Epidemiology of hamstring injuries in 538 cases from an FC Barcelona multi sports club.

OBJECTIVES: Hamstring injuries are the most common muscle injuries in team sports. The aims of this study were to describe the epidemiology of hamstring muscle injuries in the professional and amateur sport sections of a multi-sport club Football Club Barcelona (FCB) and to determine any potential correlation between return-to-play (RTP) and injury location, severity of connective tissue damage, age, sex, and athlete's level of competition. METHODS: This descriptive epidemiological study with data collected from September 2007 to September 2017 stored in the FCB database. The study included non-contact hamstring injuries sustained during training or competition. RESULTS: A total of 538 hamstring injuries were reported in the club's database, of which 240 were structurally verified by imaging as hamstring injuries. The overall incidence for the 17 sports studied was 1.29 structurally verified hamstring injuries per 100 athletes per year. The muscle most commonly involved in hamstring injuries was the biceps femoris, and the connective tissue most frequently involved was the myofascial. There was no evidence of a statistically significant association between age and RTP after injury, and no statistically significant difference between sex and RTP. However, the time loss by professionals was shorter than for amateurs, and proximal hamstring injuries took longer RTP than distal ones. CONCLUSION: In the 17 sports practiced at multi-sport club, the incidence of hamstring injury was 1.29 per 100 athletes per year. Players from sports in which high-speed sprinting and kicking are necessary, and amateurs, were at higher risk of suffering a hamstring injury. In addition, proximally located hamstring injuries involving tendinous connective tissue showed the longest RTP time. Age did not seem to have any influence on RTP. Documenting location and the exact tissue involved in hamstring injuries may be beneficial for determining the prognosis and RTP.

Reduced Match Exposure in the Previous 2 Matches Accounts for Hamstring Muscle Injury Incidence in Professional Football Players.

BACKGROUND: Hamstring strain injuries are one of the most prevalent injuries in football (soccer). We examined the influence of accumulated match-play exposure on the occurrence of hamstring strain injury in professional football from 2 teams (Spanish 1st Division, LaLiga) over 3 seasons, and determined specific cut-off points as indicators of injury risk. HYPOTHESIS: Overloaded players would be more likely to sustain a hamstring injury. STUDY DESIGN: Prospective, controlled, observational study. LEVEL OF EVIDENCE: Level 2b. METHODS: Playing time, total running distance, and high-speed running (>24 km/h) distance during official matches of players that sustained a hamstring injury were compared with uninjured, paired controls. Cumulative playing time and running performance of 4 matches before the injury was computed. Relative risk (RR) of injury occurrence was estimated by generalized estimating equations. Diagnostic accuracy was determined by receiver operating characteristics and the area under the curve. RESULTS: Thirty-seven hamstring strain injuries occurred, representing 23 ± 18 absence days per injury. Thirty-seven controls (uninjured players) were used as comparators. Low match-play exposures during 1 and 2 matches before injury were likely to explain injury occurrence (RR: 14-53%; P < 0.01). Metrics from the match before the hamstring muscle strain demonstrated the best accuracy to predict injury occurrence: high-speed running distance ≤328 m (sensitivity, 64%; specificity, 84%), playing time ≤64 min (sensitivity, 36%; specificity, 97%), and running distance ≤5.8 km (sensitivity, 39%; specificity, 97%). CONCLUSION: Relatively reduced competitive exposure in the previous 2 matches was associated with higher hamstring injury risk in professional football players. CLINICAL RELEVANCE: Screening simple metrics such as the accumulated match exposure during official matches and considering specific cut-off points for some running variables may be good indicators of injury risk and may assist in better individual injury management in professional soccer players.

Injuries in Ballroom DanceSport: A Retrospective Study on Prevalence and Relation With Demographic Data.

BACKGROUND: DanceSport is a variant of Ballroom dancing, a style that is performed as a couple dancing together. Although there are many participants worldwide, the amount of research on injuries done in this style of dancing is limited. OBJECTIVE: The aim of this study was obtaining information about the DanceSport Athletes in the Netherlands including anthropometrics, level, frequency and duration of dance training per week. Our second objective was to investigate injury prevalence and type of injuries. STUDY DESIGN: Retrospective questionnaire study. METHODS: All 816 registered active dancers within the Dutch DanceSport Association received an online questionnaire with questions on anthropometrics, level of dancing, frequency and duration of dance training, and questions on injuries. The Chi-Square test was used to calculate differences between categorical variables. RESULTS: A total of 218 dancers (33.7%) completed the questionnaire, 107 males (49.1%), and 111 females (50.9%). The mean age for men was 42 ± 15.9 and 36 ± 15.1 for women. 176 dancers (80.7%) reported 1 or more injuries. Foot, ankle, and lower leg injuries were reported most frequently, 49 males (45.8%), and 60 females (54.1%). No significant difference was found in the total number of injuries for the variables sex (P = .761) and discipline (P = .225). Significantly more head and neck injuries were identified in female Standard dancers (P < .001) compared to male dancers. Also, Standard dancers have more back injuries compared to dancers in both disciplines (P < .009). CONCLUSION: With the described anthropometrics and an 80% lifetime prevalence of injuries, this group can be compared to other dance forms. Significant differences in injuries of the head and neck for female Standard dancers compared to male dancers and significantly more back injuries in Standard dancers compared to dancers in both disciplines were found. Future studies need to translate and validate existing questionnaires in Dutch for use in this population.

