#ReadyToplay: hamstring injuries in women's football - a two-season prospective cohort study in the Norwegian women's premier league.

In this two-season prospective cohort study (2020-2021), we aimed to describe the characteristics, clinical findings and magnetic resonance imaging (MRI) findings of hamstring injuries in the Norwegian women's premier league. Hamstring injuries were examined by team physiotherapists using a standardised clinical examination and injury form. Injury location and severity (modified Peetrons classification) were graded based on MRI by two independent radiologists. Fifty-three hamstring injuries were clinically examined, 31 of these with MRI. Hamstring injuries caused 8 days (median) lost from football (interquartile range: 3-15 days, range: 0-188 days), most were non-contact and occurred during sprinting. Gradual-onset (53%) and sudden-onset injuries (47%) were evenly distributed. The injuries examined with MRI were classified as grade 0 (52%), grade 1 (16%) or grade 2 (29%). One proximal tendinopathy case was not graded. Grade 2 injuries caused more time loss than grade 0 (19 ± 8 vs. 7 ± 7 days, p = 0.002). Of injuries with MRI changes, 60% were in the m. biceps femoris, mainly the muscle-tendon junction, and 40% in the m. semimembranosus, most in the proximal tendon. Compared to previous findings from men's football, a higher proportion of hamstring injuries in women's football had a gradual onset and involved the m. semimembranosus, particularly its proximal tendon.

Calibration of the sub-aperture backscatter system on OMEGA EP.

The sub-aperture backscatter (SABS) diagnostic on the OMEGA EP Laser System [Waxer et al., Opt. Photonics News 16, 30 (2005)] is a diagnostic that is used to measure the backscattered and sidescattered light during laser-plasma interaction experiments [W. L. Kruer, The Physics of Laser Plasma Interactions, Frontiers in Physics Vol. 73, edited by D. Pines (Addison-Wesley, Redwood City, CA, 1988) and Myatt et al., Phys. Plasmas 21, 055501 (2014)] that are relevant to high-energy-density physics and inertial confinement fusion. The diagnostic collects stimulated Brillouin scattering (SBS) UV light at around 351 nm and stimulated Raman scattering (SRS) in the visible-light regime in the 420-720-nm-wavelength range and provides spectrally and temporally resolved information. Five 1-in. light collectors, composed of a lens, ground glass diffuser, and coupling into a 300-µm fiber, are positioned behind the last steering mirror on one of the four beamlines to catch a portion of the beam cross section (∼1.5%) of the emission that is scattered into the beamline. The SRS light is collected in two light collectors, combined, and transported via graded index fibers to a streaked spectrometer. The SABS-SRS streak spectrometer has a temporal and spectral resolution of 100 ps and 1 nm, respectively. Three other light collectors collect, combine, and transport the SBS signal to a Hamamatsu high-voltage photodiode, where an oscilloscope digitizes the data, providing a time resolution of better than 1 ns. To obtain an absolute energy calibration of SRS measurements, light signals of known energy and wavelength were injected into the light collectors one at a time. The resulting counts on the streak camera charge-coupled device for SRS are then correlated with the incident fluence of scattered light at the light collector in order to allow a quantitative assessment of streak camera sensitivity to determine the energy of the scattered light during experiments. The measurements were performed in situ from the light collectors to the detectors. Additional offline measurements provided the transmission of the optics between the target chamber center and the light collectors.

Introducing a new method to record injuries during military training: a prospective study among 296 young Norwegian conscripts.

INTRODUCTION: Most epidemiological studies in the field of military medicine have been based on data from medical records and registries. The aims of this study were to test a self-reporting injury surveillance system commonly used in sports medicine in a military setting, and to describe the injury pattern among Norwegian army conscripts during a period of military training. METHOD: A total of 296 conscripts in His Majesty the King's Guard were asked to report all injuries each week for 12 weeks, using a modification of the Oslo Sports Trauma Research Center Questionnaire on Health Problems (OSTRC-H2). We recorded all injuries irrespective of their need for medical attention or consequences for military participation. In addition, we retrieved data on injuries recorded by military physicians in the medical record from the Norwegian Armed Forces Health Register. RESULTS: The mean weekly response rate was 74%. A total of 357 injuries were recorded, of which 82% were only captured through the OSTRC-H2 and 3% only in the medical records. The average weekly prevalence of injury was 28% (95% CI: 25% to 31%), and 10% (95% CI: 8% to 12%) experienced injuries with a substantial negative impact on training and performance. The greatest injury burden was caused by lower limb injuries, with knee and foot injuries as the predominant injury locations. CONCLUSION: The OSTRC-H2 is suitable for use in a military setting and records substantially more injuries than the standard medical record. The prevalence of injuries among conscripts is high and comparable with many elite sports.

