Body Mass Index as a Predictor of Injuries in Athletics

Investigation of exercise-related leg pain, fear of pain, kinesiophobia, and injury anxiety in athletes

BACKGROUND

This study aimed to investigate the relationship between exercise-induced leg pain, fear of pain, kinesiophobia and injury anxiety in amateur and professional athletes. Secondarily, the present study also aimed to investigate the relationship between women or men athletes and individual or team sports.

METHODS

A cross-sectional study was conducted with a total of 304 athletes. Participants were categorized as amateur and professional athletes, male and female athletes, individual and team athletes. Participants were evaluated with Exercise Induced Leg Pain Questionnaire (EILP), Fear of Pain Questionnaire (FOPQ), Sports Injury Anxiety Scale (SIAS), and Tampa Scale of Kinesiophobia (TSK). Parametric tests were used for statistical analysis. A statistical significance level of 0.05 was chosen.

RESULTS

Fear of pain and anxiety about sports injury were significantly less in men (p < 0.05). Loss of social support for sports injury anxiety was less in women (p < 0.05). Anxiety about sports re-injury was less in professional athletes (p < 0.05). Anxiety about letting down important Others and loss of social support were greater in team sports (p < 0.05). Besides, there was a positive, moderate, and significant correlation between the Fear of Pain Questionnaire- III Total and Tampa scale for kinesiophobia (r = 0.411, p < 0.01). Finally, a positive, moderate and significant correlation was found between Sport Injury Anxiety Scale Total and Tampa scale for kinesiophobia (r = 0.579, p < 0.01).

CONCLUSION

Exercise and movement were associated with psychological parameters related to injury and pain in athletes. Female athletes were found to have more injury anxiety and fear of pain. In addition, amateur athletes have more injury anxiety. Besides, injury anxiety was found to be higher in individuals in team sports. Future studies may further investigate these groups who are more disadvantaged in terms of anxiety, fear of pain and kinesiophobia. In addition, clinicians should pay attention to the criteria for a biopsychosocial approach by choosing appropriate descriptive phrases to avoid exacerbating athletes' anxiety.

Injury Epidemiology and Risk Factors in Older Pickleball Players

This study aimed to identify pickleball-related injury prevalence and risk factors in older adults and evaluate injury incidence during a pickleball tournament. A cross-sectional study analyzed self-reported injuries from the past 12 months and new injuries during the 2018 US Open Pickleball Championships. Data were collected on demographics, play characteristics, and psychological attributes. Injury details came from self-reports and medical tent records. Hierarchical logistic regression identified significant injury predictors. Of 237 participants, 32.1% reported past-year injuries, mainly in lower extremities (57.9%) and muscle/tendon tissues (61.8%). The tournament had a 5.8% incidence of new injuries, primarily in lower extremities and skin/muscle tissues. Key risk factors were male gender, lower BMI, and increased weekly play hours. No significant associations were found with psychological variables. Pickleball players have a high injury prevalence, especially in lower extremities, linked to longer play hours, male gender, and lower BMI.

Key Performance Indicators for College American Football Starters: An Exploratory Study

OBJECTIVES

The purpose of this study was twofold: (a) to profile body composition and physical fitness characteristics of collegiate American football starters and (b) to examine differences in key performance indicators across position groups. These indicators included select measures of body composition, joint kinematics, as well as muscular strength and power.

METHODS

Sixteen National Collegiate Athletic Association (NCAA) Division-II American football athletes (age: 22.25 ± 1.1 years; height: 183.75 ± 7.8 cm; and body mass: 97.22 ± 20.39 kg) volunteered to participate in this study. A Kruskal-Wallis one-way analysis of variance by ranks test with Dunn test post-hoc adjustments was used to examine position differences between Line (n = 3), Big Skill (n = 6), and Skill (n = 7) position groups with α priori set at p < 0.05.

RESULTS

The findings of this study suggest that significant differences in body composition (p = 0.004), muscular strength (p = 0.01), and muscular power (p = 0.03) exist between position groups. However, no significant differences were observed in joint kinematics as assessed by the bilateral squat test (p > 0.05).

CONCLUSIONS

Therefore, key findings from this study suggest that although significant differences in body composition, muscular strength, and muscular power exist, an emphasis should be placed on the regular assessment, development, and maintenance of optimal joint kinematics within collegiate American football populations as this appears to be a shared key performance indicator among starters.

