Pedret, C. The acute effects of different stretching exercises on jump performance. J Strength Cond Res 25(11): 2991–2998, 2011—

The purpose of this study was to demonstrate the short-term effects of different stretching exercises during the warm-up period on the lower limbs.

A controlled, crossover clinical study involving 49 volunteers (14 women and 35 men; mean age: 20.4 years) enrolled in a “physical and sporting activities monitor” program. The explosive force was assessed using the Bosco test. The protocol was as follows:

The test involved a (pre) jump test, general warm-up, intervention and (post) jump test. Each volunteer was subjected to each of the 5 interventions (no stretching [NS] and stretching: static passive stretching [P]; proprioceptive neuromuscular facilitation [PNF] techniques; static active stretching in passive tension [PT]; static active stretching in active tension [AT]) in a random order. The jump test was used to assess the squat jump, countermovement jump (CMJ), elasticity index (EI), and drop jump.

An intragroup statistical analysis was performed before and after each intervention to compare the differences between the different stretching exercises. An intergroup analysis was also performed. Significant differences (p < 0.05) were found between all variables for the interventions “P,” “PNF,” and “TA” in the intragroup analysis, with each value being higher in the postjump test. Only the “P” intervention showed a significant difference (p = 0.046) for “EI,” with the postvalue being lower. Likewise, significant differences (p < 0.05) were observed for the “CMJ” measurements during the intergroup analysis, especially between “NS” and the interventions “P,” “PNF,” “AT,” and “PT,” with each value, particularly that for “AT,” being higher after stretching.

The results of this study suggest that static active stretching in AT can be recommended during the warm-up for explosive force disciplines.

NFL Patellar Tendon Ruptures new study!!

2011-10-31T17:03:00.001-04:00

Take a look at this study that was published in the latest issue of The American Journal of Sports Medicine about Patellar Tendon Ruptures. I suspect that if the serial use of MSK ultrasound which easy to use and visualizes the Patellar tendon very well and can also be Dynamically acessed would help decrease the incident of patellar tendon ruptures. Let me know what you think!

Patellar Tendon Ruptures in National Football League Players

by Boublik, M., Schlegel, T., Koonce, R., Genuario, J., Lind, C., Hamming, D.

Background: Although knee injuries are common among professional football players, ruptures of the patellar tendon are relatively rare. Predisposing factors, mechanisms of injury, treatment guidelines, and recovery expectations are not well established in high-level athletes.
Hypothesis: Professional football players with isolated rupture of the patellar tendon treated with timely surgical repair will return to their sport.
Study Design: Case series; Level of evidence, 4.
Methods: Twenty-four ruptures of the patellar tendon in 22 National Football League (NFL) players were identified from 1994 through 2004. Team physicians retrospectively reviewed training room and clinic records, operative notes, and imaging studies for each of these players. Player game statistics and draft status were analyzed to identify return to play predictors. A successful outcome was defined as participating in 1 regular-season NFL game.
Results: Eleven of the 24 injuries had antecedent symptoms. The most common mechanism of injury was an eccentric overload to a contracting extensor mechanism. Physical examination demonstrated a palpable defect in all players. Twenty-two were complete ruptures, and 2 were partial injuries. Three of the 24 cases had a concomitant anterior cruciate ligament (ACL) injury. In 19 of the 24 injuries, the player returned to participate in at least 1 game in the NFL. Players who returned were drafted, on average, in the fourth round, while those who failed to return to play were drafted, on average, in the sixth round. Of those players who returned to play, the average number of games played was 45.4, with a range of 1 to 142 games.
Conclusion: Patellar tendon ruptures can occur in otherwise healthy professional football players without antecedent symptoms or predisposing factors. The most common mechanism of injury is eccentric overload. Close attention should be paid to stability examination of the knee given the not uncommon occurrence of concomitant ACL injury. Although this is usually a season-ending injury when it occurs in isolation, acute surgical repair generally produces good functional results and allows for return to play the following season. Players chosen earlier in the draft are more likely to return to play.

Ultrasound-Guided Sclerosing Treatment in Patients With Patellar Tendinopathy (Jumper's Knee): 44-Month Follow-up

2011-10-29T14:56:00.001-04:00

Ultrasound-Guided Sclerosing Treatment in Patients With Patellar Tendinopathy (Jumper's Knee): 44-Month Follow-up
by Hoksrud, A., Bahr, R. on Oct 28, 2011 8:37 PM
Background: A randomized controlled study has shown good clinical results after treatment with sclerosing injections into the area with neovessels in patients with patellar tendinopathy, but no study has investigated medium- or long-term outcomes.

