September 2021 Sports Medicine Journal Roundup

September 2021 JOURNAL ROUNDUP

This month, we review all of September’s Sports Medicine Journals all in one place here on the sports medicine review.

The American Journal of Sports Medicine (September 2021)

  • The incidence of patellar tendon rupture in the US military population is substantially higher than has been reported in the civilian population.
  • Among military personnel, men, Black servicemembers, and those aged 35 to 44 years were at highest risk for patellar tendon rupture.
  • Three-quarters of patients were able to return to full activity without limitations.
  • The re-rupture rate was low and unaffected by fixation method.
  • Nonoperative management of FAI syndrome is effective in a majority of adolescent patients, with significant improvements in PROs persisting at a mean 5-year follow-up.
  • Nonsurgically treated athletes with a complete acute adductor longus avulsion returned to sport in 2 to 3 months.
  • At the 1-year follow-up after injury, athletes had high self-reported function, no performance limitations, normal adductor strength and range of motion, and signs of partial or full tendon continuity as shown on MRI.
  • This indicates that the primary treatment for athletes with acute adductor longus tendon avulsions should be nonsurgical as the time to return to sport is short, there are good long-term results, and there is no risk of surgical complications.
  • Adding a large dose of shoulder strengthening to current nonoperative care for patients with subacromial impingement did not result in superior shoulder-specific patient-reported outcomes.
  • Moreover, approximately half of all randomized patients did not achieve the Patient Acceptable Symptom State (PASS) after 4 months of nonoperative care, leaving many of these patients with unacceptable symptoms.
  • This study showed that adding more exercise is not a viable solution to this problem.
  • Simultaneous PRP and suramin use reduced fibrosis in the injured muscle and promoted healing without negatively affecting the muscle’s contractile properties.
  • The underlying molecular mechanism may be associated with the phosphorylated Smad2 pathway.
  • Intra-articular injections of MSCs without any adjuvant therapies improves pain and function for osteoarthritis.
  • Significantly better outcomes were obtained with the use of bone marrow MSCs as compared with adipose MSCs and with the use of cultured MSCs as opposed to uncultured MSCs.

British Journal of Sports Medicine (September 2021)

  • Acute muscle strains, stress fractures and bone stress injuries were identified as the main injury concerns in this cohort of young male athletics athletes.
  • The injury characteristics differed between event groups.
  • The present study shows that beta2-agonists do not affect aerobic performance in non-asthmatic subjects regardless of type, dose, administration route, duration of treatment or performance level of participants.
  • The results of the present study should be of interest to WADA and to anyone who is interested in equal opportunities in competitive sports.
  • Disorders of depression, post-traumatic stress, schizophrenia, anxiety, alcohol dependence and bipolar were included.
  • Yoga showed greater reductions in depressive symptoms than waitlist, treatment as usual and attention control (standardised mean difference=0.41; 95% CI −0.65 to −0.17; p<0.001).
  • Greater reductions in depressive symptoms were associated with higher frequency of yoga sessions per week (β=−0.44, p<0.01).
  • Numerous randomised controlled trials point to lack of efficacy of the most common knee and shoulder arthroscopic procedures.
  • It should not be assumed that this has contributed to decreased rates of arthroscopic surgery.
  • The concurrent decrease in most of the other joint arthroscopic procedures was unexpected.
  • Our review highlights that mental health is central to concussion recovery.
  • Assessment, prevention and intervention of mental health status should be integrated into standard follow-up procedures.
  • Further research is needed to clarify the mechanisms underlying observed relationships between mental health, post-concussion symptoms and other psychosocial factors.
  • Results suggest that concussion may both precipitate and exacerbate mental health difficulties, thus impacting delayed recovery and psychosocial outcomes.

Sports Medicine (September 2021)

  • Preliminary evidence suggests that the occurrence of a distinct plateau (VO2pl) in continuous incremental tests is determined by physiological factors like anaerobic capacity, VO2-kinetics and accumulation of metabolites in the submaximal intensity domain.
  • Subsequent studies should take more attention to the use of valid VO2pl definitions, which require a cut-off at ~ 50% of the submaximal VO2 increase and rather large sampling intervals.
  • Furthermore, if verification bouts are used to verify the achievement of VO2peak/VO2max, it should be ensured that they can be sustained for sufficient durations.
  • Traditionally this relationship has been attributed to a decreased ATP resynthesis rate due to inadequate substrate availability at the whole-muscle level.
  • Emerging evidence points to a direct coupling between muscle glycogen and steps in the excitation–contraction coupling including altered muscle excitability and calcium kinetics.
  • Current knowledge about doping prevalence in competitive sport relies upon weak and disparate evidence.
  • To address this, we offer a comprehensive set of assessment criteria for studies examining doping behavior data as evidence for doping prevalence.
  • To facilitate future evidence syntheses and meta-analyses, we also put forward “best practice” recommendations and reporting guidelines that will improve evidence quality.
  • Eccentric knee flexor strength quantified during performance of the Nordic hamstring exercise (NHE) during pre-season provides limited information about the occurrence of a future hamstring strain injury (HSI).
  • Acute aerobic exercise performed in the postprandial state decreases glucose and insulin concentrations in healthy adults.
  • Acute aerobic exercise also increases glucagon concentrations irrespective of metabolic state.
  • Therefore, aerobic exercise undertaken in the postprandial state is an effective strategy to improve acute glycaemic control in healthy adults, supporting the role of aerobic exercise in reducing cardiometabolic disease incidence.

Sports Health Journal (September/October 2021)

  • Concussions in the NFL are a key focus for player safety.
  • Concussion reduction strategies were implemented before 2018, after which there was a sustained 2-year decrease in concussion incidence, providing a new benchmark from which to work toward further injury reduction.
  • The management and RTP in elite athletes after cervical spine injury is a highly complex and multifactorial topic. The overall evidence in this review suggests that RTP in asymptomatic athletes after both ACDF and PF is safe, and there is little evidence for decreased performance postoperatively.
  • Surgical management results in a higher RTP rate compared with athletes managed conservatively.
  • Face mask use during 60 minutes of low-to-moderate exercise intensity in the heat did not significantly affect Trec or HR.
  • Although face mask use may affect overall breathing discomfort due to the changes in the face mask microenvironment, face mask use itself did not cause an increase in whole body thermal stress.
  • No significant differences in quadriceps flexibility and strength, muscle activation time, and patient-reported outcomes in the involved knees were found between the 2 groups (P values > 0.05).
  • Patients treated with autologous chondrocyte implantation [ACI],  matrix-induced ACI [MACI], and autologous osteochondral transplantation [AOT] all demonstrated statistically significant improvements in functional outcome scores with radiographic evidence of healing at minimum of 2-year follow-up.
  • Evidence is insufficient to recommend one particular treatment over another.

Current Sports Medicine Reports (September 2021)