ISSN:1050-642X    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

PurposeGroin injuries are a major diagnostic and therapeutic challenge in sports medicine. The aim of this review is to describe the clinical and surgical findings associated with an atypical lower abdominal pain syndrome occurring in elite ice hockey players.Case SummariesEleven professional ice hockey players from various National Hockey League teams were referred to the Montreal General Hospital between 1989 and 1996, suffering from atypical refractory pain and paraesthesia in the lower abdomen. Despite the use of conventional investigative procedures such as physical examination, ultrasound, bone scan, computed tomography scan, and magnetic resonance imaging scan, preoperative findings were consistently negative. Operative findings revealed varying degrees of tearing of the external oblique aponeurosis and external oblique muscle associated with ilioinguinal nerve entrapment. Repair of the external oblique tear, ablation of the ilioinguinal nerve, followed by a 12-week planned course of physiotherapy allowed all to return to professional ice hockey careers.DiscussionWhile soft tissue injuries are the most common cause of groin pain in the athlete, tears of the external oblique aponeurosis and superficial inguinal ring have rarely been cited as a consistent cause of lower abdominal pain in athletes. Inguinal nerve entrapment is also rare in patients without a history of previous lower abdominal surgery.RelevanceThese 11 cases emphasize the importance of including another diagnostic possibility in the differential diagnosis of chronic overuse injuries of the lower abdomen.

ISSN:1050-642X    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveWe sought to establish injury incidence, onset, location, type, and severity for a collegiate baseball team. The second objective was to compare the number of musculoskeletal problems for which baseball players sought treatment with those that resulted in time lost or modified participation.MethodsThis was a prospective, epidemiologic study. A complaint was defined as any evaluation by a player to the medical staff that required cither evaluation or treatment. An injury was defined as any complaint that resulted in altered participation or time lost from practice or game participation. Participants were Division I collegiate baseball team with one athletic trainer and one academic sports medicine specialist. All members of the collegiate baseball team were studied over a 3-year period to determine the overall incidence of injury per 1,000 exposures (A-E) to practice or participation, injuries sustained over 3 years by collegiate baseball players.ResultsOverall there were 277 complaints and 52 injuries (19%). The A-E rate was 5.83. Forty-six percent of the injuries occurred in practice and 54% in games. Seventy-three percent of the injuries resulted in <7 days lost from sport, and 25% resulted in >21 days lost participation. The most common origin of injury was strains (23%), sprains (19%), and contusions (17%). Fifty-eight percent of the injuries were to the upper extremity, 15% to the trunk/back, and 27% to a lower extremity. Upper extremity injuries accounted for 75% of the total time lost from the sport. When divided by position, the shoulder injuries occurred in pitchers (69%), infielders (19%), and outfielders (12%). Rotator cuff tendinitis was the most frequent complaint, was the most frequent injury, and resulted in the most time lost from the sport.ConclusionsDefining injury as time lost or as altered participation underestimates the frequency with which players seek evaluation and treatment. Injuries are divided widely across anatomic site, but upper extremity injures cause the most time lost from the sport. Further study of the origin and prevention of upper extremity injuries in baseball is warranted.

ISSN:1050-642X    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveTo determine the effect of massage on anterior chronic exertional compartment syndrome (CECS) with respect to symptoms, intracompartmental pressures, and work output of the anterior compartment in dorsiflexion.DesignOne group-repeated measures design.SettingA private sports medicine clinic in Melbourne, Australia.ParticipantsSeven athletes (six men and one woman), aged between 21 and 29 years, were selected on the basis of clinical suspicion for anterior CECS. Historical questionnaire and examination were followed by intracompartmental pressure testing of the anterior compartment. Study exclusion criteria were history of a bleeding diathesis and previous treatment consisting of compartment fasciotomy or massage. All athletes completed the study.InterventionsA 5-week course of massage consisting of two sessions in the first week and one session per week thereafter, for a total of six treatments. Between each session, a twice-daily standard stretching program involving both anterior and posterior compartments was performed.Main Outcome MeasuresPostexercise anterior compartment pressures (mm Hg) before and after treatment, work output (J) in dorsiflexion to pain onset before and after treatment, self-reported symptoms before and after treatment.ResultsThere was no significant difference in the 3-minute postexercise compartment pressures after the treatment. There was a significant (p = 0.016) increase, however, in work performed in dorsiflexion to pain onset following the massage course.ConclusionsIntermittent massage combined with specific stretching should be considered in the treatment of anterior CECS.

