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Injuries in Sports: Epidemiology, Identification, Prevention, Treatment, and Return to Play (Closed)

Editors


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Guest Editor
Polytechnic Institute of Viana do Castelo, School of Sport and Leisure, 4960-320 Melgaço, Portugal
Interests: football; soccer; match analysis; performance analysis; network analysis
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Faculty of Health Sciences, Universidad Isabel I, Burgos, Spain
Interests: physical performance; external loads; training-related fatigue; match load monitoring; contextual factors; sports injuries; team sports
Special Issues, Collections and Topics in MDPI journals

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Guest Editor

Topical Collection Information

Dear Colleagues,

A growing body of literature demonstrates the importance of assessing and reporting the prevalence of injuries to get important feedback for the better identification of injury mechanisms with the aim of implementing more appropriate preventive protocols or rehabilitation processes. Therefore, epidemiology, identification, treatment, return to play, and prevention are hot topics in sports injuries that should be continuously updated in an attempt to decrease the exposure to injury risk and decrease the time from injury to full recovery. Moreover, peripherical covariables that may contribute to injury occurrence as fitness status, congested schedules, load management, nutrition, sleep, and recovery are also topics that appear related to injury reports. Therefore, our Special Issue seeks submission that adopt multidimensional approaches in helping practitioners and scientists to decrease injury risk, accelerate the identification of injuries, implement better rehabilitation protocols, and employ individualized training protocols for return-to-play and injury prevention. Considering that more research should be done and published about such important topics, the aim of the Special Issue “Injuries in Sports: Epidemiology, Identification, Prevention, Treatment, and Return to Play” is to publish high-quality original investigations, narratives, and systematic reviews in the field of team sport injuries. We look forward to receiving contributions related (but not limited) to the following topics: (i) epidemiology of sports injuries in youth, adult, recreational, and elite athletes; (ii) identification of injury mechanisms; (iii) evidence-based treatments; (iv) return-to-play programs; (v) strength and conditioning programs for injury prevention or return to play; (vi) load management and relationships with injury occurrence and risk; (vii) physical status and its impact on injury; and (viii) recovery dimensions (e.g., sleep, nutrition, supplementation, rest) and their impact on injury. We would welcome papers related to evidence of successful intervention strategies. All manuscripts will be peer-reviewed by experts in the field.

Dr. Filipe Manuel Clemente
Dr. Daniel Castillo
Dr. Javier Raya-González 
Guest Editors

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Keywords

  • injury epidemiology
  • injury identification
  • injury treatment
  • return to play
  • injury prevention
  • recovery strategies
  • load management
  • strength and conditioning

Published Papers (19 papers)

2022

Jump to: 2021, 2020

10 pages, 1381 KiB  
Article
Injuries and Overuse Injuries in Show Jumping—A Retrospective Epidemiological Cross-Sectional Study of Show Jumpers in Germany
by Heinz-Lothar Meyer, Philip Scheidgen, Christina Polan, Paula Beck, Bastian Mester, Max Daniel Kauther, Marcel Dudda and Manuel Burggraf
Int. J. Environ. Res. Public Health 2022, 19(4), 2305; https://doi.org/10.3390/ijerph19042305 - 17 Feb 2022
Cited by 7 | Viewed by 3132
Abstract
This retrospective cross-sectional epidemiological study deals with sport-specific injury patterns in show jumping. A total of 363 show jumpers of all levels (S) answered a retrospective questionnaire about injuries and overuse damages which occurred in the course of their careers. Demographic data and [...] Read more.
This retrospective cross-sectional epidemiological study deals with sport-specific injury patterns in show jumping. A total of 363 show jumpers of all levels (S) answered a retrospective questionnaire about injuries and overuse damages which occurred in the course of their careers. Demographic data and information on injuries in various body regions were collected. In addition to descriptive analysis, significance tests were performed. For better statistical comparability with other sports, exposure time was extrapolated with total career duration and weekly training hours, and injuries per 1000 jumping hours were calculated. The study included 251 (69%) women and 112 (31%) men, who were on average 26.9 ± 10.9 years old. The injury rate for the entire collective was 3.7 per 1000 h of exposure. The most frequently affected body region was the head (31%). Overuse complaints play a subordinate role and mainly affect the upper extremities (65%). The riders of the professional lower performance levels are less likely to injure themselves per 1000 h than riders of the higher performance levels. Riders who often or always wore a helmet suffered significantly fewer head injuries (p = 0.008) and had a significantly lower total injury duration than riders who did not wear a helmet (p = 0.006). Similarly, the study showed that riders who often or always wore a safety vest suffered significantly fewer spinal injuries (p = 0.017) and had significantly fewer injuries per 1000 riding hours (p = 0.031) than riders who did not wear a safety vest. Based on the present results, there should be an extension of the general helmet requirement and a requirement to wear safety vests in show jumping in general. Full article
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2021