The Scattered Light Time-history Diagnostic suite at the National Ignition Facility.

The Scattered Light Time-history Diagnostic (SLTD) is being implemented at the National Ignition Facility (NIF) to greatly expand the angular coverage of absolute scattered-light measurements for direct- and indirect-drive inertial confinement fusion (ICF) experiments. The SLTD array will ultimately consist of 15 units mounted at a variety of polar and azimuthal angles on the NIF target chamber, complementing the existing NIF backscatter suite. Each SLTD unit collects and diffuses scattered light onto a set of three optical fibers, which transport the light to filtered photodiodes to measure scattered light in different wavelength bands: stimulated Brillouin scattering (350 nm-352 nm), stimulated Raman scattering (430 nm-760 nm), and ω/2 (695 nm-745 nm). SLTD measures scattered light with a time resolution of ∼1 ns and a signal-to-noise ratio of up to 500. Currently, six units are operational and recording data. Measurements of the angular dependence of scattered light will strongly constrain models of laser energy coupling in ICF experiments and allow for a more robust inference of the total laser energy coupled to implosions.

Experimental Evidence of Harnessed Expansion of a High-Z Plasma Using the Hollow Wall Design for Indirect Drive Inertial Confinement Fusion.

The effectiveness of a dome-shaped wall covered by a thin gold foil (hollow wall) [M. Vandenboomgaerde et al., Phys. Plasmas 25, 012713 (2018)PHPAEN1070-664X10.1063/1.5008669] in holding back the high-Z plasma expansion in a gas-filled hohlraum is demonstrated for the first time in experiments reproducing the irradiation conditions of indirect drive at the ignition scale. The setup exploits a 1D geometry enabling record of the complete history of the gold expansion for 8 ns by imaging its emission in multiple x-ray energy ranges featuring either the absorption zones or the thermal emission regions. The measured expansion dynamics is well reproduced by numerical simulations. This novel wall design could now be tailored for the megajoule scale to enable the propagation of the inner beams up to the equator in low gas-filled hohlraum thus allowing the fine-tuning of the irradiation symmetry on the timescale required for ignition.

Characteristics of functional movement screening testing in elite handball players: Indicative data from the 9.

OBJECTIVES: To test 9 + screening batterie's intra-rater reliability, to provide indicative data of elite handball players, and to analyze difference between age, playing positions and level of play. DESIGN: Descriptive study. SETTING: Icelandic elite male handball players. PARTICIPANTS: 182 elite male handball players. MAIN OUTCOME MEASURES: Nine + screening battery. RESULTS: Reliability test: Intra-class correlation for the total score was 0.95. The correlation of each of the test factors varied from 0.63 to 0.91. The mean total score was 22.3 ±â€¯2.9 (95%CI 16.7-28.1), with no difference in total score comparing players age or level of play. Goalkeepers displayed a higher total score than other players (F3,151 = 5.75, p = 0.001). Junior players had a lower score than senior players in tests measuring abdominal strength and core stability; Test 5; │2(3, 182) = 41.5, p < 0.0001, Test 6; │2(3, 182) = 55.7, p < 0.0001, Test 7; │2(3, 182) = 11.8, p < 0.005, but higher scores in tests measuring trunk and shoulder mobility Test 8; │2(3, 182) = 18.2, p < 0.0001, Test 9; │2(3, 182) = 22.2, p = 0.006. CONCLUSIONS: The 9+ intra-rater reliability was acceptable for the total score and individual tests. Age-related differences were provided in many individual tests.

No association between rate of torque development and onset of muscle activity with increased risk of hamstring injury in elite football.

