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Quintana-Cepedal M, Roces-Vila I, Del Valle M, Olmedillas H. Epidemiology of injuries in elite female rink hockey players: A two season observational study. Phys Ther Sport 2024; 67:7-12. [PMID: 38394829 DOI: 10.1016/j.ptsp.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVES To record the time-loss injuries of female rink hockey players and describe the affected region, tissue, and onset of injury. DESIGN Cross-sectional survey study. SETTING First (Ok Liga) and Second (Plata) division clubs. PARTICIPANTS 280 player-seasons. MAIN OUTCOME MEASURES Incidence of overall, training, and match injuries (number of injuries per 1000 h) from two seasons. RESULTS A total of 229 injuries occurred in 56,438 h of exposure. The overall incidence was 4 injuries per 1000 h (4/1000 h), with a significantly higher rate of injuries during matches (15.2/1000 h) compared to training sessions (2.6/1000 h) (p < 0.001). Injuries affecting the lower limb were the most common (2.3/1000 h), followed by upper limb (1.2/1000 h), and head/trunk (0.6/1000 h). The tissue with the highest incidence of injury was the muscle/tendon (1.3/1000 h), followed by the ligament (0.8/1000 h). Around one in every three injuries (31%) affected either the thigh or hip/groin (73 injuries). CONCLUSIONS The injury incidence in elite female rink hockey is moderate and occurs mainly during match sessions. Preventative measurements should be implemented in rink hockey with a special concern for injuries affecting the thigh, and hip/groin.
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Affiliation(s)
- Marcos Quintana-Cepedal
- Department of Functional Biology, University of Oviedo, Oviedo, Spain; Asturian Research Group in Performance, Readaptation, Training, and Health (ASTUres), Oviedo, Spain
| | - Isaac Roces-Vila
- Department of Functional Biology, University of Oviedo, Oviedo, Spain
| | - Miguel Del Valle
- Asturian Research Group in Performance, Readaptation, Training, and Health (ASTUres), Oviedo, Spain; Department of Cellular Morphology and Biology, University of Oviedo, Oviedo, Spain
| | - Hugo Olmedillas
- Department of Functional Biology, University of Oviedo, Oviedo, Spain; Asturian Research Group in Performance, Readaptation, Training, and Health (ASTUres), Oviedo, Spain.
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Bisciotti GN, Di Pietto F, Rusconi G, Bisciotti A, Auci A, Zappia M, Romano S. The Role of MRI in Groin Pain Syndrome in Athletes. Diagnostics (Basel) 2024; 14:814. [PMID: 38667460 PMCID: PMC11049591 DOI: 10.3390/diagnostics14080814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Groin pain syndrome (GPS) is one of the most frequent injuries in competitive sports. Stresses generated in the lower limbs by quick turns and accelerations, such as in soccer, basketball or hockey, can produce localized regions of increased forces, resulting in anatomical lesions. The differential diagnoses are numerous and comprise articular, extra-articular, muscular, tendinous and visceral clinical conditions and a correct diagnosis is crucial if treatment is to be efficient. MRI is the gold standard of diagnostic techniques, especially when an alternative pathology needs to be excluded and/or other imaging techniques such as ultrasound or radiography do not lead to a diagnosis. This paper, based on the current literature, gives a comprehensive review of the anatomy of the pubic region and of the typical MRI findings in those affected by GPS. Many clinical conditions causing GPS can be investigated by MRI within appropriate protocols. However, MRI shows limits in reliability in the investigation of inguinal and femoral hernias and therefore is not the imaging technique of choice for studying these clinical conditions.
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Affiliation(s)
| | - Francesco Di Pietto
- Dipartimento di Diagnostica per Immagini, Pineta Grande Hospital, 81030 Castel Volturno, Italy
| | - Giovanni Rusconi
- Dipartimento di Diagnostica per Immagini, Pineta Grande Hospital, 81030 Castel Volturno, Italy
| | | | - Alessio Auci
- Dipartimento delle Diagnostiche, Azienda USL Toscana Nord Ovest, 56121 Massa, Italy;
| | - Marcello Zappia
- Department of Medicine and Health Science V. Tiberio, Università degli Studi del Molise, 86100 Campobasso, Italy;
| | - Stefania Romano
- Department of Radiology, S. Maria delle Grazie Hospital, 80078 Pozzuoli, Italy;
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Quintana-Cepedal M, de Pablo Marquez B, Del Valle Soto M, Olmedillas H. High Prevalence of Seasonal and Current Groin Problems in Rink Hockey Players. Int J Sports Med 2024. [PMID: 38346702 DOI: 10.1055/a-2267-0262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Groin problems are common in multidirectional sports. The aim of the present study is to assess seasonal, current, and trends for groin problems in rink hockey players, irrespective of their playing position, age, or gender. Rink hockey players from three countries [n=446 (162 female, 284 male)] were invited to participate in an online questionnaire. This form evaluated the prevalence of groin problems (time-loss and non-time-loss) for the 2022-2023 season, as well as monthly prevalence of groin problems (time-loss and non-time-loss). All groin problems were compared between playing position, gender, and age to assess between-group differences. Senior males reported the highest time-loss (25%) and non-time-loss (51%) for seasonal prevalence; while U-17 males reported the lowest in both categories of groin problems (time-loss 9%, non-time-loss 27%). No significant differences between playing position or gender were found for any of the groin problems analyzed. In-season prevalence (9-15.7%) of groin problems was significantly higher than pre-season (7.4%) prevalence (p<0.01). Seasonal prevalence of groin problems is common in rink hockey, regardless of gender, playing position, or age. Preventive efforts should be directed towards all players, regardless of their individual characteristics.
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Affiliation(s)
- Marcos Quintana-Cepedal
- Department of Functional Biology, University of Oviedo, Oviedo, Spain
- Asturian Research Group in Performance, Readaptation, Training, and Health (ASTURES), University of Oviedo, Oviedo, Spain
| | | | - Miguel Del Valle Soto
- Asturian Research Group in Performance, Readaptation, Training, and Health (ASTURES), University of Oviedo, Oviedo, Spain
- Department of Morphology and Functional Biology, University of Oviedo, Oviedo, Spain
| | - Hugo Olmedillas
- Asturian Research Group in Performance, Readaptation, Training, and Health (ASTURES), University of Oviedo, Oviedo, Spain
- Functional Biology, Universidad de Oviedo, Oviedo, Spain
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4
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Thorarinsdottir S, Amundsen R, Larmo A, Pedersen R, Andersen TE, Bahr R, Møller M. Groin injuries in women's premier league football in Norway: A two-season prospective cohort study describing clinical and imaging characteristics. Scand J Med Sci Sports 2024; 34:e14611. [PMID: 38534061 DOI: 10.1111/sms.14611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 12/13/2023] [Accepted: 03/13/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVE To describe the prevalence, incidence, and burden of groin injuries in the Norwegian women's premier football league and to describe their clinical and imaging characteristics. METHODS During the 2020 and 2021 seasons, players in the Norwegian women's premier league reported groin injuries weekly, using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems (OSTRC-H2). We calculated weekly prevalence, incidence, and burden of groin injuries. The team physical therapists classified the player-reported injuries based on the Doha classification system. Injuries with more than 3 days' time loss or reported in 2 consecutive weeks were eligible for magnetic resonance imaging (MRI). RESULTS On average, 3.9% (95% CI: 3.4-4.4) of players reported a groin injury at any time; of which 78% caused time loss. The incidence rate was 1.6 injuries/1000 h (95% CI: 1.3-2.0) and their burden was 11 days lost/1000 h. The physical therapists examined 67 of 124 player-reported groin injuries (53%). Adductor-related injury was most common (55%) followed by iliopsoas (15%) and rectus femoris-related (12%). Pubic-related injuries caused most time loss (median: 24 days, IQR: 5-133). In this study, 42 injuries were investigated with MRI; 8 (19%) showed no changes, 6 (14%) an acute musculotendinous lesion, and 32 (76%) a nonacute finding (e.g., central symphyseal disc protrusion, tendinopathies). CONCLUSION The incidence rate and burden of groin injuries were high. Adductor-related injuries were most common, but pubic-related injuries caused most time loss. Most MRI examinations demonstrated nonacute findings.
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Affiliation(s)
- Solveig Thorarinsdottir
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Roar Amundsen
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | | | | | - Thor Einar Andersen
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- The Norwegian FA Medical Centre (Idrettens helsesenter), Oslo, Norway
| | - Roald Bahr
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Merete Møller
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- Research Unit of Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Asimakidis ND, Bishop CJ, Beato M, Mukandi IN, Kelly AL, Weldon A, Turner AN. A survey into the current fitness testing practices of elite male soccer practitioners: from assessment to communicating results. Front Physiol 2024; 15:1376047. [PMID: 38567112 PMCID: PMC10985349 DOI: 10.3389/fphys.2024.1376047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
This study provides insight into the current fitness testing practices in elite male soccer. One hundred and two practitioners from professional soccer leagues across 24 countries completed an online survey comprising 29 questions, with five sections: a) background information, b) testing selection, c) testing implementation, d) data analysis, and e) data reporting. Frequency analysis was used to evaluate the responses to fixed response questions and thematic analysis was used for open-ended questions to generate clear and distinct themes. Strength (85%) and aerobic capacity (82%) represent the most frequently assessed physical qualities. Scientific literature (80%) is the most influential factor in testing selection and practitioners conduct fitness testing less frequently than their perceived ideal frequency per season (3.6 ± 2 vs. 4.5 ± 2). Time and competitive schedule were the greatest barriers to fitness testing administration. Practitioners mostly used a 'hybrid' approach (45%) to fitness testing, blending 'traditional' (i.e., a day dedicated to testing) and 'integrated' (i.e., testing within regular training sessions) methods. Microsoft Excel is the most used software for data analysis (95%) and visualization (79%). An equal use of the combination of best and mean scores of multiple trials (44%) and the best score (42%) was reported. Comparing a player's test performance with previous scores (89%) was the most common method for interpreting test results. However, only 38% considered measurement error. Digital displays and verbal feedback are the most common data reporting methods, with different data reporting processes for coaches and players. Practitioners can use data and findings from this study to inform their current testing practices and researchers to further identify areas for investigation, with the overarching aim of developing the field of fitness testing in elite male soccer.
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Affiliation(s)
- Nikolaos D. Asimakidis
- Faculty of Science and Technology, London Sport Institute, Middlesex University, London, United Kingdom
| | - Chris J. Bishop
- Faculty of Science and Technology, London Sport Institute, Middlesex University, London, United Kingdom
| | - Marco Beato
- School of Health and Sports Sciences, University of Suffolk, Ipswich, United Kingdom
| | - Irvin N. Mukandi
- Faculty of Science and Technology, London Sport Institute, Middlesex University, London, United Kingdom
| | - Adam L. Kelly
- Faculty of Health, Education and Life Sciences, Birmingham City University, Birmingham, United Kingdom
| | - Anthony Weldon
- Faculty of Health, Education and Life Sciences, Birmingham City University, Birmingham, United Kingdom
| | - Anthony N. Turner
- Faculty of Science and Technology, London Sport Institute, Middlesex University, London, United Kingdom
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McMinn KJ, Diewald SN, Harrison C, Cronin JB, Ye‐Lee D. Inter- and intra-session variability of compression strain gauge for the adductor groin squeeze test on soccer athletes. Healthc Technol Lett 2024; 11:16-20. [PMID: 38370163 PMCID: PMC10869877 DOI: 10.1049/htl2.12074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 12/15/2023] [Accepted: 01/11/2024] [Indexed: 02/20/2024] Open
Abstract
The importance of hip adductor strength for injury prevention and performance benefits is well documented. The purpose of this study was to establish the intra- and inter-day variability of peak force (PF) of a groin squeeze protocol using a custom-designed compression strain gauge device. Sixteen semi-professional soccer players completed three trials over three separate testing occasions with at least 24-h rest between each session. The main findings were that the compression strain gauge was a reliable device for measuring PF within and between days. All intraclass correlations were higher than 0.80 and coefficients of variations were below 10% across the different sessions and trials. Due to the information gained through the compression strain gauge, the higher sampling frequency utilized, portability, and the relatively affordable price, this device offers an effective alternative for measuring maximal strength for hip adduction.