Jump to: 2022, 2020

13 pages, 705 KiB  
Article
Basketball-Specific Small-Sided Games Training during Ramadan Intermitting Fasting: Do Changes in Body Composition, Sleep Habits, and Perceived Exertion Affect Technical Performance?
by Seifeddine Brini, Daniel Castillo, Javier Raya-González, Carlo Castagna, Anissa Bouassida, Riadh Khalifa, Sabri Gaied Chortane and Filipe Manuel Clemente
Int. J. Environ. Res. Public Health 2021, 18(22), 12008; https://doi.org/10.3390/ijerph182212008 - 16 Nov 2021
Cited by 6 | Viewed by 3132
Abstract
The objective of this study was to assess the effects of an additional small-sided games (SSGs) training program during Ramadan intermitting fasting (RIF) on technical performance depending on changes in body composition, sleep habits, and ratings of perceived exertion (RPE). Twenty-four professional male [...] Read more.
The objective of this study was to assess the effects of an additional small-sided games (SSGs) training program during Ramadan intermitting fasting (RIF) on technical performance depending on changes in body composition, sleep habits, and ratings of perceived exertion (RPE). Twenty-four professional male basketball players from the Tunisian first division participated in this study. The players were randomly assigned to an intervention group (INT; n = 12) or an active control group (CON; n = 12). Both groups completed a four-week SSG training program (three sessions per week). During the first and fourth weeks of the SSGs training, the two groups were evaluated to detect changes in technical performance, dietary intake, body composition, sleep quality index (PSQI) survey outcomes, RPE, heart rate (HR), and blood lactate concentration [La]. During the fourth week of the RIF period, body composition, dietary intake, sleep latency, sleep duration, and HR significantly decreased only for INT (p < 0.001). However, RPE significantly increased (p < 0.001), and technical performances were negatively affected (p < 0.01). MANCOVA (adjusted for the percentage of change in sleep duration, body mass, and RPE) showed no significant differences in either group. In conclusion, our results showed that the technical performance of professional basketball male players was significantly affected at the end of RIF independently of changes in RPE, sleep habits, and body composition. Full article
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9 pages, 676 KiB  
Article
Influence of Football Match-Play on Isometric Knee Flexion Strength and Passive Hip Flexion Range of Motion in Football Referees and Assistant Referees
by Vicente Fernández-Ruiz, Álvaro López-Samanes, Juan Del Coso, José Pino-Ortega, Javier Sánchez-Sánchez, Pablo Terrón-Manrique, Marco Beato and Víctor Moreno-Pérez
Int. J. Environ. Res. Public Health 2021, 18(22), 11941; https://doi.org/10.3390/ijerph182211941 - 13 Nov 2021
Cited by 6 | Viewed by 2390
Abstract
The aim of this study was to examine the acute effect of officiating a football (soccer) match on isometric knee flexion strength and passive hip flexion range-of-motion (ROM) in referees and assistant football referees. Twelve referees (25.3 ± 3.3 years) and twenty-three assistant [...] Read more.
The aim of this study was to examine the acute effect of officiating a football (soccer) match on isometric knee flexion strength and passive hip flexion range-of-motion (ROM) in referees and assistant football referees. Twelve referees (25.3 ± 3.3 years) and twenty-three assistant referees (25.1 ± 4.8 years) underwent measurements on isometric knee flexion strength and passive hip flexion ROM before and after officiating an official football match. Referees’ and assistant referees’ running patterns were monitored during the match using GPS technology. In comparison to pre-match values, referees reduced their isometric knee flexion strength (−12.36%, p = 0.046, Effect size [ES] = −0.36) in the non-dominant limb, while no significant differences were reported in the dominant limb (−0.75%, p = 0.833, ES = −0.02). No effect of the match was found in hip flexion ROM values in dominant (−4.78%, p = 0.102, ES = −0.15) and non-dominant limb (5.54%, p = 0.544, ES = 0.19). In assistant referees, the pre-to-post-match changes in isometric knee flexion strength (dominant limb −3.10%, p = 0.323, ES = −0.13; non-dominant limb −2.18%, p = 0.980, ES= 0.00) and hip flexion ROM (dominant limb 1.90% p = −0.816, ES = 0.13; non-dominant limb 3.22% p = 0.051, ES = 0.23) did not reach statistical significance. Officiating a match provoked a reduction in isometric knee flexion strength in the non-dominant limb of football referees, while no differences were reported in assistant referees. Full article
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15 pages, 1604 KiB  
Article
The Potential Role of Hamstring Extensibility on Sagittal Pelvic Tilt, Sagittal Spinal Curves and Recurrent Low Back Pain in Team Sports Players: A Gender Perspective Analysis
by Antonio Cejudo, Josep María Centenera-Centenera and Fernando Santonja-Medina
Int. J. Environ. Res. Public Health 2021, 18(16), 8654; https://doi.org/10.3390/ijerph18168654 - 16 Aug 2021
Cited by 16 | Viewed by 5023
Abstract
It is assumed that mechanical restriction of hamstring tightness disrupts sagittal spine–pelvis–leg alignment and alters the lumbar–pelvic rhythm predisposing to low back pain (LBP) in athletes; however, this association is not clear. A prospective cross-sectional cohort study was conducted to determine the influence [...] Read more.
It is assumed that mechanical restriction of hamstring tightness disrupts sagittal spine–pelvis–leg alignment and alters the lumbar–pelvic rhythm predisposing to low back pain (LBP) in athletes; however, this association is not clear. A prospective cross-sectional cohort study was conducted to determine the influence of hamstring extensibility (HE) on sagittal pelvic tilt, sagittal spinal curves, and LBP in 94 soccer and basketball players (61 man and 33 woman) with (n = 36) and without recurrent LBP (n = 58). Descriptive analysis displayed significant gender differences for HE, sagittal pelvic tilt, and lumbar curve. Differences were found between the low-HE and high-HE groups in lumbosacral angle in for the maximum trunk forward flexion (LH-MTFP). Low-HE was associated with LH-MTFP, lumbar curve and LBP in male players (p ≤ 0.023). In female players, LH-MTFP and lumbar curve were associated with low-HE (p ≤ 0.020). Low-HE predicted LH-MTFP (p = 0.000; OR = 65.6950) and LBP (p = 0.028; OR = 13.915) in male players. The decision tree analysis showed that 50.8% of the players were classified with restricted LH-MTFP, 77.4% with low-HE among male players. The 100% of male players with recurrent LBP had low-HE. The 65% of female players with low-HE had restricted LH-MTFP. Measurement of HE, lumbar curve, and LH-MTFP are important in making training decisions for to reduce the incidence of recurrent LBP in soccer and basketball players. Full article
