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Clinical Aspects of Return to Sport After Injuries
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Clinical Aspects of Return to Sport After Injuries

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Sports Medicine".

Deadline for manuscript submissions: 20 February 2025 | Viewed by 9124

Special Issue Editors

Prof. Dr. Anna Mika

E-Mail Website
Guest Editor
Institute of Clinical Rehabilitation, University of Physical Education in Kraków, 31-571 Kraków, Poland
Interests: rehabilitation medicine; sports medicine; exercise science; biomechanics; bioengineering
Special Issues, Collections and Topics in MDPI journals
Dr. Łukasz Oleksy

E-Mail Website
Guest Editor
1. Department of Physiotherapy, Faculty of Health Sciences, Medical College Krakow, Jagiellonian University, Krakow, Poland
2. Oleksy Medical & Sports Sciences, Łańcut, Poland
Interests: rehabilitation medicine; sports medicine; exercise science; return to sport; injury risk; biomechanics; bioengineering
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Optimal athletic training should lead to a high level of performance, but, usually, a high volume of repetition and a lack of variety in movement patterns can result in muscle imbalance, altering tissue stress, which leads to injury. Returning to sport after injury is often a difficult and time-consuming process. However, it is crucial to understand the underlying mechanisms of sports injury, which allow for successive treatment, rehabilitation or sport training individualization. There is a need to define the key performance indicators in the return-to-sport monitoring process and to develop guidelines for effective therapeutic intervention after injuries. The aim of this Special Issue is to provide a comprehensive overview of the advances in the diagnosis and treatment of sports injuries, with a particular emphasis on all clinical and functional aspects that influence the safe and effective return to sport after an injury. Therefore, this Special Issue aims to highlight the explanations for alterations in the musculoskeletal system, particularly emphasizing mechanisms of tissue overload and injury from the biomechanical, rehabilitation and sport perspectives. Research papers as well as review papers are encouraged.

Prof. Dr. Anna Mika
Dr. Łukasz Oleksy
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • musculoskeletal system
  • tissue overload
  • diagnostic methods
  • rehabilitation
  • treatment
  • injury prevention
  • return to sport
  • rehabilitation medicine
  • sports medicine

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Published Papers (5 papers)

