PURPOSE: To determine correlation between stress fracture of the posterior tibia and flexor digitorum longusmuscle injury caused by athletic or sporting activity during adolescence. MATERIALS AND METHODS: Eleven casesdiagnosed as stress fracture after X-ray and MR imaging of the lower leg were reviewed. With regard to eachfracture, the following features were noted: age, sex, and athletic or sporting activity of the patient, and site.Using MR imaging techniques, axial and sagittal T1 and T2 weighted images were obtained in all cases and T1-GdDTPA images in seven. RESULTS: The activities undertaken were running (n=3), football (n=2), ballet (n=2),taekwando (n=1), badminton (n=1), field hockey (n=1), and basketball (n=1). MR images revealed localized corticalthickness (n=11), linear intramedullary callus showing a low signal on T1 and T2 weighted images (n=9), marrowhyperemia (n=7), and flexor digitorum longus muscle injury showing a high signal on T1-Gd DTPA and T2 weightedimage (n=7). CONCLUSION: Stress fracture of the posterior tibia might be induced by flexor digitorum longusmuscle activity induced by athletic or sporting activities during adoleseence.
Adolescent ; Basketball ; Bony Callus ; Football ; Fractures, Stress* ; Hockey ; Humans ; Leg ; Magnetic Resonance Imaging ; Pentetic Acid ; Racquet Sports ; Running ; Sports ; Tibia*

OBJECTIVE: To determine whether an active rehabilitation program that involves repetitive effortful muscle contractions, including core stability, balancing exercises, progressive resistance exercises, and running activities, after a sports hernia, is effective. METHODS: Forty soccer players with sports hernias were randomly divided into two equal groups: group A (active rehabilitation program) and group B (conventional treatment). The methods of assessment included a visual analog scale (VAS) and hip internal and external range of motion assessments. Group A received conventional treatment (heat, massage, transcutaneous electrical nerve stimulation, and mobilization) plus an active rehabilitation program, while group B received only conventional treatment. Three treatment sessions were given each week for 2 months. Evaluations were performed pre- and post-treatment. RESULTS: A decrease in VAS was seen in both groups at the end of treatment, 80.25% in group A and 41.93% in group B. The difference between the two groups was statistically significant (p=0.0001), whereas there were no statistical differences in internal and external rotation between the groups at the end of treatment (p>0.05). After treatment, an improvement in outcome measures of group A compared to group B (p=0.01) was seen. Thirteen patients in group A and only three patients in group B returned to sports activities without groin pain. CONCLUSION: Active rehabilitation was effective for sports hernia management measured by a decrease in pain and the return to sports.
Exercise ; Groin ; Hernia ; Hip ; Humans ; Massage ; Muscle Contraction ; Outcome Assessment (Health Care) ; Range of Motion, Articular ; Rehabilitation ; Return to Sport ; Running ; Soccer ; Sports ; Transcutaneous Electric Nerve Stimulation ; Visual Analog Scale

The posterior cruciate ligament has been considered the basic stabilizer which performs important functions because of its location and orientation within the knee joint. Therefore, failure to recognize or to repair its tear results in a poorly functioning knee. An isolated injury to the posterior cruciate ligament is believed to be unconmon and is seen most commonly in association with other ligamentous injury and dislocation of the knee joint. But recently its injuries are of frequent occurrence because of increasing traffic accident and sports activities as football, soccer, and skiing. The authors experienced 12 cases of isolated posterior cruciate ligament injury from March, 1978 to February, 1982 at the Department of Orthopaedic Surgery, Capital Arrned Forces General Hospital and the results were as follows: 1. The most common cause of injury was passenger traffic accident (5 cases) and followed by soccer (4 cases), football (2 cases), and skiing (1 case). 2. There were 3 causative mechanisms by which the posterior cruciate ligament was injured; anteroposterior force on the front of the knee joint (5 cases), hyperextension of the knee joint (4 cases), and posteriorly directed rotatory force (3 cases). 3. Tears of the posterior cruciate ligament occured at its tibial attachment (5 cases), with avulsion of a bone fragment at its tibial attachment (3 cases), at its femoral attachment (2 cases), and its mid-portion (1 case). 4. The major findings in this injury included giving-way or instability on walking, abrasion or contusion over the anterior proximal tibial surface, presence of a posterior drawer sign, sagging of the tibia, bloody effusion, and X-ray evidence of avulsion fracture. 5. One case was treated conservatively and 11 cases surgically using screw fixation and direct or pull through suture through a posterior S-shaped incision (5 cases), medial parapatellar and posterior S-shaped incision (3 cases), and medial hockey-stick incision (3 cases) and were immobilized in a long leg cast with 30 to 45 degrees of the knee flexion for 6 to 7 weeks. 6. The results evaluated by Apleys method were excellent in 8 cases; good in 2 cases, and fair in 2 cases.
Accidents, Traffic ; Clinical Study ; Contusions ; Dislocations ; Football ; Hospitals, General ; Knee Joint ; Knee ; Leg ; Ligaments ; Methods ; Posterior Cruciate Ligament ; Skiing ; Soccer ; Sports ; Sutures ; Tears ; Tibia ; Walking