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Affiliation(s)
- Kieran J. McMinn
- Sports Performance Research Institute New ZealandAUT UniversityAucklandNew Zealand
| | - Shelley N. Diewald
- Sports Performance Research Institute New ZealandAUT UniversityAucklandNew Zealand
| | - Craig Harrison
- Sports Performance Research Institute New ZealandAUT UniversityAucklandNew Zealand
| | - John B. Cronin
- Sports Performance Research Institute New ZealandAUT UniversityAucklandNew Zealand
| | - Dana Ye‐Lee
- Sports Performance Research Institute New ZealandAUT UniversityAucklandNew Zealand
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Farrell SG, Hatem M, Bharam S. Acute Adductor Muscle Injury: A Systematic Review on Diagnostic Imaging, Treatment, and Prevention. Am J Sports Med 2023; 51:3591-3603. [PMID: 36661128 DOI: 10.1177/03635465221140923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Controversies remain regarding the diagnosis, imaging, and treatment of acute adductor injuries in athletes. PURPOSE To investigate the diagnostic imaging, treatment, and prevention of acute adductor injuries based on the most recent and relevant scientific evidence. STUDY DESIGN Systematic review; Level of evidence, 4. METHODS The PubMed and Web of Science databases were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify articles studying acute adductor injury in athletes. Inclusion criteria were original publication on acute adductor injury in amateur or professional athletes, level 1 to 4 evidence, mean patient age >15 years, and results presented as return-to-sport, pain, or functional outcomes. Quality assessment was performed with the CONSORT (Consolidated Standards of Reporting Trials) statement or the methodological index for non-randomized studies criteria. Articles were grouped as imaging, treatment, prevention focused, or mixed. RESULTS A total of 30 studies published between 2001 and 2021 were selected, involving 594 male patients with a mean age 26.2 years (range, 16-68 years). The most frequent sports were soccer (62%), basketball (14%), futsal (6%), American football (3%), and ice hockey and handball (2%). Risk factors for acute adductor injury were previous acute groin injury, adductor weakness compared with the uninjured side, any injury in the previous season, and reduced rotational hip range of motion. The frequency of complete adductor muscle tears on magnetic resonance imaging was 21% to 25%. For complete adductor tears, the average time to return to play was 8.9 weeks in patients treated nonoperatively and 14.2 weeks for patients treated surgically. Greater stump retraction was observed in individuals treated surgically. Partial acute adductor tears were treated nonoperatively with physical therapy in all studies in the present systematic review. The average time to return to play was 1 to 6.9 weeks depending on the injury grade. The efficacy of adductor strengthening on preventing acute adductor tears has controversial results in the literature. CONCLUSION Athletes with partial adductor injuries returned to play 1 to 7 weeks after injury with physical therapy treatment. Nonoperative or surgical treatment is an acceptable option for complete adductor longus tendon tear.
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Affiliation(s)
| | - Munif Hatem
- Department of Orthopedic Surgery, Baylor University Medical Center at Dallas, Dallas, Texas, USA
| | - Srino Bharam
- Northwell Lenox Hill Hospital, New York, New York, USA
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8
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Mitrousias V, Chytas D, Banios K, Fyllos A, Raoulis V, Chalatsis G, Baxevanidou K, Zibis A. Anatomy and terminology of groin pain: Current concepts. J ISAKOS 2023; 8:381-386. [PMID: 37308079 DOI: 10.1016/j.jisako.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 04/13/2023] [Accepted: 05/31/2023] [Indexed: 06/14/2023]
Abstract
Groin pain is a common symptom in athletes. The complex anatomy of the area and the various terms used to describe the etiology behind groin pain have led to a confusing nomenclature. To solve this problem, three consensus statements have been already published in the literature: the Manchester Position Statement in 2014, the Doha agreement in 2015, and the Italian Consensus in 2016. However, when revisiting recent literature, it is evident that the use of non-anatomic terms remains common, and the diagnoses sports hernia, sportsman's hernia, sportsman's groin, Gilmore's groin, athletic pubalgia, and core muscle injury are still used by many authors. Why are they still in use although rejected? Are they considered synonyms, or they are used to describe different pathology? This current concepts review article aims to clarify the confusing terminology by examining to which anatomical structures authors refer when using each term, revisit the complex anatomy of the area, including the adductors, the flat and vertical abdominal muscles, the inguinal canal, and the adjacent nerve branches, and propose an anatomical approach, which will provide the basis for improved communication between healthcare professionals and evidence-based treatment decisions.
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Affiliation(s)
- Vasileios Mitrousias
- Department of Anatomy, Faculty of Medicine, University of Thessaly, 41334 Larissa, Greece; Department of Orthopaedic Surgery and Musculoskeletal Trauma, General University Hospital of Larissa, 41110 Larissa, Greece.
| | - Dimitrios Chytas
- Department of Physiotherapy, University of Peloponnese, 23100 Sparta, Greece
| | - Konstantinos Banios
- Department of Anatomy, Faculty of Medicine, University of Thessaly, 41334 Larissa, Greece
| | - Apostolos Fyllos
- Department of Anatomy, Faculty of Medicine, University of Thessaly, 41334 Larissa, Greece
| | - Vasileios Raoulis
- Department of Anatomy, Faculty of Medicine, University of Thessaly, 41334 Larissa, Greece
| | - Georgios Chalatsis
- Department of Orthopaedic Surgery and Musculoskeletal Trauma, General University Hospital of Larissa, 41110 Larissa, Greece
| | - Kyriaki Baxevanidou
- Department of General Surgery, General Hospital of Larissa, 41221, Larissa, Greece
| | - Aristeidis Zibis
- Department of Anatomy, Faculty of Medicine, University of Thessaly, 41334 Larissa, Greece
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Silva R, Pereira A, Rodrigues-Gomes S, Lopes T. An Unlikely Cause of Groin Pain: Obturator Externus Tear in a Professional Soccer Player. Cureus 2023; 15:e44612. [PMID: 37795064 PMCID: PMC10547448 DOI: 10.7759/cureus.44612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2023] [Indexed: 10/06/2023] Open
Abstract
Groin pain is a common and complex problem in athletes, especially soccer players, associated with a wide variety of possible injuries in numerous anatomical structures. One of the causes of groin pain is damage to the deep muscles of the hip region, with isolated traumatic injury of the obturator externus muscle rarely described and probably underdiagnosed. This report describes a clinical case of a soccer player who presented with acute hip pain and buttock pain resulting from a rapid change of position in load, associated with pain with active hip external rotation and passive internal rotation. MRI demonstrated the presence of subaponeurotic/myo-aponeurotic obturator externus muscle tear. A conservative treatment was decided, targeting pain reduction and progressing range of motion gain and muscle strengthening of the stabilizing muscles of the pelvis and hip, and subsequently, it led to re-athletisation, with soccer-specific exercises. Return to play was 23 days after injury. This case shows that a high level of suspicion is necessary for the correct diagnosis; treatment is generally conservative and the isolated rupture of the external obturator can be considered relatively benign. However, it has the potential to be associated with a long period of absence from training and games.
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Affiliation(s)
- Rui Silva
- Sports Medicine, Futebol Clube do Porto, Porto, PRT
- Physical Medicine and Rehabilitation, Centro de Medicina de Reabilitação de Alcoitão, Cascais, PRT
| | - Adriana Pereira
- Physical Medicine and Rehabilitation, Centro de Medicina de Reabilitação de Alcoitão, Cascais, PRT
| | - Sérgio Rodrigues-Gomes
- Radiology, Espregueira-Mendes Sports Center, Porto, PRT
- Radiology, Grupo Unilabs, Porto, PRT
| | - Tiago Lopes
- Physical Medicine and Rehabilitation, Centro de Reabilitação do Norte, Porto, PRT
- Physical Medicine and Rehabilitation, Espregueira-Mendes Sports Center, Porto, PRT
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Gurau TV, Gurau G, Voinescu DC, Anghel L, Onose G, Iordan DA, Munteanu C, Onu I, Musat CL. Epidemiology of Injuries in Men's Professional and Amateur Football (Part I). J Clin Med 2023; 12:5569. [PMID: 37685638 PMCID: PMC10488230 DOI: 10.3390/jcm12175569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
Background (1): Football is the most popular sport among men, associated with a certain risk of injury, which leads to short- and long-term health consequences. While the injury profile of professional footballers is known, little is known about the injury profile of amateur footballers; amateur football is a major and diverse area, the development of which should be a priority for football associations around the world and UEFA. The aim of this study was to perform a systematic review of epidemiological literature data on injuries in professional and amateur football players belonging to certain leagues. Methods (2): A systematic review according to the PRISMA guidelines was performed until June 2023 in the databases PubMed, Web of Science, Google Academic, Google Scholar, and Diva portal. Forty-six studies reporting injury incidence in professional and amateur men's football were selected and analyzed. Two reviewers independently extracted data and assessed study quality using an adapted version of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and the Newcastle Ottawa Scale (NOS) to assess risk of bias for the quality of external validity. Results (3): The overall incidence of injuries in professional male football players was 7.75 ± 2.28, 95% confidence interval, injuries/1000 h of exposure and that of amateur football players was 7.98 ± 2.95, 95% confidence interval, injuries/1000 h of exposure. The incidence of match injuries (30.64 ± 10.28, 95% confidence interval, injuries/1000 exposure hours) was 7.71 times higher than the training injury incidence rate (3.97 ± 1.35, 95% confidence interval, injuries/1000 h) in professional football players and 5.45 times higher in amateurs (17.56 ± 6.15 vs. 3.22 ± 1.4, 95% confidence interval, injuries/1000 h). Aggregate lower extremity injuries had the highest prevalence in both categories of footballers, being 83.32 ± 4.85% in professional footballers and 80.4 ± 7.04% in amateur footballers: thigh, ankle, and knee injuries predominated. Conclusions (4): Professional and amateur football players are at substantial risk of injury, especially during matches that require the highest level of performance. Injury rates have implications for players, coaches, and sports medicine practitioners. Therefore, information on football injuries can help develop personalized injury risk mitigation strategies that could make football safer for both categories of football players. The current findings have implications for the management, monitoring, and design of training, competition, injury prevention, especially severe injury, and education programs for amateur football players.
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Affiliation(s)
- Tudor Vladimir Gurau
- Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University of Galati, 800008 Galati, Romania;
| | - Gabriela Gurau
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (G.G.); (C.L.M.)
| | - Doina Carina Voinescu
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galați, Romania; (D.C.V.); (L.A.)
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania
| | - Lucretia Anghel
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galați, Romania; (D.C.V.); (L.A.)
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania
| | - Gelu Onose
- Neuromuscular Rehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Ar-Seni”, 041915 Bucharest, Romania;
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania
| | - Daniel Andrei Iordan
- Department of Individual Sports and Kinetotherapy, Faculty of Physical Education and Sport, ‘Dunarea de Jos’ University of Galati, 800008 Galati, Romania
- Center of Physical Therapy and Rehabilitation, ‘Dunărea de Jos’ University of Galati, 800008 Galati, Romania
| | - Constantin Munteanu
- Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa” Iaşi, 700454 Iaşi, Romania;
| | - Ilie Onu
- Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa” Iaşi, 700454 Iaşi, Romania;
| | - Carmina Liana Musat
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (G.G.); (C.L.M.)
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galați, Romania; (D.C.V.); (L.A.)
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Cotellessa F, Puce L, Formica M, May MC, Trompetto C, Perrone M, Bertulessi A, Anfossi V, Modenesi R, Marinelli L, Bragazzi NL, Mori L. Effectiveness of a Preventative Program for Groin Pain Syndrome in Elite Youth Soccer Players: A Prospective, Randomized, Controlled, Single-Blind Study. Healthcare (Basel) 2023; 11:2367. [PMID: 37685401 PMCID: PMC10486402 DOI: 10.3390/healthcare11172367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/19/2023] [Accepted: 08/20/2023] [Indexed: 09/10/2023] Open
Abstract
Groin pain syndrome (GPS) is a prevalent issue in soccer. This study assessed the effectiveness of a new preventive protocol on GPS for youth soccer players. The protocol included targeted stretching and strengthening exercises for the adductor and core muscles from preseason to midseason. A questionnaire and two pain provocation tests were used for the evaluation. Mild GPS required positive results in at least two evaluations, while severe GPS was associated with pain incompatible with engagement in any activity confirmed by diagnostic ultrasound. Forty-two elite male athletes (aged 16.9 ± 0.7 years) participated in the study, with half of them assigned to the usual training (control group) and the remaining athletes undergoing the preventive protocol (treatment group) for 24 weeks. GPS rates were 14.3% (three diagnoses: two mild, one severe) in the treatment group and 28.6% (six diagnoses: three mild, three severe) in the control group. Toward the end of the season, three players, one from the treatment group and two from the control group had to stop playing due to severe GPS problems. In addition, one player in the control group stopped midseason. Even though the reduction in the risk of developing GPS was not significant (relative risk of 0.50 ([95%CI 0.14 to 1.74], p = 0.2759), the halved incidence of severe GPS and the increased muscle strength related to the treatment (p = 0.0277) are encouraging data for future studies.
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Affiliation(s)
- Filippo Cotellessa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (F.C.); (C.T.); (M.P.); (A.B.); (V.A.); (R.M.); (L.M.); (L.M.)
| | - Luca Puce
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (F.C.); (C.T.); (M.P.); (A.B.); (V.A.); (R.M.); (L.M.); (L.M.)
| | - Matteo Formica
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.F.); (M.C.M.)
