Ankle Sprain in Young Athletes: A 2-Year Retrospective Study at a Multisport Club / Entorse no tornozelo em jovens atletas: Um estudo retrospectivo de 2 anos em um clube multiesportivo

Abstract Objective The present study aimed to analyze ankle sprains in young athletes of basketball, futsal, artistic gymnastics, trampoline, tennis, judo, and volleyball over 2 seasons. Methods Data of 529 athletes in the 1st year and of 495 athletes in the 2nd year of analysis were investigated from the injury record database of a sports club. The following data were considered: the demographic characteristics (age, body mass, height, and sex), the mechanism (contact or noncontact), the severity, the moment at which the injury occurred, and the recurrence. Also, the incidence rate, the injury risk of the first ankle sprain, and the incidence rate ratio between sports were calculated. Results The athletes sustained 124 ankle sprains in the 2 years of analysis. The majority occurred during training (76.6%) and lead to absence from sports practice (75.8%). The injury recurrence was low: 2 athletes (1.6%) had a recurrence in the same year and 5 (4.0%) in the following year. The incidence rate (0.79 to 12.81 per 1,000 hours) and the injury risk (1.14 to 19.44%) varied among sports. Volleyball, basketball, and futsal presented the highest injury rate incidence. Tennis, gymnastics, and trampoline showed the lowest injury rate incidence. Judo showed an incidence rate different from those of basketball and volleyball in the 1st year and similar to those of other sports in the 2nd year. Conclusion Ankle sprain greatly impacted sports practice and presented characteristics that differ among the investigated sports. These findings may contribute to developing preventive injury programs.

Resumo Objetivo O presente estudo teve como objetivo analisar entorses no tornozelo em jovens atletas de basquete, futsal, ginástica artística, trampolim, tênis, judô e vôlei ao longo de duas temporadas. Métodos Foram investigados dados de 529 atletas no 1° ano e 495 atletas no 2° ano de análise a partir do banco de dados de registros de lesões de um clube esportivo. Foram considerados os seguintes dados: as características demográficas (idade, massa corporal, altura e sexo), o mecanismo (contato ou não contato), a severidade, o momento em que ocorreu a lesão e a recorrência. Além disso, foram calculadas a taxa de incidência, o risco de lesão da primeira entorse no tornozelo e a razão da taxa de incidência entre os esportes. Resultados Os atletas sofreram 124 entorses no tornozelo nos 2 anos de análise. A maioria ocorreu durante o treinamento (76,6%) e levou à interrupção da prática esportiva (75,8%). A recorrência da lesão foi baixa: 2 atletas (1,6%) tiveram recorrência no mesmo ano e 5 (4,0%) no ano seguinte. A taxa de incidência (0,79 a 12,81 por 1.000 horas) e o risco de lesão (1,14 a 19,44%) variaram entre os esportes. Vôlei, basquete e futsal apresentaram a maior incidência de lesões. Tênis, ginástica e trampolim apresentaram a menor incidência de lesões. O judô apresentou uma taxa de incidência diferente das do basquete e do vôlei no 1° ano e semelhante às dos outros esportes no 2° ano. Conclusão A entorse no tornozelo impactou muito a prática esportiva e apresentou características que diferem entre os esportes investigados. Esses achados podem contribuir para o desenvolvimento de programas de prevenção de lesões.

Epidemiology of injuries due to ankle sprain diagnosed in an orthopedic emergency room / Epidemiologia das lesões por entorse do tornozelo diagnosticadas em pronto atendimento de ortopedia

ABSTRACT Objective To use magnetic resonance imaging to assess the prevalence of foot and ankle ligament injuries and fractures associated with ankle sprain and not diagnosed by x-ray. Methods We included 180 consecutive patients with a history of ankle sprain, assessed at a primary care service in a 12-month period. Magnetic resonance imaging findings were recorded and described. Results Approximately 92% of patients had some type of injury shown on the magnetic resonance imaging. We found 379 ligament injuries, 9 osteochondral injuries, 19 tendinous injuries and 51 fractures. Only 14 magnetic resonance imaging tests (7.8%) did not show any sort of injury. We observed a positive relation between injuries of the lateral complex, syndesmosis and medial ligaments. However, there was a negative correlation between ankle ligament injuries and midfoot injuries. Conclusion There was a high rate of injuries secondary to ankle sprains. We found correlation between lateral ligament injuries and syndesmosis and deltoid injuries. We did not observe a relation between deltoid and syndesmosis injuries or between lateral ligamentous and subtalar injuries. Similarly, no relation was found between ankle and midfoot injuries.