Effects of Plyometric Training on Physical Fitness Attributes in Handball Players: A Systematic Review and Meta-Analysis

This meta-analysis aimed to examine the effects of plyometric training on physical fitness attributes in handball players. A systematic literature search across PubMed, SCOPUS, SPORTDiscus, and Web of Science identified 20 studies with 563 players. Plyometric training showed significant medium-to-large effects on various attributes: countermovement jump with arms (ES = 1.84), countermovement jump (ES = 1.33), squat jump (ES = 1.17), and horizontal jump (ES = 0.83), ≤ 10-m linear sprint time (ES = -1.12), > 10-m linear sprint time (ES = -1.46), repeated sprint ability with change-of-direction time (ES = -1.53), agility (ES = -1.60), maximal strength (ES = 0.52), and force-velocity (muscle power) (ES = 1.13). No significant impact on balance was found. Subgroup analysis indicated more pronounced agility improvements in players ≤ 66.6 kg compared to > 66.6 kg (ES = -1.93 vs. -0.23, p = 0.014). Additionally, greater improvements were observed in linear sprint and repeat sprint ability when comparing training durations of > 8 weeks with those ≤ 8 weeks (ES = -2.30 to -2.89 vs. ES = -0.92 to -0.97). In conclusion, plyometric training effectively improves various physical fitness attributes, including jump performance, linear sprint ability, maximal strength, muscle power and agility.

Injuries in professional women's elite soccer players in Kosovo: epidemiological injury study

BACKGROUND

An emphasis has been given lately towards women's engagement together with their potential in soccer. As this sport develops with athletes becoming more physically fit and skilled, it is unclear what the consequences in terms of injuries are. Having this in mind, this study aimed to investigate the major injuries that occur in women's soccer players.

METHODS

This descriptive epidemiological study invited all 286 women's soccer players from the 12 participating women clubs in the Kosovo 1st Soccer League (elite football level) during the 2021/2022 season, out of which 142 from 12 clubs participated. Exposure time for 1000 h of playing and training were recorded in addition to the anthropometric data, playing position, and prior injury history during the end of the season, practice, and match. The exact type of injury, severity, and post-injury recovery time, as well as the circumstances surrounding the injuries, were recorded.

RESULTS

In total 84 injuries were registered with an overall injury ratio (IR) being 3.21 (CI: 2.56, 3.98) injuries/1000 exposure hours. During the competitive season, each player sustained 1.4 injuries on average. IRs were significantly higher during competition (n = 50; IR = 1.57; CI: 1.52, 1.62) compared to training (n = 34; IR = 0.26, CI: 0.25, 0.27). Out of a total of 142 women players, 84 (59.2%) injuries occurred, and no record of injuries was made in 58 (40.8%) players. The overall IR was observed to be 3.21 (CI: 1.24, 3.27), with moderate and severe injuries accounting for 38.1% of total injuries (each), followed by mild (16.7%) and minimal (7.1%) injuries.

CONCLUSION

The women IR in Kosovo women's soccer players is low while being circa 11% below the international average. Almost 2 out of every 4 injuries were categorized as traumatic, with the IRs being more than 5-fold larger during games than during training. Additionally, these findings emphasize the higher rate of injuries amongst younger athletes, suggesting caution to be taken by the coaches when planning for the match. The collected data may help coaches and trainers create more targeted women's soccer injury prevention programs.

Investigation and analysis of training injury and its psychological effects on firefighters in Beijing A cross-sectional study

Firefighters' high-intensity training often leads to injuries in the musculoskeletal system. Studies have found that these injuries in the musculoskeletal system may contribute to poor psychological issues. At the same time, low psychological well-being increases the risk of injuries, illness, and mortality. According to research reports, firefighters generally have a good psychological state. So this study aims to survey and analyze the training-related injuries and psychological states of firefighting and rescue personnel in Beijing. This cross-sectional study employed a questionnaire survey to gather data from a total of 214 firefighters in a certain city. The participants were required to complete a questionnaire about musculoskeletal injuries and psychological status, and then these data were statistically analyzed. The incidence of training-related injuries is relatively high among firefighting and rescue teams, with the highest proportions observed in the lower back, knees, and ankles. Overweight and obese firefighters are more prone to ankle injuries. In the group with injuries, the subjective well-being index is lower compared to the group without injuries. Firefighters experiencing moderate to severe pain due to injuries exhibit lower subjective well-being indices compared to those with mild pain. Psychological resilience and the impact of pain on training and sleep can predict the subjective well-being index of firefighters. It is recommended that firefighting and rescue teams enhance preventive measures for musculoskeletal injuries during training to elevate the subjective well-being of firefighters.

Healthcare providers have insufficient up-to-date knowledge of lower limb sports injuries, and their knowledge is similar to that of athletes

BACKGROUND

Being up-to-date with evidence-based knowledge of lower limb sports injuries is essential for Healthcare professionals (HCPs).

PURPOSE

To assess whether HCPs possess up-to-date knowledge of lower limb sports injuries by comparing their knowledge to that of athletes.

