Dynamic Postural Stability Is Decreased During the Single-Leg Drop Landing Task in Male Collegiate Soccer Players With Chronic Ankle Instability

Increased Femoral Neck Anteversion is Prevalent in Male Elite Youth Soccer Players with Chronic Ankle Instability

Purpose

The aim of this study was to compare femoral neck anteversion (FNA) and determine the prevalence of increased FNA in male elite youth soccer players with and without chronic ankle instability (CAI). Secondary aims were to evaluate the utility of FNA in predicting CAI and compare ankle and hip muscle strength in the two groups.

Materials and methods

The study included a total of 44 male elite youth soccer players, 22 with CAI (mean age 16.09 ± 1.34) and 22 without CAI (mean age 16.73 ± 1.28). FNA was measured with Craig's test, range of motion (ROM) was measured with a universal goniometer, and ankle and hip maximum voluntary isometric strength (MVIS) was measured with a handheld dynamometer.

Results

The mean FNA angles of the CAI and control groups were 15.82° ± 1.44° and 12.09° ± 2.37°, respectively (p > 0.05). FNA was greater than 15° in 72% of the CAI group versus 4% of the control group (p < 0.05). A 1° increase in FNA was associated with threefold higher odds of having CAI (odds ratio 3.06, 95% confidence ratio: 1.37-6.81, p < 0.01). Mean ankle eversion and hip abduction MVIS values were 2.67 ± 0.52 Nm/kg and 3.83 ± 0.48 Nm/kg in the CAI group, compared to 3.03 ± 0.58 Nm/kg and 4.46 ± 0.98 Nm/kg in the control group, respectively (p < 0.05).

Conclusion

Male elite youth soccer players with CAI had greater FNA and were more likely to have increased FNA than those without CAI. They also exhibited ankle eversion and hip abduction muscle strength deficiencies compared to peers without CAI. FNA may be useful as a predictor of CAI in male elite youth soccer players.

Return to Play Assessment After Lateral Ankle Sprains - German Male Elite Youth Football (Soccer) Academy Baseline Data

Background

Lateral ankle sprain (LAS) is one of the most common types of injury in football (soccer). Normative baseline data of performance tests for Return to Play (RTP) decision are still lacking.

Purpose

The primary aim of this study was to generate baseline values for uninjured elite youth football players for a multifactorial RTP assessment and compare with previously published data. A secondary aim was to investigate the use of the Limb Symmetry Index (LSI) as a method to determine whether an athlete passes a performance test or not.

Study Design

Observational Cohort study.

Methods

Baseline data of performance tests (Y-Balance [YBT-LQ], Heel Rise [HRT]; Singe Leg Squat [SLST]; Single Leg Drop Jump [SLDJ]; Side Hop [SHT]; Figure of 8 Hop [F-8]; Modified Agility T-Test [MAT]) were assessed in 20 elite youth football players, aged 16-21 years. Additionally, the traditional LSI (dividing the result of the non-dominant leg by the result of the dominant leg and multiplying by 100) and directionally corrected LSI (the worst value is divided by the better value and multiplied by 100) were calculated. The test values were compared to previously reported study results. LSI and side-to-side comparisons between dominant and non-dominant leg sides were analyzed using the Wilcoxon test.

Results

Male elite youth football players achieved better results in the dynamic performance tests (SHT, F-8, and MAT) compared to reference values of the cohorts previously described in the literature: YBT-LQ total score (cm) dominant (dom) 99.3±8.3, non-dominant (ND) 99.5±10.4; HRT (average number) dom. 27.1±5.4, ND 25.2±5.1); SLDJ height (cm) dom 15±5, ND 15±5 and contact time (sec) dom 0.29±0.08, ND 0.29±0.07, Reactive Strength Index (RSI) dom 0.52±0.12, ND 0.50±0.13); SHT (sec) dom 7.12±0.73, ND 7.39±0.93; F-8 (sec) dom 10.52±1.02, ND 10.37±1.04; and MAT (sec) 5.82±0.22. Directionally corrected LSI differed significantly from the traditional calculated LSI (p<0.05).

Conclusion

The findings of this study highlight the need to determine specific baseline data for RTP testing in male elite youth football players after LAS. The traditional LSI should not be used as a "stand alone method" for determining RTP. LSI calculations should consider the direction of asymmetry to determine passing a performance test or not.

Level of evidence

3b.

Factors Associated With a Lateral Ankle Sprain in Young Female Soccer Players: A Prospective Cohort Study

Background

Previous studies have attempted to determine if certain risk factors can predict the occurrence of a lateral ankle sprain (LAS) in female soccer players. Unfortunately, there is limited evidence with regard to risk factors associated with an LAS in female soccer players.

Purpose

To identify intrinsic risk factors for an LAS among young female soccer players.

