Medical check of competitive canoeists

Development of a video camera-type kayak motion capture system to measure water kayaking

Background

In kayaking, trunk motion is one of the important factors that prevent injury and improve performance. Kinematic studies in kayaking have been reported in laboratory settings using paddling simulators and ergometers. However, such studies do not reflect kayaking on water, the actual competitive environment. Therefore, we developed a video camera-type kayak motion capture system (KMCS) wherein action cameras were fixed to a kayak to capture images of markers attached to an athlete's body. This study aimed to compare the kinematic data between KMCS and an optical motion capture system (OMCS) in kayaking and to determine the accuracy of the KMCS analysis.

Methods

In a competition, five elite junior female kayak athletes performed kayak paddling under the unloaded condition using a kayak. The kayak was secured using a tri-folding bench and a towel, and twenty strokes were recorded during maximal paddling. One stroke was defined as the period from right catch to left catch, and the first six strokes were used to evaluate the accuracy. Trunk angles (tilting, turning, and rotation) were examined with the simultaneous use of KMCS and OMCS, and the differences between these systems were evaluated. To ensure reliability, intraclass correlation coefficient (ICC; a two-way mixed model for absolute agreement) was calculated for each angle. Furthermore, Bland-Altman analysis was performed to understand the agreement between the two systems.

Results

Root mean square errors (RMSEs) were 1.42° and 3.94° for turning and rotation, respectively, and mean absolute errors (MAEs) were 1.08° and 3.00° for turning and rotation, respectively. The RMSE and MAE for tilting were 2.43° and 1.76°, respectively, which indicated that the validity was comparable to that of other angles. However, the range of motion in tilting was lower than that in turning and rotation. Bland-Altman analysis showed good agreement in the total range of motion, with mean bias values of -0.84°, -0.07°, and -0.41° for tilting, turning, and rotation, respectively. The ICCs for tilting, turning, and rotation were 0.966, 0.985, and 0.973, respectively, and showed excellent reliability.

Conclusions

The newly developed KMCS effectively measured the trunk motion with good accuracy in kayaking. In future studies, we intend to use KMCS to measure kayaking on water and collect data for performance improvement and injury prevention.

Somatic characteristic, morphological asymmetry and postural stability of youth male canoeists compared to control. A cross-sectional study

OBJECTIVE

To determine the relationships between selected morphological characteristics and the level of body composition asymmetry with postural stability among canoeists and a control group.

METHODS

The sample consisted of 43 males (21 canoeists 21.8±3.29 years and 22 university students 21.7±1.32 years). Measurements included body height and weight. Segmental body composition analysis was assessed using the bioelectrical impedance by determining: fat mass (FM, kg, %), fat-free mass (FFM, kg) and predicted muscle mass (PMM, kg). Postural stability was tested using the BIODEX Balance System. Anterior-posterior stability index (APSI), medial-lateral stability index (MLSI) and overall stability index (OSI) were calculated.

RESULTS

Our findings suggest that the canoeists had statistically lower level of fatty tissue compared to controls. There was a statistically important difference between groups in lower limb FM (% and kg). In both groups morphological asymmetry was observed, but in most cases-in athletes. Asymmetries between right and left arms appeared in all parameters, while asymmetries between right and left legs were noted in all parameters except FM (kg). There were relationships between stature and body weight with postural stability in canoeists. Canoeists demonstrated better balance than controls, particularly in the APSI. For all stability indices, significant differences were observed between right and left legs across all participants.

CONCLUSIONS

Athletes, with larger asymmetries or poorer balance, require more attention to improve performance and reduce the risk of overload injury. Future studies needed to develop sport-specific level of morphofunctional asymmetry which would be optimal for sport results and health as well.

Relationship Between Training Factors and Injuries in Stand-Up Paddleboarding Athletes

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.

Prevalence and risk factors for back pain in sports: a systematic review with meta-analysis

OBJECTIVES

We aimed to determine the prevalence of low back pain (LBP) in sport, and what risk factors were associated with LBP in athletes.

DESIGN

Systematic review with meta-analysis.

DATA SOURCES

Literature searches from database inception to June 2019 in Medline, Embase, Cumulated Index to Nursing and Allied Health Literature (CINAHL), Web of Science and Scopus, supplemented by grey literature searching.

ELIGIBILITY CRITERIA

Studies evaluating prevalence of LBP in adult athletes across all sports.