- Orthopedic Clinic, Department of Integrated Surgical and Diagnostic Sciences (DISC), University of Genoa, 16132 Genoa, Italy
| | - Maria Cesarina May
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.F.); (M.C.M.)
| | - Carlo Trompetto
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (F.C.); (C.T.); (M.P.); (A.B.); (V.A.); (R.M.); (L.M.); (L.M.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.F.); (M.C.M.)
| | - Marco Perrone
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (F.C.); (C.T.); (M.P.); (A.B.); (V.A.); (R.M.); (L.M.); (L.M.)
| | - Andrea Bertulessi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (F.C.); (C.T.); (M.P.); (A.B.); (V.A.); (R.M.); (L.M.); (L.M.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.F.); (M.C.M.)
| | - Vittorio Anfossi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (F.C.); (C.T.); (M.P.); (A.B.); (V.A.); (R.M.); (L.M.); (L.M.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.F.); (M.C.M.)
| | - Roberto Modenesi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (F.C.); (C.T.); (M.P.); (A.B.); (V.A.); (R.M.); (L.M.); (L.M.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.F.); (M.C.M.)
| | - Lucio Marinelli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (F.C.); (C.T.); (M.P.); (A.B.); (V.A.); (R.M.); (L.M.); (L.M.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.F.); (M.C.M.)
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON M3J 1P3, Canada;
| | - Laura Mori
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy; (F.C.); (C.T.); (M.P.); (A.B.); (V.A.); (R.M.); (L.M.); (L.M.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (M.F.); (M.C.M.)
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12
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de Queiroz JHM, Frota JP, Dos Reis FA, de Oliveira RR. Development and Predictive Validation of the Brazilian Adductor Performance Test for Estimating the Chance of Hip Adductor Injuries in Elite Soccer Athletes. Int J Sports Physiol Perform 2023; 18:653-659. [PMID: 37080542 DOI: 10.1123/ijspp.2022-0306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 02/24/2023] [Accepted: 03/10/2023] [Indexed: 04/22/2023]
Abstract
PURPOSE To develop and validate the Brazilian Adductor Performance Test (BAPT) for predicting hip adductor muscle injuries in elite soccer athletes. METHODS A total of 108 soccer athletes were assessed, followed up for 3 months, and evaluated for a history of adductor injury 6 months before BAPT evaluation. The Shapiro-Wilk test was used as the normality test. The Mann-Whitney U test was used to compare BAPT scores between injured and uninjured athletes. Binary logistic regression was performed to identify the athletes' chances of injury based on their BAPT scores. A receiver operating characteristic curve was used to determine the cutoff point for the number of repetitions in the BAPT and Spearman bivariate correlation and identify factors potentially related to the test score. Furthermore, the intraclass correlation coefficient was used to determine interexaminer agreement. The level of significance was set at 95%. RESULTS The BAPT scores for hip adductor injury history did not differ significantly (P = .08). A significant deficit was identified in the BAPT scores of the injured athletes at the 3-month follow-up (P = .001). The cutoff point identified was 33 repetitions. Low BAPT scores increased the chance of injury by 20% (odds ratio, 1.20%; P = .001). The interexaminer agreement was .96 (P = .001). CONCLUSION BAPT can be used to identify athletes most likely to sustain hip adductor muscle injuries, indirectly reducing the rate of this injury in soccer clubs.
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Affiliation(s)
- Jeffeson Hildo Medeiros de Queiroz
- Tendon Research Group, Master Program in Physical Therapy and Functioning-Department of Physical Therapy, Federal University of Ceará, Fortaleza, CE,Brazil
| | | | | | - Rodrigo Ribeiro de Oliveira
- Tendon Research Group, Master Program in Physical Therapy and Functioning-Department of Physical Therapy, Federal University of Ceará, Fortaleza, CE,Brazil
- Ceará Sporting Club, Fortaleza, CE,Brazil
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Zilles G, Grim C, Wegener F, Engelhardt M, Hotfiel T, Hoppe MW. [Groin pain in sports games: a systematic review]. SPORTVERLETZUNG SPORTSCHADEN : ORGAN DER GESELLSCHAFT FUR ORTHOPADISCH-TRAUMATOLOGISCHE SPORTMEDIZIN 2023; 37:18-36. [PMID: 36878218 DOI: 10.1055/a-1912-4642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
BACKGROUND In sports games, epidemiological data show that groin pain is relatively common and can lead to repeated loss of time. Consequently, it is essential to be aware of the evidence-based prevention strategies. The aim of this systematic review was to examine risk factors and prevention strategies for groin pain and to rank them based on their evidence in sports games. METHODS The review was conducted according to the PRISMA guidelines, using a PICO-scheme in the PubMed, Web of Science and SPOLIT databases. We included all available intervention and observational studies on the influence of risk factors and prevention strategies on groin pain in sports games. The methodological quality and level of evidence was assessed using the PEDro-Scale and OCEBM model, respectively. Finally, the quantity, quality and level of evidence was used to rank each risk factor for its grade. RESULTS Moderate evidence was found for four risk factors that significantly influence the risk of groin pain: male sex, previous groin pain, hip adductor strength and not participating in the FIFA 11+ Kids. Moreover, moderate evidence was found for the following non-significant risk factors: older age, body height and weight, higher BMI, body fat percentage, playing position, leg dominance, training exposure, reduced hip abduction, adduction, extension, flexion, and internal rotation-ROM, hip flexor strength, hip abductor, adductor, flexor and core strengthening with balance exercises, clinical hip mobility tests and physical capacities. CONCLUSION The identified risk factors can be considered when developing prevention strategies to reduce the risk of groin pain in sports games. Thereby, not only the significant, but also the non-significant risk factors should be considered for prioritisation.
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Affiliation(s)
- Gabriel Zilles
- Bewegungs- und Trainingswissenschaft, Sportwissenschaftliche Fakultät, Universität Leipzig, Leipzig, GERMANY
| | - Casper Grim
- Osnabrücker Zentrum für Muskuloskelettale Chirurgie, Klinikum Osnabrück, Osnabrück, GERMANY
| | - Florian Wegener
- Bewegungs- und Trainingswissenschaft, Sportwissenschaftliche Fakultät, Universität Leipzig, Leipzig, GERMANY
| | - Martin Engelhardt
- Osnabrücker Zentrum für Muskuloskelettale Chirurgie, Klinikum Osnabrück, Osnabrück, GERMANY
| | - Thilo Hotfiel
- Osnabrücker Zentrum für Muskuloskelettale Chirurgie, Klinikum Osnabrück, Osnabrück, GERMANY
| | - Matthias Wilhelm Hoppe
- Bewegungs- und Trainingswissenschaft, Sportwissenschaftliche Fakultät, Universität Leipzig, Leipzig, GERMANY
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Nilsen DH, Furnes O, Kroken G, Robsahm TE, Johnsen MB, Engebretsen L, Nordsletten L, Bahr R, Lie SA. Risk of total hip arthroplasty after elite sport: linking 3304 former world-class athletes with the Norwegian Arthroplasty Register. Br J Sports Med 2022; 57:bjsports-2022-105575. [PMID: 36588424 PMCID: PMC9811096 DOI: 10.1136/bjsports-2022-105575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES At present, there is no cure for osteoarthritis (OA), but severe hip joint degeneration can require total hip arthroplasty (THA). The literature on OA after elite sport is limited. We hypothesise that elite athletic activity increases the risk of receiving a THA later in life. METHODS We linked a cohort of former Norwegian world-class athletes (1402 females and 1902 males, active 1936-2006) to the Norwegian Arthroplasty Register (THA performed 1987-2020). We used standardised incidence ratio (SIR), one-minus Kaplan-Meier and relative Cox regression (relative HR, RHR), with 95% CIs, and funnel plots at age 75, to assess THA risk for different sport disciplines, joint impact categories of sport disciplines and sex. The risk of THA for the corresponding general Norwegian population was used as reference. RESULTS We found an overall increased risk for THA for the former elite athletes (SIR 2.11, 95% CI 1.82 to 2.40) at age 75 years, compared with the general population. THA risk at age 75 years was 11.6% for female athletes and 8.3% for male athletes. SIR was 1.90 (95% CI 1.49 to 2.31) for female and 2.28 (95% CI 1.87 to 2.70) for male athletes. Among males, high joint impact sport disciplines were associated with increased risk compared with low-impact sport disciplines (RHR 1.81, 95% CI 1.06 to 3.08, p=0.029). CONCLUSION Having been an elite athlete was associated with a doubling of THA risk compared with the general population for both sexes. High joint impact sport disciplines were associated with subsequent THA for male athletes.
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Affiliation(s)
- Daniel Hoseth Nilsen
- Norwegian Arthroplasty Register, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, Norway
| | - Ove Furnes
- Norwegian Arthroplasty Register, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Gard Kroken
- Norwegian Arthroplasty Register, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, Norway
| | | | - Marianne Bakke Johnsen
- Department of Rehabilitation Science and Health Technology, Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Lars Engebretsen
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
| | - Lars Nordsletten
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
| | - Roald Bahr
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Stein Atle Lie
- Norwegian Arthroplasty Register, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
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Pulici L, Certa D, Zago M, Volpi P, Esposito F. Injury Burden in Professional European Football (Soccer): Systematic Review, Meta-Analysis, and Economic Considerations. Clin J Sport Med 2022; 33:00042752-990000000-00071. [PMID: 36730365 DOI: 10.1097/jsm.0000000000001107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 10/21/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE We performed a systematic review and meta-analysis to evaluate the injury burden and the related economic cost in European professional male football players. DATA SOURCES Multiple database research was performed up to August 5, 2022 (PubMed, EMbase, Scopus, Cochrane Library), including only studies that reported severity in the number of days of absence for each injury, incidence reported in the number of injuries/1000 hours, or reported number of injuries and exposure time and adult male football players, professionals from European clubs. Two reviewers extracted data and assessed paper quality with the Strengthening the Reporting of Observational Studies in Epidemiology statement and the Newcastle-Ottawa Scale. MAIN RESULTS Twenty-two studies have reported incidence, severity, and burden of injuries in professional football. The highest injury burden was found for ligament-joint injuries (37.9 days/1000 hours; 222 397 €/1000 hours) and for muscle injuries (34.7 days/1000 hours; 203 620 €/1000 hours). Injury locations with high burden were knee injuries (34.8 days/1000 hours; 20 4206 €/1000 hours)-mainly anterior cruciate ligament injuries (14.4 days/1000 hours; 84 499 €/1000 h)-followed by thigh injuries (25.0 days/1000 hours; 146 700 €/1000 hours), hamstrings injuries (15.4 days/1000 hours; 90 367 €/1000 hours), hip-and-groin injuries (16.1 days/1000 hours; 94 475 €/1000 hours), primarily adductor muscles injuries (9.4 days/1000 hours; 55 159€/1000 hours), and ankle injuries (13.1 days/1000 h; 76 871 €/1000 hours) with ankle sprains (7.4 days/1000 hours; 43 423 €/1000 hours). CONCLUSIONS Being exposed to injury risk has serious consequences for individual and club performance and economy. This review identified the most relevant targets in injury management, compared their injury data with reference values, and provided economic evidence when trying to gain buy-in from the key decision makers.
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Affiliation(s)
| | - Denis Certa
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy; and
| | - Matteo Zago
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy; and
| | - Piero Volpi
- Knee Surgery and Sport Traumatology Unit, Humanitas Clinical and Research Center, IRCCS Rozzano, Milan, Italy
| | - Fabio Esposito
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy; and
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Dupré T, Potthast W. Are sprint accelerations related to groin injuries? A biomechanical analysis of adolescent soccer players. Sports Biomech 2022:1-13. [PMID: 36260511 DOI: 10.1080/14763141.2022.2133740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 10/04/2022] [Indexed: 10/24/2022]
Abstract
Groin injuries have one of the highest incidences in soccer and can be career threatening, especially for adolescents, due to their high recurrence rate. Quick accelerations have been connected to groin injuries along with kicking and change of directions. Purpose of this study was to examine the hip joint kinematics, kinetics and the muscle forces of adductor longus and gracilis during first ground contact of a linear sprint acceleration performed by adolescent soccer players. Twenty-two male participants were investigated with 3D motion capture and two force plates. Inverse dynamics were used to calculate the kinematics, kinetics and muscle forces. The kinematics show a constant extension during the stance phase and a quick transition from an abduction to an adduction movement at 90% stance, which coincides with the highest forces in adductor longus and gracilis. This indicates a high load on the adductor muscles due to eccentric contractions combined with high muscle forces in the adductors. Compared to previously investigated inside passing and change of direction movements, adductor muscle forces and angular velocities are higher in this study. Therefore, it is suggested that sprint accelerations are likely to be connected to the development of groin injuries in adolescent soccer players.