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9 pages, 1011 KiB  
Article
Sports Specialization and Sports-Related Injuries in Japanese School-Aged Children and Adolescents: A Retrospective Descriptive Study
by Ryosuke Shigematsu, Shuta Katoh, Koya Suzuki, Yoshio Nakata and Hiroyuki Sasai
Int. J. Environ. Res. Public Health 2021, 18(14), 7369; https://doi.org/10.3390/ijerph18147369 - 9 Jul 2021
Cited by 10 | Viewed by 4683
Abstract
Although early sports specialization is associated with sports-related injuries, relevant quantitative studies on young non-elite athletes, the majority of sports participants, are scarce. We described sports specialization time points and the characteristics of sports-related injuries. Undergraduate students at a university in Japan ( [...] Read more.
Although early sports specialization is associated with sports-related injuries, relevant quantitative studies on young non-elite athletes, the majority of sports participants, are scarce. We described sports specialization time points and the characteristics of sports-related injuries. Undergraduate students at a university in Japan (n = 830) recalled their history of sports participation from elementary to high school and sports-related injuries in a self-administered questionnaire. Of 570 valid respondents, 486 (85%) engaged in sports at least once. Significantly more respondents played multiple sports in upper elementary school (30%) than in other school categories (1–23%). In junior high and high schools, 90% and 99% played only one sport, respectively. Of the 486 respondents who played sports, 263 (54%) had experienced acute or overuse injuries. The proportion of injured participants significantly differed by school category: lower elementary school (4%), upper elementary school (21%), junior high (35%), and high school (41%). The proportions of acute or overuse injuries in males were higher than those in females. In conclusion, this study clarified a slight variation in sports items, particularly in junior high and high schools, which demonstrates 13 years as the age of beginning specialization in a single sport. More than half of the non-elite athletes experienced sports-related injuries. Injuries were frequently observed in males and those in junior high and high schools. Full article
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9 pages, 1434 KiB  
Article
An Investigation of Knee Injury Profiles among Iranian Elite Karatekas: Observations from a Cross-Sectional Study
by Hamidreza Naserpour, Julien S. Baker, Amir Letafatkar, Giacomo Rossettini and Frédéric Dutheil
Int. J. Environ. Res. Public Health 2021, 18(13), 6888; https://doi.org/10.3390/ijerph18136888 - 27 Jun 2021
Cited by 5 | Viewed by 3162
Abstract
Karate training, despite the many positive health benefits, carries a risk of injury for participants. The current cross-sectional study aimed to investigate knee injury profiles among Iranian elite karatekas. Participants who attended the national team qualifiers, which included 390 male Kumite karatekas (age [...] Read more.
Karate training, despite the many positive health benefits, carries a risk of injury for participants. The current cross-sectional study aimed to investigate knee injury profiles among Iranian elite karatekas. Participants who attended the national team qualifiers, which included 390 male Kumite karatekas (age 24 ± 3 years old and weight 63 ± 12 kg), participated in this study. Information on knee injuries (injury history, type of injury mechanisms, and effects of knee symptoms on the ability to perform daily activities and recreational activities) were obtained using the Knee Outcome Survey (KOS). Using Pearson’s correlation coefficient, the study examined the relationships between different variables, including KOS subscales and levels of self-reported knee joint function. Our findings indicated that 287 karatekas (73.6%) experienced knee injuries. The anterior cruciate ligament (ACL) rupture (6.9%), articular cartilage (5.4%), and meniscus damage (3.8%) were the main typology of injury. In addition, there were no differences in knee injuries between the non-dominant and dominant legs. Most injuries occurred during the preparatory period (n = 162, 50%), especially during training periods. The KOS subscales scores (Mean ± Sd) for activities of daily living (ADL) and sports activity (SAS) were, respectively, 89 ± 11 and 91 ± 9. The self-reported scores for both the ADL and SAS subscales were, respectively, 89 ± 11 and 90 ± 10. Pearson coefficients of ADL and SAS subscales with their self-reported score were r = 0.761 (p < 0.0001) and r = 0.782 and (p < 0.0001), respectively. The profile of knee injuries in the current investigation is similar to previous surveys that reported lower extremity injury patterns. The findings of this study could be adopted to inform practice aimed at planning interventions for the reduction and prevention of knee injuries among karatekas. Full article
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10 pages, 652 KiB  
Article
Frequency of Injury and Illness in the Final 4 Weeks before a Trail Running Competition
by Rubén Gajardo-Burgos, Manuel Monrroy-Uarac, René Mauricio Barría-Pailaquilén, Yessenia Norambuena-Noches, Dina Christa Janse van Rensburg, Claudio Bascour-Sandoval and Manuela Besomi
Int. J. Environ. Res. Public Health 2021, 18(10), 5431; https://doi.org/10.3390/ijerph18105431 - 19 May 2021
Cited by 11 | Viewed by 3835
Abstract