RESULTS

Eighty-six studies were included (30 732, range 20-5958, participants), of which 45 were of 'high' quality. Definitions of LBP varied widely, and in 17 studies, no definition was provided. High-quality studies were pooled and the mean point prevalence across six studies was 42%; range 18%-80% (95% CI 27% to 58%, I2=97%). Lifetime prevalence across 13 studies was 63%; range 36%-88% (95% CI 51% to 74%, I2=99%). Twelve-month LBP prevalence from 22 studies was 51%; range 12%-94% (95% CI 41% to 61%, I2=98%). Comparison across sports was limited by participant numbers, study quality and methodologies, and varying LBP definitions. Risk factors for LBP included history of a previous episode with a pooled OR of 3.5; range 1.6-4.0 (95% CI 1.9 to 6.4). Statistically significant associations were reported for high training volume, periods of load increase and years of exposure to the sport.

CONCLUSION

LBP in sport is common but estimates vary. Current evidence is insufficient to identify which sports are at highest risk. A previous episode of LBP, high training volume, periods of load increase and years of exposure are common risk factors.

Musculoskeletal Injury in Paddle Sport Athletes

INTRODUCTION

Kayak racing has been an Olympic sport since 1936. The sport is evolving with the introduction of ocean skis and stand-up-paddle boards (SUP). Musculoskeletal injury incidence surveys have been conducted for ultra-marathon events, but no data have been published for other racing formats.

OBJECTIVE

To identify and compare the rates and types of injuries sustained by paddling athletes as a function of discipline and training parameters in Sprint, Marathon, Ultra-Marathon, and Ocean events.

METHODS

Competitors from 6 kayak and/or ocean surf-ski races in Australia were surveyed. Before each race, competitors were asked to complete a questionnaire. The questionnaire investigated paddling-related injuries over the previous 5 years, athlete morphology, flexibility, equipment and its setup, training volume, and environment.

RESULTS

Five hundred eighty-three competitors were surveyed. Disciplines included 173 racing-kayak (K1), 202 touring-kayak, 146 ocean-skis, 42 SUP, and 20 other. The top 5 paddling-related injuries were shoulder (31%), low back (23.5%), wrist (16.5%), neck (13.7%), and elbow (11.0%). The highest percentage of injury was found in K1 paddlers for shoulder (40.5%), SUP for low back (33.3%), and ocean-ski for wrist (22.6%). After controlling for on-water training hours, the relative risk (RR) of wrist injury was significantly increased in ocean-ski paddlers (1.86) and in paddlers with decreased flexibility (1.53-1.83). Relative risk of shoulder and low-back injury was significantly increased in athletes with lower training volumes (1.82-2.07). Younger athletes had lower RR of wrist and shoulder injury (0.58-0.62).

Pediatric and adolescent injury in aquatic adventure sports

Drowning is a leading cause of death in children. Each year there are thousands of injuries in children, some fatal, associated with aquatic adventure sports. Personal water craft rapidly accelerate children to high velocities, as does being towed behind boats on skis or tubes, whereupon children have no control of their speed or direction. Canoeing and white-water kayaking particularly stress the upper limbs and shoulder dislocations are a primary concern. Surfing and kite-surfing generate more injuries to the head and face than other parts of the body and, in scuba diving, children most frequently injure their ears due to the acute pressure changes experienced. Aquatic injuries cost more in children than in adults and residual functional deficits may last a lifetime. There is a pressing need for research into the prevalence and incidence of aquatic injuries in children, so the effectiveness of preventive interventions can be determined.

Shoulder Injuries in Canoeing and Kayaking

OBJECTIVE

We report the largest case series of shoulder injuries among paddlers so far to establish common mechanisms and patterns of injury. We also discuss how these injuries were managed and report the proportion of paddlers that return to paddlesport.

DESIGN

Case series.

SETTING

Upper Limb Unit, Wrightington Hospital, United Kingdom. Manchester Arm Clinic, United Kingdom.

PATIENTS

Fifty-seven shoulder injuries to professional and recreational paddlers were reviewed at a mean follow-up time of 55 months from the first consultation. The patient cohort had a mean age of 36 years and consisted of 56% males.

ASSESSMENT OF RISK FACTORS

Sex, mechanism of injury, acute/nonacute injury, and level of sport participation.

MAIN OUTCOME MEASURES

Patient data were analyzed with regards to Constant score, QuickDASH score, and VAS satisfaction score before and after treatment.

RESULTS

The most common mechanism of injury was a capsize which accounted for 15 (26%) injuries. Ten injuries caused by a capsize were labral tears all of which needed surgery. A significant improvement in patient outcome scores was noted. Patients were able to return to a high level of paddling such as 3 slalom paddlers who returned to international competition; one of whom had bilateral surgery.