Biomechanics is the application of mechanical principles to living organisms. Evaluation of sporting techniques such as running biomechanics and swim stroke biomechanics and understanding of the biomechanics of different sporting activities is a vital foundation for the sports medicine practitioners. The purpose of this article is to provide the clinicians with relevant and easily applicable descriptions of the common sporting techniques. The key for the better sports performance and prevention of injury is exercising with correct biomechanics. Understanding normal sporting biomechanics makes the clinician to apply injury prevention strategies. Biomechanics of lower limb including standing, walking, running and biomechanics of upper limb during throwing and overhead activities are described.
Athletic Injuries ; Athletic Performance ; Biomechanics ; Lower Extremity ; Running ; Sports ; Sports Medicine ; Stroke ; Tennis ; Upper Extremity ; Walking

Biomechanics is the application of mechanical principles to living organisms. Evaluation of sporting techniques such as running biomechanics and swim stroke biomechanics and understanding of the biomechanics of different sporting activities is a vital foundation for the sports medicine practitioners. The purpose of this article is to provide the clinicians with relevant and easily applicable descriptions of the common sporting techniques. The key for the better sports performance and prevention of injury is exercising with correct biomechanics. Understanding normal sporting biomechanics makes the clinician to apply injury prevention strategies. Biomechanics of lower limb including standing, walking, running and biomechanics of upper limb during throwing and overhead activities are described.
Athletic Injuries ; Athletic Performance ; Biomechanics ; Lower Extremity ; Running ; Sports ; Sports Medicine ; Stroke ; Tennis ; Upper Extremity ; Walking

There is no sport in which the shoulder does not play an integral role. There are many patients with shoulder joint problems in volleyball, baseball, tennis and golf. In volleyball, a quick strong spike is necessary. Therefor, the treatment of shoulder injuries as well as the protection of the shoulder is a great concern of the player. The authors have done and analysis of the playing history and the clinical studies of the volleyball players who have been recorded as patients of the department of orthopedic surgery, Korea National Police hospital, from January 1977 to December 1980. Results of the study are as follows: l. Of the ages between 17 and 25, the average age was 19.9. 2. Out of 228 case studies 96 complained of shoulder pain or 42.1%. 3. The 84, or 87.6% of the players used the posterior angle spike. The anterior angle spikers and middle angle spikers were 6 players or 6.2% each. 4. Of 60 posterior angle spikers attempted to change spiking angle, 46 or 76% were able to alieviable the shoulder pain. 5. In the posterior angle spikers the lever arm is at its shortest extent so the cases of pain were analyzed as due to repeated impingement of supraspinatus tendon.
Arm ; Baseball ; Golf ; Humans ; Korea ; Orthopedics ; Police ; Shoulder Joint ; Shoulder Pain ; Shoulder ; Sports ; Tendons ; Tennis ; Volleyball

OBJECTIVES: Accurate assessment of energy expenditure is important for estimation of energy requirements in athletic children. The objective of this study was to evaluate the accuracy of accelerometer for prediction of selected activities' energy expenditure and intensity in athletic elementary school children. METHODS: The present study involved 31 soccer players (16 males and 15 females) from an elementary school (9-12 years). During the measurements, children performed eight selected activities while simultaneously wearing the accelerometer and carrying the portable indirect calorimeter. Five equations (Freedson/Trost, Treuth, Pate, Puyau, Mattocks) were assessed for the prediction of energy expenditure from accelerometer counts, while Evenson equation was added for prediction of activity intensity, making msix equations in total. The accuracy of accelerometer for energy prediction was assessed by comparing measured and predicted values, using the paired t-test. The intensity classification accuracy was evaluated with kappa statistics and ROC-Curve. RESULTS: For activities of lying down, television viewing and reading, Freedson/Trost, Treuth were accurate in predicting energy expenditure. Regarding Pate, it was accurate for vacuuming and slow treadmill walking energy prediction. Mattocks was accurate in treadmill running activities. Concerning activity intensity classification accuracy, Pate (kappa=0.72) had the best performance across the four intensities (sedentary, light, moderate, vigorous). In case of the sedentary activities, all equations had a good prediction accuracy, while with light activities and Vigorous activities, Pate had an excellent accuracy (ROC-AUC=0.91, 0.94). For Moderate activities, all equations showed a poor performance. CONCLUSIONS: In conclusion, none of the assessed equations was accurate in predicting energy expenditure across all assessed activities in athletic children. For activity intensity classification, Pate had the best prediction accuracy.
Athletes ; Child* ; Classification ; Deception ; Energy Metabolism* ; Humans ; Male ; Running ; Soccer ; Sports* ; Television ; Vacuum ; Walking