We aimed to (i) determine self-reported injury and illness frequency in trail runners 4 weeks preceding competition; (ii) compare athletes with and without injury/illness by sex, age, body mass index (BMI) and competition distance; (iii) describe mechanism of injury, anatomical region (injury)/organ system [...] Read more.
We aimed to (i) determine self-reported injury and illness frequency in trail runners 4 weeks preceding competition; (ii) compare athletes with and without injury/illness by sex, age, body mass index (BMI) and competition distance; (iii) describe mechanism of injury, anatomical region (injury)/organ system (illness) involved, consequences of injury on preparation and self-perception of injury severity; (iv) compare anatomical region (injury) and organ system (illness) by sex. A total of 654 trail runners (age 36.2, IQR 30.6–43.0; 36.9% females) participated in this retrospective cross-sectional study by completing a self-reported questionnaire. Injury and illness frequency rates were 31.3% (n = 205, CI: 27.7–35.0%) and 22.3% (n = 146, CI: 19.1–25.7%), respectively. No significant difference was found between injured vs. non-injured or ill vs. non-ill study participants by sex, age, BMI and competition distance. Regarding injuries, gradual onset (41.6%) and knee (33.2%) were the most indicated mechanism and anatomical region of injury. At least 85.4% of trail runners changed their training following injury and 79% indicated that their injury would affect their competition performance. Regarding illness, the respiratory tract was the most frequent organ system involved (82.9%). Male and female participants reported similar proportions of anatomical regions (injury) and organ systems (illness) affected. These results could help to generate education strategies and appropriate medical support before and during these competitions. Full article
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10 pages, 974 KiB  
Article
Contribution of Lower Extremity Joints on Energy Absorption during Soft Landing
by Akihiro Tamura, Kiyokazu Akasaka and Takahiro Otsudo
Int. J. Environ. Res. Public Health 2021, 18(10), 5130; https://doi.org/10.3390/ijerph18105130 - 12 May 2021
Cited by 12 | Viewed by 3078
Abstract
Soft landing after jumping is associated with the prevention of lower extremity injuries during sports activities in terms of the energy absorption mechanisms. In this study, the contribution of lower extremity joints during soft landing was investigated. Subjects comprised 20 healthy females. Kinetics [...] Read more.
Soft landing after jumping is associated with the prevention of lower extremity injuries during sports activities in terms of the energy absorption mechanisms. In this study, the contribution of lower extremity joints during soft landing was investigated. Subjects comprised 20 healthy females. Kinetics and kinematics data were obtained during drop vertical jumps using a three-dimensional motion analysis system. Negative mechanical work values in the lower extremity joints were calculated during landing. A multiple regression analysis was performed to determine which lower extremity joints contributed more in achieving soft landing. The means of mechanical work of the hip, knee, and ankle in the sagittal plane were −0.30 ± 0.17, −0.62 ± 0.31, and −1.03 ± 0.22 J/kg, respectively. Results showed that negative mechanical work in the hip and knee is effective in achieving soft landing. These findings indicate that energy absorption in the hip and knee joints might be an important factor in achieving soft landing, whereas that in the ankle has a negative effect. Therefore, when improving soft landing techniques, we should consider energy absorption in the hip and knee via eccentric activation of the hip and knee extensors during landing. Full article
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16 pages, 569 KiB  
Article
Epidemiology of Sports-Related Injuries and Associated Risk Factors in Adolescent Athletes: An Injury Surveillance
by Pablo Prieto-González, Jose Luis Martínez-Castillo, Luis Miguel Fernández-Galván, Arturo Casado, Sergio Soporki and Jorge Sánchez-Infante
Int. J. Environ. Res. Public Health 2021, 18(9), 4857; https://doi.org/10.3390/ijerph18094857 - 2 May 2021
Cited by 62 | Viewed by 13012
Abstract
The present study aimed to determine the epidemiology of sport-related injuries in amateur and professional adolescent athletes and the incidence of different risk factors on those injuries. Four hundred ninety-eight athletes aged 14 to 21 voluntarily participated in this prospective injury surveillance, conducted [...] Read more.
The present study aimed to determine the epidemiology of sport-related injuries in amateur and professional adolescent athletes and the incidence of different risk factors on those injuries. Four hundred ninety-eight athletes aged 14 to 21 voluntarily participated in this prospective injury surveillance, conducted from 1 January 2019 to 31 December 2019. The information collected included: personal data, sports aspects, characteristics of the injuries, and lifestyle. Forty point four percent of the participants suffered an injury in 2019 (39% of them in a previously injured area). The average injury rate was 2.64 per 1000 h. Soccer presented the highest rate (7.21). The most common injuries were: lumbar muscle strains (12.24%), ankle sprains (11.98%), and bone fractures (9.31%). Ankles (36.12%), knees (19.32%), and shoulders (6.47%) concentrated the highest number of injuries. Fifty-nine point twenty-eight percent of the injuries occurred during practices, and 40.72% during competition or peri-competition. Higher injury rates were associated (in this order) with the following factors: (a) Greater number of hours of practice per week. (b) Not performing warm-ups. (c) Using inadequate sports facilities. (d) Being aged 14–17. (e) Not performing physical preparation. (f) Inappropriate training load. (g) Not performing injury-preventive activities. (h) Performing sports technique without the supervision of one sports coach. (i) Inadequate sports equipment. In conclusion, since most injury risk factors are modifiable, it is imperative to implement strategies to reduce amateur and professional adolescent athletes’ injury rates. Full article
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11 pages, 2439 KiB  
Article