CONCLUSIONS

Paddlers most commonly injure their shoulder when preventing a capsize, during a capsize or while rolling. The paddles strokes performed at these times often require paddlers to place their shoulder in a dangerous abducted and externally rotated position. We believe this is one of the commonest causes of serious shoulder injuries to paddlers.

Effect of a Hamstring Flexibility Program Performed Concurrently During an Elite Canoeist Competition Season

Álvarez-Yates, T and García-García, O. Effect of a hamstring flexibility program performed concurrently during an elite canoeist competition season. J Strength Cond Res 34(3): 838-846, 2020-The aim of this study was to determine the acute effect of an 8-week specific hamstring flexibility training on junior canoeist during the competition season. Sixteen canoeists participated, divided into 3 groups: 5 in experimental group 1 (EG1), 5 in experimental group 2 (EG2), and 6 in a control group. The EG1 underwent a supervised program consisted by simple static stretching, dynamic static stretching, and proprioceptive neuromuscular facilitation (PNF), whereas the EG2 performed a program without PNF and no supervision. Two measurements were performed to analyze the effect on the knee joint range of motion (ROM) and trunk flexion; neuromuscular and contractile properties in biceps femoris (BF) and semitendinosus (ST) muscles; and maximum power and average speed in lower limbs. A mixed-design factorial analysis of variance (p ≤ 0.05) was performed and the effect size was calculated. The results show significant improvements (p ≤ 0.05) in both legs for knee joint ROM and trunk flexion in EG1 (8.9 and 25.5%; 5.7 and 20.9% in the right and left leg, respectively) and EG2 (6.7 and 22%; 3.9 and 24.4%), only EG1 improved muscular stiffness in BF (27.4% left leg) and ST (20.5 and 24.3%), and lateral symmetry in BF (49%) without decreasing average speed in lower limbs. All improvements have a large effect size. In conclusion, it is suggested that a supervised hamstring flexibility program performed concurrently during a canoeist competition season can produce an increase in the knee joint ROM and trunk flexion, without negative repercussions in contractile and neuromuscular capacities, maximum power, and average velocity in lower limbs.

Functional Movement Screening and Paddle-Sport Performance

The purpose of the study reported here was to determine the relationship between an endurance paddle-sport athlete’s total functional movement screening (FMS) score and individual race performance. Fifty elite level endurance canoeists and kayakers completed the seven-stage FMS protocol prior to the 2016 United States Canoe and Kayak Association National Championship race. Time taken to finish the race was then associated to overall FMS score and respective sub-scores. Total FMS score and various sub-scores were significantly related to race performance. Female and male athletes differed in which sub-scores were shown to be significantly correlated to finishing time. Outcomes from this study indicate that limitations in functional movement are related to endurance paddle-sport race performance.

Body structure and composition of canoeists and kayakers: analysis of junior and teenage polish national canoeing team

The somatic build, biological age, general state of health, mental predisposition and physical fitness are the criteria for selection of individuals in competitive sport. The present study aims to analys the differences in body structure and composition of canoeists and kayakers and derive conclusions regarding the criteria for selection of individuals incompetitive sport. The research was conducted on a group of 32 men aged between 17 and 22: 16 kayakers and 16 Canadian canoeists of the junior and teenage Polish national canoeing team. Body composition was examined by means of bioelectrical segmental impedance. Body build type was determined using the anthropometric Heath-Carter method. Statistical analysis was performed using the Welch t-test. The examination of morphological features reveals significant differences in the studied parameters between the canoeists and kayakers. There are also significant differences between competitors of the Sydney 2000 Olympic Games and the studied group. We found that competitive kayakers should be taller than canoeists. The lower part of the body in kayakers is more developed than in canoeists and canoeists are more dehydrated than kayakers.

Injuries, ill-health and fatalities in white water rafting and white water paddling

White water (WW) activities such as paddling (canoeing and kayaking) and rafting are popular sports for recreational and professional participants. An increase in participation has been seen worldwide. However, these activities come with a risk of injury and even death if not conducted safely. A review was conducted to identify the types of injuries and ill-health that occur as a result of these activities. Injury and fatality rates were assessed to establish the risk attributed to these activities. Web of Science, PubMed, Ergonomics Abstracts and PsycINFO databases were searched and a total of 16 published articles were identified and reviewed. The shoulders and back were the most vulnerable sites for injury in WW paddling. Injuries to the face and lower limbs were most common in WW rafters. However, injury rates are low and estimates are discussed. Due to different methods used across the studies, the reported injury rates are not comparable. This review identified three illnesses incurred through WW activities. There may be more but these are not currently reported in the literature. A relative paucity of studies regarding injuries and fatalities in WW activities was identified. Directions for future research are suggested and discussed.