RESUMO Objetivo Avaliar na ressonância magnética a prevalência das diferentes lesões ligamentares do tornozelo e do pé, bem como de fraturas não diagnosticáveis radiograficamente, em pacientes com queixa de entorse do tornozelo. Métodos Foram incluídos no estudo 180 pacientes consecutivos, com história de entorse do tornozelo, atendidos em um serviço de Atenção Primária no período de 12 meses. Os achados dos exames de ressonância magnética foram catalogados e descritos. Resultados Aproximadamente 92% dos pacientes apresentaram algum tipo de lesão na ressonância. Dentre as injúrias observadas, estavam 379 lesões ligamentares, 9 lesões osteocondrais, 19 lesões tendíneas e 51 fraturas. Apenas 14 ressonâncias magnéticas (7,8%) não mostraram qualquer tipo de lesão. Observamos relação positiva entre lesões do complexo lateral, sindesmose e medial. No entanto, houve correlação negativa entre lesões ligamentares do tornozelo e aquelas do mediopé. Conclusão Foi alta a ocorrência de lesões secundárias à entorse. Apontamos correlação entre as lesões ligamentares laterais com as sindesmodais e do deltoide. Não notamos relação entre as lesões do deltoide e da sindesmose, e nem entre as ligamentares laterais e a subtlalar. Também não foram observadas relações entre as lesões do tornozelo e as do mediopé.

Injuries in elite Jamaican netballers / Heridas en los voleibolistas jamaicanos de élite

OBJECTIVES: The purpose of this study is to identify the nature, spectrum and frequency of injuries among national netballers in Jamaica. METHODS: A retrospective study utilizing a questionnaire was used to gather the necessary information among netball players over a five-year period spanning two world cups. A 31-item questionnaire on player's profile, protective equipment, site of injury and associated factors of injury was completed by a study population recruited from players who had represented Jamaica at the senior level, under 21 or under 16 age groups between 2003 and 2007. Statistical analysis was done using the SPSS version 12. RESULTS: Most of the injuries were confined to the ankle and knee, with the playing surface and poor landing technique the main reasons for the injuries. CONCLUSIONS: There are wide variations in training, players' fitness, levels of coaching and the standards of playing courts, all of which might have contributed to players' injuries.

OBJETIVOS: El propósito de este studio es identificar la natural, el espectro y la frecuencia de las heridas entre los voleibolistas nacionales de Jamaica. MÉTODOS: Por medio de un cuestionario, se realizó un estudio retrospectivo entre los jugadores de voleibol a fin de obtener la información necesaria, el cual cubrió un período de cinco años. Un cuestionario de 31 items sobre el perfil del jugador, el equipo de protección, el lugar de la herida y los factors asociados con la herida, fue respondido por una población de estudio, reclutada de jugadores que habían representado a Jamaica en la categoría de mayores, correspondiente a los grupos de menos de 21 años y menos de 16 años de edad. El análisis estadístico se realizó usando la versión 12 del SPSS. RESULTADOS: La mayoría de las heridas estuvieron confinadas al tobillo y las rodillas, siendo la superficie del terreno de juego y la pobre técnica de aterrizaje, las razones principales de las heridas. CONCLUSIONES: Existe una amplia gama de variaciones en el entrenamiento, el estar en forma (fitness), los niveles de coaching, y las normas de las canchas de juego, todas las cuales pudieron haber contribuido a que los jugadores sufrieran heridas.

