Ultrasound Examination of the Ligament Complex Within the Medial Aspect of the Ankle and Foot.

To properly diagnose and treat injuries to the ankle or foot, the physician must have good anatomical knowledge of the ligaments involved. The bundles can be distinguished and identified by ultrasound examination of the medial aspect, but this may be a challenging task. In the present illustrated study, we discuss how a detailed ultrasound examination can be made of the different ligaments within the medial aspect of the ankle and foot.

Safety and Performance of Titanium Suture Anchors Used in Knee Ligament Repair Procedures.

Injuries to the knee ligaments can be particularly disabling in young patients, given the risk of long-term disability if adequate fixation is not achieved during initial repair. The TWINFIX™ titanium (Ti) suture anchor with ULTRABRAID™ Suture (Smith and Nephew, London, UK) was designed to secure tendon and ligament reconstructions with increased boney ingrowth at the anchor site with minimal invasive technique. This retrospective analysis looked at 33 patients (41 implants) operated with this device between 2015 and 2019 at a single institution. The average age of patients was 33.18 years (standard deviation [SD], 15.26), with an average body mass index of 24.88 (SD, 3.49). The indications were lateral extra-articular tenodesis during anterior cruciate ligament reconstruction, medial patellofemoral ligament reconstruction, quadriceps or patellar tendon repair and medial collateral ligament repair. After an average follow up of 24.3 + 6.53 months, there was no reports of clinical failure or radiographic evidence of implant failure or loosening. One patient experienced a complication unrelated to the study device, requiring manipulation under anesthesia with resolution of symptoms. This case series supports the safety and performance of this implants for the knee procedures in which its use is indicated. Additional follow-up will be required to determine whether these effects are sustained at medium- and long-term durations.

Prognostic Factors of Perceived Disability and Perceived Recovery After Whiplash: A Longitudinal, Prospective Study With One-year Follow-up.

OBJECTIVES: The understanding of the role that cognitive and emotional factors play in how an individual recovers from a whiplash injury is important. Hence, we sought to evaluate whether pain-related cognitions (self-efficacy beliefs, expectation of recovery, pain catastrophizing, optimism, and pessimism) and emotions (kinesiophobia) are longitudinally associated with the transition to chronic whiplash-associated disorders in terms of perceived disability and perceived recovery at 6 and 12 months. METHODS: One hundred sixty-one participants with acute or subacute whiplash-associated disorder were included. The predictors were: self-efficacy beliefs, expectation of recovery, pain catastrophizing, optimism, pessimism, pain intensity, and kinesiophobia. The 2 outcomes were the dichotomized scores of perceived disability and recovery expectations at 6 and 12 months. Stepwise regression with bootstrap resampling was performed to identify the predictors most strongly associated with the outcomes and the stability of such selection. RESULTS: Baseline perceived disability, pain catastrophizing, and expectation of recovery were the most likely to be statistically significant, with an overage frequency of 87.2%, 84.0%, and 84.0%, respectively. CONCLUSION: Individuals with higher expectations of recovery and lower levels of pain catastrophizing and perceived disability at baseline have higher perceived recovery and perceived disability at 6 and 12 months. These results have important clinical implications as both factors are modifiable through health education approaches.

Is it Possible to Reduce Pain-Related Fear in Individuals with Knee Osteoarthritis? a Systematic Review of Randomised Clinical Trials.

OBJECTIVE: To evaluate the effectiveness of different interventions in reducing pain-related fear outcomes in people with knee osteoarthritis who have or have not had previous knee surgery, and to analyze whether included trials reported their interventions in full detail. METHODS: Systematic searches were carried out in the Cochrane CENTRAL, CINAHL, EMBASE, PEDro, PsycINFO, PubMed, and SPORTDiscus from the inception of the database up to November 2019. Searches were manually updated to July 2021. We included randomized clinical trials that evaluated pain-related fear outcomes as a primary or secondary outcome in adults with knee osteoarthritis. The Cochrane Risk of Bias Tool 2 and the GRADE approach evaluated the risk of bias and the certainty of the evidence, respectively. RESULTS: Eighteen trials were included. Four trials evaluated pain-related fear as a primary outcome and all evaluated kinesiophobia in samples that had previously undergone a knee surgical procedure. These trials found that interventions based primarily on cognitive aspects (e.g. cognitive-behavioral principles) can be effective in reducing kinesiophobia. Trials evaluating pain-related fear as the secondary outcome also found that interventions that included cognitive aspects (e.g. pain neuroscience education) decreased the levels of pain-related fear (e.g. fear of falling or kinesiophobia) in patients with or without a previous knee surgery. However, serious to very serious risk of bias and imprecisions were found in included trials. Thus, the certainty of the evidence was judged as low and very low using the GRADE approach. All trials reported insufficient details to allow a complete replication of their interventions. CONCLUSIONS: Interventions that include cognitive aspects may be the best option to reduce pain-related fear in people with knee osteoarthritis. However, we found a general low and very low certainty of the evidence and the findings should be considered with caution.

The Influence of Stud Characteristics of Football Boots Regarding Player Injuries.