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Affiliation(s)
- Thomas Dupré
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, Cologne, Germany
- Department of Exercise Science, Olympic Training Centre Rhineland-Palatinate/Saarland, Mainz, Germany
| | - Wolfgang Potthast
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, Cologne, Germany
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Marušič J, Šarabon N. Hip adduction and abduction strength in youth male soccer and basketball players with and without groin pain in the past year. PLoS One 2022; 17:e0275650. [PMID: 36197941 PMCID: PMC9534424 DOI: 10.1371/journal.pone.0275650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 09/21/2022] [Indexed: 11/25/2022] Open
Abstract
The objectives of this study were to 1) assess the differences between youth soccer and basketball players with and without past year groin pain (GP) in hip adduction and abduction strength and several training characteristics (age at the start of regular training, weekly training frequency, warm-up and training duration, use of stretching and/or stabilisation exercises during warm-up, use of resistance training); 2) present strength reference values for youth soccer and basketball players. 227 players participated (age 16.9 ± 1.4 years; height 184.2 ± 8.5 cm; mass 75.5 ± 11.9 kg). Hip adduction and abduction strength was measured in supine position (hip, knee and ankle in neutral position) using a MuscleBoard dynamometer. Interlimb asymmetries and hip adduction:abduction ratios were calculated. Past year GP and training characteristics were assessed with a retrospective questionnaire. 11.9% of players reported past year GP (16.9% in soccer and 6.4% in basketball). The only significant difference between the past year GP and the control groups was found in the age of the players at the start of regular training (7.2 ± 1.8 years for the GP group vs. 8.5 ± 2.6 years for the control group). Additionally, soccer players without past year GP have significantly higher hip adduction strength (1.1 ± 0.2 Nm/kg vs. 1.0 ± 0.2 Nm/kg) and adduction:abduction strength ratio (1.10 ± 0.18 vs. 1.03 ± 0.16) compared to basketball players. Our results show that hip adduction and abduction strength, interlimb asymmetry and hip adduction:abduction ratio do not differentiate between players with and without past year GP (p = 0.29-0.90), which means that their adduction or abduction strength can be analysed regardless of the GP presence in the past year. Additionally, players with past year GP started regularly training at significantly lower age, which could indicate the problematic nature of early/premature sports specialisation.
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Affiliation(s)
- Jan Marušič
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
| | - Nejc Šarabon
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
- Science to Practice, Ltd., Laboratory for Motor Control and Motor Behavior, Ljubljana, Slovenia
- * E-mail:
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SÝKORA J, LÍŠKA D, PUPIŠ M, BRŰNN D, ŠVANTNER R, PUPIŠOVÁ Z. Groin injury assessment in healthy elite youth football players. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2022. [DOI: 10.23736/s0393-3660.20.04547-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Dunne C, Callaway AJ, Thurston J, Williams JM. Validity, reliability, minimal detectable change, and methodological considerations for HHD and portable fixed frame isometric hip and groin strength testing: A comparison of unilateral and bilateral testing methods. Phys Ther Sport 2022; 57:46-52. [PMID: 35921781 DOI: 10.1016/j.ptsp.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Comparative assessment of bilateral (KangaTech) and unilateral (HHD) testing modalities through concurrent validity and test-retest reliability. Methodological considerations explored include minimum repetitions and comparison of average and maximum values. DESIGN Experimental, observational. SETTING Biomechanics laboratory. PARTICIPANTS Thirty-three participants. MAIN OUTCOME MEASURES Concurrent validity using peak force. Test-retest reliability used Abduction and Adduction using 2 trials, randomised between devices. Maximum peak force and average of both trials were used. RESULTS HHD and KT360 are concurrently valid (r = 0.996); with no significant difference (z = -0.681). Excellent HHD reliability (ICC:0.92-0.96) and KT360 (ICC:0.89-0.97). Significant difference between max peak force and average peak force but within the calculated MDC(%). No significant differences between max peak force between trials. Spearman-Brown prophecy predicted excellent reliability for one trial (ICC:0.81-0.95). Bilateral facilitation was demonstrated using the KT360 with 94.6-101.2% increase in force compared to HHD. CONCLUSIONS With no significant difference between first and second max effort, and excellent prophesised reliability, one rep max effort should be acceptable to use. Body positioning within the KT360 seems to elicit bilateral facilitation rather than deficit, therefore unilateral and bilateral force values are not interchangeable.
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Affiliation(s)
- Cian Dunne
- Department of Rehabilitation and Sport Sciences, Bournemouth University, BH12 5BB, UK
| | - Andrew J Callaway
- Department of Rehabilitation and Sport Sciences, Bournemouth University, BH12 5BB, UK.
| | - Joanna Thurston
- Department of Rehabilitation and Sport Sciences, Bournemouth University, BH12 5BB, UK
| | - Jonathan M Williams
- Department of Rehabilitation and Sport Sciences, Bournemouth University, BH12 5BB, UK
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Rapid Spike in Hip Adduction Strength in Early Adolescent Footballers: A Study of 125 Elite Male Players From Youth to Senior. Int J Sports Physiol Perform 2022; 17:1407-1414. [PMID: 35534012 DOI: 10.1123/ijspp.2022-0025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/21/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE To investigate the differences in hip adductor and abductor muscle strength in elite male footballers from youth to senior level. METHODS We tested 125 players from the under-13-years (U'13) to senior squads of a Danish male professional football club in this cross-sectional design study. Hip adductor and abductor force (in newtons), torque (in newton meters), normalized torque (in newton meters per body mass), and adduction-to-abduction ratio were measured using handheld dynamometry. RESULTS Between U'13 and senior level, adductor force increased by 104%, torque by 127%, and normalized torque by 21%. Abductor force increased by 78%, torque by 126%, and normalized torque by 17%. For incremental differences between age groups, significant increases were observed between the ages of U'13 to U'14 (18%-39%) and U'14 to U'15 (19%-33%) for all strength measures (P ≤ .021). No incremental difference was observed for adductor-to-abductor ratio. CONCLUSIONS The large increases in hip adductor and abductor strength occurring between the ages of U'13 and U'15 offer insight into the strength capabilities and stress demands in these players, which may relate to injury vulnerability, and facilitate clinicians in selecting best-suited exercise interventions.
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Risk Factors for Groin Pain in Male High School Soccer Players Undergoing an Injury Prevention Program: A Cluster Randomized Controlled Trial. TRAUMA CARE 2022. [DOI: 10.3390/traumacare2020020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Little is known about the risk factors for developing groin pain in high school soccer players. Therefore, the purpose of the study is to investigate the risk factors for developing inguinal pain in high school soccer players who are undergoing an injury prevention program. A cluster randomized controlled trial was conducted on 202 high school soccer players. Players were allocated to either group A (3 schools, 66 players) receiving the Copenhagen adduction exercise (CAE) alone, or group B (2 schools, 73 players) receiving the CAE and Nordic hamstrings exercise, or group C, the control group without any intervention (2 schools, 63 players). Hip range of motion (ROM) and strength measures were assessed prior to a groin injury prevention program and used in univariate and multivariate analysis to predict development of groin pain. Logistic regression analysis identified that hip abduction ROM and eccentric adductor strength of the dominant leg were factors in the development of groin pain. Increased abduction ROM and decreased eccentric adductor muscle strength of the dominant leg were risk factors for the development of groin pain.
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Kurittu E, Vasankari T, Brinck T, Parkkari J, Heinonen OJ, Kannus P, Hänninen T, Köhler K, Leppänen M. Injury incidence and prevalence in Finnish top-level football - one-season prospective cohort study. SCI MED FOOTBALL 2022; 6:141-147. [PMID: 35475750 DOI: 10.1080/24733938.2021.1917775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OJECTIVE To investigate the injury characteristics in Finnish male football players. DESIGN One-season prospective epidemiological study. Data were collected via injury reports from the medical staff and directly from the players using the Olso Sports Trauma Research Center Health Questionnaire. PARTICIPANTS The first team squads of Finnish football league (n = 12 teams, 236 players). MAIN OUTCOME MEASUREMENT Injury incidence. RESULTS A total of 541 injuries occurred during the exposure of 62 878 hours. Injury incidence per 1000 exposure hours was 8.6 (30.6 in matches and 3.4 in training). A player sustained on average 2.3 (median 2, range 0-13) injuries during the study. Thigh and ankle were the most commonly injured body parts for acute injuries and hip/groin were the most commonly injured body part for overuse injuries. The median absence time for all injuries was 12 (range 0-107) days, 12 (range 0-107) for acute, and 8 (range 0-61) for overuse injuries. Thigh injuries caused the greatest consequences in terms of absence from full participation (median 5 days, range 0-88). CONCLUSION Lower limb muscle injuries were the most prevalent injuries in the study. Collecting data directly from the players enabled to report more injuries compared to what was reported only by the medical staff.
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Affiliation(s)
- Einari Kurittu
- Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Tommi Vasankari
- Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Tuomas Brinck
- Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland.,Tampere University Hospital, Tampere, Finland
| | - Olli J Heinonen
- Paavo Nurmi Centre and Unit for Health & Physical Activity, University of Turku, Turku, Finland
| | - Pekka Kannus
- Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland.,Tampere University Hospital, Tampere, Finland
| | - Timo Hänninen
- Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland
| | - Klaus Köhler
- Clinic for Sports and Exercise Medicine, Foundation for Sports and Exercise Medicine, Helsinki, Finland
| | - Mari Leppänen
- Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland
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23
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In Professional Male Soccer Players, Time-Loss Groin Injury Is More Associated With the Team Played for Than With Training/Match-Play Duration. J Orthop Sports Phys Ther 2022; 52:217-223. [PMID: 35128945 DOI: 10.2519/jospt.2022.10845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate the relationship between training/match-play duration and time-loss groin injury in professional male soccer players, and to determine whether previously identified intrinsic risk factors influenced this relationship. DESIGN Prospective cohort study. METHODS A total of 579 professional male soccer players were prospectively followed from July 2013 to June 2015. Time-loss groin injuries and individual training and match-play duration were recorded using standardized surveillance methods. Acute training/match-play duration and chronic training/match-play duration were considered as interacting variables. Nonlinear Cox regression analysis (modeled using restricted cubic splines), clustered by player identification number, examined the relationship between training/match-play duration and groin injury. Previously identified intrinsic risk factors of previous groin injury and eccentric adduction strength were included in the multivariable regression analysis. RESULTS There was no clinically meaningful relationship between training/match-play duration and groin injury risk. Team played for had the strongest influence on groin injury risk (relative log hazard ratio -2.28 to 0.97). Groin injury risk was highest when accumulated chronic and acute training duration was also highest, but large confidence intervals indicate considerable uncertainty around this finding. Previous groin injury and eccentric adduction strength were not associated with groin injury risk when training/match-play duration and team were included in the model. CONCLUSION In professional male soccer players, there was no clinically meaningful relationship between groin injury risk and training/match-play duration. Team played for either protected against or increased groin injury risk, indicating that team-related factors not measured in this study had greater effect on groin injury risk than training/match-play duration. J Orthop Sports Phys Ther 2022;52(4):217-223. Epub 5 Feb 2022. doi:10.2519/jospt.2022.10845.
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24
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Fares MY, Stewart K, McBride M, Maclean J. Lower limb injuries in an english professional football club: injury analysis and recommendations for prevention. PHYSICIAN SPORTSMED 2022; 51:260-268. [PMID: 35191360 DOI: 10.1080/00913847.2022.2045176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Lower limb injuries constitute a problem in the sport of football. Our aim is to explore patterns and trends of lower limb injuries in an English professional football club. METHODS This is a descriptive epidemiological study. Reports provided by the club's physical therapy team were screened for injuries among professional football players sustained over four seasons, from 2015/2016 to 2018/2019. Data included setting of injury (in-match or training), anatomical location of injury, type of injury, number of days off and month of injury. RESULTS A total of 296 lower limb injuries were recorded in our study, with a rate of 11.14 per 1000 football hours. Injury rate during games was 51.38 per 1000 football hours, significantly greater than that during training at 3.81 per 1000 football hours (p = 0.021). The thigh was significantly the most commonly injured location at 4.67 per 1000 football hours (p < 0.001). Grade I tears were the most common injury type at 1.73 per 1000 football hours, significantly greater than grade III tears (p = 0.027), contusions (p = 0.043), fractures (p = 0.02), and lacerations (p = 0.019). Injury rates were found to be greatest during preseason and declined as season progressed. On average, an injury sidelined the affected footballer for a total of 20 days. CONCLUSION Lower limb injuries were more common during matches than training. The thigh is the most common injury location, and grade I muscle tear was the most common type of injury. Injury rates were higher early on in the season. Potential prevention strategies include spacing out competition, adopting training and exercise regimens that cater for recovery, and increasing research regarding injury mechanisms.
