RESUMEN
Background: Groin pain is frequently reported by soccer players. A prevention program incorporating the Copenhagen adduction exercise (CAE) has been shown effective in decreasing adductor muscle injury in semi-professional soccer players. However, the effect of such programs on groin pain in high school soccer players is unknown. No reports have examined the effects of combining the CAE with other targeted exercises such as the Nordic hamstrings exercise (NHE). Purpose: To evaluate the preventative effects of exercise on groin pain in high school soccer players in three groups comprising NHE alone, combined NHE and CAE, and a control group. Design: Randomized Controlled Clinical Trial. Methods: A cluster randomized controlled trial spanning 16 weeks was conducted on 202 high school soccer players from seven high schools in a Japanese under 18 Soccer League. Players were allocated to either group A (three schools, 66 players) receiving the CAE alone, or group B (two schools, 73 players) receiving the CAE and NHE, or control group C (two schools, 63 players) who performed their usual training. This study compared the number of injuries, injury rate, and severity of the injury of groin pain in these three groups. Results: The number of players injured was less in group B (4 players) compared to C (18 players), and time-lost to soccer was less in groups A (6 players) and B (3 players) compared to group C (16 players). Injury rates were significantly lower in groups A and B, with the relative risk of injury compared to group C of 0.42 (95% CI 0.19% to 0.90%) in group A and 0.19 (95% CI 0.07 to 0.54) in group B. Conclusion: A 16-week program incorporating the CAE in training sessions in high school soccer players reduced the incidence of groin pain and which may be related to injury severity according to time -lost to soccer, however the combination of both the CAE and NHE may be more effective than the CAE alone. Level of Evidence: 2b.
RESUMEN
BACKGROUND: Ultrasonography (US) has become a useful tool in the evaluation of thickness and continuity of damaged ligaments owing to the rapid advances in its performance and availability. Furthermore, US examination is economical and can be undertaken in a more timely manner than MRI, as it can be performed during the first patient visit. It is also likely to be more accurate than the traditional method of palpating ligaments to diagnose possible injury. The anterior talofibular ligament (ATFL) is most frequently injured of the lateral ankle ligaments and easy to depict on US. This study aimed to assess the treatment outcomes of lateral ankle ligament injuries using a new classification for ATFL injuries based on US findings. METHODS: A total of 140 acute lateral ankle ligament injuries in 132 patients (46 men, 86 women) treated non-operatively were evaluated retrospectively. The average age of the patients was 17.8 years (range, 7-57 years). Patients with a complaint of lateral ankle injury were examined using US, and the anterior talofibular ligament damage was classified into 5 types depending on the type of the injury. The treatment method was selected based on the ultrasonographic classification, and the clinical results were assessed by original evaluation and compared between treatment methods and classification types. RESULTS: A Good or Excellent treatment result was obtained in 133 out of 140 injuries (95.0%). Significant differences were observed in the distribution of treatment methods by injury type (P < 0.001), and the distribution of outcomes was significantly different from the uniform distribution (P < 0.001). Our findings demonstrate that the ultrasonographic classification proposed in this study can be used to determine the appropriate treatment resulting in good outcomes for all types of anterior talofibular ligament damage. CONCLUSION: Visualization of injured ligaments using US may introduce a novel approach of rating and treating ligament injuries.
