July 2018 Journal Review Roundup

Primary Care Sports Medicine Journal Roundup - July 2018

American Journal of Sports Medicine (July 2018)

  • 20 UCL injuries in 177,000 athlete exposures

  • Incidence 1.12 / 10,000 AE

  • 85% during throwing, 71% late (4th inning or later)

  • MLB players spent 117 days on DL, minor league 93.9

  • Rates of subsequent injuries (shoulder, elbow, forearm) significantly higher in both leagues

  • 26 (19.4%) MLB and 56 (8.9%) minor league players required an UCL reconstruction

  • Passive knee extension range of motion (hazard ratio [HR], 0.97 [95% CI, 0.95-0.99]; P = .008) and ankle dorsiflexion range of motion (HR, 0.93 [95% CI, 0.88-0.99]; P = .02) were independently associated with the injury risk.

  • Among recreational runners, women sustain injuries at a higher rate than men

  • Greater knee stiffness, more common in runners with higher body weights (≥80 kg), significantly increases the odds of sustaining an overuse running injury

  • Contrary to several long-held beliefs, flexibility, arch height, quadriceps angle, rearfoot motion, lower extremity strength, weekly mileage, footwear, and previous injury are not significant etiologic factors across all overuse running injuries.

  • Overall clinical incidence for all sports was 1.9 (95% CI, 1.8-2.0) for male sports and 1.5 (95% CI, 1.4-1.6) for female sports.

  • Female athletes were at a 1.9 (95% CI, 1.8-2.2) times greater risk for enduring SRCs than male athletes in sex-comparable sports, with a greater risk in baseball/softball (RR, 2.7 [95% CI, 1.9-3.8]), basketball (RR, 2.5 [95% CI, 2.1-2.9]), and soccer (RR, 1.6 [95% CI, 1.4-1.9]).

  • Female student-athletes had significantly longer time loss than male student-athletes ( P < .001).

  • The mean number of missed school days did not differ between sexes ( P = .70).

British Journal of Sports Medicine (July 2018)

Updated ankle treatment guidelines – free!
  • Psychological interventions demonstrate small (0.2) to large (1.21) effects on sports injury rates.

  • The research area demonstrates a cumulative moderate risk in reporting bias (52%).

  • Limited to moderate evidence that one in four athletes did not return to their previous level of sport participation after surgery for FAI syndrome.

  • Only 37% of the included studies clearly distinguished RTS from RTS-PRE.

  • Thus, if a player asks a surgeon ‘Will I get back to my previous level of performance?’ there are presently little to no published data from which to base an answer.

Sports Medicine (July 2018)

  • “based on the empirical evidence currently available, active cool-downs are largely ineffective for improving most psychophysiological markers of post-exercise recovery, but may nevertheless offer some benefits compared with a passive cool-down”

  • A great majority of patients RTS and RTW after THA within a timeframe of 28 and 17 weeks, respectively

Sports Health (July 2018)

  • Physicians have changed their preferred techniques for ACLR, anterior shoulder stabilization, and PCL reconstruction.

  • Physicians have also become more conservative with pregame Toradol injections.

Clinical Journal of Sports Medicine (July 2018)

  • “All 15 injuries were identified on MRI and CEUS, whereas 10 injuries showed abnormalities in conventional ultrasound. “

  • “Because the number and quality of studies was low, the effects of marijuana on athletic performance remain unclear.”