METHODS

With an expert panel, we developed an online quiz of 10 multiple-choice questions on various topics related to lower-limb sports injuries. Maximal score was 100. We used social media to invite HCPs (5 groups: Physiotherapists, Chiropractors, Medical Doctors, Trainers, and Other therapists) and athletes of all levels (amateur, semi-pro, and pro) to participate. We drafted the questions according to conclusions from the latest systematic reviews and meta-analyses.

RESULTS

1526 participants completed the study. Final quiz scores ranged from zero (n = 28, 1.8%) to 100 (n = 2, 0.1%) and were distributed normally with a mean score of 45.4 ± 20.6. None of the 6 groups' means surpassed the set threshold of 60 points. Multiple linear regressions of covariates indicated that age, gender, engagement in physical activity, learning hours per week, reading scientific journals, reading popular magazines and blogs, trainers, and other therapists' groups explained 19% of the variances (-5.914<β < 15.082, 0.000<p < 0.038).

CONCLUSIONS

HCPs have insufficient up-to-date knowledge of lower limb sports injuries, and their knowledge is similar to that of athletes of all levels. HCPs probably do not possess the proper tools to assess scientific literature Academic and sports medicine societies should look into ways to improve the scientific knowledge integration of HCPs.

Risk Prediction of Injury Among Recreational Badminton Players in India

BACKGROUND/PURPOSE

Since badminton has emerged as a frequently played non-contact recreational sport in India, it is essential to document the injury patterns and incidence. However, there is no existing literature on this topic among Indian players.

MATERIALS AND METHODS

A web-based questionnaire was circulated among recreational badminton players across North India, enquiring about demographic details, injury characteristics, and factors associated with an injury like BMI, warm-up practice, and physical training.

RESULTS

Data of 237 eligible participants revealed an injury incidence rate of 57.1%. The ankle and dominant-side shoulder were the most common anatomical regions affected. The most common injury types were ligament sprain and muscle/tendon strain. Factors like age, frequency, duration of play, type of footwear, BMI, prior warm-up, court surface, and physical training were significantly associated with injury incidence on univariate logistic regression analysis. On multivariate logistic regression analysis, we found male gender, a lack of prior warm-up, inadequate physical training, and age group between 26 and 30 years to be four independent risk factors for injury.

CONCLUSION

The recreational badminton player of India had a relatively higher incidence of injury compared with the limited published data from other countries. Modifiable factors like a proper warm-up before the game, regular physical fitness training, and injury awareness programs can reduce the injury rates.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s43465-022-00663-y.

Surgical treatment of displaced isolated lateral malleolar fractures: incidence of adverse events requiring revision: a retrospective cohort study

BACKGROUND

Recent systematic reviews support that non-operative management should be the standard treatment for all stable isolated lateral malleolar fractures (ILMFs), regardless of fibular fracture displacement. Surgical fixation of ILMFs carries a risk of adverse events (AEs), and many patients will later require implant removal. We wanted to estimate the incidence of AEs requiring revision after surgical fixation of "potentially stable" displaced ILMFs before non-operative treatment became standard care in our department.

MATERIALS AND METHODS

To identify patients with "potentially stable" ILMFs who had been treated surgically in a historical cohort, we retrospectively applied the stability-based classification system, introduced by Michelson et al., to a cohort of 1006 patients with ankle fractures treated surgically from 2011 to 2016. The primary outcome of this retrospective cohort study was the incidence of AEs that had functionally significant adverse effects on outcome and required revision in the first 12 months after surgery. AEs were graded and categorized using the Orthopedic Surgical Adverse Events Severity (OrthoSAVES) System.

RESULTS

The study population comprised 108 patients with "potentially stable" displaced ILMFs; 4 patients (3.7% [95% CI (0.1-7.3%]) experienced AEs requiring revision in the first twelve months after surgery. There were 5 additional patients (4.6%) with functionally significant AEs where revision surgery was not indicated within the first twelve months after surgical fixation. A further 5 patients (4.6%) had AEs managed in the outpatient clinic (grade II); 36 patients (33.3%) required secondary implant removal due to implant-related discomfort.

CONCLUSIONS

Surgical fixation of ILMFs carries a risk of severe AEs, and many patients will subsequently need implant-removal procedures. Further prospective studies are required to ascertain whether non-operative treatment can lower the risk of AEs and the need for additional surgical procedures.