Purpose: This study investigates the effect of sclerosing treatment 44 months (range, 42-47 months) after start of treatment.

Study Design: Case series; Level of evidence, 4.

Methods: Patients with a diagnosis of jumper’s knee and neovascularization corresponding to the painful area were recruited and treated with ultrasound-guided sclerosing injections using polidocanol. Primary outcome was Victorian Institute of Sport Assessment (VISA) score, which was recorded before the start of treatment, after 12 months, and 44 months after the start of the study period.

Results: Twelve of the 29 patients (14 tendons) who were followed up at 44 months had undergone arthroscopic surgery after sclerosing treatment, either to the patellar tendon (n = 6) or for other intra-articular lesions (n = 8). For patients who did not receive additional treatment after the sclerosing injections (n = 23 tendons), VISA score was 55 (range, 28-71) at baseline and 81 (range, 39-100) at 12-month follow-up (P < .001 vs baseline).Their VISA score at 44 months’ follow-up was 89 (range, 73-100; P = .047 vs 12 months). For patients who went through arthroscopic tendon surgery, VISA score was 53 (range, 39-71) at baseline and 71 before surgery (range, 48-98; P = .14 vs baseline). Their VISA score at 44 months was 91 (range, 76-100; P = .0.16 vs 12 months; P = .005 vs baseline). For patients who went through non–tendon surgery, VISA score was 45 (range, 15-69) at baseline and 57 (range, 32-95) before surgery (P = .29 vs baseline). Their VISA score at 44 months was 92 (range, 72-100; P = .006 vs before surgery; P < .001 vs baseline).

Conclusion: Sclerosing treatment with polidocanol was effective for the majority of the patients. Nevertheless, one-third elected to seek additional treatment through arthroscopic surgery during the 44-month follow-up period.

When do Rotator Cuff Repairs Fail? New study

2011-10-28T11:26:00.001-04:00

When Do Rotator Cuff Repairs Fail? Serial Ultrasound Examination After Arthroscopic Repair of Large and Massive Rotator Cuff Tears

by Miller, B. S., Downie, B. K., Kohen, R. B., Kijek, T., Lesniak, B., Jacobson, J. A., Hughes, R. E., Carpenter, J. E. on Oct 8, 2011 2:36 AM

Background: Despite advances in arthroscopic repair of rotator cuff tears, recurrent tears after repair of large and massive tears remain a significant clinical problem. The primary objective of this study was to define the timing of structural failure of surgically repaired large and massive rotator cuff tears by serial imaging with ultrasound. The secondary objective of this study was to investigate the association between recurrent tears and clinical outcome after rotator cuff repair.

Hypothesis: Recurrent tear after arthroscopic repair of large rotator cuff tears is more likely to occur late (>3 months) in the postoperative period and will be associated with inferior clinical outcome scores.

Study Design: Cohort study; Level of evidence, 3.

Methods: Twenty-two consecutive patients with large (>3 cm) rotator cuff tears underwent arthroscopic repair with a standardized technique. Serial ultrasound examinations were performed at 2 days, 2 weeks, 6 weeks, 3 months, 6 months, 12 months, and 24 months after surgery. Western Ontario Rotator Cuff (WORC) Index scores were also collected at these time points.

Results: Nine (41%) of the 22 arthroscopically repaired rotator cuff tears demonstrated recurrent tears. Seven of the 9 retears occurred within 3 months of surgery, and the other 2 occurred between 3 and 6 months. No retears occurred after 6 months. At 24-month follow-up, WORC scores favoring intact rotator cuffs over retears approached statistical significance (mean WORC intact 123.9 vs retear 659.8; P = .07).

Conclusion: Recurrent rotator cuff tears are not uncommon after arthroscopic repair of large and massive tears. These recurrent tears appear to occur more frequently in the early postoperative period (within the first 3 months) and are associated with inferior clinical outcomes.

Cold water immersion, Contrast baths, and Recovery between workouts shows some Promise.

