Identifying Sex-Specific Risk Factors for Stress Fractures in Adolescent Runners.

Identifying Sex-Specific Risk Factors for Stress Fractures in Adolescent Runners.

Med Sci Sports Exerc. 2013 Apr 11;
Tenforde AS, Sayres LC, Liz McCurdy M, Sainani KL, Fredericson M

PURPOSE: Adolescent females and males participating in running represent a population at high risk of stress fracture. Few investigators have evaluated risk factors for prospective stress fracture in this population. METHODS: To better characterize risk factors for and incidence of stress fractures in this population, we collected baseline risk factor data on 748 competitive high school runners (442 girls and 306 boys) using an online survey. We then followed them prospectively for the development of stress fractures for an average of 2.3±1.2 total seasons of cross-country and track and field; follow-up data were available for 428 girls and 273 boys. RESULTS: We identified prospective stress fractures in 5.4% of girls (N=23) and 4.0% of boys (N=11). Tibial stress fractures were most common in girls, and the metatarsus was most frequently fractured in boys. Multivariate regression identified four independent risk factors for stress fractures in girls: prior fracture, BMI <19, late menarche (age menarche ?15 years), and previous participation in gymnastics or dance. For boys, prior fracture and increased number of seasons were associated with an increased rate of stress fractures, whereas prior participation in basketball was associated with a decreased risk of stress fractures. CONCLUSION: Prior fracture represents the most robust predictor of stress fractures in both sexes. Low BMI, late menarche, and prior participation in gymnastics and dance are identifiable risk factors for stress fractures in girls. Participation in basketball appears protective in boys and may represent a modifiable risk factor for stress fractures. These findings may help guide future translational research and clinical care in the management and prevention of stress fractures in young runners. HubMed – rehab

 

How injuries affect rehabilitation workload in a National Team during an elite soccer event? An experience from the FIFA 2010 World Cup.

J Sports Med Phys Fitness. 2013 Apr; 53(2): 192-7
Eirale C, Farooq A, Bisciotti G, Chalabi H

Aim: Many epidemiological studies have been performed in soccer but none of them investigated the incidence of injury in association with the utilization of clinical and rehabilitation services of the medical team. This study aims to examine such correlation in a National football team during the recent 2010 World Cup. Methods: All injuries occurred to the Algerian National Team players during the pre competition stage and the World Cup were recorded, together with the exposure. Moreover, duration and frequency of each consultation performed by doctors, physiotherapists, masseurs and pitch rehabilitator was recorded. Results: Incidence of injuries was 7.54 per 1000h exposure and six players were injured at the beginning of the stage but all players were available for official matches. Difference in the duration of rehabilitation sessions on the field is present among the players who joined the camp already injured and the players who were not injured at the commencement of the camp (8.83±10.63 vs. 2.00±4.46 hours, P<0.05) while there was no difference in rehabilitation between players that occurred in an injury during after the beginning of the camp and uninjured players. Conclusion: A medical team composed of two physicians, four physiotherapists, one pitch rehabilitator and two masseurs facilitated us to reasonably distribute this workload with good rehabilitation outcomes based on players' availability during competition. Moreover, the skills of a pitch rehabilitator appear to be useful, most evidently when starting the camp with previously injured athletes. Conversely, injuries occurring during the tournament didn't affect rehabilitation workload significantly. HubMed – rehab

 

Biomechanical comparison of forward and lateral lunges at varying step lengths.

J Sports Med Phys Fitness. 2013 Apr; 53(2): 130-8
Riemann B, Congleton A, Ward R, Davies GJ

Aim: Lunges are commonly included in rehabilitation and strength training programs; however limited information regarding differences between lateral and forward lunges with varying step lengths in young adults exists. The current study compared sagittal plane joint kinematics and kinetics between forward and lateral lunges using self-selected and standardized (60% height) step lengths. Methods: Thirty-two young adults (16 men, 16 women) completed six lunges of each direction/distance combination while stepping (dominant) limb ankle, knee, and hip peak flexion and net joint extensor moment impulse were quantified. Results: While lateral direction (P=0.063) step lengths were statistically equal between self-selected and standardized lunges, forward self-selected distances were 10% less than the standardized (P<0.001). Compared to forward lunges, lateral lunge ankle flexion was 83.5% greater (P<0.001) for standard and 55.3% greater (P<0.001) for self-selected distances. Knee flexion was 12.8% greater (P<0.001) during forward lunges compared to lateral lunges, with no significant hip direction differences. Ankle impulse during the lateral lunges was 71.3% greater (P<0.001) compared to forward lunges. Lateral lunge knee impulse was 47.6% greater (P<0.001) for standardized and 16.9% greater (P=0.001) for self-selected distances compared to forward lunges. Forward lunge hip impulse was 64.5% greater for the standardized (P<0.001) and 44.6% greater for self-selected (P<0.001) distances compared to lateral lunges. Conclusion: Forward lunges, particularly using 60% body height step length, appear to place the greatest demands on the hip extensors. Lateral lunges prompted greater ankle flexion and greater ankle and knee extensor kinetic contributions. These data provide rationale for lunge variation selection for young adults. HubMed – rehab