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Affiliation(s)
- Mohamad Y Fares
- College of Medical, Veterinary, and Life Sciences, University of Glasgow, Glasgow, Scotland, UK
| | - Katy Stewart
- College of Medical, Veterinary, and Life Sciences, University of Glasgow, Glasgow, Scotland, UK.,Hampden Sports Clinic, Glasgow, Scotland, UK
| | | | - John Maclean
- College of Medical, Veterinary, and Life Sciences, University of Glasgow, Glasgow, Scotland, UK.,Hampden Sports Clinic, Glasgow, Scotland, UK.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland, UK
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25
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Lenz R, Holl N, Lutter C, Krüger J, Weber MA, Tischer T. Leistenschmerz beim Sportler. ARTHROSKOPIE 2022. [DOI: 10.1007/s00142-022-00516-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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26
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Alonso-Calvete A, Lorenzo-Martínez M, Padrón-Cabo A, Rey E. Effects of Copenhagen Adduction Exercise on the Architectural Characteristics of Adductors in U-17 Male Soccer Players: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412956. [PMID: 34948565 PMCID: PMC8701296 DOI: 10.3390/ijerph182412956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/30/2021] [Accepted: 11/30/2021] [Indexed: 12/14/2022]
Abstract
Groin injuries are one of the most prevalent in male soccer players, especially due to the hip adductor muscles’ weakness which is considered as a risk factor in these injuries. The Copenhagen adduction (CA) exercise has been demonstrated to increase the strength of adductor muscles, but its effects on the architectural characteristics of adductor muscles have not been studied yet. This study aimed to analyze the effects of the CA exercise on the muscle thickness of the adductors. Twelve male U-17 soccer players were randomized into two groups: the control group with no intervention and the experimental group with an intervention based on an eight-week training with CA exercise. The muscle thickness of adductors was measured before and after the intervention using ultrasound imaging. A significant increase in muscle thickness was found in both control (p = 0.002) and experimental group (p < 0.001), but the experimental group did not show additional effects in comparison with the control group. In conclusion, an 8-week CA exercise intervention does not increase the muscle thickness of adductors in U-17 soccer players more than their regular training.
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Affiliation(s)
- Alejandra Alonso-Calvete
- Facultade de Ciencias da Educación e do Deporte, Universidade de Vigo, 36310 Pontevedra, Spain; (A.A.-C.); (M.L.-M.); (E.R.)
| | - Miguel Lorenzo-Martínez
- Facultade de Ciencias da Educación e do Deporte, Universidade de Vigo, 36310 Pontevedra, Spain; (A.A.-C.); (M.L.-M.); (E.R.)
| | - Alexis Padrón-Cabo
- Department of Physical Education and Sport Science, Faculty of Sports Sciences and Physical Education, University of Coruña, 15001 A Coruña, Spain
- Correspondence: ; Tel.: +34-670-088-148
| | - Ezequiel Rey
- Facultade de Ciencias da Educación e do Deporte, Universidade de Vigo, 36310 Pontevedra, Spain; (A.A.-C.); (M.L.-M.); (E.R.)
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27
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Moreno-Pérez V, Peñaranda M, Soler A, López-Samanes Á, Aagaard P, Del Coso J. Effects of Whole-Season Training and Match-Play on Hip Adductor and Abductor Muscle Strength in Soccer Players: A Pilot Study. Sports Health 2021; 14:912-919. [PMID: 34758654 DOI: 10.1177/19417381211053783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Previous investigations have associated weakness of hip muscles with a higher likelihood of developing hip groin injury. However, no previous investigation has examined the influence of soccer training and match-play during the season on maximal isometric hip adductor and abductor muscle strength. HYPOTHESIS Maximal hip adductor and abductor muscle strength would increase after the preseason, maintaining relatively constant levels across the soccer season. DESIGN Cross-sectional study. LEVEL OF EVIDENCE Level 3. METHODS A total of 26 semiprofessional male soccer players underwent measurements of maximal isometric hip adductor and abductor muscle strength at 3 time points of the soccer season: preseason, midseason, and end-season to investigate the longitudinal effect of soccer training and competition during a complete season on maximal isometric hip adductor and abductor muscle strength in the semiprofessional Spanish soccer player. RESULTS Compared with preseason, hip abductor muscle strength increased in the midseason (14.2% and 17.1%, for dominant and nondominant limb, respectively; P < 0.001) and in the end-season (13.1%; P = 0.005, and 14.1%; P < 0.005). In contrast, hip adductor muscle strength remained unchanged across the season in both limbs. As a result, the adductor/abductor strength ratio in the nondominant limb was reduced at midseason and end-season time points (-14.6% and -18.4%, respectively; P < 0.001) with a corresponding tendency in the dominant limb (-9.3% and -15.0%, respectively; P > 0.05). CONCLUSION While maximal hip abductor muscle strength increased throughout the season, hip adductor muscle strength remained stable across the season. This produced a substantial deficit in hip adductor/abductor strength ratio at midseason and end-season. CLINICAL RELEVANCE The progressive imbalance in adductor/abductor strength across the soccer season may be an indicator of increased risk of groin injury and may reinforce the need for preventive rehabilitation activities focused on enhancing adductor muscle strength.
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Affiliation(s)
- Víctor Moreno-Pérez
- Sports Research Center, Miguel Hernandez University of Elche, Alicante, Spain.,Center for Translational Research in Physiotherapy, Department of Pathology and Surgery, Miguel Hernandez University of Elche, San Joan, Spain
| | | | | | - Álvaro López-Samanes
- Exercise Physiology Group, School of Physiotherapy, Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | - Per Aagaard
- Department of Sports Science and Clinical Biomechanics, Research Unit for Muscle Physiology and Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Juan Del Coso
- Centre for Sport Studies, Rey Juan Carlos University, Fuenlabrada, Spain
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28
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The Intra- and Inter-Rater Reliability of a Hip Rotation Range-of-Motion Measurement Using a Smartphone Application in Academy Football (Soccer) Players. Sports (Basel) 2021; 9:sports9110148. [PMID: 34822348 PMCID: PMC8623895 DOI: 10.3390/sports9110148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/14/2021] [Accepted: 10/22/2021] [Indexed: 11/23/2022] Open
Abstract
The clinical assessment of hip rotation range-of-motion (ROM) is important for managing hip and groin injuries in footballers. Previously published reliability studies on hip ROM have employed protocols that are difficult to replicate under everyday clinical conditions. This single trial, intra- and inter-rater reliability study included 41 male academy football (soccer) players, aged 14–15 years, from one European football academy. Passive hip internal rotation (IR) and external rotation (ER) ROM were measured in supine with hip and knee flexed to 90°. The ROM was determined using a smartphone application, with the smartphone attached to the lower leg. The tests were performed on two separate occasions, one week apart, by two different physiotherapists and on both sides (left and right hips). Reliability was evaluated using Intra-Class Correlation Coefficients (ICCs) and Minimal Detectable Change (MDC). Hip IR and ER ROM displayed moderate to good intra-rater agreement (ICCs 0.54–0.75), with MDCs ranging from 10.9° to 16.4°. Inter-rater reliability displayed poor to moderate reliability (ICCs 0.33–0.75), with MDCs ranging from 11.7° to 16.5°. A hip rotation ROM test using a smartphone application and a protocol closely reflecting everyday clinical conditions displayed moderate to good intra-rater reliability and poor to moderate inter-rater reliability. Due to the high MDCs, the practical applicability of this test procedure is limited and further refinement is necessary.
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29
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Lawrenson PR, Crossley KM, Hodges PW, Vicenzino BT, King MG, Heerey JJ, Semciw AI. Hip muscle activity in male football players with hip-related pain; a comparison with asymptomatic controls during walking. Phys Ther Sport 2021; 52:209-216. [PMID: 34607123 DOI: 10.1016/j.ptsp.2021.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 09/16/2021] [Accepted: 09/19/2021] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Compare muscle activity between male football players with and without hip-related pain. Morphological and intra-articular features of hip-related pain are proposed pre-cursors to hip osteoarthritis. Altered muscle activity is a feature of severe hip osteoarthritis, but it is not known whether differences exist earlier in the pathological spectrum. DESIGN Cross-sectional; SETTING: University laboratory; PARTICIPANTS: Forty-two male football players with hip-related pain; and 19 asymptomatic controls. MAIN OUTCOME MEASURES Hip muscle activity (Gluteus maximus, gluteus medius, tensor facia latae, adductor longus and rectus femoris) was recorded during walking using surface electromyography (EMG). RESULTS Men with hip-related pain had sustained rectus femoris activity prior to toe-off (47-51% of the gait cycle) (p = 0.01, ES = 0.51) unlike controls who had reduced activity. In men with severe hip-related pain, gluteus maximus EMG was sustained into mid-stance (12-20% of the gait cycle) (F = 6.15, p < 0.01) compared to controls. CONCLUSIONS Differences in rectus femoris and gluteus maximus activity were identified between male footballers with and without hip-related pain. The pattern of gluteus maximus EMG relative to peak, approaching mid-stance in severe hip-related pain, is consistent with observations in severe hip osteoarthritis. This supports the hypothesis that symptom severity may influence muscle activity across the spectrum of hip degeneration.
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Affiliation(s)
- Peter R Lawrenson
- The University of Queensland, School of Health & Rehabilitation Sciences, Brisbane, QLD, 4072, Australia; University of Otago, Department of Anatomy, School of Biomedical Sciences, Dunedin, 9016, New Zealand; La Trobe Sport and Exercise Medicine Research Centre (LASEM), College of Science, Health and Engineering, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.
| | - Kay M Crossley
- The University of Queensland, School of Health & Rehabilitation Sciences, Brisbane, QLD, 4072, Australia; La Trobe Sport and Exercise Medicine Research Centre (LASEM), College of Science, Health and Engineering, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.
| | - Paul W Hodges
- The University of Queensland, School of Health & Rehabilitation Sciences, Brisbane, QLD, 4072, Australia.
| | - Bill T Vicenzino
- The University of Queensland, School of Health & Rehabilitation Sciences, Brisbane, QLD, 4072, Australia.
| | - Matthew G King
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), College of Science, Health and Engineering, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.
| | - Joshua J Heerey
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), College of Science, Health and Engineering, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.
| | - Adam I Semciw
- The University of Queensland, School of Health & Rehabilitation Sciences, Brisbane, QLD, 4072, Australia; La Trobe Sport and Exercise Medicine Research Centre (LASEM), College of Science, Health and Engineering, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia; Northern Centre for Health, Education and Research, Northern Health, Melbourne, Vic, Australia.
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30
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Breen D, Farrell G, Delahunt E. The clinical assessment of hip muscle strength in professional rugby union players. Phys Ther Sport 2021; 52:115-120. [PMID: 34481341 DOI: 10.1016/j.ptsp.2021.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 11/25/2022]
Abstract
Groin/hip injuries are prevalent in rugby union (RU). Assessment of hip muscle strength is important when designing bespoke injury prevention and rehabilitation programmes. OBJECTIVE The primary aim of this study was to determine normative values of hip muscle strength in elite-level RU players. A secondary aim of this study was to compare the Copenhagen Hip and Groin Outcome Score (HAGOS) between players with and without a history of groin/hip injury. DESIGN Cross-sectional cohort study. SETTING Professional RU club. PARTICIPANTS 58 male professional RU players competing in the PRO14 league elite club level competition. MAIN OUTCOME MEASURES Handheld dynamometry eccentric strength values of hip abduction (ABD), adduction (ADD), internal rotation (IR) and external rotation (ER), HAGOS. RESULTS Players' dominant (DOM) and non-dominant (NDOM) hip strength values were, 2.38 and 2.34 N m/kg for ABD, 2.79 and 2.71 N m/kg for ADD, 2.69 and 2.55 N m/kg for IR, and 2.65 and 2.54 N m/kg for ER. ADD:ABD strength ratio was 1.17 ± 0.26 for the DOM limb and 1.16 ± 0.24 for the NDOM limb. There was no clinically significant difference in strength between players' DOM and NDOM limbs. Players with a history of groin/hip injury scored lower on four of the HAGOS subscales (pain; symptoms; sport; quality of life) compared to those without a history of groin/hip injury. CONCLUSIONS This study may help establish normative hip strength and HAGOS values for elite-level RU players. The results presented have important implications for the assessment of hip muscle strength and could provide clinical markers for return-to-play following injury.
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Affiliation(s)
- David Breen
- The Performance Team MCFC Academy, Manchester City FC, CFA Etihad Campus, 400 Ashton New Road, Manchester, England, United Kingdom.
| | - Garreth Farrell
- Medical Department, Leinster Rugby, Newstead Building A, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Eamonn Delahunt
- School of Public Health, Physiotherapy & Sport Science, University College Dublin, Dublin 4, Ireland.
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31
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The dominant leg is more likely to get injured in soccer players: systematic review and meta-analysis. Biol Sport 2021; 38:397-435. [PMID: 34475623 PMCID: PMC8329968 DOI: 10.5114/biolsport.2021.100265] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 08/31/2020] [Accepted: 09/03/2020] [Indexed: 12/26/2022] Open
Abstract
In soccer (football), dominant limb kicking produces higher ball velocity and is used with greater frequency than the non-dominant limb. It is unclear whether limb dominance has an effect on injury incidence. The purpose of this systematic review with meta-analysis is to examine the relationship between limb dominance and soccer injuries. Studies were identified from four online databases according to PRISMA guidelines to identify studies of soccer players that reported lower extremity injuries by limb dominance. Relevant studies were assessed for inclusion and retained. Data from retained studies underwent meta-analyses to determine relative risk of dominant versus non-dominant limb injuries using random-effects models. Seventy-four studies were included, with 36 of them eligible for meta-analysis. For prospective lower extremity injury studies, soccer players demonstrated a 1.6 times greater risk of injury to the dominant limb (95% CI [1.3-1.8]). Grouped by injury location, hamstring (RR 1.3 [95% CI 1.1-1.4]) and hip/groin (RR 1.9 [95% CI 1.3-2.7]) injuries were more likely to occur to the dominant limb. Greater risk of injury was present in the dominant limb across playing levels (amateurs RR 2.6 [95% CI 2.1-3.2]; youths RR 1.5 [95% CI 1.26-1.67]; professionals RR 1.3 [95% CI 1.14-1.46]). Both males (RR 1.5 [95% CI 1.33-1.68)] and females (RR 1.5 [95% CI 1.14-1.89]) were more likely to sustain injuries to the dominant limb. Future studies investigating soccer injury should adjust for this confounding factor by using consistent methods for assigning limb dominance and tracking use of the dominant versus non-dominant limb.