Hamstring injuries remain a significant burden in sports that involve high-speed running. In elite male football, hamstring injury has repeatedly been identified as the most common non-contact injury, representing 12% of all injuries. As the incidence remains high, investigations are aimed at better understanding how to improve prevention efforts. Intrinsic risk factors such as strength have been investigated extensively in a cohort of professional football players; however, other intrinsic measures of neuromuscular function have not been studied in this cohort. This study aims to investigate the association between timing of hamstring muscle activity onset and the rate of torque development during the early phase of isokinetic strength testing with risk of hamstring injury in professional football players in a prospective cohort study. All teams (n = 18) eligible to compete in the premier football league in Qatar underwent a comprehensive strength assessment during their annual periodic health evaluation at Aspetar Orthopaedic and Sports Medicine Hospital in Doha, Qatar. Variables included rate of torque development and timing of muscle activity onset. A total of 367 unique players (60.6% of all QSL players) competed for 514 player seasons (103 players competed both seasons) and sustained 65 hamstring injuries. There was no difference in the onset of muscle activity between the biceps femoris and medial hamstrings comparing the injured to uninjured players. For both onset of muscle activity and rate of torque development, there were no significant differences between any of the variables (P > .05), with small effect sizes detected across all the different variables (d < 0.3). Rate of torque development and onset of muscle activity were not associated with a risk of future hamstring injury. The use of these measures as part of a periodic health evaluation to identify risk of hamstring injury is unsupported.

Interseason variability in isokinetic strength and poor correlation with Nordic hamstring eccentric strength in football players.

In elite sport, the use of strength testing to establish muscle function and performance is common. Traditionally, isokinetic strength tests have been used, measuring torque during concentric and eccentric muscle action. A device that measures eccentric hamstring muscle strength while performing the Nordic hamstring exercise is now also frequently used. The study aimed to investigate the variability of isokinetic muscle strength over time, for example, between seasons, and the relationship between isokinetic testing and the new Nordic hamstring exercise device. All teams (n = 18) eligible to compete in the premier football league in Qatar underwent a comprehensive strength assessment during their periodic health evaluation at Aspetar Orthopaedic and Sports Medicine Hospital in Qatar. Isokinetic strength was investigated for measurement error, and correlated to Nordic hamstring exercise strength. Of the 529 players included, 288 players had repeated tests with 1/2 seasons between test occasions. Variability (measurement error) between test occasions was substantial, as demonstrated by the measurement error (approximately 25 Nm, 15%), whether separated by 1 or 2 seasons. Considering hamstring injuries, the same pattern was observed among injured (n = 60) and uninjured (n = 228) players. A poor correlation (r = .35) was observed between peak isokinetic hamstring eccentric torque and Nordic hamstring exercise peak force. The strength imbalance between limbs calculated for both test modes was not correlated (r = .037). There is substantial intraindividual variability in all isokinetic test measures, whether separated by 1 or 2 seasons, irrespective of injury. Also, eccentric hamstring strength and limb-to-limb imbalance were poorly correlated between the isokinetic and Nordic hamstring exercise tests.

Video analysis of acute injuries and referee decisions during the 24th Men's Handball World Championship 2015 in Qatar.

Although handball is a contact sport with a high risk of acute match injuries, their mechanisms have not yet been investigated. We aimed to describe the mechanisms of acute match injuries in elite male handball and evaluate referee performance in injury situations. Based on injury surveillance from the 24th Men's Handball World Championship 2015 in Qatar, injury situations and the referee decisions were identified on video footage. A total of 55 injury situations and 37 referee decisions were included for analysis. The injury situations were analyzed individually by five handball experts, followed by a consensus meeting. An expert referee panel performed individual blinded evaluation of the referee decisions, followed by an online consensus meeting. Injuries were evenly distributed among attackers (n = 29) and defenders (n = 26). The most frequent injury cause was contact trauma due to a tackle (n = 27). At the time of injury, attackers were most frequently performing a jump shot (n = 9), while defenders were completing a tackle (n = 10). Defenders most commonly tackled the throwing arm (n = 7) or toward the head/face region (n = 6) of injured attackers, while attackers most frequently hit injured defenders with the knee during jump shots (n = 5). Agreement between the referees and the expert panel was weak (kappa: 0.22, 95% CI 0.07 to 0.36), with substantially more lenient rule interpretation by the referees. Our results suggest that stricter refereeing and rule amendments should be considered to prevent acute match injuries in elite handball, especially in relation to tackling episodes when an attacker is performing a jump shot.

