Pool-Based Surfboard Elicits Activation of Posterior Shoulder Muscles During a Surfing Stroke.

ABSTRACT: Pexa, BS, Johnston, CD, Elder, EE, Ford, KR, Patterson, MQ, and Myers, JB. Pool-based surfboard elicits activation of posterior shoulder muscles during a surfing stroke. J Strength Cond Res 38(7): 1300-1304, 2024-Surfboard paddling may activate posterior shoulder muscles, which are critical to baseball pitchers' injury risk and performance. The purpose of this study was to measure posterior shoulder muscle activation during different phases of the surf stroke (propulsion vs. recovery) on a pool-based surfboard. Twenty healthy active adult subjects completed a familiarization and testing session with the pool-based surfboard. During the testing session, electromyography (EMG) sensors were placed on 6 posterior shoulder muscles: latissimus dorsi, infraspinatus, posterior deltoid, upper trapezius, middle trapezius, and lower trapezius. Subjects completed 4 laps in a pool at 3 separate resistances (low, moderate, and heavy) in a randomized order. The peak EMG signal during each phase (propulsion and recovery) was recorded. A 2-way within subject ANOVA (resistance-by-phase) with post hoc Bonferroni's corrections was used to identify differences in EMG activation. There was a significant main effect of phase for the latissimus dorsi (F = 91.3, p < 0.001), upper trapezius (F = 36.5, p < 0.001), middle trapezius (F = 33.8, p < 0.001), and lower trapezius (F = 21.6, p < 0.001). The latissimus dorsi demonstrated higher activation during the propulsion phase (p < 0.001), and all trapezius muscles demonstrated higher activation during the recovery phase (p < 0.001). There was a significant main effect of resistance for the posterior deltoid (F = 3.4, p = 0.043), with higher muscle activation in the low resistance trials compared with the heavy resistance trials (p = 0.036). Recreationally active individuals demonstrate activation of the posterior shoulder when using a pool-based surfboard. This pool-based surfboard may be beneficial to activate the posterior musculature and may be more accessible than standard surfing to baseball athletes.

College Soccer Student-Athletes Demonstrate Differences in Self-Reported Athlete Health When Grouped by Match Volume.

CONTEXT: Physical changes following activity are well documented, but there is limited information about self-reported outcomes around competitive matches. High training volumes and poor recovery could predispose athletes to overuse injury. The purpose of this study was to identify the changes in daily athlete health measures before, during, and after the day of each match in high- and low-volume groups. DESIGN: Prospective cohort. METHODS: Fifty-five soccer athletes (age: 19.8 [1.2] y, 26 males, 29 females) provided daily measures of readiness, physical fatigue, mental stress, sleep quality, and soreness intensity match days, days 1 (D01) and 2 (D02) following matches, and standard practice days. Participants were grouped into high volume and low volume, based off the minutes played during the season. RESULTS: Soreness increased, readiness decreased, and fatigue increased on D01 compared with match days (P < .008) in the high-volume group. Between groups, the high-volume group demonstrated higher soreness on D01 and D02, lower readiness on D01 and D02, and lower fatigue on D01, compared with the low-volume group (P < .008). CONCLUSIONS: Soccer athletes demonstrate significant changes in self-reported athlete health variables around competitive matches. These changes are similar to physical outcomes, potentially indicating that the athlete health variables may be used to track athlete recovery from competition, potentially limiting the impact of overuse injuries.

Infraspinatus Cross-Sectional Area and Shoulder Range of Motion Change Following Live-Game Baseball Pitching.

CONTEXT: Following a baseball pitching bout, changes can occur to glenohumeral range of motion that could be linked to injury. These effects are in part due to the posterior shoulder's eccentric muscle activity, which can disrupt muscle contractile elements and lead to changes in muscle cross-sectional area (CSA), as measured by ultrasound. OBJECTIVE: To assess changes in muscle CSA, and range of motion immediately before and after pitching, and days 1 to 5 following pitching. DESIGN: Repeated measures. SETTING: Satellite athletic training room. PATIENTS: Ten elite college baseball pitchers participating in the fall season (age: 18.8 [1.2] y, height: 189.2 [7.3] cm, mass: 93.1 [15.3] kg, 8 starters, 2 long relievers). INTERVENTION: A pitching bout of at least 25 pitches (63.82 [17.42] pitches). MAIN OUTCOME MEASURES: Dominant and nondominant infraspinatus CSA, as measured by ultrasound, and glenohumeral range of motion including internal rotation (IRROM), external rotation (ERROM), and total rotation range of motion (TROM) before pitching, after pitching, and days 1 to 5 following the pitching bout. RESULTS: Dominant limb CSA significantly increased day 1 after pitching, and returned to baseline on day 2 (P < .001). Dominant and nondominant TROM did not change until day 5 (4.4°, P < .001) and day 3 (4.5°, P < .001), respectively, where they increased. Dominant IRROM was significantly decreased for 3 days (day 1: 1.9°, P < .001; day 2: 3.1°, P < .001; day 3: 0.3°, P < .001) following pitching and returned to baseline on day 4, with no such changes in the nondominant limb. Dominant external rotation significantly increased immediately post pitching (4.4°, P < .001) but returned to baseline by day 1. CONCLUSIONS: The results of the study demonstrate that infraspinatus CSA does not recover until 2 days following pitching, and IRROM does not recover until 4 days following pitching. Baseball pitching elicits damage to the posterior shoulder muscle architecture, resulting in changes to physical characteristics that last up to 4 days following pitching.