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32
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Candela V, De Carli A, Longo UG, Sturm S, Bruni G, Salvatore G, Denaro V. Hip and Groin Pain in Soccer Players. JOINTS 2021; 7:182-187. [PMID: 34235383 PMCID: PMC8253608 DOI: 10.1055/s-0041-1730978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 04/18/2021] [Indexed: 10/29/2022]
Abstract
Purpose The aim of this article is to illustrate the recent framework necessary to standardize studies on groin pain and review the existing literature on groin pain in football. Methods The common pathological processes underlying groin pain such as muscle, tendon or ligament strain, bone injury or fracture, sport hernia, bursitis, osteitis pubis, and hip-related diseases have been reviewed and current management options have been considered. Results Groin pain is considered a pain in pubic or lower abdominal or adductors region which can be monolateral or bilateral. It is common in high-intensity team sports and can negatively affect an athlete's professional carrier, causing serious disruption in the performance. Despite a high prevalence of groin pain in athletes, diagnosis and management of the underlying pathological processes remain a challenge for surgeons, radiologists, and physiotherapists alike. Conclusion A multidisciplinary approach is essential for patients with groin pain allowing prompt diagnosis and initiation of treatment thus facilitating more rapid return to play and preventing potential long-term sequelae of chronic groin pathology.
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Affiliation(s)
- Vincenzo Candela
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Trigoria, Rome, Italy
| | - Angelo De Carli
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza," Italy
| | - Umile Giuseppe Longo
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Trigoria, Rome, Italy
| | - Sofia Sturm
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Trigoria, Rome, Italy
| | - Giorgio Bruni
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza," Italy
| | - Giuseppe Salvatore
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Trigoria, Rome, Italy
| | - Vincenzo Denaro
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Trigoria, Rome, Italy
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Saito M, Niga S, Nihei T, Uomizu M, Ikezawa Y, Tsukada S. The cleft sign may be an independent factor of magnetic resonance imaging findings associated with a delayed return-to-play time in athletes with groin pain. Knee Surg Sports Traumatol Arthrosc 2021; 29:1474-1482. [PMID: 33452578 DOI: 10.1007/s00167-020-06410-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 12/07/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE To investigate the prevalence of magnetic resonance imaging (MRI) findings and define prognostic factors of the return-to-play time in young athletes with groin pain. METHODS A total of 1091 consecutive athletes were retrospectively screened; 651 athletes, aged 16-40 years, with pain in the groin regions were assessed using MRI. Of these athletes, 356 were included for analysing the time to return-to-play. Univariate and multiple linear regression analyses were used to determine the associations between the time to return-to-play (primary outcome variable) and the following variables: age, sex, body mass index, type of sports, Hip Sports Activity Scale, clear trauma history, and 12 MRI findings. RESULTS Four MRI findings, including cleft sign, pubic bone marrow oedema of both the superior and inferior ramus, and central disc protrusion of the pubic symphysis, appeared together in more than 44% of the cases. The median time to return-to-play was 24.7 weeks for athletes with a cleft sign on MRI, which was significantly longer than the 11.9 weeks for athletes without the sign. The median time to return-to-play was 20.8 weeks for athletes with BMI > 24, which was significantly longer than the 13.6 weeks for athletes with BMI ≦ 24. In multiple linear regression analysis of 356 athletes, in whom hip-related groin pain was excluded, and who were followed-up until the return-to-play, the body mass index and cleft sign were the independent factors associated with a delayed return-to-play. In contrast, iliopsoas muscle strain and other muscle injuries were associated with a shorter return-to-play. CONCLUSIONS Multiple MRI findings were present in almost half of all cases. Body mass index and the cleft sign were independently associated with a delayed return-to-play time in young athletes suffering from groin pain. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Masayoshi Saito
- Department of Orthopaedic Surgery, St. Luke's International Hospital, 9-1 Akashicho, Chuo-ku, Tokyo, 104-8560, Japan
| | - Sadao Niga
- JIN Orthopaedic & Sports Clinic, 3-10-7 Suzuya, Chuo-ku, Saitama, Saitama, 338-0013, Japan.
| | - Tadahiro Nihei
- JIN Orthopaedic & Sports Clinic, 3-10-7 Suzuya, Chuo-ku, Saitama, Saitama, 338-0013, Japan
| | - Mari Uomizu
- Department of Orthopaedic Surgery, Nerima General Hospital, 1-24-1 Asahigaoka, Nerima-ku, Tokyo, 176-8530, Japan
| | - Yuji Ikezawa
- JIN Orthopaedic & Sports Clinic, 3-10-7 Suzuya, Chuo-ku, Saitama, Saitama, 338-0013, Japan
| | - Sachiyuki Tsukada
- Department of Orthopaedic Surgery, Hokusuikai Kinen Hospital, 3-2-1 Higashihara, Mito, Ibaraki, 310-0035, Japan
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34
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van Klij P, Langhout R, van Beijsterveldt AMC, Stubbe JH, Weir A, Agricola R, Fokker Y, Mosler AB, Waarsing JH, Verhaar J, Tak I. Do hip and groin muscle strength and symptoms change throughout a football season in professional male football players? A prospective cohort study with repeated measures. J Sci Med Sport 2021; 24:1123-1129. [PMID: 33888428 DOI: 10.1016/j.jsams.2021.03.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 01/11/2021] [Accepted: 03/30/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Groin injuries are common in professional male football and result in significant complaints, time-loss and cost. We aimed to study: 1. Normal values of hip muscle strength and self-reported hip and groin function (Hip And Groin Outcome Score (HAGOS)). 2. Changes in these values throughout the season. 3. If previous (groin) injuries, leg dominance or league were associated with these outcome measures. DESIGN Prospective cohort study. METHODS 313 professional male football players (11 clubs) participated. Player characteristics and previous injuries were registered. Hip muscle strength (hand-held dynamometer) and HAGOS measurements were done at the start, middle and end of the season. RESULTS Data from 217 players were analysed. Adduction strength (mean±standard deviation, Nm/Kg) was 3.40±0.72 (start), 3.30±0.65 (mid) and 3.39±0.74 (end) (p=0.186). Abduction strength was 3.45±0.67, 3.14±0.57 and 3.28±0.61 (p<0.001). Adduction/abduction ratio was 1.00±0.21, 1.07±0.22 and 1.05±0.23 (p<0.001). Statistically, the HAGOS-subscale 'Pain' (median [interquartile range]) deteriorated slightly during the season (p=0.005), especially from mid-season (97.5 [90.6-100.0]) to end-of-season (95.0 [87.5-100.0]) (p=0.003). Other subscale scores remained unchanged between time points; 85.7 (symptoms), 100.0 (daily living), 96.9 (sports and recreation) 100.0, (physical activities) and 90.0 (quality of life). Previous injuries were associated with lower HAGOS-scores. Dominant legs had higher abduction strength (p<0.001) and lower adduction/abduction ratio (p<0.001). No differences between leagues were found for hip muscle strength and HAGOS-scores. CONCLUSIONS In Dutch male professional football players, hip muscle strength and HAGOS-scores remained relatively stable throughout the season. Pain increased slightly, which while statistically significant, was not clinically relevant.
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Affiliation(s)
- P van Klij
- Department of Orthopaedic Surgery, Erasmus MC, University Medical Center, The Netherlands.
| | - R Langhout
- Physiotherapy Dukenburg Nijmegen, Department Manual Therapy and Sports Rehabilitation, The Netherlands; Academic Centre for Evidence Based Sports Medicine (ACES), The Netherlands
| | | | - J H Stubbe
- Codarts, University of the Arts, The Netherlands; Performing Artist and Athlete Research Lab (PEARL), The Netherlands; Department of General Practice, Erasmus MC University Medical Centre Rotterdam, The Netherlands
| | - A Weir
- Department of Orthopaedic Surgery, Erasmus MC, University Medical Center, The Netherlands; Aspetar Orthopaedic and Sports Medicine Hospital, Qatar; Sports Medicine and Exercise Clinic Haarlem (SBK), The Netherlands
| | - R Agricola
- Department of Orthopaedic Surgery, Erasmus MC, University Medical Center, The Netherlands
| | - Y Fokker
- Amsterdam University of Applied Sciences, Centre for Applied Research in Sports and Nutrition, The Netherlands
| | - A B Mosler
- Aspetar Orthopaedic and Sports Medicine Hospital, Qatar; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Australia
| | - J H Waarsing
- Department of Orthopaedic Surgery, Erasmus MC, University Medical Center, The Netherlands
| | - J Verhaar
- Department of Orthopaedic Surgery, Erasmus MC, University Medical Center, The Netherlands
| | - I Tak
- Academic Centre for Evidence Based Sports Medicine (ACES), The Netherlands; Physiotherapy Utrecht Oost - Sports Rehabilitation and Manual Therapy Clinic, The Netherlands; Amsterdam Collaboration on Health and Safety in Sports (ACHSS)/IOC Research Centre of Excellence, The Netherlands
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Dupré T, Tryba J, Potthast W. Muscle activity of cutting manoeuvres and soccer inside passing suggests an increased groin injury risk during these movements. Sci Rep 2021; 11:7223. [PMID: 33790373 PMCID: PMC8012386 DOI: 10.1038/s41598-021-86666-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/18/2021] [Indexed: 11/13/2022] Open
Abstract
Cutting manoeuvres and inside passing are thought to increase the risk of sustaining groin injuries. But both movements have received little research attention in this regard. The purpose of this study was to investigate the muscle activity of adductor longus and gracilis as well as hip and knee joint kinematics during \documentclass[12pt]{minimal}
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\begin{document}$$90^{\circ }$$\end{document}90∘-cutting and inside passing. Thirteen male soccer players were investigated with 3D-motion capturing and surface electromyography of adductor longus and gracilis while performing the two movements. Hip and knee joint kinematics were calculated with AnyBody Modelling System. Muscle activity of both muscles was significantly higher during the cutting manoeuvre compared to inside passing. Kinematics showed that the highest activity occurred during phases of fast muscle lengthening and eccentric contraction of the adductors which is known to increase the groin injury risk. Of both movements, cutting showed the higher activity and is therefore more likely to cause groin injuries. However, passing might also increase the risk for groin injuries as it is one of the most performed actions in soccer, and therefore most likely causes groin injuries through overuse. Practitioners need to be aware of these risks and should prepare players accordingly through strength and flexibility training.
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Affiliation(s)
- Thomas Dupré
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, 50933, Cologne, Germany.
| | - Julian Tryba
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, 50933, Cologne, Germany
| | - Wolfgang Potthast
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, 50933, Cologne, Germany
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Iqbal A, Kalia S, Beale D, James SL, Botchu R. Isolated distal adductor magnus tendon avulsion as a rare cause of medial knee pain. A case report. Indian J Radiol Imaging 2021; 30:507-509. [PMID: 33737782 PMCID: PMC7954158 DOI: 10.4103/ijri.ijri_523_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 05/06/2020] [Accepted: 09/01/2020] [Indexed: 11/05/2022] Open
Abstract
Avulsion injuries of adductor frequently involve the proximal origin. We report the first case of avulsion fracture of adductor magnus at its insertion and discuss the relevant anatomy.