A valid and reliable method to measure jump-specific training and competition load in elite volleyball players.

Use of a commercially available wearable device to monitor jump load with elite volleyball players has become common practice. The purpose of this study was to evaluate the validity and reliability of this device, the Vert, to count jumps and measure jump height with professional volleyball players. Jump count accuracy was determined by comparing jumps recorded by the device to jumps observed through systematic video analysis of three practice sessions and two league matches performed by a men's professional volleyball team. Jumps performed by 14 players were each coded for time and jump type and individually matched to device recorded jumps. Jump height validity of the device was examined against reference standards as participants performed countermovement jumps on a force plate and volleyball-specific jumps with a Vertec. The Vert device accurately counted 99.3% of the 3637 jumps performed during practice and match play. The device showed excellent jump height interdevice reliability for two devices placed in the same pouch during volleyball jumps (r = .99, 95% CI 0.98-0.99). The device had a minimum detectable change (MDC) of 9.7 cm and overestimated jump height by an average of 5.5 cm (95% CI 4.5-6.5) across all volleyball jumps. The Vert device demonstrates excellent accuracy counting volleyball-specific jumps during training and competition. While the device is not recommended to measure maximal jumping ability when precision is needed, it provides an acceptable measure of on-court jump height that can be used to monitor athlete jump load.

The prevalence and severity of health problems in youth elite sports: A 6-month prospective cohort study of 320 athletes.

Little is known regarding the overall health of youth elite athletes. Our aim was to describe the prevalence and severity of health problems in a cohort of youth elite athletes representing a variety of endurance, team, and technical sports. Elite sport athletes (N = 260, 16.2 years) from different Sport Academy High Schools in Norway, and a group of their teammates (N = 60, 16.4 years) attending regular high schools, were included in the study. The Oslo Sports Trauma Research Centre (OSTRC) questionnaire on health problems was used to self-report injuries and illnesses for 26 weeks. At any given time, an average of 43% [95% CI: 37%-49%] of the elite sport athletes had some form of health problem and 25% [20%-31%] had substantial health problems. The prevalence of health problems was similar between the elite team sport athletes and their teammates, except for substantial injuries (22% [16%-30%] vs 10% [5%-20%]). Endurance sport athletes reported more illnesses (23% [15%-35%]) than technical and team sport athletes (10% [5%-20%] and 8% [4%-14%]). In contrast, technical and team sport athletes reported more injuries (36% [95% CI: 25-48] and 37% [95% CI 29-45]) compared to endurance sport athletes (15% [8%-25%]). The total impact of health problems was roughly split in thirds between overuse injuries (37%), acute injuries (34%), and illnesses (30%). This is the first prospective study to present self-reported injury and illness data in a large heterogeneous group of youth elite athletes, documenting a substantial impact of both injuries and illnesses on the health of this population.

A framed, 16-image Kirkpatrick-Baez x-ray microscope.

A 16-image Kirkpatrick-Baez (KB)-type x-ray microscope consisting of compact KB mirrors [F. J. Marshall, Rev. Sci. Instrum. 83, 10E518 (2012)] has been assembled for the first time with mirrors aligned to allow it to be coupled to a high-speed framing camera. The high-speed framing camera has four independently gated strips whose emission sampling interval is ∼30 ps. Images are arranged four to a strip with ∼60-ps temporal spacing between frames on a strip. By spacing the timing of the strips, a frame spacing of ∼15 ps is achieved. A framed resolution of ∼6-µm is achieved with this combination in a 400-µm region of laser-plasma x-ray emission in the 2- to 8-keV energy range. A principal use of the microscope is to measure the evolution of the implosion stagnation region of cryogenic DT target implosions on the University of Rochester's OMEGA Laser System [T. R. Boehly et al., Opt. Commun. 133, 495 (1997)]. The unprecedented time and spatial resolutions achieved with this framed, multi-image KB microscope have made it possible to accurately determine the cryogenic implosion core emission size and shape at the peak of stagnation. These core size measurements, taken in combination with those of ion temperature, neutron-production temporal width, and neutron yield allow for inference of core pressures, currently exceeding 50 Gbar in OMEGA cryogenic target implosions [Regan et al., Phys. Rev. Lett. 117, 025001 (2016)].