Training Load and Current Soreness Predict Future Delayed Onset Muscle Soreness in Collegiate Female Soccer Athletes.

Background: Delayed onset muscles soreness (DOMS) is an indication of muscle stress and trauma that develops from excessive musculoskeletal loads. Musculoskeletal loads can be measured with wearable devices, but there is limited research on specific training load metrics that most correlate with DOMS after activity. Purpose: To determine the predictive capabilities of training load variables on the development of lower extremity DOMS in female collegiate soccer athletes throughout an entire season. Study Design: Prospective Cohort. Methods: Twenty-seven collegiate female soccer athletes reported their lower extremity DOMS each day prior to all soccer activity. Participants wore Polar heart rate and global positioning monitors to capture training load measures. Pearson correlation coefficients were used to assess the relationships between the training load variables and change in DOMS when collapsed across dates. Separate linear mixed models were performed with the following day's DOMS as the outcome variable, training load and the current day's DOMS as predictor variables, and participants serving as random intercepts. Results: All training load variables significantly predicted change in DOMS, with number of decelerations (ρ=0.72, p <0.001), minutes spent at greater than 80% of maximum heart rate (HRmax) (ρ=0.71 , p <0.001), and distance (ρ=0.70 , p <0.001) best correlating with change in DOMS. Linear mixed models revealed a significant interaction of all training load and current day's DOMS on the following day's DOMS (p<0.001), but number of decelerations, HRmax, and total number of accelerations demonstrated the highest coefficient of determination (R2 marginal=33.2% - 29.2% , R2 conditional= 46.9% - 44.8%). Conclusions: Training load variables paired with the current day's DOMS significantly predict lower extremity DOMS in the future, with number of decelerations, accelerations, and HRmax best predicting future DOMS. Although this demonstrates that training load variables predict lower extremity DOMS, future research should incorporate objective measures of strength or jump kinetics to identify if similar relationships exist. Level of Evidence: Level 3.

Quantification Method and Training Load Changes in High School Cross-Country Runners Across a Competitive Season.

CONTEXT: Running programs traditionally monitor external loads (eg, time and distance). Recent efforts have encouraged a more comprehensive approach to also account for internal loads (eg, intensity, measured as the session rating of perceived exertion [sRPE]). The combination of external and internal loads accounts for the possible interaction between these loads. Although weekly changes in training loads have been reported between external loads and the combination of external and internal loads during 2- and 4-week training cycles, no authors have indicated whether these differences occur during an entire cross-country season in high school runners. OBJECTIVE: To compare changes in training loads, as measured by (1) external loads and (2) combined external and internal loads in high school runners during an interscholastic cross-country season. DESIGN: Case series. SETTING: Community-based setting with daily online surveys. PATIENTS OR OTHER PARTICIPANTS: Twenty-four high school cross-country runners (females = 14, males = 10, age = 15.9 ± 1.1 years, running experience = 9.9 ± 3.2 years). MAIN OUTCOME MEASURE(S): Week-to-week percentage changes in training load were measured by external loads (time, distance) and combined external and internal loads (time × sRPE [timeRPE] and distance × sRPE [distanceRPE]). RESULTS: Overall, the average weekly change was 7.1% greater for distanceRPE than for distance (P = .04, d = 0.18). When the weekly running duration decreased, we found the average weekly change was 5.2% greater for distanceRPE than for timeRPE (P = .03, d = 0.24). When the weekly running duration was maintained or increased, the average weekly change was 10% to 15% greater when external and internal loads were combined versus external loads alone, but these differences were nonsignificant (P = .11-.22, d = 0.19-0.34). CONCLUSIONS: Progression in the training load may be underestimated when relying solely on external loads. The interaction between internal loads (sRPE) and external loads (distance or time) appears to provide a different measure of the training stresses experienced by runners than external loads alone.