Estudo epidemiológico das lesões do pé e tornozelo na prática desportiva recreacional / Epidemiological study of foot and ankle injuries in recreational sports

OBJETIVO: Trata-se de estudo retrospectivo apresentando a incidência, tipo e extensão das lesões ocorridas no pé e / ou tornozelo como resultado da prática esportiva recreacional. MÉTODOS: Foram atendidos 131 pacientes, destes 123 do sexo masculino e oito do feminino, com história de trauma e dor no pé e/ou tornozelo após a prática de esportes recreacionais. A média de idade dos pacientes masculinos foi de 24,53 anos. A avaliação foi realizada através de um protocolo de pesquisa, que continha as variáveis de idade, sexo, diagnóstico e o tipo de esporte recreativo. RESULTADOS: Os esportes foram classificados, segundo a American Medical Association, que os divide em: de contato e de não contato. 82,4% da amostra praticavam esportes de contacto, contra 17,6% dos de não contacto classificados. CONCLUSÕES: A entorse do tornozelo foi significativamente o tipo de lesão mais encontrada, principalmente as do grau I e II. O futebol foi o esporte responsável pela maior incidência das lesões e dentre as suas várias modalidades prevaleceu o futsal (35%). Nos esportes de não contacto o principal esporte em ocorrências foi a corrida. Nível de Evidência IV, Série de Casos.

OBJECTIVE: This is a retrospective study showing the incidence, type and extent of injuries occurring in the foot and/or ankle as a result of recreational sports practice. METHODS: We treated 131 patients, of which 123 were male and 8 female, with a history of trauma and pain in the foot and/or ankle after the practicing recreational sports. The average age of the male patients was 24.53 years. The evaluation was done through a research protocol, which contained the variables age, sex, diagnosis, and type of recreational sport. RESULTS: The sports were classified according to the American Medical Association, which divides them into contact and non-contact sports. 82.4% of the sample practiced contact sports, while 17.6% practicedsports classified as non-contact. CONCLUSIONS: The sprained ankle was the most frequent type of injury, especially those of grade I and II. Soccer was the sport responsible for the highest incidence of injuries and among its various forms the indoor soccer presented the highest frequency of injuries (35%). In the non-contact sports, the highest incidence was found in running. Level of Evidence IV, Case Series.

Posterior ankle impingement in fast bowlers in cricket / Pinzamiento posterior del tobillo en lanzadores de críquet rápidos

OBJECTIVES: To determine common features of posterior ankle impingement in fast bowlers in the West Indies and to compare modes of treatment with respect to return to play without pain. METHODS: Retrospective analysis of ankle impingement injuries treated in fast bowlers in the West Indies. RESULTS: Six fast bowlers had evidence of os trigonum in the front foot only. Pain was felt on forced plantar flexion and dorsiflexion on front foot landing; no pain was felt with running. Four had large os trigonum on radiographs, and one was only detectable on Magnetic Resonance (MRI) Imaging. The condition resolved in two bowlers with low workloads who had injections with steroid. The remainder had surgical excision which led to recovery. CONCLUSION: This injury is being seen increasingly in fast bowlers. Steroid injections are useful in bowlers with low workloads but surgical excision is recommended in bowlers with heavy workloads. Further investigation is required in the biomechanics of bowling to determine the cause for the increase in this condition.

OBJETIVO: Determinar rasgos comunes del pinzamiento posterior del tobillo en lanzadores rápidos de West Indies, y comparar modos de tratamiento dirigidos a que puedan volver a jugar sin dolor. MÉTODO: Análisis retrospectivo del tratamiento de lesiones por pinzamiento del tobillo en lanzadores rápidos de West Indies. RESULTADOS: Seis lanzadores rápidos presentaban evidencia de os trigonum en el pie delantero solamente. Sentían dolor en la flexión plantar forzada y dorsiflexión al aterrizar con el pie delantero; no sentían ningún dolor al correr. Cuatro tenían os trigonum grandes según podía observarse en las radiografías, y un os trigonum era sólo detectable mediante imagen por resonancia magnética (IRM). La condición se resolvió en dos lanzadores con baja carga de trabajo, que recibieron inyecciones de esteroides. El resto recibió una escisión quirúrgica que condujo finalmente a la recuperación. CONCLUSIÓN: Este tipo de lesión viene observándose cada vez más en lanzadores rápidos. Las inyecciones de esteroide son útiles en lanzadores con baja carga de trabajo, pero en el caso de aquellos con alta carga de trabajo, se recomienda la escisión quirúrgica. Se requiere más investigación de la biomecánica del lanzamiento en el críquet a fin de determinar la causa del aumento de esta condición.