Knee function among elite handball and football players 1-6 years after anterior cruciate ligament injury.

The aim of the study was to describe objective and self-reported knee function for athletes who have returned to elite handball and football play after an ACL injury, comparing these to non-injured players at the same level. A total of 414 handball and 444 football players completed baseline tests from 2007 through 2014, examining lower extremity strength, dynamic balance, knee laxity, and knee function (KOOS questionnaire). Measures were compared between injured and non-injured legs and between injured legs and legs of controls. Eighty (9.3%) of the 858 players reported a previous ACL injury, 1-6 years post-injury (3.5±2.5 years), 49 handball (61.3%) and 31 football players (38.7%). We found no difference in strength or dynamic balance between previously ACL-injured (N=80) and non-injured players legs (N=1556). However, lower quadriceps (6.3%, 95% CI: 3.2-9.2) and hamstrings muscle strength (6.1%, 95% CI: 3.3-8.1) were observed in previously ACL-injured legs compared to the non-injured contralateral side (N=80). ACL-injured knees displayed greater joint laxity than the contralateral knee (N=80, 17%, 95% CI: 8-26) and healthy knees (N=1556, 23%, 95% CI: 14-33). KOOS scores were significantly lower for injured knees compared to knees of non-injured players. ACL-injured players who have successfully returned to elite sport have comparable strength and balance measures as their non-injured teammates. Subjective perception of knee function is strongly affected by injury history, with clinically relevant lower scores for the KOOS subscores Pain, Function, Sport, and Quality Of Life.

The effect of overhead target on the lower limb biomechanics during a vertical drop jump test in elite female athletes.

The purpose of the study was to investigate the effect of an overhead target on the jump height and lower limb biomechanics in all three planes of motion in a vertical drop jump (VDJ) task among elite female handball and football (soccer) players. The hypothesis was that adding an overhead target to the VDJ task improves jump height, increases joint loading, and decreases frontal plane knee control. Five hundred and twenty-three female handball and football players (mean ± SD: 21 ± 4 years, 168 ± 6 cm, 65 ± 8 kg) completed the test. The overhead target increased jumping height by 5.8%. Furthermore, the overhead target led to statistically significant changes in many of the lower limb biomechanical variables examined. However, all the changes in kinematics and kinetics were clinically insignificant, as indicated by the small effect sizes. Strong to moderate positive Spearman's rank correlations were found between the two conditions. Therefore, an overhead target is unlikely to increase the range of responses in biomechanical variables in elite female handball and football athletes.

Interseason variability of a functional movement test, the 9+ screening battery, in professional male football players.

BACKGROUND: The Nine Plus screening battery test (9+) is a functional movement test intended to identify limitations in fundamental movement patterns predisposing athletes to injury. However, the interseason variability is unknown. AIM: To examine the variability of the 9+ test between 2 consecutive seasons in professional male football players. METHODS: Asymptomatic Qatar Star League players (n=220) completed the 9+ at the beginning of the 2013 and 2014 seasons. Time-loss injuries in training and matches were obtained from the Aspetar Injury and Illness Surveillance Program. No intervention was initiated between test occasions. RESULTS: A significant increase in the mean total score of 1.6 points (95% CI 1.0 to 2.2, p<0.001) was found from season 1 (22.2±4.1 (SD)) to season 2 (23.8±3.3). The variability was large, as shown by an intraclass correlation coefficient (ICC) of 0.24 (95% CI 0.11 to 0.36) and a minimal detectable change (MDC) of 8.7 points. Of the 220 players, 136 (61.8%) suffered a time-loss injury between the 2 tests. There was an improvement in mean total scores in the injured (+2.0±0.4 (SE), p<0.001) group but not in the uninjured group (+0.9±0.5, p=0.089). The variability from season 1 to season 2 was large both in the injured (ICC 0.25, 0.09 to 0.40, MDC 8.3) and uninjured (ICC 0.24, 0.02 to 0.43, MDC 9.1) groups. CONCLUSIONS: The 9+ demonstrated substantial intraindividual variability in the total score between 2 consecutive seasons, irrespective of injury. A change above 8 points is necessary to represent a real change in the 9+ test between seasons.