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Affiliation(s)
- Aamer Iqbal
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | | | | | - Steven L James
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - Rajesh Botchu
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
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Dawkins J, Ishøi L, Willott JO, Andersen LL, Thorborg K. Effects of a low‐dose Copenhagen adduction exercise intervention on adduction strength in sub‐elite male footballers: A randomised controlled trial. TRANSLATIONAL SPORTS MEDICINE 2021. [DOI: 10.1002/tsm2.238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Jack Dawkins
- Department for Health University of Bath Bath UK
| | - Lasse Ishøi
- Department of Orthopaedic Surgery Sports Orthopaedic Research Centre Copenhagen University Hospital Amager‐Hvidovre Denmark
| | | | - Lars L. Andersen
- National Research Centre for the Working Environment Copenhagen Denmark
| | - Kristian Thorborg
- Department of Orthopaedic Surgery Sports Orthopaedic Research Centre Copenhagen University Hospital Amager‐Hvidovre Denmark
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Surgical versus conservative management of traumatic proximal adductor longus avulsion injuries: A systematic review. Surgeon 2021; 20:123-128. [PMID: 33692004 DOI: 10.1016/j.surge.2021.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/05/2021] [Accepted: 01/27/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Proximal avulsion injuries of the adductor longus have been managed both conservatively and operatively with good clinical outcomes, but there is no consensus on which option yields the best results. Thus, the present study aimed to review the available literature, comparing the outcomes and the time to return to sports with different management options. MATERIAL AND METHODS This study was conducted according to the PRISMA statement. The literature search was conducted in September 2020. All the clinical trials investigating the management of traumatic proximal adductor longus avulsion injuries were considered for inclusion. Only studies reporting data from athletes were considered. The outcomes of interest were the time to return to sport and return to preinjury activity level. RESULTS Data from 46 patients were retrieved. The mean follow-up was 24.6 ± 23.8 months. The study population was represented by male athletes with a mean age of 30.0 ± 4.8. Mean stump retraction was 3.3 ± 0.6 cm in the surgical and 1.7 ± 0.6 in the conservative cohort (P = 0.07). The rate of patients returning to prior activity level was similar in the two groups, but surgically treated patients required a longer time to return to sport (3.9 ± 1.5 months vs. 2.2 ± 1.0 months, P = 0.0001). CONCLUSION Conservative management for traumatic avulsion of the proximal adductor longus insertion may produce shorter time to return to sport. Both conservative and operative strategies allowed to achieve similar pre-injury activity level. LEVEL OF EVIDENCE IV, systematic review.
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Light N, Johnson A, Williams S, Smith N, Hale B, Thorborg K. Injuries in youth football and the relationship to player maturation: An analysis of time-loss injuries during four seasons in an English elite male football academy. Scand J Med Sci Sports 2021; 31:1324-1334. [PMID: 33560529 DOI: 10.1111/sms.13933] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 01/15/2021] [Accepted: 01/22/2021] [Indexed: 12/01/2022]
Abstract
A better insight into injuries in elite-youth football may inform prevention strategies. The purpose of this prospective cohort study was to investigate the frequency, incidence, and pattern of time-loss injuries in an elite male football academy, exploring injuries in relation to age and maturation status. Across four consecutive playing seasons, playing exposure and injuries to all academy players (U'9 to U'21) were recorded by club medical staff. Maturation status at the time of injury was also calculated for players competing in U'13 to U'16 aged squads. Time-loss injury occurrence and maturation status at time of injury were the main outcome measures. A total of 603 time-loss injuries were recorded, from 190 different players. Playing exposure was 229 317 hours resulting in an overall injury rate of 2.4 p/1000 h, ranging from 0.7 p/1000 h (U'11) to 4.8 p/1000 h (U'21). Most injuries were traumatic in mechanism (73%). The most common injury location was the thigh (23%), and the most common injury type was muscle injury (29%) combining to provide the most common injury diagnosis; thigh muscle injury (17%). In U'13-U'16 players, a higher number of injuries to early-maturing players were observed in U'13-U'14 players, while more injuries to U'15-U'16 players occurred when classed as "on-time" in maturity status. Maturation status did not statistically relate to injury pattern; however, knee bone (not-fracture) injuries peaked in U'13 players while hip/groin muscle injuries peaked in U'15 players.
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Affiliation(s)
- Neil Light
- Department of Sport and Exercise Sciences, University of Chichester, Chichester, UK
| | - Adam Johnson
- Brighton and Hove Albion Football Club, Brighton, UK
| | | | - Neal Smith
- Department of Sport and Exercise Sciences, University of Chichester, Chichester, UK
| | - Beverley Hale
- Department of Sport and Exercise Sciences, University of Chichester, Chichester, UK
| | - Kristian Thorborg
- Department of Orthopedic Surgery, Sports Orthopedic Research Center Copenhagen (SORC-C), Copenhagen University Hospital, Amager-Hvidovre, Copenhagen, Denmark
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Perrone MA, Noorzad A, Hamula M, Metzger M, Banffy M, Gerhardt M. Hip Adductor Longus Tendon Origin Anatomy Is Consistent and May Inform Surgical Reattachment. Arthrosc Sports Med Rehabil 2021; 3:e227-e232. [PMID: 33615269 PMCID: PMC7879210 DOI: 10.1016/j.asmr.2020.09.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/19/2020] [Indexed: 11/28/2022] Open
Abstract
Purpose To define the topographic anatomy of the footprint of the adductor longus origin on the pubis and its underlying bony morphology to better inform surgical repair of adductor longus tendon injuries. Methods Five cadaveric pelvis specimens were dissected, making 10 adductor footprints available for analysis. The adductor longus tendon origin was isolated and the surrounding tissue debrided. The circumference of the tendinous attachment to the pubic crest was marked before excising the tendon and fibrocartilage enthesis from the pubis. Radiopaque paint was prepared by mixing 30 mL of all-purpose acrylic paint (Anita’s no. 11150 Island Blue; Rust-Oleum Corp, Vernon Hills, IL) with 15g of E-Z-HD 98% w/w barium sulfate (Bracco Diagnostics Inc., Anjou Quebec, Canada) and applied to the marked footprint. The specimens underwent a 1.0-mm slice computed tomographic scan with 3-dimensional reconstructions. Synapse PACS (FujiFilm, Valhalla, NY) software for measurements of the tendon footprint and underlying bone. Results Average age and weight of the specimens at the time of death was 37 years and 204.6 ± 48.7 lbs, respectively. The width and length of the tendon origin was 12.0 ± 1.1 mm and 10.9 ± 1.1 mm, respectively. The distance of the center of the footprint from the center of the pubic tubercle was 8.5 ± 1.4 mm lateral and 12.2 ± 0.4 mm caudal. The osseous thickness underlying the footprint was 18.7 ± 3.7 mm at an angle of 34.5 ± 1.5° in relation to the sagittal plane. The correlation between specimen body weight and the thickness of the bone underlying the footprint was strongly positive (r = 0.92). Conclusions We found that there is a consistent angle from the center of the adductor longus tendon footprint to the point of maximal underlying bony thickness, as well as a positive correlation between body mass index and osseous thickness, which may inform anatomic reattachment of this tendon. Clinical Relevance Our findings will assist surgeons in identifying the footprint of the adductor longus tendon and safely perform anatomic repair of adductor longus tendon avulsions.
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Affiliation(s)
- Michael A Perrone
- Cedars Sinai Kerlan-Jobe Orthopaedic Institute, Los Angeles, California, U.S.A
| | - Ali Noorzad
- Cedars Sinai Department of Orthopaedics, Los Angeles, California, U.S.A
| | - Mathew Hamula
- Cedars Sinai Kerlan-Jobe Orthopaedic Institute, Los Angeles, California, U.S.A
| | - Melodie Metzger
- Metzger Biomechanics Laboratory at Cedars-Sinai Medical Center, Los Angeles, California, U.S.A
| | - Michael Banffy
- Cedars Sinai Kerlan-Jobe Orthopaedic Institute, Los Angeles, California, U.S.A
| | - Michael Gerhardt
- Cedars Sinai Kerlan-Jobe Orthopaedic Institute, Los Angeles, California, U.S.A.,Santa Monica Orthopaedic and Sports Medicine Group, Los Angeles, California, U.S.A
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Comparison of Modular Control during Side Cutting before and after Fatigue. Appl Bionics Biomech 2021; 2021:8860207. [PMID: 33505517 PMCID: PMC7808840 DOI: 10.1155/2021/8860207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 12/18/2020] [Accepted: 12/23/2020] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study was to clarify the coordination between the trunk and lower limb muscles during sidestep and to compare this coordination before and after fatigue intervention. The intervention was lateral jump until exhaustion. Nonnegative matrix factorization (NMF) was used to extract muscle synergies from electromyography. Subsequently, to compare the muscle synergies, a scalar product that evaluates the coincidence of synergies was calculated. Three muscle synergies were extracted before and after the intervention from the NMF analysis. In accordance with the evaluation of the scalar product, these synergies were the same before and after the intervention. One of these synergies that engaged the internal oblique/transversus abdominis, rectus femoris, and adductor muscle was activated from before landing to midstance during sidestep motion; therefore, this synergy is thought to suppress excessive hip abduction. However, the activation timing of this synergy was delayed after the intervention (P = 0.028, effect size: 0.54, Wilcoxon test). This delay is considered to decrease hip stability. Thus, this change may induce a reduction in hip control function.
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Khaitin V, Bezuglov E, Lazarev A, Matveev S, Ivanova O, Maffulli N, Achkasov E. Markers of muscle damage and strength performance in professional football (soccer) players during the competitive period. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:113. [PMID: 33569415 PMCID: PMC7867942 DOI: 10.21037/atm-20-2923] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background The present study investigated the impact of competitive soccer on the short-term changes in isometric strength of the adductor muscle group during the competitive season. Methods In this cohort study we evaluated the association between a serum marker of muscle damage [creatine phosphokinase (CPK)] and isometric strength of the adductor muscles of the hip in 30 professional football players (age: 26.7±2.9 years) during two seasons of the national top-level championship. Serum CPK level was determined the day before the match, 12–20, 36–48, 60–72 h after the match. The maximum voluntary isometric contraction force of the adductor muscles complex was determined immediately after having taken blood samples. Results There was evidence of a statistically significant positive association between age, body mass index (BMI), percentage of body fat, and muscle strength, and between weight and muscle strength. There was evidence of a statistically significant negative association between the level of CPK and the maximum isometric strength of the adductors of soccer players. Changes in CPK levels were associated with the muscle strength recovery trend (P<0.001). The strength/CPK ratio at different time points had a U-shaped curve. Conclusions Exercise induced muscle damage significantly affects the strength of the adductor muscle group of professional soccer players during the competitive period. The lower the CPK level, the greater the athletes' strength at a given time point. Also, the greater the decrease in CPK level, the greater the rate of strength restoration.
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Affiliation(s)
- Vladimir Khaitin
- Pavlov First Saint-Petersburg State Medical University, Saint-Petersburg, Russia.,FC Zenit, Saint-Petersburg, Russia
| | - Eduard Bezuglov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,Federal Research and Clinical Center of Sports Medicine and Rehabilitation of Federal Medical Biological Agency, Moscow, Russia.,High Performance Sport Laboratory, Moscow Witte University, Moscow, Russia
| | - Artemii Lazarev
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,High Performance Sport Laboratory, Moscow Witte University, Moscow, Russia
| | - Sergey Matveev
- Pavlov First Saint-Petersburg State Medical University, Saint-Petersburg, Russia
| | - Olga Ivanova
- Lomonosov Moscow State University, Moscow, Russia
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Salerno, Italy.,Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (SA), Italy.,Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, Queen Mary University of London, London, England.,School of Pharmacy and Bioengineering, Keele University School of Medicine, Stoke on Trent, England
| | - Evgeny Achkasov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Kemp JL, Mosler AB, Hart H, Bizzini M, Chang S, Scholes MJ, Semciw AI, Crossley KM. Improving function in people with hip-related pain: a systematic review and meta-analysis of physiotherapist-led interventions for hip-related pain. Br J Sports Med 2020; 54:1382-1394. [PMID: 32376673 PMCID: PMC7677471 DOI: 10.1136/bjsports-2019-101690] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To report the effectiveness of physiotherapist-led interventions in improving pain and function in young and middle-aged adults with hip-related pain. DESIGN Systematic review and meta-analysis. DATA SOURCES A comprehensive, reproducible search strategy was performed on five databases in May 2019. Reference lists and grey literature were also searched. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Population: people aged ≥18 years with hip-related pain (with or without a diagnosis of femoroacetabular impingement syndrome). INTERVENTION(S) physiotherapist-led interventions for hip pain. Comparators: sham treatment, no treatment or other treatment (eg, hip arthroscopic surgery). OUTCOMES primary outcomes included patient-reported hip pain and function. Secondary outcomes included physical function measures. RESULTS 1722 papers were identified. After exclusion criteria were applied, 14 studies were included for analysis. They had varied risk of bias. There were no full-scale placebo-controlled randomised controlled trials (RCTs) of physiotherapist-led treatment. Pooled effects ranged from moderate effects (0.67 (95% CI 0.07 to 1.26)) favouring physiotherapist-led intervention over no treatment post-arthroscopy, to weak effects (-0.32 (95% CI 0.57 to 0.07)) favouring hip arthroscopy over physiotherapist-led treatment. CONCLUSION Physiotherapist-led interventions might improve pain and function in young and middle-aged adults with hip-related pain, however full-scale high-quality RCT studies are required. PROSPERO REGISTRATION NUMBER CRD42018089088.