Incidence and factors related to ankle sprains in athletes of futsal national teams

Introduction: Like soccer, the most popular sport on the planet, futsal also is regulated by the Fédération Internationale de Football Association (FIFA). Although futsal is increasingly popular worldwide, few authors have studied futsal injuries. Objective: To analize the incidence and factors related one of the most common sports injury - the ankle sprain - in world elite fustsal athletes. Methods: 65 male athletes from six national futsal teams (Brazil, Argentina, Chile, Italy, Croatia and Czech Republic) answer a questionnaire included information about their personal data, history of ankle sprains during their careers, and more in-depth data on ankle sprains in their careers, 63.27 per cent in both ankles, total of 75,38 per cent of the athlets had suffered ankle sprains in their careers, 63,27 per cent in both ankles, 24,49 per cent in the dominant ankle only, and 12,24 per cent in the nondominant ankle only. Among the 2006 injuries, 81,25 per cent were characterized as inversion injuries and 18,75 per cent as eversion injuries; 50 per cent were recurrences, and 37,5 per cent of the athletes still had clinical synmptoms (as pain or instability) at the time of data colection. Conclusions: Ankle sprains occur frequently in futsal athletes and can result in peristent symptoms. We hope the present results help physiotherapists to design rehabilitation and prevention symptoms. We hope the present results help physiotherapists to design rehabilitation and prevention efficient programs, thus reducing players's time out of sporting activities and improving their performance.

Prevalência de lesões das equipes de base e adultas que representaram a Seleção Brasileira de Basquete em 2003 / Prevalence of injuries of Brazilian Basketball National Team (principal and sub-21) during 2003 season

Este estudo possui o objetivo de apresentar a prevalência, provável etiologia e localização das lesões das equipes de base e adulta, masculinas e femininas, que representaram o Brasil em 2003. No total, foram 117 queixas correspondendo ao período de trinta dias corridos, encontrando um índice de 1,08 lesões/jogador/mês na equipe juvenil masculina, 4,25 na equipe sub 21 feminina, 1,66 na equipe adulta feminina e 2,75 na adulta masculina. Encontrou-se um maior índice de lesões atraumáticas, incluindo as lesões musculares, doenças sistêmicas e lesões tendinosas em três das quatro categorias estudadas, apresentando apenas a juvenil masculina um maior número de queixas traumáticas (09/13 queixas). Dentre as lesões traumáticas, no geral, as lesões de maior predominância foram às entorses de tornozelo, seguida dos traumas diretos na região dos MMSS e MMII. Em relação ao local de acometimento, as queixas mais freqüentes foram nos membros inferiores, sendo, 61,5% na masculina juvenil, 49% na sub 21 feminina, 75% na adulta feminina e 66,7% na equipe adulta masculina. Em relação à posição de jogo, o risco de lesões foi diferente entre as posições em quadra. Os pivôs apresentaram um maior número de queixas em três dos quatro grupos estudados, provavelmente devido ao maior contato físico na região do garrafão. Pela característica do desporto em estudo, o contato físico é excessivo e as lesões traumáticas, principalmente as entorses de tornozelo, são representativas. A região dos membros inferiores foi a mais acometida.

The aim of this study is to evaluate injuries’ etiology and localization of Brazilian Basketball National Team (male and female, principal and sub-21) during 2003 season. All data of this study were collected by physician’s team. The diagnosis performed was clinical, rarely complementary exams were used; 117 complaints were made by athletes during 2003 season (currently 30 days) performing 1,08 injuries/athlete/month in junior male team; 4,25 injuries/athlete/month in sub-21 female team; 2,75 injuries/athlete/month in principal male team and 1,66 injuries/athlete/month in principal female team. In 3 of 4 teams the more frequent complaints had no trauma relationship (muscle or tendinous injuries and clinical diseases). The traumatic injuries were less frequent. The most frequent injury was ankle’s torsion, followed by hand’s and leg’s trauma. By localization, the most common injuries were in legs (61.5% in junior male team; 49% sub-21 female team; 66.7% in principal male team and 75% in principal female team). According to position in court, complaints from centers’ were more common (3 of 4 teams evaluated) mainly traumatic injuries, probably because of physical contact. Due to extreme contact sport, ankle’s torsion, traumatic injuries in hands are most representative. By localization, injuries in legs are most common.