December 2019 Sports Medicine Journal Roundup
The American Journal of Sports Medicine (Dec 2019)
ACLR does not necessarily enable a return to preinjury sports participation. By returning to pivoting sports after ACLR, athletes are also facing a high risk of contralateral ACL injuries.
A single session of gait retraining using a 10% increase in step rate resulted in significant improvements in running kinematics, pain, and function in runners with PFP.
These improvements were maintained at 3-month follow-up.
Both early and delayed anatomic surgical repair of partial proximal hamstring avulsions leads to successful functional outcomes, a high rate of return to athletic activity, and low complication rates at the 6.5-year follow-up.
Nonoperative treatments should first be attempted.
The rate of RTS among competitive athletes after bilateral hip arthroscopy was similar to the square of published RTS rates after unilateral hip arthroscopy. Both those who returned to play and those who did not showed significant improvement in PROs after surgery.
However, those who returned to sports achieved significantly higher scores in all outcome measures.
Additionally, patients returning to sports showed a significantly higher rate of attaining the MCID and PASS scores for the HOS-SSS.
McGuine, T. A., Pfaller, A., Kliethermes, S., Schwarz, A., Hetzel, S., Hammer, E., & Broglio, S. (2019). The Effect of Sport-Related Concussion Injuries on Concussion Symptoms and Health-Related Quality of Life in Male and Female Adolescent Athletes: A Prospective Study. The American Journal of Sports Medicine, 47(14), 3514–3520. https://doi.org/10.1177/0363546519880175
After an SRC, high school athletes reported initial disablement (increased symptoms and lower HRQoL) through their RTP.
However, after RTP, no similar disablement was detected through 12 months after injury.
Mouarbes, D., Menetrey, J., Marot, V., Courtot, L., Berard, E., & Cavaignac, E. (2019). Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis of Outcomes for Quadriceps Tendon Autograft Versus Bone–Patellar Tendon–Bone and Hamstring-Tendon Autografts. The American Journal of Sports Medicine, 47(14), 3531–3540. https://doi.org/10.1177/0363546518825340
Quad tendon (QT) autograft had comparable clinical and functional outcomes and graft survival rate compared with bone–patellar tendon–bone (BPTB) and hamstring tendon (HT) autografts.
However, QT autograft showed significantly less harvest site pain compared with BPTB autograft and better functional outcome scores compared with HT autograft.
Guerra, E., Previtali, D., Tamborini, S., Filardo, G., Zaffagnini, S., & Candrian, C. (2019). Midshaft Clavicle Fractures: Surgery Provides Better Results as Compared With Nonoperative Treatment: A Meta-analysis. The American Journal of Sports Medicine, 47(14), 3541–3551. https://doi.org/10.1177/0363546519826961
Surgical treatment of MCFs significantly reduces the nonunion rate and shortens the time to union as compared with the nonoperative approach and, despite a slightly higher incidence of complications, leads to better shoulder functional scores at short- and long-term follow-up.
Patients sustaining a major knee injury have a substantially increased risk of developing knee OA, highlighting the importance of knee injury prevention programmes and secondary prevention strategies to prevent or delay knee OA development.
Exercise interventions can result in clinically meaningful blood pressure reductions, particularly if initiated early and alongside education.
Sports Medicine (December 2019)
Based on current literature, balance training and COD technique modification are the most effective training modalities for reducing knee joint loading (small to moderate effect sizes).
One study reported dynamic core stability training was effective in reducing knee joint loads, but further research is needed to definitively confirm the efficacy of this method.
Perturbation-enhanced plyometric training, the F-MARC 11 + soccer specific warm-up, Oslo Neuromuscular warm-up, and resistance training are ineffective training modalities to reduce COD knee joint loads.
Conflicting findings have been observed for the Core-Pac and mixed training program.
High-level youth players lose large portions of the seasonal development to injury, with players seemingly suffering long absences from training and matches, consequently affecting health and well-being and possibly burdening club/parental finances and healthcare systems.
Physical exercise training (PET) effects on physical fitness in healthy workers are moderated by age, specifically cardiorespiratory fitness and occupation type (muscular endurance).
Further, independently computed subgroup analyses indicated that the training period of the PET programs may play an important role in improving CRF in workers.
Pooled evidence demonstrates greater improvements in VO2max in healthy men compared with women in response to a given dose of endurance training, suggesting the presence of sexual dimorphism in the trainability of aerobic capacity.
Sports Health Journal (November / December 2019)
We do not recommend the assessment of head impulse function in adolescents with SRC unless more definitive signs of peripheral vestibular injury are present.
We recommend using the VOMS to assess symptoms of suspected SRC injury in adolescents.
An understanding of common injury types and mechanisms according to age and level of play aids the clinician in diagnosis and management.
This information can also guide preventative strategies in the areas of education, coaching, rule enforcement, rule modifications, equipment improvement, and sportsmanship.
Arthroscopic SLAP repair is associated with a fair return to sport, with 69.6% of individuals undergoing arthroscopic SLAP repair returning to sport.
SLAP repair in pitchers has significantly decreased return to sport in comparison with nonpitching athletes.
Athletes on average return to sport within 9 months postoperatively.
The risk for post mononucleosis splenic injuries remains elevated longer than current guidelines suggest.
Restricting activity for 31 days after mononucleosis symptom onset may reduce the risk of splenic injury.
Current Sports Medicine Reports (December 2019)
Treatment of athletes who encounter a venous thromboembolism (VTE) or have a bleeding disorder require appropriate care and management to minimize morbidity and mortality. Incidence of clotting and bleeding disorders in athletes are the same as the general population; however, athletes are susceptible to acquired thrombogenic risk factors
In conclusion, the study shows a specific fatigability resistance profile consisting of an early decrease of eccentric hamstring performance compared with the quadriceps profile. In addition, we confirm that physiological consequences are important during strenuous isokinetic exercises but eccentric exercise produces less stress on the cardiovascular and metabolic systems than does concentric exercise.
Clinical practice guidelines are not definitive in regard to what classifies a patient as having hypothyroidism.
Thyroid-stimulating hormone and free T4 are recommended to screen for thyroid disease