BACKGROUND: the main aim of this study was to analyze the relationship between sole pattern parameters of football boots with the frequency of injuries that occur in semiprofessional and amateur footballers. METHODS: The study sample was composed of 77 male football players. All were at least 18 years old, played at least 10 h per week, gave signed informed consent to take part and properly completed the Visual Analogue Scale. This study analysed data from each player's medical history, including age, injuries, years of practice, field type and surface condition information. RESULTS: The visual analogic score in semiprofessional players was higher (2.05 ± 2.43) than in amateur players (1.00 ± 1.1). A total of 141 lesions were collected, equivalent to 1.81 injuries for each football player studied (n = 77). The result of the ROC curve indicated that the player's years of practice could predict significantly (p < 0.05) the presence of lower limb injuries, with an area under the curve of 0.714. CONCLUSIONS: This study described the predictive capacity of sole pattern characteristics concerning lower limb injuries in amateur and semiprofessional footballers. Football boot variables associated with the number of studs were associated with foot and ankle overload injuries.

Effects of Strength vs. Plyometric Training Programs on Vertical Jumping, Linear Sprint and Change of Direction Speed Performance in Female Soccer Players: A Systematic Review and Meta-Analysis.

The main purpose of this systematic review and meta-analysis was to compare the effects of strength training (ST) and plyometric training (PT) on vertical jump, linear sprint and change of direction (COD) performance in female soccer players. A systematic search of the PubMed, Web of Science, Google Scholar and SportDiscus databases revealed 12 studies satisfying the inclusion criteria. The inverse-variance random-effects model for meta-analyses was used. Effect sizes (ES) were represented by the standardized mean difference and presented alongside 95% confidence intervals (CI). The magnitude of the main effect was small to moderate (vertical jump (ES 0.53 (95% CI-0.11, 0.95), Z = 2.47 (p = 0.01); linear sprint (ES -0.66 (95% CI-2.03, -0.21), Z = 2.20 (p = 0.03); COD (ES -0.36 (95% CI-0.68, -0.03), Z = 2.17 (p = 0.03)). Subgroup analyses were performed (i.e., ST and PT duration, frequency, session duration and total number of sessions), revealing no significant subgroup differences (p = 0.12-0.88). In conclusion, PT provides better benefits than ST to improve vertical jump, linear sprint and COD performance in female soccer players. However, significant limitations in the current literature prevent assured PT and ST prescription recommendations being made.

Influence of contextual factors on physical demands and technical-tactical actions regarding playing position in professional soccer players.

BACKGROUND: The aim of this study was to analyse the physical demands and technical-tactical actions for each playing position according to game location and final outcome in professional soccer players. METHODS: A convenience sample was obtained from twenty-one professional male soccer players, belonged to same soccer team of the Spanish Second Division. Players' physical demands were monitored during each match using a portable 18 Hz GPS unit and 600 Hz triaxial accelerometer. These analysed demands were total distance, moderate speed running distance (>14.4 km·h-1), high-speed running distance (>19.8. km·h-1), sprint distance (>25.0 km·h-1), number of accelerations between 2 and 4 m·s-2 and above 4 m·s-2, and number of decelerations between 2 and 4 m·s-2 and above 4 m·s-2. The data related to technical-tactical actions were obtained from WyScout®, a computerized multiple-camera tracking system based on the OPTA® track analysis tool. The obtained indicators were general, defensive and offensive. RESULTS: For all players, higher total distance (p = 0.045; effect size [ES] = 0.24, small effect) was covered and greater deceleration 2-4 m·ss-2 (p = 0.001; ES = 0.68, medium effect) was performed when the team plays at home and lose and for all players, playing at home and winning demanded higher defensive volume (p =0.014; ES = - 1.49, large effect) and nº interceptions (p =0.031; ES = - 1.40, large effect) in comparison to playing at home and losing. CONCLUSIONS: The physical demands and technical-tactical actions vary when contextual game factors (i.e., match location and final outcome) are considered. We can confirm that, although the training of physical demands does not influence the final result of the match, the training of technical tactical actions could help to achieve an optimal performance of the team to win matches.

Incidence of injuries among professional football players in Spain during three consecutive seasons: A longitudinal, retrospective study.

OBJECTIVES: The aim of the study was to determine risk factors that maybe be associated with a higher incidence of injuries in elite football players in the Spanish league during a three-year follow-up. Injury was defined as a musculoskeletal complaint (pain and/or discomfort) reported by players to the medical staff and receiving medical attention. DESIGN: A longitudinal retrospective study. SETTING: and participants: Seventy-one players from Malaga Football Club, who were in the first squad team for three consecutive seasons. MAIN OUTCOME MEASURES: Incidence, location, severity of injuries were reported according to the Injury Consensus Group for football injuries. RESULTS: Three hundred and fifty six injuries were found, with the highest proportion (44%) being located in the thigh. We found 6.9 (SD 5.87) injuries per 1000 h of match time and 0.23 (SD 0.22) per 1000 h of training. Forwards presented the highest rates in both incidence and severity of injury. Exposure to training was inversely related to the total number of injuries, which means that the greater the exposure to training the lesser the number of injuries. CONCLUSIONS: This information can assist clinicians in the identification of risk factors and, thus, the elaboration of prevention programmes that reduce football injuries.