Summer activities: incidents and accidents

Summer invites activities and sports that are unique to this time of year. Although safety is a priority, there are commonly accidents and incidents that occur while individuals are participating in these activities. The prevalence and incidence of several types of injuries and trauma related to water activities, camping, caving, backpacking, and hiking are discussed. Treatment of nonfatal drowning is discussed, along with the pathophysiologic process that must be corrected for optimal outcomes. Summer is a time for outdoor cooking, campfires, and the traditional Fourth of July firework pastimes, which can result in admissions to critical care areas.

The Hawkesbury Canoe Classic: musculoskeletal injury surveillance and risk factors associated with marathon paddling

OBJECTIVE

The aim of this study was to assess the incidence and risk factors for musculoskeletal injury associated with marathon paddling.

METHODS

A prospective observational cohort study was conducted during the 2006 Hawkesbury Canoe Classic (HCC), an annual 111-km paddling race in Sydney, Australia. Before the race, a written questionnaire was distributed to competitors to gather information regarding their age, gender, type of craft they were competing in, paddling experience, HCC experience, training distances, and preceding injuries. The paddler's average race speed was also used for analysis. Injuries were recorded throughout the race. Logistic regression analysis was used to identify if any of the variables were associated with injuries observed during the race.

RESULTS

Six hundred and twelve paddlers competed in the race, with 298 respondents participating in the study. Eighty-eight paddlers with a total of 135 injuries presented for medical assessment. More than one third of injuries involved the shoulder (35.6%), followed by the thoracic spine (23%), and lumbar spine (17%). Men were 3.6 times (CI: 1.39 to 9.32, P = .01) more likely to present with an injury compared with the women. A faster average speed (ie, faster finishing time) was correlated with a decrease in injury presentation (odds ratio 0.77, CI: 0.63 to 0.93, P = .01). Modifiable risk factors such as age, type of craft, paddling experience, HCC experience, training distances, and preceding injuries were not shown to increase the chance of injury presentation.

CONCLUSIONS

Further data gathered over a series of this race may point to modifiable risk factors that may help reduce the incidence of injury.

Sagittal spinal and pelvic postures of highly-trained young canoeists

The objective of this study was to determine the sagittal spinal curvatures and pelvic position in standing and kneeling in the canoe in young canoeists. Forty-four young highly-trained canoeists (mean age: 15.11 ± 0.61 years) were recruited. Thoracic and lumbar curvatures and pelvic inclination were evaluated with a Spinal Mouse system in standing position and in the base position (kneeling on one knee in the canoe) and catch phase of the stroke. The mean thoracic kyphosis, lumbar lordosis and pelvic inclination in standing were 44.66 ± 8.80º, −30.34 ± 8.31º, and 14.20 ± 7.32º, respectively. In the canoe, the thoracic, lumbar and pelvic angles were 39.66 ± 9.52º, −24.32 ± 6.79º, and 15.18 ± 4.34º, respectively, for the base position (p<0.001 with respect to standing, except for pelvic inclination), and 28.93 ± 10.45º, −13.45 ± 10.60º, and 37.61 ± 6.27º, respectively, for the catch phase of the stroke (p<0.001 with respect to standing and base position). A higher percentage of hyperkyphotic postures in standing than in the canoe was found, while thoracic hypokyphosis increased in the catch phase of the stroke. In regards to the lumbar curve, the percentage of hypolordosis postures in the base position was higher than when standing. Lumbar kyphotic postures were detected in the catch phase of the stroke. In conclusion, the standing thoracic hyperkyphosis in young canoeists may be related to factors other than the posture and movement in the canoe. The canoeists adopted a lumbar flexed posture at the catch phase of the stroke, although this position may not affect the sagittal configuration of lumbar spine in standing. Postural training should be included in the training program of canoeists to improve the thoracic posture in the standing position.