Efficacy of Electromyographic-Biofeedback Supplementation Training with Patellar Taping on Quadriceps Strengthening in Patellofemoral Pain Syndrome among Young Adult Male Athletes
by Asma Alonazi, Shahnaz Hasan, Shahnawaz Anwer, Azfar Jamal, Suhel Parvez, Faiz Abdulaziz Saleh Alfaiz and Heng Li
Int. J. Environ. Res. Public Health 2021, 18(9), 4514; https://doi.org/10.3390/ijerph18094514 - 23 Apr 2021
Cited by 13 | Viewed by 5123
Abstract
This study compares the effects of electromyographic-biofeedback (EMG-BF)-guided isometric quadriceps strengthening with patellar taping and isometric exercise alone in patellofemoral pain syndrome (PFPS) among young adult male athletes. Sixty young adult male athletes with PFPS participated in the study. Participants were randomly divided [...] Read more.
This study compares the effects of electromyographic-biofeedback (EMG-BF)-guided isometric quadriceps strengthening with patellar taping and isometric exercise alone in patellofemoral pain syndrome (PFPS) among young adult male athletes. Sixty young adult male athletes with PFPS participated in the study. Participants were randomly divided into two groups: (1) EMG-BF-guided isometric exercise training with patellar taping (experimental group, n = 30), and (2) sham EMG-BF training with an isometric exercise program (control group, n = 30). Participants conducted their respective exercise programs for five days per week across four weeks. Study outcomes were pain (measured by the visual analog scale), functional disability (measured by the Kujala Anterior Knee Pain scale), and quadriceps strength (measured by an ISOMOVE dynamometer). Measurements were taken at baseline, Week 2, Week 4, and during a follow-up at Week 6. The experimental group demonstrated significantly lower VAS score at Weeks 2 and 4 compared to that of the control group (p = 0.008 and 0.0005, respectively). The score remained significantly lower at the Week 6 follow-up compared to the control group (p = 0.0005). There were no differences in knee function at Weeks 2 and 4 between the two groups (p = 0.086 and 0.171, respectively); however, the experimental group showed significantly better knee function at Week 6 compared to the control group (p = 0.002). There were no differences in quadriceps strength at Week 2 between the two groups (p = 0.259); however, the experimental group demonstrated significantly higher quadriceps strength at Weeks 4 and 6 compared to the control group (p = 0.0008). Four weeks of EMG-BF supplementation training with patellar taping demonstrated significant improvements in pain intensity, functional disability, and quadriceps muscle strength in young adult male athletes with PFPS. Full article
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13 pages, 606 KiB  
Article
Water Ski Injuries and Chronic Pain in Collegiate Athletes
by Hyun Chul Jung, Hanna Straltsova, Michael A. Woodgate, Kyung-Min Kim, Jung-Min Lee, Joon-Hee Lee and Joshua J. Gann
Int. J. Environ. Res. Public Health 2021, 18(8), 3939; https://doi.org/10.3390/ijerph18083939 - 9 Apr 2021
Cited by 1 | Viewed by 3810
Abstract
This study examined the rate of injuries and chronic pain in collegiate water-ski athletes as a preliminary study. We also compared the mechanics and cause of injuries by the level of water-skiing experiences. A total number of 96 collegiate water-ski athletes, aged 21.4 [...] Read more.
This study examined the rate of injuries and chronic pain in collegiate water-ski athletes as a preliminary study. We also compared the mechanics and cause of injuries by the level of water-skiing experiences. A total number of 96 collegiate water-ski athletes, aged 21.4 ± 2.23 years, participated in the study. An off-line questionnaire was distributed at the collegiate tournaments in the United States. The questionnaire consisted of 20 questions, including demographic information, body region and type of injuries, mechanics and cause of injuries, chronic pain and pain management. A Chi-squared test was used to examine the differences in injury rates by sex and the level of experiences (beginner: <5 years, intermediate: 5–10 years, advanced: <10 years). The significance level was set at ≤0.05. A total of 336 water skiing-related injuries were observed from 96 participants. The ankle/feet, knee, and head/neck regions were the most common body regions injured, representing 26.5, 16.7, and 15.8%, respectively. Female athletes were more likely to have nerve injuries than male athletes (p = 0.039). The intermediate athletes were more likely to have trunk (p = 0.047) and upper extremity (p = 0.042) injuries than beginner athletes, and the beginner athletes had less joint/ligament (p = 0.001) and bone injury (p = 0.010) compared to the advanced athletes. Torsion/twisting (32.8%) and deceleration (26.9%) were the most common mechanism of injury. Beginner athletes experienced injuries more due to insufficient skill (p = 0.03), while the advanced athletes were likely to have more injuries by the loss of control (p = 0.01). Collegiate athletes had higher rates of chronic pain in the trunk (42.7%) and skeletal muscle (43.8%), and they participated in stretching/exercise (40.8%) and massage/form rolling (29.6%) to manage their chronic pain. The present study revealed that injury rates in males and females were 49.7% and 50.2%, respectively. Female athletes were more likely to have a nerve injury than male athletes. The mechanics and cause of injuries were different by the level of experiences where different training approaches may be required to minimize the injuries. Additionally, the strength and conditioning program that is systematically designed for core strength is needed to eliminate chronic trunk pain in collegiate water-skiing athletes. Full article
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10 pages, 359 KiB  
Article
Epidemiology of Injuries in First Division Spanish Women’s Soccer Players
by Rodrigo Martín-San Agustín, Francesc Medina-Mirapeix, Andrea Esteban-Catalán, Adrian Escriche-Escuder, Mariana Sánchez-Barbadora and Josep C. Benítez-Martínez
Int. J. Environ. Res. Public Health 2021, 18(6), 3009; https://doi.org/10.3390/ijerph18063009 - 15 Mar 2021
Cited by 11 | Viewed by 5079
Abstract