The Case for Retiring Flexibility as a Major Component of Physical Fitness

Flexibility refers to the intrinsic properties of body tissues that determine maximal joint range of motion without causing injury. For many years, flexibility has been classified by the American College of Sports Medicine as a major component of physical fitness. The notion flexibility is important for fitness has also led to the idea static stretching should be prescribed to improve flexibility. The current paper proposes flexibility be retired as a major component of physical fitness, and consequently, stretching be de-emphasized as a standard component of exercise prescriptions for most populations. First, I show flexibility has little predictive or concurrent validity with health and performance outcomes (e.g., mortality, falls, occupational performance) in apparently healthy individuals, particularly when viewed in light of the other major components of fitness (i.e., body composition, cardiovascular endurance, muscle endurance, muscle strength). Second, I explain that if flexibility requires improvement, this does not necessitate a prescription of stretching in most populations. Flexibility can be maintained or improved by exercise modalities that cause more robust health benefits than stretching (e.g., resistance training). Retirement of flexibility as a major component of physical fitness will simplify fitness batteries; save time and resources dedicated to flexibility instruction, measurement, and evaluation; and prevent erroneous conclusions about fitness status when interpreting flexibility scores. De-emphasis of stretching in exercise prescriptions will ensure stretching does not negatively impact other exercise and does not take away from time that could be allocated to training activities that have more robust health and performance benefits.

Influence of Menstrual Cycle Phases on Neural Excitability in the Primary Somatosensory Cortex and Ankle Joint Position Sense

Introduction: Ankle sprain (AS) is one of the most common injuries among women engaged in competitive sports and recreational activities. Many studies have shown that several factors contributing to AS are influenced by the menstrual cycle. Despite the finding that abnormal joint position sense (JPS) is one of the major risk factors of AS, the alteration of the JPS throughout the menstrual cycle and its associated neural mechanisms remain unclear.

Objective: This study aimed to examine whether the menstrual cycle phases affect neural excitability in the primary somatosensory cortex (S1) and JPS.

Methods: Fourteen right-footed women participated in this study. Somatosensory-evoked potential and paired-pulse inhibition (PPI) were measured to assess S1 excitatory and inhibitory functions. Ankle JPS was measured using an active joint position matching method. Menstrual syndrome was evaluated using the menstrual distress questionnaire. All assessments were conducted in the follicular, ovulatory, and luteal phases.

Results: The two main findings of this study were as follows: First, PPI decreased in the ovulatory phase than in the follicular phase. This may have been the reason for estrogen altering the neural inhibition and facilitation balance throughout the menstrual cycle. Second, JPS was not changed during the menstrual cycle.

Conclusion: In conclusion, phases of the menstrual cycle affect the neural excitability in S1 as shown by the decreased PPI in the ovulatory phase, and the ankle JPS was unchanged throughout the menstrual cycle.

Off-Season Training Habits and BMI, Not Preseason Jump Measures, Are Associated with Time-Loss Injury in Female Collegiate Soccer Players

The primary purpose of this study was to determine the effectiveness of the standing long jump (SLJ) and the single-leg hop (SLH) tests to discriminate lower quadrant (low back and lower extremities) injury occurrence in female collegiate soccer players. The secondary purpose of this study was to determine associations between injury and off-season training habits or anthropometric measures. SLJ, SLH, and anthropometric measures were collected during a preseason screening clinic. Each subject completed a questionnaire providing demographic information and off-season training habits. Each athlete performed three SLJ and three SLH per leg. SLJ and SLH scores were not associated with an increased risk of a noncontact time-loss lower quadrant (LQ) injury. Athletes with a higher BMI or who reported less time training during the off-season were two times more likely to sustain an injury. Athletes who had both a higher body mass index (BMI) and lower off-season training habits were three times (relative risk = 3.1 (95% CI: 1.7, 5.5) p-value = 0.0001) more likely to sustain a noncontact time-loss lower quadrant injury. Preseason SLJ and SLH scores do not discriminate injury risk in female collegiate soccer players. Higher BMI and lower off-season training habits are associated with an increased risk of LQ injury.

American Football Sets Players' Body Mass Index

Objectives. Document American football, National Football League (NFL), Lean State (LS) or Heavy State (FS) Public High School (PHS), sets similar player position mean body mass indexes (BMI). Review health risks related to BMI. Methods. Public accessible 2014-2015 football rosters were used to calculate individual player’s BMI for four PHS teams about each LS and FS Capital City and 32 NFL teams. Mean BMI were compared for male player positions: quarterback (Q), backfield (B), and line (L) players. Results. Q, B, and L mean BMI were not significantly different for LS and FS PHS and NFL, but mean BMI was significantly (P < .01) different for Q or B versus L. Conclusion. Football sets similar BMI for player positions with PHS line prone to obese BMI (considered healthy for NFL players) regardless of regional BMI trends. We propose PHS football set player BMI upper limit 30 to support public health and sports safety goals.