may 2021 journal review round up cover


This month, we review all of May’s Sports Medicine Journals all in one place here on the sports medicine review.
  • At 1 to 2 years after ACL reconstruction, female athletes demonstrated no differences in combined MVPA and only a very small reduction in vigorous PA, yet they had higher levels of self-reported knee pain and symptoms, reduced knee function in sports, lower quality of life, and poorer objective knee function compared with matched controls.
  • Treatment with bone marrow mesenchymal stem cells (BM-MSCs) or leukocyte-poor platelet-rich plasma (Lp-PRP) in combination with rehabilitation in chronic patellar tendinopathy is effective in reducing pain and improving activity levels in active participants.
  • Participants who received BM-MSC treatment demonstrated greater improvement in tendon structure compared with those who received Lp-PRP.
  • This study provides insights into arthroscopic meniscal debridement and repair practice trends among ABOS Part II examinees. Meniscal debridement is decreasing and meniscal repair is increasing.
  • Younger patient age and treatment by a sports medicine subspecialty examinee are associated with a higher likelihood of repair over debridement.
  • Elasticity significantly increased for the UCL, indicating laxity, but not for the FPMs after 100 pitches.
  • Furthermore, the ratio of elasticity (UCL/FPMs) and the elbow flexion range of motion before pitching were significantly related to the change rate of UCL elasticity.
  • The estimated rate of athletes who did not return to sport after hip arthroscopy for FAIS was 12%, with the majority of athletes being unable to return because of persistent hip pain.
  • There is a severe lack of evidence on the athlete characteristics and clinical course of the nonreturning athletes, and the rate of subsequent hip procedures is unknown.
  • The outcomes and reasons for athletes not returning to sport should be reported in detail to improve patient care.
  • Capsular distension is a highly recommended choice for treatment of frozen shoulder, contributing greatly to pain relief and functional improvement; steroid injection is also a prevailing effective intervention.
  • Among new options, extracorporeal shockwave therapy and laser therapy show potential benefits for multiple outcomes.
  • Individualized optimal intervention should be considered, given that treatment effect is moderated by factors including the disease stage, time of assessment, adjunctive therapies, female sex, and diabetes.


  • This review provides moderate-quality evidence that an exercise programme, and a programme combining exercise and education, are effective to reduce future LBP intensity and associated disability.
  • It is uncertain whether prevention programmes can improve future QoL and workability.
  • Further high-quality RCTs evaluating prevention programmes aiming to reduce future impact of LBP are needed.
  • Low and very low certainty evidence suggests exercise is effective compared with passive interventions with or without invasive treatment in LET, but the effect is small.
  • In patients with patellar tendinopathy (PT), progressive tendon-loading exercises (PTLE) resulted in a significantly better clinical outcome after 24 weeks than eccentric exercise therapy (EET).
  • PTLE are superior to EET and are therefore recommended as initial conservative treatment for PT.
  • In adults with mid-portion Achilles tendinopathy, heel lifts were more effective than calf muscle eccentric exercise in reducing pain and improving function at 12 weeks.
  • However, there is uncertainty in the estimate of effect for this outcome and patients may not experience a clinically worthwhile difference between interventions.
  • Address the evidence of EIMD as a predisposing factor for exertional heat stroke (EHS)
  • Propose a possible mechanism of how performing muscle-damaging exercise in the heat may aggravate muscle damage and subsequent risk of EHS and acute kidney injury (AKI)
  • Current trail running literature consists mainly of injury and illness outcomes specifically in relation to single-day race participation events.
  • Limited evidence is available on training-related injury and illness in trail running.
  • Our review showed that injury and illness are common among trail runners, but certain studies included in this review only focused on dermatological injuries (e.g. large number of feet blisters) and GIT symptoms.
  • Specific areas for future research were identified that could improve the management of trail running injury and illness.
  • Climate change impacts affect Physical Activity (PA) at a worldwide scale.
  • PA is observed to play both a mitigation and an amplification role in climate changes.
  • While the prevalence of high sport specialization was low among Little League baseball players, other behaviors associated with specialization such as year-round play and the receiving of private coaching were more common.
  • Highly specialized Little League players demonstrated worse throwing arm health compared with low-specialization players.
  • For adolescent baseball players, arm care injury prevention programs focusing on important musculoskeletal impairments are effective at reducing injury incidence rates.
  • Multimodal injury prevention programs that improve multiple musculoskeletal impairments are more comprehensive and may result in better injury reduction than programs focusing on a singular impairment.
  • Percutaneous Ultrasonic Tenotomy (PUT) is a minimally invasive treatment technique that can be considered in patients with tendinopathy refractory to conservative treatment measures.
  • Further higher quality studies are necessary to accurately assess the comparative effectiveness of this treatment modality.
  • Interventions focused on addressing a greater degree of plantarflexion range of motion, body mass index, and body mass and their load on the force-absorbing plantar surface structures may be a good starting point in the prevention and treatment of active individuals with Plantar Fasciitis.