The epidemiology of injuries in female soccer has been studied extensively in several national leagues. Even so, data on the first division Spanish league are limited. The objective of this study was to describe the epidemiology of the first division of the Spanish [...] Read more.
The epidemiology of injuries in female soccer has been studied extensively in several national leagues. Even so, data on the first division Spanish league are limited. The objective of this study was to describe the epidemiology of the first division of the Spanish Women’s Soccer League and to analyze data in relation to game position, circumstance, or the moment of injury. Fifteen teams and 123 players participated in the study. Players’ characteristics and their injuries (location, type, diagnosis, circumstance, and moment) were collected. Injuries were described by their frequencies (number and percentage) and incidence rates (IR) with 95% confidence intervals (CIs). Lower limb injuries accounted for 86.8% of total injuries. Anterior cruciate ligament (ACL) and meniscus injuries occurred in totality in non-contact circumstance (0.35/1000 h; 95% CI, 0.18 to 0.62 and 0.23/1000 h; 95% CI, 0.10 to 0.45, respectively). Match injury IRs (19.02/1000 h; 95% CI, 14.89 to 23.97) were significantly higher than training (1.70/1000 h; 95% CI, 1.27 to 2.22). As a conclusion, structures such as the ACL or meniscus are most commonly injured in the non-contact circumstance in the first division of the Spanish Women’s Soccer League. In addition, match situations involve a greater risk of injury than training, increasing the risk to the ankle and knee injuries as the season progresses. Full article
12 pages, 394 KiB  
Article
Relationship between Training Factors and Injuries in Stand-Up Paddleboarding Athletes
by Arkaitz Castañeda-Babarro, Julio Calleja-González, Aitor Viribay, Diego Fernández-Lázaro, Patxi León-Guereño and Juan Mielgo-Ayuso
Int. J. Environ. Res. Public Health 2021, 18(3), 880; https://doi.org/10.3390/ijerph18030880 - 20 Jan 2021
Cited by 7 | Viewed by 3273
Abstract
Stand-up paddleboarding (SUP) is an increasingly popular sport but, as in other sports, there is an injury ratio associated with practicing it. In other types of sport, some factors have been linked to the likelihood of suffering an injury, among which stretching, core [...] Read more.
Stand-up paddleboarding (SUP) is an increasingly popular sport but, as in other sports, there is an injury ratio associated with practicing it. In other types of sport, some factors have been linked to the likelihood of suffering an injury, among which stretching, core training and resistance training may be considered the most significant. Therefore, the main aim of this study was to identify the training factors that could influence injuries suffered by participants in international SUP competitions. Ninety-seven questionnaires were collected from paddlers who participated in an international SUP circuit, with epidemiological data being gathered about injuries and different questions related to the training undertaken. A multi-factor ANOVA test was used to identify the factors which influence the state of injury. Results showed that almost 60% of injuries occurred in the arms or in the upper thoracic region, around 65% of which were in tendons or muscles and, in almost half of cases, were related to overuse. Likewise, the results showed that athletes with injury performed fewer resistance training sessions per week (p = 0.028), over fewer months per year (p = 0.001), more weekly training sessions (p = 0.004) and, lastly, a greater volume of weekly training (p = 0.003) than athletes without injury. Moreover, the most important training factors that reduce the likelihood of suffering an injury were taken into account-in. particular, resistance training alone (p = 0.011) or together with CORE training (p = 0.006) or stretching (p = 0.012), and the dominant side of paddling (p = 0.032). In conclusion, resistance training would seem to reduce the likelihood of injury among SUP practitioners, and such benefits could be obtained by resistance training alone or in combination with CORE training or stretching. Full article
13 pages, 893 KiB  
Article
Analyzing the Magnitude of Interlimb Asymmetries in Young Female Soccer Players: A Preliminary Study
by Javier Raya-González, Filipe Manuel Clemente and Daniel Castillo
Int. J. Environ. Res. Public Health 2021, 18(2), 475; https://doi.org/10.3390/ijerph18020475 - 8 Jan 2021
Cited by 21 | Viewed by 3175
Abstract
Although asymmetries in lower limbs have been linked with players’ performance in male soccer players, literature that has been published addressing female soccer is scarce. Thus, the aim of this study was twofold: (i) describe the asymmetries of women soccer players during jumping, [...] Read more.
Although asymmetries in lower limbs have been linked with players’ performance in male soccer players, literature that has been published addressing female soccer is scarce. Thus, the aim of this study was twofold: (i) describe the asymmetries of women soccer players during jumping, change-of-direction and range-of-motion tests; and (ii) test possible relationships between asymmetries and injury risk in female soccer players. Sixteen female players (15.5 ± 1.5 years) performed a battery of fitness tests (i.e., jump ability, change-of-direction ability and passive range-of-motion) and muscle mass analysis via dual-energy X-ray absorptiometry, through which the specific asymmetry index and the related injury risk were calculated. Significant (p < 0.05) lower asymmetries in the change-of-direction test were observed in comparison to those observed in jumping and range-of-motion tests; significant (p < 0.05) lower asymmetries in muscle mass were also reported compared to those found in the change-of-direction and countermovement jump tests. Additionally, increased injury risk for countermovement jump and hip flexion with extended knee range-of-motion (relating to asymmetry values) and for ankle flexion with flexed knee range-of-motion in both legs (relating to reference range-of-motion values), as well as increased individual injury risk values, were observed across all tests. These findings suggest the necessity to implement individual approaches for asymmetry and injury risk analyses. Full article
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2020