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Research

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11 pages, 1112 KiB  
Article
Distal Triceps Tendon Repair in Strength Athletes Leads to Satisfactory Return to Sports: A Retrospective Analysis of 22 Cases
by Michael Stephan Gruber, Martin Bischofreiter, Felix Rittenschober, Michael Schachermayr, Reinhold Ortmaier and Mathias Ritsch
J. Clin. Med. 2024, 13(16), 4913; https://doi.org/10.3390/jcm13164913 - 20 Aug 2024
Viewed by 900
Abstract
Background: Distal triceps brachii tendon rupture (DTTR) is a relatively rare injury that is common in bodybuilding and high-intensity contact sports and can lead to significant functional impairment of the elbow joint. This study was conducted to evaluate clinical outcomes and the [...] Read more.
Background: Distal triceps brachii tendon rupture (DTTR) is a relatively rare injury that is common in bodybuilding and high-intensity contact sports and can lead to significant functional impairment of the elbow joint. This study was conducted to evaluate clinical outcomes and the rate of return to sports among competitive bodybuilders and high-demand strength athletes after surgical repair of DTTR. Methods: This retrospective case series was performed in an institutional setting in tertiary health care. Return to sports of 22 competing or high-demand strength athletes (meaning three or more exercises per week) were analyzed pre- and postoperatively after surgical repair of DTTR using a hybrid technique of transosseous sutures and anchor fixation. Descriptive statistics were used to analyze demographic variables, and independent and paired t-tests were used to assess clinical outcomes. Results: The follow-up showed that from pre- to postoperatively, there was no deterioration in the number of sports disciplines (2.4 and 2.5 sporting activities per person, respectively; p = 0.540) or in the frequency of weekly training (4.1 and 4.1 times per person, respectively; p = 0.329). The postoperative visual analog scale for pain (from 6.0 to 1.6, p < 0.001), level of fitness (from 5.1 to 2.6, p = 0.002), and ability to train (from 5.2 to 1.3, p < 0.001) improved significantly. The time of return to sports was 1.5–3 months and 4–6 months after the surgery for ten patients each. The overall rate of return to sports was 95%, whereas 86% returned to the preinjury level of sporting activity. Conclusions: Repair of DTTR leads to high rates of return to sports in competitive athletes. Full article
(This article belongs to the Special Issue Clinical Aspects of Return to Sport After Injuries)
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9 pages, 2175 KiB  
Article
Bucket-Handle Meniscal Tears Might Not Be an Urgency: The Time to Meniscus Repair Does Not Seem to Affect the Mid-Term Outcome—A Retrospective Study of Sixty Tears with a Mean Follow-Up of 6 Years
by Philipp Schippers, Victoria Buschmann, Felix Wunderlich, Yama Afghanyar, Sebastian Fischer, Erik Wegner, Philipp Drees, Erol Gercek and Lukas Eckhard
J. Clin. Med. 2024, 13(11), 3048; https://doi.org/10.3390/jcm13113048 - 22 May 2024
Viewed by 915
Abstract
Background: Bucket-handle meniscal tears are mostly treated arthroscopically. However, there is no clear evidence as to whether the time to surgery impacts the outcome and whether or not lesions should be treated urgently. Methods: Sixty patients were interviewed about the current [...] Read more.
Background: Bucket-handle meniscal tears are mostly treated arthroscopically. However, there is no clear evidence as to whether the time to surgery impacts the outcome and whether or not lesions should be treated urgently. Methods: Sixty patients were interviewed about the current status of their knee with a mean follow-up of 6.1 years (SD = 3.5). Forty-one patients underwent meniscus repair, and fifteen patients received partial resections. The primary outcome was the rate of reoperation after meniscus repair. Secondary outcomes were pain at rest and during exercise, return to sports, and Tegner and Lysholm scores. Results: The average time to surgery was 14.4 days, with no significant impact of surgical timing on the rate of reoperation. Furthermore, no significant differences were found in pain levels, return to sports, or Tegner and Lysholm scores based on the timing of surgery. Conclusions: In our cohort, the time to surgery was not a prognostic factor for the reoperation rate or postoperative outcome in repairing bucket-handle meniscal tears. Therefore, arthroscopic repair should not be performed in an emergency setting but conducted after careful planning by experienced arthroscopy surgeons. Regarding the return to sports, postoperative factors such as rehabilitation protocols or surgical techniques could be more important than the time to surgery. Full article
(This article belongs to the Special Issue Clinical Aspects of Return to Sport After Injuries)
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15 pages, 1063 KiB  
Article
Immediate Effect of Cryo-Compression Therapy on Biomechanical Properties and Perfusion of Forearm Muscles in Mixed Martial Arts Fighters
by Robert Trybulski, Adrian Kużdżał, Marta Bichowska-Pawęska, Andriy Vovkanych, Adam Kawczyński, Grzegorz Biolik and Jarosław Muracki
J. Clin. Med. 2024, 13(4), 1177; https://doi.org/10.3390/jcm13041177 - 19 Feb 2024
Cited by 4 | Viewed by 2019
Abstract
Mixed martial arts (MMA) fighters use their arms and hands for striking with the fists, grappling, and defensive techniques, which puts a high load on the forearms and hand muscles. New methods are needed to decrease the risk of injury and increase the [...] Read more.