ISSN:1050-642X    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveTo assess reported injuries and cases of overtraining in relation to training and competition cycles, aerobic versus anaerobic sport, and gender.MethodsA total of 163 elite male and 94 elite female athletes from eight different sports volunteered. They reported 212 musculoskeletal injuries and 38 cases of the overtraining syndrome. These injuries and cases of overtraining were then arranged according to the training or competition cycle in which they occurred, whether the sufferers were male or female athletes, and the metabolic characteristics of the sports in which the injuries and overtraining occurred.ResultsThe preparation (October to February), precompe-tition (March to May), and competition (June to August) cycles were associated with 9%, 19%, and 32% of the injuries reported by the men, respectively, and with 8%, 10%, and 22% of the injuries reported by the women, respectively. For the same cycles, cases of overtraining were found to be 15%, 24%, and 35% for the men, respectively, and 4%, 7%, and 15% for the women, respectively. For both men and women, the competition cycle produced significantly more injuries and incidents of overtraining than the preparation and precompetition cycles (p < 0.05 vs p < 0.005). Similarly, precompetition revealed significantly more injuries (p < 0.05) in men, but not in women, compared with the preparation cycle. Also, male athletes reported a significantly higher number of injuries during the precompetition (p < 0.05) and competition (p < 0.01) cycles, and more cases of overtraining during the competition cycle (p < 0.01) than did their female counterparts. No differences were found when the data were arranged according to dominant metabolic characteristics of the sports in which the injuries and overtraining occurred.ConclusionsElite athletes are more likely to become injured or overtrained during the precompetition and, especially, competition cycles than in the preparation cycle. Parallel seasonal variations were also found when data were analyzed for aerobic versus anaerobic sport and gender.

ISSN:1050-642X    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveTo identify the most common injuries and medical conditions experienced by the mentally handicapped athlete during Special Olympic competition.DesignA longitudinal, observational, and prospective study.SettingHawaii Special Olympic Summer Games, 1993–1996.ParticipantsA total of 2326 athletic participants were registered during a 4-year period in the Hawaii Special Olympic Summer Games. The athletes ranged in age from 8 to 76 years.InterventionMedical encounter forms were documented by physicians and nurses on participants treated at aid stations located at the athletic venues and Olympic village during competition.Main Outcome MeasuresThe number and type of injuries and medical conditions encountered during Special Olympic competition were recorded on standard medical forms supplied by the U.S. Special Olympic Committee.ResultsNinety athletes (3.87%) required medical attention during four annual Special Olympic Summer Games. A total of 52 (57.8%) injuries and 38 (42.2%) medical conditions were reported during the 4 years. Of the 90 encounters, 86.7% (n = 78) were acute and 13.3% (n = 12) were nonacute medical problems. More than 61% (n = 55) of the injuries and medical conditions occurred during actual competition. The majority of injuries occurred during track and field events (n = 25, 56%), and the most commonly injured site was the knee.ConclusionsDespite preexisting medical conditions and physical limitations of the Special Olympian, most of the medical demands encountered during athletic competition are acute, minor injuries. No athlete sustained more than one injury during the period studied.

ISSN:1050-642X    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveWisconsin high school wrestlers were surveyed I year before (90W) and 2 years after (93W) a new program was implemented to restrict weight loss for competition. The Wisconsin wrestling minimal weight program (WMWP) included a minimal weight limit determined from percent body fat and a nutrition education program.DesignA retrospective survey of wrestlers was conducted, with schools stratified to reflect school size and quality of the wrestling program.ParticipantsRespondents surveyed in 1990 included 713 wrestlers from 45 schools; 368 wrestlers from 29 of the same schools responded to an identical survey in 1993.Main Outcome MeasuresMeasures of weight-cutting practices, weight-loss methods, bulimic behaviors, and nutritional knowledge.ResultsThe most weight lost (MWL), the weight lost to certify (WLC), the weekly weight cycled (WWC), the longest fast (LF), and the frequency of cutting weight (FCW) all decreased significantly (x2, p < 0.05) among 93W wrestlers compared with 90W wrestlers. The results for the 90W group are as follows: MWL, 3.2 kg ± 2.6; WLC, 2.8 kg ± 2.8; WWC, 1.9 kg ± 1.5; LF, 20.5 hours ± 17.2; FCW, 6.2 ± 6.4. The results for the 93W group are as follows: MWL, 2.6 kg ± 2.6; WLC, 2.4 kg ± 2.9; WWC, 1.6 kg ± 1.4; LF, 16.5 hours ± 15.6; FCW, 4.7 ± 6.7. Weight-loss methods, including restricting food or fluids and use of rubber suits, declined significantly (x2, p < 0.05). Wrestlers exhibiting more than one of theDiagnostic and Statistical Manual of Mental Disorders(DSM-III-R)-related bulimic behaviors decreased by 11% (x2, p < 0.05), but those exhibiting all five (1.6%) remained the same.ConclusionsThe results suggest that the WMWP appeared to reduce unhealthy weight-loss behaviors among high school wrestlers. Other states should be encouraged to institute similar programs as recommended by the American Medical Association and the American College of Sports Medicine.