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2 pages, 226 KiB  
Comment
Letter to the Editor—Changes in Muscle Pattern Activity during the Asymmetric Flat Bench Press
by Atle Hole Saeterbakken, Tom Erik Solstad, Matthew Peter Shaw and Vidar Andersen
Int. J. Environ. Res. Public Health 2021, 18(1), 41; https://doi.org/10.3390/ijerph18010041 - 23 Dec 2020
Cited by 2 | Viewed by 2121
Abstract
In June 2020, the paper “Changes in Muscle Pattern Activity during the Asymmetric Flat Bench Press” was published in the International Journal of Environmental Research and Public Health [...] Full article
14 pages, 683 KiB  
Article
Variations of Workload Indices Prior to Injuries: A Study in Trail Runners
by Sérgio Matos, Filipe Manuel Clemente, Rui Silva and José María Cancela Carral
Int. J. Environ. Res. Public Health 2020, 17(11), 4037; https://doi.org/10.3390/ijerph17114037 - 5 Jun 2020
Cited by 9 | Viewed by 3815
Abstract
The purpose of this study was to compare the variations of weekly workload indices of internal and external load measures across the three weeks prior to injury occurrences in trail runners. Twenty-five trail runners (age: 36.23 ± 8.30 years old; body mass: 67.24 [...] Read more.
The purpose of this study was to compare the variations of weekly workload indices of internal and external load measures across the three weeks prior to injury occurrences in trail runners. Twenty-five trail runners (age: 36.23 ± 8.30 years old; body mass: 67.24 ± 5.97 kg; height: 172.12 ± 5.12 cm) were monitored daily for 52 weeks using global positioning systems (GPSs) to determine the total distance covered. Additionally, a rate of perceived exertion (RPE) scale was applied to determine session-RPE (sRPE: RPE multiplied by training time). The accumulated load (AL), acute: chronic workload ratio (ACWR), training monotony (TM), and training strain (TS) indices were calculated weekly for each runner. During the period of analysis, the injury occurrences were recorded. The differences were observed in AL and ACWR for sRPE and training time were significantly greater during the injury week when compared to the previous weeks. Similar evidence was found in TM and TS indices for sRPE, training time, and total distance. Furthermore, no meaningful differences were observed in AL and ACWR for total distance in the weeks prior to injury occurrence. Nevertheless, significant between-subjects variability was found, and this should be carefully considered. For that reason, an individualized analysis of the workload dynamics is recommended, avoiding greater spikes in load by aiming to keep a progressive increment of load without consequences for injury risk. Full article
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9 pages, 749 KiB  
Article
Changes in Muscle Pattern Activity during the Asymmetric Flat Bench Press (Offset Training)
by Jakub Jarosz, Artur Gołaś, Michal Krzysztofik, Patryk Matykiewicz, Katarzyna Strońska, Adam Zając and Adam Maszczyk
Int. J. Environ. Res. Public Health 2020, 17(11), 3912; https://doi.org/10.3390/ijerph17113912 - 1 Jun 2020
Cited by 13 | Viewed by 4594
Abstract
Background: This study aimed to compare the muscle activity between the symmetric and selected asymmetric loads (2.5%; 5% and 7.5% differences in load position between sides of the bar) during the flat bench press (BP) exercise at 70%1RM. The study included 10 resistance-trained [...] Read more.
Background: This study aimed to compare the muscle activity between the symmetric and selected asymmetric loads (2.5%; 5% and 7.5% differences in load position between sides of the bar) during the flat bench press (BP) exercise at 70%1RM. The study included 10 resistance-trained males (25.3 ± 2.3 years; 82.9 ± 6.9 kg; 177.8 ± 4.5 cm; 1RM BP: 104.5 ± 8.6 kg; experience: 5.6 ± 1.5 years). Methods: To assess the differences in muscle activity between both sides of the body and load placement, the participants performed several attempts of the BP with symmetric and asymmetric load at 70%1RM in a random order (symmetric; 2.5%; 5% and 7.5% differences in load position between sides of the bar). Peak muscle activity of dominant and non-dominant body-side was recorded for the pectoralis major (PM), anterior deltoid (AD), and the long head of the triceps brachii (TB). Results: A two-way repeated-measures analysis of variance (ANOVA) indicated a statistically significant main interaction between side and load (p < 0.01) for AD, PM and TB muscles. Conclusion: The results of this study showed that asymmetrically loaded BP leads to significantly higher muscle activity on the loaded side of the body. The offset training method during bilateral resistance exercise may be an effective and simple approach for reductions in muscle imbalances and improvement in bilateral exercise performance. Full article