Mixed martial arts (MMA) fighters use their arms and hands for striking with the fists, grappling, and defensive techniques, which puts a high load on the forearms and hand muscles. New methods are needed to decrease the risk of injury and increase the effectiveness of regeneration. This study aimed to assess the effectiveness of cryo-compression (CC) therapy of different times (3 and 6 min) on forearm muscles in MMA fighters by investigating muscle pain, stiffness, tension, elasticity strength, and perfusion. Twenty professional male MMA fighters aged 26.5 ± 4.5 years, with training experience of 10.3 ± 5.0 years, were enrolled on an experimental within-group study design. The participants underwent CC therapy at a temperature of 3 °C and compression of 75 mmHg for 3 min and, in the second session, for 6 min. The investigated parameters were in the following order: (1) perfusion in non-reference units (PU), (2) muscle tone (T—[Hz]), (3) stiffness (S—[N/m]), (4) elasticity (E—[arb]), (5) pressure pain threshold (PPT—[N/cm]), and (6) maximum isometric force (Fmax [kgf]) at two time points: (1) at rest—2 min before CC therapy (pre) and (2) 2 min after CC therapy (post). There were significant differences between 3 and 6 min of CC therapy for PU and T. Meanwhile, F, E, PPT, and S were significantly different when comparing pre- to post-conditions. These results provide evidence that CC therapy is a stimulus that significantly affects parameters characterizing muscle biomechanical properties, pain threshold, strength, and tissue perfusion. Full article
(This article belongs to the Special Issue Clinical Aspects of Return to Sport After Injuries)
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14 pages, 828 KiB  
Systematic Review
Return to Sport Following Arthroscopic Management of Femoroacetabular Impingement: A Systematic Review
by Ludovico Lucenti, Nicola Maffulli, Tommaso Bardazzi, Raoul Saggini, Michael Memminger, Francesco Simeone and Filippo Migliorini
J. Clin. Med. 2024, 13(17), 5219; https://doi.org/10.3390/jcm13175219 - 3 Sep 2024
Viewed by 974
Abstract
 Background: Femoroacetabular impingement (FAI) is common. The present systematic review updates the current evidence on return to sport (RTS) in patients who have undergone arthroscopic surgery for FAI in any of its variants (CAM, pincer, or both). Methods: The outcomes of interest were [...] Read more.
 Background: Femoroacetabular impingement (FAI) is common. The present systematic review updates the current evidence on return to sport (RTS) in patients who have undergone arthroscopic surgery for FAI in any of its variants (CAM, pincer, or both). Methods: The outcomes of interest were sports-related patient-reported outcome measures (PROMs) and the level and time to RTS. All available clinical studies concerning the RTS following arthroscopic management of FAI were considered. In July 2024, the following databases were accessed following the PRISMA guidelines: Embase, Web of Science, and PubMed. Only studies with a minimum of six months of follow-up were eligible. Results: From 1245 initially identified articles, 43 studies (4103 patients) met the inclusion criteria, in which 32.1% (1317 of 4103 patients) were women. The mean length of follow-up was 33.7 ± 15.8 months. The mean age was 28.1 ± 7.2 years, the mean BMI was 24.7 ± 6.4 kg/m2, and 79.6% ± 27.8% of patients returned to sport at the same or higher level at a mean of 14.3 ± 9.6 months. The mean time away from sports was 8.0 ± 3.3 months. Conclusion: Arthroscopic management for FAI leads to a high rate of RTS, with approximately 80% of patients returning to their preinjury level. Future research should focus on standardised definitions of RTS, sport-specific rehabilitation protocols, and the influence of deformity and procedures on RTS. Full article
(This article belongs to the Special Issue Clinical Aspects of Return to Sport After Injuries)
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11 pages, 251 KiB  
Protocol
Physical Therapies for Delayed Onset Muscle Soreness: A Protocol for an Umbrella and Mapping Systematic Review with Meta-Meta-Analysis
by Szczepan Wiecha, Paweł Posadzki, Robert Prill and Maciej Płaszewski
J. Clin. Med. 2024, 13(7), 2006; https://doi.org/10.3390/jcm13072006 - 29 Mar 2024
Cited by 1 | Viewed by 3683
Abstract
Background: Delayed onset muscle soreness (DOMS), also known as exercise-induced muscle damage (EIMD), is typically caused by strenuous and/or unaccustomed physical exercise. DOMS/EIMD manifests itself in reduced muscle strength and performance levels, increased muscle soreness, swelling, and elevated levels of inflammatory biomarkers. Numerous [...] Read more.
Background: Delayed onset muscle soreness (DOMS), also known as exercise-induced muscle damage (EIMD), is typically caused by strenuous and/or unaccustomed physical exercise. DOMS/EIMD manifests itself in reduced muscle strength and performance levels, increased muscle soreness, swelling, and elevated levels of inflammatory biomarkers. Numerous randomised controlled trials (RCTs) and systematic reviews (SRs) of a wide variety of physiotherapy interventions for reducing the signs and symptoms of DOMS/EIMD have been published. However, these SRs often arrive at contradictory conclusions, impeding decision-making processes. Objective: We will systematically review the current evidence on clinical outcomes (efficacy, safety) of physiotherapy interventions for the treatment of DOMS/EIMD in healthy adults. We will also assess the quality of the evidence and identify, map, and summarise data from the available SRs. Method: Umbrella review with evidence map and meta-meta-analyses. MEDLINE, Embase, Cochrane Database of Systematic Reviews, Epistemonikos and PEDro will be searched from January 1998 until February 2024. SRs of RCTs of any treatment used by physiotherapists (e.g., low-level laser therapy, electrical stimulation, heat/cold therapy, ultrasound, magnets, massage, manual therapies) to treat DOMS/EIMD in healthy adults will be eligible. Narrative/non-systematic reviews, studies of adolescents/children and medically compromised individuals, of complementary therapies, dietary, nutritional, or pharmacological interventions, as well as self-administered interventions, or those published before 1998, will be excluded. AMSTAR 2 will be used to evaluate the methodological quality of the included SRs. Corrected covered area, will be computed for assessing overlaps among included SRs, and an evidence map will be prepared to describe the credibility of evidence for interventions analysed in the relevant SRs. Discussion: DOMS/EIMD is a complex condition, and there is no consensus regarding the standard of clinical/physiotherapeutic care. By critically evaluating the existing evidence, we aim to inform clinicians about the most promising therapies for DOMS/EIMD. This umbrella review has the potential to identify gaps in the existing evidence base that would inform future research. The protocol has been registered at PROSPERO (CRD42024485501]. Full article
(This article belongs to the Special Issue Clinical Aspects of Return to Sport After Injuries)
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