ISSN:1050-642X    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveTo examine the results from doping controls conducted by the Norwegian Confederation of Sport (NCS) from 1977 to 1995.MethodsData were collected by combining three computerized databases and manual records on samples taken and results from analyses in the International Olympic Committee (IOC)-accredited laboratories in London, Huddinge, Cologne, and Oslo. Samples were declared positive if they contained any banned substance on the IOC list that was in effect at any given time.ResultsA total of 15,208 samples were taken; most of them (12,870; 85%) were from Norwegian athletes (90% unannounced tests) belonging to national federations under NCS jurisdiction (NCS members), 461 (3%) were from external Norwegian athletes (either users of private gyms or athletes in organized sports federations not affiliated with the NCS), and 1,874 (12%) were from foreign athletes (three cases with unknown affiliation). There were 130 positive samples and 24 refusals among NCS members (1.2%; men, 1.4%; women, 0.3%), 86 positive samples and 8 refusals among external Norwegian athletes (20%; men, 24%; women, 8%), and 39 positive samples and 1 refusal among foreign athletes (1.6%; men, 2.1%; women, 0.7%). A gradual decrease in the percentage of positive samples was observed among NCS members as testing frequency was increased gradually from 1987 to 1995 in the three high-prevalence sports: powerlifting, weightlifting, and athletics.ConclusionAn increase in the test frequency of doping tests was associated with a decrease in the percentage of positive samples in targeted sports.

ISSN:1050-642X    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveLower extremity alignment factors, including tibiofemoral angle, quadriceps angle (Q-angle), and limb length discrepancies, are commonly thought to be clinically relevant as contributing factors to overuse injuries of the lower extremities. To explore the scientific rationale for these clinical beliefs, we conducted a review of the available English language literature from 1966 to July 1997 relating overuse injury to lower extremity alignment.Data SourcesMedline was searched for medical subject headings and title key words to locate published works relating lower extremity morphologic characteristics to risk of overuse injury. Additional references were reviewed from reprint collections and reference lists of published work.Data Extraction and SynthesisRelevant studies were reviewed for strengths and weaknesses in design, analysis, and conclusions. Synthesis across studies concentrated on commonalities and differences of methods in definition of exposure and outcome variables.Main ResultsSix population-based studies have been conducted evaluating some aspect of lower extremity alignment as a risk factor for overuse injury. Three of these studies evaluated military recruits in basic training, two studied mixed groups of athletes, and one studied folk dancers. The time frame across studies ranged from 12 weeks to 52 weeks. A key finding was the considerable variation in the measure of lower limb alignment used as the exposure variable, as well as the method of measurement used to quantify the exposure. Some studies relied on visual examination, whereas others used digitized photographic techniques. Moreover, each study varied in the definition used for overuse injury; outcomes ranged from sell-reported cases of shin splints to radiographic confirmation of stress fracture. Five of the six studies evaluated some aspect of foot morphology, whereas only one evaluated full leg alignment parameters.ConclusionsResults were conflicting but, in general, did not support clinical beliefs of the detrimental effects of decreased longitudinal loot arch and varus tibiofemoral alignment as risk factors for lower extremity overuse injury. Differences in methodologic rigor and outcome definition prevent a meaningful synthesis of existing work. Directions for future research are suggested.

ISSN:1050-642X    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveTo review the incidence of brain injuries sustained while playing ice hockey.Data SourceMEDLINE was searched for articles from 1966 to 1997 relating to ice hockey and injuries. Additional references were reviewed from the bibliographies of the retrieved articles.Study SelectionAll clinical study designs were included.Data Extraction and SynthesisIn reviewing the literature, particular attention was paid to the relative strengths of the different study designs. Rates of head injuries were recorded (or calculated if possible) from the data.Main ResultsThe most common brain injury was concussion. The incidence of concussion (per 1000 player-hours) ranged from 0.0 to 2.8 for players aged 5 to 14 years, from 0.0 to 2.7 for high school players, from 0.2 to 4.2 for university players, and from 0.0 to 6.6 for players on elite teams. The incidence of concussion increases with higher levels of play, is higher in game play than practice for elite players, is reduced by appropriate helmets, and is showing a downward trend for players aged 5 to 14 years. Other brain injuries included rare epidural and subdural hematomas that can be lethal. Recommendations for the further reduction of brain injuries and guidelines for future studies of the incidence of head injuries in hockey are provided.

ISSN:1050-642X    

出版商:OVID    

年代:1998

数据来源: OVID