Experimental Investigation of the Collective Raman Scattering of Multiple Laser Beams in Inhomogeneous Plasmas.

Experiments have been performed evidencing significant stimulated Raman sidescattering (SRS) at large angles from the density gradient. This was achieved in long scale-length high-temperature plasmas in which two beams couple to the same scattered electromagnetic wave further demonstrating for the first time this multiple-beam collective SRS interaction. The collective nature of the coupling and the amplification at large angles from the density gradient increase the global SRS losses and produce light scattered in novel directions out of the planes of incidence of the beams. These findings obtained in plasmas conditions relevant of inertial confinement fusion experiments similarly apply to the more complex geometry of these experiments where anomalously large levels of SRS were measured.

Experimental Evidence of the Collective Brillouin Scattering of Multiple Laser Beams Sharing Acoustic Waves.

The indirect-drive scheme to inertial confinement fusion uses a large number of laser beams arranged in a symmetric angular distribution. Collective laser plasma instabilities can therefore develop that couple all the incident laser waves located in a cone to the daughter wave growing along the cone symmetry axis [D. F. DuBois et al., Phys. Fluids B 4, 241 (1992)]. With complementary diagnostics of Thomson scattering and of the scattered light, we demonstrate the occurrence of collective stimulated Brillouin sidescattering driving collective acoustic waves in indirect-drive experiments.

A one-season prospective study of injuries and illness in elite junior tennis.

The objective of this study was to estimate the incidence and prevalence of injury and illness among elite junior tennis players. A cohort of 73 players (11-14 years) in the 2012-2013 Dutch national high-performance program was followed for 32 weeks; all participants completed the study. The OSTRC Questionnaire on Health Problems was used to record self-reported injuries and illnesses and to record training and match exposure. Main outcome measures were average prevalence of overuse injury and illness and incidence density of acute injury. On average, players practiced 9.1 h/week (SD 0.6; range 2.3-12.0) and had 2.2 h of match play (SD 0.6; range 2.3-12.0). During the course of the study, 67 players reported a total of 187 health problems. The average weekly prevalence of all health problems was 21.3% (95% CI: 19.2-22.9), of which 12.1% (95% CI: 10.9-13.3) constituted overuse injuries and 5.8% (95% CI: 4.6-6.9) illnesses. The incidence of acute injuries was 1.2/1000 h of tennis play (95% CI: 0.7-1.7). The high occurrence of overuse injuries among elite junior tennis players suggests that an early focus on preventative measures is warranted, with a particular focus on the monitoring and management of workload.

Ultrasound characteristics of the patellar and quadriceps tendons among young elite athletes.

Tendons adapt in response to sports-specific loading, but sometimes develop tendinopathy. If the presence of ultrasound changes like hypoechoic areas and neovascularization in asymptomatic tendons precede (and predict) future tendon problems is unknown. The aim of this prospective cohort study was to investigate the relationship between the development of ultrasound changes in the patellar and quadriceps tendons and symptoms of jumper's knee, as well to examine the medium-term effects of intensive training on tendon thickness among adolescent athletes. Elite junior volleyball athletes were followed with semi-annual ultrasound and clinical examinations (average follow-up: 1.7 years). Of the 141 asymptomatic athletes included, 22 athletes (35 patellar tendons) developed jumper's knee. In a multivariate logistic regression analysis, a baseline finding of a hypoechoic tendon area (odds ratio 3.3, 95% confidence interval 1.1 to 9.2) increased the risk of developing symptoms of jumper's knee. Patellar tendon thickness among healthy athletes did not change (Wilk's lambda, P = 0.07) while quadriceps tendon thickness increased (P = 0.001). In conclusion, ultrasound changes at baseline were risk factors for developing symptoms of jumper's knee. Also, among healthy athletes, we observed a 7-11% increase in quadriceps tendon thickness, while there was no increase in patellar tendon thickness.