Correction to: The Relationship Between Training Load and Injury in Athletes: A Systematic Review.

"Cox proportional hazards regression models with frailty found no difference in injured vs. unin-jured players with week-to-week changes of < 20, 20-60, and > 60%, controlling for scapular con-trol, isometric rotational and abduction strength, and shoulder range of motion (p value ranges 0.09-0.68).

Medial Elbow Joint Space Increases With Valgus Stress and Decreases When Cued to Perform A Maximal Grip Contraction.

BACKGROUND: Previous research indicates that the amount of valgus torque placed on the elbow joint during overhead throwing is higher than the medial ulnar collateral ligament (UCL) can tolerate. Wrist and finger flexor muscle activity is hypothesized to make up for this difference, and in vitro studies that simulated activity of upper extremity musculature, specifically the flexor digitorum superficialis and flexor carpi ulnaris, support this hypothesis. PURPOSE: To assess the medial elbow joint space at rest, under valgus stress, and under valgus stress with finger and forearm flexor contraction by use of ultrasonography in vivo. STUDY DESIGN: Controlled laboratory study. METHODS: Participants were 22 healthy males with no history of elbow dislocation or UCL injury (age, 21.25 ± 1.58 years; height, 1.80 ± 0.08 m; weight, 79.43 ± 18.50 kg). Medial elbow joint space was measured by use of ultrasonography during 3 separate conditions: at rest (unloaded), under valgus load (loaded), and with a maximal grip contraction under a valgus load (loaded-contracted) in both limbs. Participants lay supine with their arm abducted 90° and elbow flexed 30° with the forearm in full supination. A handgrip dynamometer was placed in the participants' hand to grip against during the contracted condition. Images were reduced in ImageJ to assess medial elbow joint space. A 2-way (condition × limb) repeated-measures analysis of variance and Cohen's d effect sizes were used to assess changes in medial elbow joint space. Post hoc testing was performed with a Bonferroni adjustment to assess changes within limb and condition. RESULTS: The medial elbow joint space was significantly larger in the loaded condition (4.91 ± 1.16 mm) compared with the unloaded condition (4.26 ± 1.23 mm, P < .001, d = 0.712) and the loaded-contracted condition (3.88 ± 0.94 mm, P < .001, d = 1.149). No significant change was found between the unloaded and loaded-contracted conditions ( P = .137). CONCLUSION: Medial elbow joint space increases under a valgus load and then decreases when a maximal grip contraction is performed. This indicates that wrist and finger flexor muscle contraction may assist in limiting medial elbow joint space, a result similar to findings of previous research in vitro. CLINICAL RELEVANCE: Muscle activation of the upper extremity limits the medial elbow joint space, suggesting that injury prevention programs for throwing athletes should incorporate exercises for the elbow, wrist, and hand to limit excessive medial elbow joint space gapping during activities that create high valgus load.

The Relationship Between Training Load and Injury in Athletes: A Systematic Review.

BACKGROUND: The relationship between training load and musculoskeletal injury is a rapidly advancing area of research in need of an updated systematic review. OBJECTIVE: This systematic review examined the evidence for the relationship between training load and musculoskeletal injury risk in athlete, military, and first responder (i.e. law enforcement, firefighting, rescue service) populations. METHODS: The CINAHL, EMBASE, MEDLINE, SportDISCUS, and SCOPUS databases were searched using a comprehensive strategy. Studies published prior to July 2017 were included if they prospectively examined the relationship between training load and injury risk. Study quality was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS) and Oxford Centre for Evidence-Based Medicine levels of evidence. A narrative synthesis of findings was conducted. RESULTS: A total of 2047 articles were examined for potential inclusion. Forty-six met the inclusion criteria and 11 known to the authors but not found in the search were added, for a total of 57 articles. Overall, 47 studies had at least partially statistically significant results, demonstrating a relationship between training load and injury risk. Included articles were rated as poor (n = 15), fair (n = 6), and good (n = 36) based on NOS score. Articles assessed as 'good' were considered level 2b evidence on the Oxford Centre for Evidence-Based Medicine Model, and articles assessed as 'fair' or 'poor' were considered level 4 evidence. CONCLUSIONS: Our results demonstrate that the existence of a relationship between training load and injury continues to be well supported in the literature and is strongest for subjective internal training load. The directionality of this relationship appears to depend on the type and timeframe of load measured.