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Affiliation(s)
- Joanne L Kemp
- Latrobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Andrea B Mosler
- Latrobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Harvi Hart
- Latrobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
- Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Mario Bizzini
- Schulthess Clinic Human Performance Lab, Zurich, Switzerland
| | - Steven Chang
- La Trobe University Library, La Trobe University, Melbourne, Victoria, Australia
| | - Mark J Scholes
- Latrobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Adam I Semciw
- Latrobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Melbourne, Victoria, Australia
| | - Kay M Crossley
- Latrobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
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Lifshitz L, Bar Sela S, Gal N, Martin R, Fleitman Klar M. Iliopsoas the Hidden Muscle: Anatomy, Diagnosis, and Treatment. Curr Sports Med Rep 2020; 19:235-243. [PMID: 32516195 DOI: 10.1249/jsr.0000000000000723] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The iliopsoas is a deep muscle group which anatomically connects the spine to the lower limbs. It is composed of the iliacus, psoas major, and psoas minor muscles. The iliopsoas functions as the primary hip flexor. Because the iliopsoas is important for daily activities, including sports, impairments and pathology associated with this muscle group can cause significant limitations. Evaluating pathology associated with the iliopsoas muscle group can be challenging because the patient's complaints are often vague and difficult to discern from other hip problems. This article will review relevant anatomy, discuss common pathologies, present clinical based examination methods, and outline conservative treatment interventions focusing on manual therapy and active exercises.
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Dupré T, Lysdal FG, Funken J, Mortensen KRL, Müller R, Mayer J, Krahl H, Potthast W. Groin Injuries in Soccer: Investigating the Effect of Age on Adductor Muscle Forces. Med Sci Sports Exerc 2020; 52:1330-1337. [PMID: 31895302 DOI: 10.1249/mss.0000000000002243] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE The sudden rise in the injury incidence during adolescence is also evident in soccer-related injuries to the groin. Submaximal passing applies high stress on the adductor muscles and pubic symphysis and is therefore likely to be connected to the occurrence of groin injuries. Therefore, the purpose of the study was to compare hip joint kinematics and adductor muscle forces of different adolescent age groups during submaximal soccer passing. METHODS Sixty participants, in four groups, younger than 12, 15, 16. and 23 yr (U12, U15, U16, U23), were analyzed. A Footbonaut, equipped with a 3D motion capture system consisting of 16 cameras, was used to capture kinematic data of short passes. Inverse dynamic analysis was performed to calculate muscle forces of 10 passes of each subject. RESULTS The U15 group showed reduced angular velocities. A rise in hip adductor muscle forces was evident from the youngest group up to the oldest groups. The largest increase (49%) was found between U12 and U15. Lower-limb mass was identified as the best predictor for the increasing adductor force. CONCLUSIONS The reduced angular velocities of the U15 and the increase in muscle forces between all age groups were attributed to the increasing segment masses and length. This increases the moments of inertia of the leg segments thereby demanding higher forces to accelerate the segments. Most likely, the stress put upon the adductors apophyses increases during adolescence, as tendons are known to adapt slower than muscles, increasing the risk for overuse injuries. Coaches could use lower-limb mass as an indicator for fast increases in the force demand to identify players who would benefit from a reduced training volume.
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Affiliation(s)
- Thomas Dupré
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, GERMANY
| | - Filip Gertz Lysdal
- Sport Sciences, Department of Health Science and Technology, Aalborg University, Aalborg East, DENMARK
| | - Johannes Funken
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, GERMANY
| | - Kristian R L Mortensen
- Sport Sciences, Department of Health Science and Technology, Aalborg University, Aalborg East, DENMARK
| | - Ralf Müller
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, GERMANY
| | - Jan Mayer
- TSG 1899 Hoffenheim Fußball-Spielbetriebs GmbH, Zuzenhausen, GERMANY
| | - Hartmut Krahl
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, GERMANY
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Massa J, Vanstraelen F, Bogaerts S, Peers K. Prevalence of asymptomatic radiological findings in the groin region: a systematic review. PHYSICIAN SPORTSMED 2020; 48:378-384. [PMID: 32213080 DOI: 10.1080/00913847.2020.1746209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: The aim of this study is to investigate in current literature the prevalence of asymptomatic adductor and pubic abnormalities on MRI and ultrasound. Methods: A systematic review of the literature was carried out using PubMed to identify all studies reporting asymptomatic pubic- and adductor-related findings on MRI and/or ultrasound. All types of studies were eligible for inclusion, except case reports. Studies with an asymptomatic cohort, or where at least a part of the study population was asymptomatic, were included. Results: Thirteen studies were included. Two articles describe only asymptomatic adductor abnormalities, six articles only asymptomatic pubic abnormalities. Five articles describe both adductor and pubic abnormalities. All studies were conducted with MRI. Only one of the included articles describes asymptomatic groin findings on ultrasound. Conclusions: Asymptomatic adductor and pubic abnormalities on MRI are frequently present but vary greatly between selected studies. No exact conclusions can be drawn about the prevalence of asymptomatic adductor or pubic findings on MRI due to high heterogeneity between studies. Furthermore, the one article about ultrasound was not enough to draw conclusions for ultrasound findings. It is nonetheless clear that clinicians should be careful to make diagnoses purely based on radiologic findings. A thorough clinical examination and individual interpretation conducted by the clinician remains indispensable.
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Affiliation(s)
- Jonas Massa
- Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven , Leuven, Belgium
| | | | - Stijn Bogaerts
- Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven , Leuven, Belgium.,Department of Development and Regeneration, KU Leuven , Leuven, Belgium.,Department of Physical Medicine and Rehabilitation, University Hospitals Leuven , Pellenberg, Belgium
| | - Koenraad Peers
- Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven , Leuven, Belgium.,Department of Development and Regeneration, KU Leuven , Leuven, Belgium.,Department of Physical Medicine and Rehabilitation, University Hospitals Leuven , Pellenberg, Belgium
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48
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Lall AC, Walsh JP, Maldonado DR, Pinto LE, Ashberg LJ, Lodhia P, Radha S, Correia APR, Domb BG, Perez-Carro L, Marín-Peña O, Griffin DR. Teamwork in hip preservation: the ISHA 2019 Annual Scientific Meeting. J Hip Preserv Surg 2020; 7:2-21. [PMID: 33072394 PMCID: PMC7546541 DOI: 10.1093/jhps/hnaa037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Hip preservation surgery is now an established part of orthopedic surgery and sports medicine. This report describes the key findings of the 11th Annual Scientific Meeting of International Society for Hip Arthroscopy-the International Hip Preservation Society-in Madrid, Spain from 16 to 19 October 2019. Lectures, seminars and debates explored the most up-to-date and expert views on a wide variety of subjects, including: diagnostic problems in groin pain, buttock pain and low back pain; surgical techniques in acetabular dysplasia, hip instability, femoroacetabular impingement syndrome, labral repair and reconstruction, cartilage defects, adolescent hips and gluteus medius and hamstring tears; and new ideas about femoral torsion, hip-spine syndrome, hip capsule surgery, impact of particular sports on hip injuries, registries, robotics and training for hip preservation specialists. Surgeons, sports physicians, radiologists and physiotherapists looking after young people with hip problems have an increasingly sophisticated armoury of ideas and techniques with which to help their patients. The concept of hip preservation has developed incredibly fast over the last decade; now it is clear that the best results can only be achieved by a multidisciplinary team working together. The 2020s will be the decade of 'Teamwork in Hip Preservation'.
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Affiliation(s)
- Ajay C Lall
- American Hip Institute Research Foundation, 999 E Touhy Ave Ste 450, Des Plaines, IL 60018, USA.,American Hip Institute, 999 E Touhy Ave Ste 450, Des Plaines, IL 60018, USA
| | - John P Walsh
- American Hip Institute Research Foundation, 999 E Touhy Ave Ste 450, Des Plaines, IL 60018, USA.,Des Moines University, Desert Orthopaedic Center, 2800 E, Desert Inn Rd, Las Vegas, NV 89121, USA
| | - David R Maldonado
- American Hip Institute Research Foundation, 999 E Touhy Ave Ste 450, Des Plaines, IL 60018, USA
| | - Leonardo E Pinto
- Centro Medico Decente La Trinidad (Trinity Medical Center), Av. Principal de El Hatillo, Caracas 1080, Metropolitan District of Caracas, Venezuela
| | - Lyall J Ashberg
- Atlantis Orthopaedics, 4560 Lantana Rd Suite 100, Lake Worth, Atlantis, FL 33463, USA
| | - Parth Lodhia
- Footbridge Centre for Integrated Orthopaedic Care, 181 Keefer Pl #221, Vancouver, BC V6B 6C1, Canada
| | - Sarkhell Radha
- Croydon University Hospital, 530 London Rd, Thornton Heath CR7 7YE, London, UK
| | | | - Benjamin G Domb
- American Hip Institute Research Foundation, 999 E Touhy Ave Ste 450, Des Plaines, IL 60018, USA.,American Hip Institute, 999 E Touhy Ave Ste 450, Des Plaines, IL 60018, USA
| | - Luis Perez-Carro
- Hospital Clinica Mompia, Av. de los Condes, s/n, 39108 Mompía, Cantabria, Spain
| | - Oliver Marín-Peña
- University Hospital Infanta Leonor, Av. Gran Vía del Este, 80, 28031 Madrid, Spain and
| | - Damian R Griffin
- Warwick Medical School, University of Warwick and University Hospitals of Coventry and Warwickshire, Coventry CV4 7AL, UK
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49
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Núñez JF, Fernandez I, Torres A, García S, Manzanet P, Casani P, Suarez-Arrones L. Strength Conditioning Program to Prevent Adductor Muscle Strains in Football: Does it Really Help Professional Football Players? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176408. [PMID: 32887522 PMCID: PMC7504263 DOI: 10.3390/ijerph17176408] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/28/2020] [Accepted: 08/30/2020] [Indexed: 11/16/2022]
Abstract
Coaches at the professional level are often concerned about negative side effects from testing and intensive resistance training periods, and they are not willing to base their training prescriptions on data obtained from semiprofessional or amateur football players. Consequently, the purpose of this study was to analyze the reliability and effectiveness of two adductor injury active prevention programs using the adductor/abductor ratio and deficit between legs, on the basis of adduction-abduction power output during the exercises proposed, in professional football players. Forty-eight professional football players undertook complementary strength training for the adductor and abductor muscles in their dominant and non-dominant legs, once or twice a week throughout the playing season. The volume of the session was determined by the adductor/abductor ratio and the deficit between legs in the last session training measured. The number and severity of muscle injuries per 1000 h of exposure were recorded. Both prevention programs showed a very low rate of adductor injury (0.27 and 0.07 injuries/1000 h) with mild-to-moderate severity, maintaining a balance in percentage asymmetry between dominant and non-dominant legs for adductor (10.37%) and in the adductor/abductor ratio (0.92) in top professional football players throughout the season. The strength conditioning program proposed can help to prevent adductor muscle injuries in top professional football players.
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Affiliation(s)
- Javier F. Núñez
- Department of Sports and Informatics, Sport Faculty, University of Pablo de Olavide of Sevilla, 41013 Sevilla, Spain;
- Correspondence: ; Tel.: +34-606-204-313
| | - Ismael Fernandez
- Physical Trainer Coach of Valencia C.F, 46010 Valencia, Spain; (I.F.); (S.G.)
| | | | - Sergio García
- Physical Trainer Coach of Valencia C.F, 46010 Valencia, Spain; (I.F.); (S.G.)
| | - Pablo Manzanet
- Physical Trainer Coach of Villarreal C.F., 12540 Vila-Real, Spain;
| | - Pascual Casani
- Head of Medical Staff of Valencia C.F., 46010 Valencia, Spain;
| | - Luis Suarez-Arrones
- Department of Sports and Informatics, Sport Faculty, University of Pablo de Olavide of Sevilla, 41013 Sevilla, Spain;
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50
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Effectiveness of Field-Based Resistance Training Protocols on Hip Muscle Strength Among Young Elite Football Players. Clin J Sport Med 2020; 30:470-477. [PMID: 30418198 DOI: 10.1097/jsm.0000000000000649] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The objective of this study was to examine the effects of an 8-week progressive resistance training program on hip joint muscles' strength measures, using the Copenhagen adduction (CA) and the sliding hip (SH) exercises. DESIGN Prospective randomized controlled trial. SETTING Sport training and medical centers. PARTICIPANTS Forty-two young male football athletes (age 17.5 ± 1.1 years; height 178.3 ± 3.2 cm; body mass 66.1 ± 8.6 kg) allocated to a CA, SH, and matched control (C) group. INTERVENTIONS Two weekly sessions of CA and SH. MAIN OUTCOME MEASURES Maximal eccentric strength test for the hip adductor (EHAD) and maximal eccentric strength test for the hip abductor (EHAB) muscles, and the relative EHAD/EHAB ratio assessed through a break test in the side-lying position. RESULTS No significant differences between groups were found at baseline for any of the assessed variables (all P > 0.053). The CA group had a significant strength increase in the right and left leg (d = 2.11, d = 1.9, respectively). The SH group also had a significant strength increase in the right and left leg (d = 1.68 and d = 1.67, respectively). The CA group presented EHAD/EHAB improvements in the right and left leg (d = 0.84 and d = 1.14, respectively). The SH group also presented EHAD/EHAB improvements in the right and left leg (d = 1.34 and d = 1.44, respectively). CONCLUSIONS Both exercises' protocols were effective in inducing significant increases on EHAD, EHAB, and EHAD/EHAB ratio when compared with the control group. Practitioners should be aware of the training effectiveness of both protocols.
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