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9 pages, 1437 KiB  
Article
Eccentric-Overload Production during the Flywheel Squat Exercise in Young Soccer Players: Implications for Injury Prevention
by Javier Raya-González, Daniel Castillo, Marta Domínguez-Díez and José Luis Hernández-Davó
Int. J. Environ. Res. Public Health 2020, 17(10), 3671; https://doi.org/10.3390/ijerph17103671 - 22 May 2020
Cited by 14 | Viewed by 4849
Abstract
This study aimed to evaluate the differences in power production between movement phases (i.e., concentric and eccentric) during the execution of resistance exercises with a flywheel device, differentiating between execution regimes (i.e., bilateral, unilateral dominant leg and unilateral non-dominant leg). Twenty young elite [...] Read more.
This study aimed to evaluate the differences in power production between movement phases (i.e., concentric and eccentric) during the execution of resistance exercises with a flywheel device, differentiating between execution regimes (i.e., bilateral, unilateral dominant leg and unilateral non-dominant leg). Twenty young elite soccer players (U−17) performed two sets of six repetitions of the bilateral half-squat (inertia 0.025 kg·m−2) and the lateral-squat exercise (inertia 0.010 kg·m−2) on a flywheel device. During the testing sessions, mean and peak power in concentric (MPcon) and eccentric (MPecc) phases were recorded. The non-dominant leg showed higher values in all power variables measured, although substantial differences were only found in MPecc (ES = 0.40, likely) and PPcon (ES = 0.36, possibly). On the other hand, for both exercises, MPcon was higher than MPecc (ES = −0.57 to −0.31, possibly/likely greater), while only PPecc was higher than PPcon in the dominant lateral-squat (ES = 0.44, likely). These findings suggest that young soccer players have difficulty in reaching eccentric-overload during flywheel exercises, achieving it only with the dominant leg. Therefore, coaches should propose precise preventive programs based on flywheel devices, attending to the specific characteristics of each limb, as well as managing other variables to elicit eccentric-overload. Full article
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18 pages, 634 KiB  
Review
Risk Factors for Upper Limb Injury in Tennis Players: A Systematic Review
by Afxentios Kekelekis, Pantelis Theodoros Nikolaidis, Isabel Sarah Moore, Thomas Rosemann and Beat Knechtle
Int. J. Environ. Res. Public Health 2020, 17(8), 2744; https://doi.org/10.3390/ijerph17082744 - 16 Apr 2020
Cited by 24 | Viewed by 12048
Abstract
Studies in tennis injuries have successfully identified the incident rate, the location, and the type of the injury. The majority of the studies have multiple perspectives (epidemiology, biomechanics, performance), however only a few studies were able to identify risk factors or mechanisms that [...] Read more.
Studies in tennis injuries have successfully identified the incident rate, the location, and the type of the injury. The majority of the studies have multiple perspectives (epidemiology, biomechanics, performance), however only a few studies were able to identify risk factors or mechanisms that contribute to tennis injuries. Until now, there has not been a systematic literature review that identifies risk factors for tennis injuries. The objective of this review was to identify and critically appraise the evidence related to risk factors for upper limb injury in tennis players. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework, using a research question developed by the Patient Problem, (or Population) Intervention, Comparison or Control, and Outcome (PICO) methodology. The quality of the studies included was moderate to low, indicating prolonged tennis (exposure to tennis), scapular dyskinesis, muscle fatigue, scapulothoracic properties, shoulder kinetics or kinematics, skill level, and technique as risk factors for upper limb injury in tennis players. In this review, it is evidenced that the majority of tennis injuries are associated with overuse and a chronic time course, however, tennis injuries do not arise from a linear combination of isolated and predictive factors. Therefore, the multifactorial and complex nature of tennis injuries has to be further examined. The necessity of more randomized control trial studies is highly recommended. Full article
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