2011-10-26T14:36:00.000-04:00

Sprint Cycling Performance Is Maintained with Short-Term Contrast Water Immersion

CRAMPTON, DAVID1; DONNE, BERNARD1; EGANA, MIKEL1; WARMINGTON, STUART A.2

Abstract

Purpose: Given the widespread use of water immersion during recovery from exercise, we aimed to investigate the effect of contrast water immersion on recovery of sprint cycling performance, HR and, blood lactate.

Methods: Two groups completed high-intensity sprint exercise before and after a 30-min randomized recovery. The Wingate group (n = 8) performed 3 × 30-s Wingate tests (4-min rest periods). The repeated intermittent sprint group (n = 8) cycled for alternating 30-s periods at 40% of predetermined maximum power and 120% maximum power, until exhaustion. Both groups completed three trials using a different recovery treatment for each trial (balanced randomized application). Recovery treatments were passive rest, 1:1 contrast water immersion (2.5 min of cold (8°C) to 2.5 min of hot (40°C)), and 1:4 contrast water immersion (1 min of cold to 4 min of hot). Blood lactate and HR were recorded throughout, and peak power and total work for pre- and postrecovery Wingate performance and exercise time and total work for repeated sprinting were recorded.

Results: Recovery of Wingate peak power was 8% greater after 1:4 contrast water immersion than after passive rest, whereas both contrast water immersion ratios provided a greater recovery of exercise time (∼10%) and total work (∼14%) for repeated sprinting than for passive rest. Blood lactate was similar between trials. Compared with passive rest, HR initially declined more slowly during contrast water immersion but increased with each transition to a cold immersion phase.

Conclusions: These data support contrast water immersion being effective in maintaining performance during a short-term recovery from sprint exercise. This effect needs further investigation but is likely explained by cardiovascular mechanisms, shown here by an elevation in HR upon each cold immersion.

Medicine & Science in Sports & Exercise:

November 2011 - Volume 43 - Issue 11 - pp 2180-2188

doi: 10.1249/MSS.0b013e31821d06d9

Do Lace-up Ankle Braces on Basketball Players Work?

2011-10-25T09:45:00.000-04:00

The Effect of Lace-up Ankle Braces on Injury Rates in High School Basketball Players

Timothy A. McGuine, PhD, ATC*†,

Alison Brooks, MD† and

Scott Hetzel, MS†

+Author Affiliations

^†University of Wisconsin-Madison, Madison, Wisconsin
Investigation performed at the University of Wisconsin, Madison, Wisconsin

↵* Timothy A. McGuine, PhD, ATC, UW Health Sports Medicine Center, 621 Science Drive, Madison, WI 53711 (e-mail: tmcguine@uwhealth.org).

Presented at the 37th annual meeting of the AOSSM, San Diego, California, July 2011.

Abstract

Background: Ankle injuries are the most common injury in basketball players. However, no prospective studies have been performed to determine if wearing lace-up ankle braces will reduce the incidence of ankle injuries in high school athletes.

Purpose: This trial was undertaken to determine if lace-up ankle braces reduce the incidence and severity of acute first-time and recurrent ankle injuries sustained by high school basketball players.

Design: Randomized controlled trial; Level of evidence, 1.

Methods: A total of 1460 male and female basketball players from 46 high schools were randomly assigned to a braced or control group. The braced group players wore lace-up ankle braces during the 2009-2010 basketball season. Athletic trainers recorded brace compliance, athlete exposures, and injuries. Cox proportional hazards models (adjusted for demographic covariates), accounting for intracluster correlation, were utilized to compare time to first acute ankle injury between groups. Injury severity (days lost) was tested with the Wilcoxon rank-sum test.

Results: The rate of acute ankle injury (per 1000 exposures) was 0.47 in the braced group and 1.41 in the control group (Cox hazard ratio [HR] 0.32; 95% confidence interval [CI] 0.20, 0.52; P < .001). The median severity of acute ankle injuries was similar (P = .23) in the braced (6 days) and control group (7 days). For players with a previous ankle injury, the incidence of acute ankle injury was 0.83 in the braced group and 1.79 in the control group (Cox HR 0.39; 95% CI 0.17, 0.90; P = .028). For players who did not report a previous ankle injury, the incidence of acute ankle injury was 0.40 in the braced group and 1.35 in the control group (Cox HR 0.30; 95% CI 0.17, 0.52, P < .001).

Conclusion: Use of lace-up ankle braces reduced the incidence but not the severity of acute ankle injuries in male and female high school basketball athletes both with and without a previous history of an ankle injury.