OBJECTIVE: To investigate the effect of adding Nordic exercise as post-training in decreasing hamstring initial, recurrent injuries rates, and their severity. METHODS: In this randomly controlled trial study, 34 professional football players aged 21 to 35 years were randomly assigned into two groups (17 players each) from Sporting clubs at Alexandria, Egypt. For group one, Nordic hamstring exercise (NHE) was performed pre-training and post-training. For group two, NHE was only performed pre-training. The control group was the same team during the previous season. Length of the trial was 12 weeks. The Australian football association injury form was used to collect incidence of injuries for each subject in both groups. RESULTS: Pooled results based on total injuries showed that group one had significantly less hamstring initial injuries (92% less) than the previous season, while group two had 80% less initial injuries and 85% less recurrent injuries than previous season. Regarding the severity of injuries in term of mean number of absent days, it was 1 day for group one and 2.7 days for group two while it was 7.95 days for the previous season during total risk time of 116.3±13.2 and 117.6±5.7 exposure hours for group one and group two, respectively. CONCLUSION: The use of NHE as a prevention protocol was effective in reducing all hamstring injuries with the use of NHE during pre-training and post-training having the greatest effect.
Egypt ; Football ; Incidence ; Leg Injuries ; Recurrence ; Seasons ; Soccer ; Sports

PURPOSE: Ligament reattachment technique using a suture anchor appears to show satisfactory functional outcomes and mechanical stability compared with conventional bone tunnel technique. This study was prospectively conducted in order to evaluate functional outcomes of modified Brostrom procedures using the suture bridge technique for chronic ankle instability in athletes. MATERIALS AND METHODS: Twenty eight athletes under 30 years of age were followed for more than two years after undergoing the modified Brostrom procedure using the suture bridge technique. Functional evaluation consisted of the foot and ankle outcome score (FAOS), foot and ankle ability measure (FAAM) score. Range of motion and time to return to exercise were evaluated using a periodic questionnaire. Talar tilt angle and anterior talar translation were measured through stress radiographs for evaluation of mechanical stability. RESULTS: FAOS improved significantly from preoperative mean 59.4 points to 91.4 points (p<0.001). Daily living and sport activity scores of FAAM improved significantly from preoperative mean 50.5, 32.5 points to 94.8, 87.3 points, respectively (p<0.001). Talar tilt angle and anterior talar translation improved significantly from preoperative mean 16.8degrees, 13.5 mm to 4.2degrees, 4.1 mm at final follow-up (p<0.001). Times to return to exercise were as follows: mean 10.2 weeks in jogging, 15.4 weeks in spurt running, 13.1 weeks in jumping, 11.5 weeks in walking on uneven ground, 9.1 weeks in standing on one leg, 7.2 weeks in tip-toeing gait, 8.4 weeks in squatting, and 10.6 weeks in descending stairs. CONCLUSION: Modified Brostrom procedure using the suture bridge technique showed satisfactory functional outcomes for chronic ankle instability in athletes. Optimal indication and cost-effectiveness of the suture bridge technique will be studied in the future.
Ankle* ; Athletes* ; Follow-Up Studies ; Foot ; Gait ; Humans ; Jogging ; Leg ; Ligaments ; Prospective Studies ; Range of Motion, Articular ; Running ; Sports ; Suture Anchors ; Sutures* ; Walking ; Surveys and Questionnaires

Dementia pugilistica (DP) or chronic traumatic encephalopathy (CTE) is a neurodegenerative disease or dementia that may affect amateur or professional boxers as well as athletes in other sports who suffer concussions. The condition is thought to affect around 15% to 20% of professional boxers and caused by repeated concussive or subconcussive blows. CTE was in the past referred to as dementia pugilistica, which reflected the prevailing notion that this condition was restricted to boxers. Recent research, however, has demonstrated neuropathological evidence of CTE in retired American football players, a professional wrestler, a professional hockey player and a soccer player, as well as in nonathletes. It is probable that many individuals are susceptible to CTE, including those who experience falls, motor vehicle accidents, assaults, epileptic seizures, or military combat, and that repeated mild closed head trauma of diverse origin is capable of instigating the neurodegenerative cascade leading to CTE. We report a 62-year old man suspicious of dementia pugilistica with clinical features of frontotemporal dementia and parkinsonism.
Athletes ; Brain Injury, Chronic ; Dementia ; Epilepsy ; Football ; Frontotemporal Dementia ; Head Injuries, Closed ; Hockey ; Humans ; Military Personnel ; Motor Vehicles ; Neurodegenerative Diseases ; Parkinsonian Disorders ; Soccer ; Sports