Most modifiable risk factors for hamstring muscle injury in women's elite football are extrinsic and associated with the club, the team, and the coaching staff and not the players themselves: the UEFA Women's Elite Club Injury Study.

PURPOSE: To describe the perceived importance of suggested hamstring injury risk factors according to chief medical officers (CMOs) of European women's professional football clubs. A secondary objective was to compare if these perceptions differed between teams with a lower-than-average and higher-than-average hamstring injury burden. METHODS: The CMOs of eleven European professional women's football clubs were initially asked to suggest modifiable risk factors for hamstring injury. These risk factors were rated in according with their perceived importance on a 5-graded Likert scale. Participating teams were divided in two groups depending on their hamstring injury burden during the 2020/21 season. The LOW group consisted of six teams that had a lower-than-average hamstring injury burden. The HIGH group consisted of five teams that had a higher-than-average hamstring injury burden. RESULTS: Twenty-one risk factors were suggested, most of which were extrinsic in nature, hence associated with the coaching staff, the team or the club organization rather than with the players themselves. The risk factors with the highest average importance were: "lack of communication between medical staff and coaching staff" and "load on players" (each with a weighted average of 3.9), followed by "lack of regular exposure to high-speed football actions during training" and "playing matches 2-3 times a week" (weighted average of 3.8 and 3.7). Differently from the LOW group, the HIGH group perceived the coaching factors (style of coach leadership, training/exercise surveillance by coaching staff) as more important. CONCLUSION: In accordance to the eleven CMOs recruited in this study, most risk factors for hamstring injuries are extrinsic in nature and associated with the club, the team, and the coaching staff, and not the players themselves. LEVEL OF EVIDENCE: Level III.

Effects of Different Hamstring Eccentric Exercise Programs on Preventing Lower Extremity Injuries: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis aims to investigate the effects and differences of various hamstring eccentric training protocols for the prevention of lower limb injuries, and we further propose a more refined hamstring eccentric training protocol for the prevention of lower limb injuries. A literature search for the effects of hamstring eccentric training on lower extremity sports injuries was conducted using the PubMed, Web of Science, and EMBASE databases, and the literature was searched covering the period from the date of the database's creation to 20 August 2022. A meta-analysis of the included literature was performed using R.4.21 for lower extremity injuries, injuries in various parts of the lower extremity, and subgroup analysis for exercise frequency, exercise cycle, and exercise population. A total of 23 randomized controlled trial (RCT) studies were found to be included in the meta-analysis, and 15 of these trials, totaling 14,721 patients, were determined to be included in the overall lower extremity injury prevention effect. The analysis showed that the implementation of a hamstring eccentric training program reduced lower extremity injuries by 28%, and it resulted in a 46% decrease in hamstring injury rate and a 34% decrease in knee injury rate. The subgroup analysis revealed that the frequency of exercise was most significant in the twice-a-week exercise group, that the exercise program was most effective in preventing injuries in the 21-30-week exercise period, and that the program was most effective in preventing injuries in elite athletes and amateur adult athletic populations, compared with adolescents.

Hamstrings injury incidence, risk factors, and prevention in Rugby Union players: a systematic review.

BACKGROUND: Hamstring strain injuries are one of the most common injuries in Rugby Union, representing up to 15% of all injuries sustained. We aimed to systematically review and summarize the scientific literature that addressed hamstring strain injury incidence, risk factors, injury prevention or strengthening strategies, and strength or asymmetry measures in Rugby Union. METHODS: We conducted a systematic search to locate published peer-reviewed articles from PubMed, SPORTDiscusTM, Web of Science®, and Scopus® e-databases. Studies included were original research conducted in Rugby Union that evaluated hamstring strength, hamstring strengthening interventions, and/or hamstring injury outcomes. Included studies were quality assessed using the Newcastle-Ottawa Scale. RESULTS: Twenty-four studies met inclusion and altogether involved 2866 participants. Isokinetic testing was the most common method used to quantify hamstring strength and imbalances in Rugby Union; with data indicating that professionals are stronger than amateurs, and forwards are stronger than backs. Regarding risk factors, we identified playing position, fatigue, previous injuries, between leg strength imbalances, lack of readiness to return to play post injury, and game actions (i.e. running). There is evidence to support the use of Nordic eccentric strength measures to inform practice, with strength and imbalances useful in predicting injuries. Strengthening programs with Nordic exercises significantly increased hamstring strength, increased muscle thickness, and decreased imbalance ratios in female and male players. A significant reduction in injury incidence and severity in professional players has been observed in players performing routines incorporating progressive Nordic exercises. CONCLUSION: The etiology of hamstring strain injuries is multifactorial, with playing position, fatigue, previous injuries, leg imbalances, lack of readiness to return to play, and running actions identified as contributing factors across levels. Combining strategies to prevent hamstring injuries and recurrences, and to inform return to play, is likely worthwhile and should include Nordic strength assessment and Nordic exercises.