Study Design

Cohort study; Level of evidence, 2.

Methods

Participants were 161 young female soccer players in Japan who were evaluated for LAS risk factors during a preseason medical assessment. The assessment included anthropometric, joint laxity, joint range of motion, muscle flexibility, muscle strength, and balance measurements. Each athlete's history of LASs was also collected. The participants were monitored during a single-yearseason for LASs, as diagnosed by physicians.

Results

There were 26 instances of an LAS in 25 players (15.5%) during the season. Injured players were significantly more likely to have sustained a previous ankle sprain (P = .045) and demonstrated significantly worse balance than their peers without an LAS during the double- and single-leg balance tests (P = .008 for both). Athletes with lower hamstring-to-quadriceps muscle strength ratios were also significantly more likely to sustain an LAS (P = .02).

Conclusion

Poor balance, a low hamstring-to-quadriceps ratio, and a history of ankle sprains were associated with an increased risk of LASs in young female soccer players in the current study. These findings may be useful for developing a program to prevent LASs in this population.

Optimal fibular tunnel direction for anterior talofibular ligament reconstruction: 45 degrees outperforms 30 and 60 degrees

PURPOSE

There is currently no consensus on the optimal drilling direction of the fibular bone tunnel for anterior talofibular ligament (ATFL) reconstruction, and few studies have investigated the potential injury to the peroneus longus and brevis tendons and the possibility of fibular fractures during the drilling process. The aim of this study was to assess the potential risk of drilling the tunnel from different directions and determine the most appropriate tunnel direction. The hypothesis was that drilling the tunnel in the 45-degree direction would be the safest and most suitable for the fibular tunnel.

METHODS

Forty-eight fibular tunnels were drilled on fresh ankle specimens using a K-wire guide and a 5.0 mm hollow drill. Three tunnel orientations were created, parallel to the sagittal plane of the long axis of the fibula and angled 30°, 45°, and 60° to the coronal plane. The length of the fibular tunnel and the distances from the outlet of the K-wire to the peroneus longus and brevis tendons were measured. The occurrence of a fibula fracture was also observed.

RESULTS

The lengths of the bone tunnels in the three groups were 32.9 ± 6.1 mm (30°), 27.2 ± 4.4 mm (45°) and 23.6 ± 4.0 mm (60°). The length of the tunnel drilled at 30° was the longest when compared with that of the tunnels drilled at 45° and 60° (all p values < 0.05). The distances from the outlet of the K-wire to the peroneus longus tendon were 3.0 ± 3.8 mm (30°), 3.8 ± 3.2 mm (45°) and 5.3 ± 1.8 mm (60°), and the distances to the peroneus brevis tendon were 4.2 ± 4.0 mm (30°), 6.1 ± 3.8 mm (45°), 7.9 ± 3.5 mm (60°). In terms of protecting the peroneus longus and brevis tendons, drilling in the 60° direction was better than drilling in the 30° and 45° directions (all p values < 0.05). The risk of injury to the peroneal longus and brevis tendons was 62.5% (30°), 31.3% (45°), and 0% (60°). Although no fibular fractures were observed in any of the three directions, drilling the bone tunnel in the 60° direction disrupted the lateral cortex of the fibula.

CONCLUSION

This study shows that drilling the tunnel in the 45° direction is less likely to cause injury to the peroneus longus and brevis tendons, while ensuring that the tunnel has a sufficient length and avoiding fracturing the distal fibula. Drilling a fibular bone tunnel in a 45° direction is safer and recommended for ATFL reconstruction.

The ability to produce a timely explosive force may affect loading rate at landing

Background

Sports injuries are strongly associated with the impact loading at landing. The abilities to produce force and adjust timing are simultaneously required to absorb impact loading.

Aims

Hence, we aimed to examine the hypothesis that the ability to produce an explosive force at the right timing is related to the ability to absorb the impact loading at landing.

Methods

Twenty-nine healthy young men volunteered to participate in the study. We proposed a new test to measure the rate of force development (RFD) in accordance with the countdown signal. To evaluate the ability to produce explosive force at the right time, we measured the rate of change between the RFD at the standard start signal and the RFD at the countdown signal. Furthermore, to evaluate the ability to land from a jump, we measured the loading rate at single-leg drop landing (20 cm).

Results

We divided the participants into two groups based on the timing effect: the positive group (participants with increased RFD at the countdown signal, n = 11) and the negative group (participants with decreased RFD at the countdown signal, n = 18). The loading rate was significantly greater (P < .01) in the negative group (47.4 ± 11.2 body weight (BW)/s) than in the positive group (34.7 ± 7.1 BW/s).

Conclusions

Participants with increased RFD at the countdown signal had a lower loading rate at landing. Our results suggest that the ability to produce a timely explosive force may be a determinant of safe landing ability.