Lesões musculoesqueléticas na temporada de 2006 em atletas da seleção brasileira feminina principal de canoagem velocidade

OBJETIVO: Este estudo objetivou analisar a incidência, o tipo, a etiologia e a localização anatômica das lesões musculoesqueléticas na Seleção Brasileira de Canoagem Velocidade Feminina na Temporada de 2006. METODOLOGIA: Participaram do estudo as oito atletas da seleção, com média de idade de 19,50 anos (± 3,78); massa corporal média de 58,67 kg (± 5,44) e estatura média de 162,00 cm (± 4,00). RESULTADOS: Após a análise dos dados, obteve-se o índice de 5,06 lesões por atleta a cada 1000 horas de atividade esportiva. Observou-se também que 87,50% das atletas foram acometidas por lesões, com um total de 82,05% de casos reincidentes. As lesões mais freqüentes foram: contratura muscular (48,72%) e tendinite (23,08%). O tronco (56,41%), principalmente na região torácica e tóraco-lombar, e os MMSS (41,03%), principalmente no ombro, foram as regiões mais acometidas. CONCLUSÃO: Por conseqüência do gesto esportivo, a etiologia das lesões foi de origem atraumática devido principalmente a sobrecarga das estruturas anatômicas. Acreditamos que com a caracterização das lesões nesta modalidade esportiva, a fisioterapia desportiva poderá realizar um trabalho preventivo focado nas lesões específicas encontradas, com o objetivo que diminuir sua incidência e reincidência.

Tracing prehistoric activities: Musculoskeletal stress marker analysis of a stone-age population on the Island of Gotland in the Baltic sea

The skeletal remains from the Middle Neolithic (2750-2300 BC) burial ground at Ajvide, Gotland, are analyzed in order to explore musculoskeletal patterns and to attempt to trace general as well as three specific prehistoric activities (archery, harpooning, and kayaking) that are likely to have been performed in this marine setting of fishing, hunting, and gathering. Scoring of muscular and ligament attachments is performed using the scoring method of Hawkey and Merbs ([1995] Int. J. Osteoarchaeol. 5:324-338) for muskuloskeletal stress markers (MSM). The skeletal material consists of 24 male and 15 female adult individuals divided into three age groups: young (<24 years), middle (25-39 years), and old (>40 years). Thirty upper body MSM sites, on both the left and right sides, are scored and form the basis of the study. Results show that males most frequently have higher mean MSM scores than females. Bilateral asymmetry was noted as low in both sexes. Age proved to be a contributing factor to increased MSM scores, with a greater age-related increase in females. MSM patterns were analyzed statistically in muscle groups associated with the three investigated activities. Significant positive correlations were observed in male individuals in muscle groups associated with archery and to some extent harpooning, an indication that these activities would mainly have been performed by men. Correlations in kayaking muscles were not evidently consistent with the kayaking motion. Furthermore, the costoclavicular ligament, often referred to in connection with "kayaker's clavicle," showed no positive statistical correlation with the kayaking muscles.

Epidemiology of non-submersion injuries in aquatic sporting and recreational activities

Although the issues of drowning and near-drowning in aquatic sporting and recreational activities receive considerable attention in the epidemiological literature, there is not a recognised literature on non-submersion injuries occurring in these activities. This review draws together the epidemiological literature on non-submersion injuries and describes the incidence, nature and causes of these injuries, common risk factors, and strategies for prevention. Activities covered by the review include swimming, diving, boating, surf sports, fishing, water polo and water sliding. For most activities there is a dearth of good quality descriptive studies, with most involving cases-series designs and few providing estimates of incidence. Inconsistencies in inclusion criteria and the reporting of incidence rates makes comparisons within and between activities difficult. Incidence rates were identified for most activities and in general the incidence of injury was low, especially for more serious injury. However, some activities were associated with severely disabling injury, such as spinal cord injury (diving) and amputation (from propeller strikes in water skiing and swimming). Only three studies reporting the significance of postulated risk factors were identified. Lack of knowledge about the water being entered and alcohol consumption are significant risk factors in recreational diving; increased blood alcohol concentrations were reported to increase the risk of death in boating; and obesity and tandem riding were reported to increase the risk of injury on public water slides. Few evaluations of preventive measures were identified. Two studies reported reductions in the incidence of water slide injuries following the introduction of design changes and supervision, but neither had a non-intervention comparison group. Improvements in swimming and diving skills were reported in three studies, but these were not designed to measure changes in the risk of injury.This review demonstrates that there is a need for well-designed epidemiological research on non-submersion injury in aquatic sporting and recreational activities. The first priority should be for studies designed to describe accurately the incidence, nature, severity and circumstances of these injuries, followed by research on the significance of postulated risk factors. Once this research has been undertaken, interventions targeted at reducing the incidence of injury in aquatic sporting and recreational activities can be designed and evaluated.