Is Workload Associated With Hamstring and Calf Strains in Professional Baseball Players? An Analysis of Days of Rest, Innings Fielded, and Plate Appearances.

BACKGROUND: The influence of player workload on hamstring and calf injuries in professional baseball players remains unknown. HYPOTHESIS: Increased workload would significantly increase hamstring and calf strain injury risk. STUDY DESIGN: Case-control. LEVEL OF EVIDENCE: Level 3. METHODS: All professional baseball players who sustained a hamstring or calf injury between 2011 and 2017 were identified using the Major League Baseball (MLB) Health and Injury Tracking System (HITS). A separate player usage dataset was used to determine workload. We then compared these variables between player games 2, 6, 12, and >12 weeks before a documented calf strain to player games from a noncalf injury control group. In a paired analysis, we compared the acute workload (2, 6, and 12 weeks) before injury with the injured player's workload >12 weeks before injury. RESULTS: There were 175 unique calf strains (71% occurred in position players) and 1042 unique hamstring strains (97.8% occurred in position players) documented in the MLB HITS database from 2011 to 2017. In all time periods, position players with fewer days rest, more innings fielded, and more plate appearances were associated with a higher risk of subsequent hamstring and calf strains. Having only 1 day rest was associated with a 2.08-fold increase in percentage of players who sustained a subsequent calf strain compared with those with 4 days rest. Position players with >5 days of rest had a 4.03-fold decrease in percentage of players who sustained a hamstring strain compared with players with 1 day rest. Position players who fielded >9 innings per game had a 2.01-fold increase in percentage of players with a subsequent calf strain and a 3.68-fold increase in percentage of players who sustained a subsequent hamstring strain compared with players who only fielded 1 innings per game. CONCLUSION: Position players with fewer days rest, more innings fielded, and more plate appearance per game had an increased risk of sustaining a hamstring or calf injury. CLINICAL RELEVANCE: Increased workload had a direct relationship with risk of hamstring and calf strains in professional baseball players. Teams should consider more days rest for position players to avoid calf injuries.

Injury-Inciting Activities in Male and Female Football Players: A Systematic Review.

BACKGROUND: A comprehensive examination of the sport-specific activities performed around the time of injury is important to hypothesise injury mechanisms, develop prevention strategies, improve management, and inform future investigations. The aim of this systematic review is to summarise the current literature describing the activities performed around the time of injury in football (soccer). METHODS: A systematic search was carried out in PubMed, Web of Science, SPORTDiscus, and OpenGrey. Studies were included if participants were football players aged > 13 years old and the activities performed at the time of injury were reported together with the total number of injuries. Risk of bias was assessed using an adapted version of checklists developed for prevalence studies. The activities reported by the studies were grouped to account for inconsistent reporting, and the proportion of each injury activity was calculated. Data were not meta-analysed due to high heterogeneity of methods and classification criteria. RESULTS: We included 64 studies reporting on 56,740 injuries in total. ACL injures were analysed by 12 studies, ankle/foot and knee injuries were analysed by five studies, thigh injuries were analysed by four studies, hip/groin injuries were analysed by three studies, and hamstring injuries were analysed by two studies. Five studies analysed more than one type of injury and 38 studies did not specify the type of injuries analysed. Running and kicking were the predominant activities leading to thigh and hamstring injuries. Changing direction and kicking were the predominant activities leading to hip and groin injuries and duels were the predominant activities leading to ankle injuries. Duels and pressing seem the predominant activities leading to ACL injuries, while results for other knee and general injuries were inconsistent. CONCLUSIONS: A qualitative summary of the activities performed at the time of injury has been reported. The results need to be interpreted carefully due to the risk of bias observed in the included studies. If we are to meaningfully progress our knowledge in this area, it is paramount that future research uses consistent methods to record and classify injuries and activities leading up to and performed at the time of injury. REGISTRATION: The protocol of this systematic review was registered at the Open Science Framework ( https://doi.org/10.17605/OSF.IO/U96KV ).

Lower Extremity Musculoskeletal Injuries After Concussion in Collegiate Student-Athletes.

BACKGROUND: An association has been identified between concussion and lower extremity musculoskeletal injury (LEMSKI) after return to sports participation. However, the collegiate student-athlete studies have relied on relatively small single-institution studies, which limits generalizability. PURPOSE: To assess odds of, and time to, LEMSKI after concussion in US collegiate athletes, using the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP). STUDY DESIGN: Descriptive epidemiology study. METHODS: Data from the NCAA ISP during the 2010-2011 through 2019-2020 athletic seasons were considered for analysis. Frequency distributions were examined for details related to the initial and subsequent injuries (injuries to bone, bursa, joint, ligament, muscle, or tendon). Multivariable logistic regression models and random-effects Poisson regression models examined odds of time loss (TL) and non-time loss (NTL) LEMSKI after concussion, as well as the time interval between initial concussion and subsequent LEMSKI in a single athletic season, or initial musculoskeletal injury (MSKI) and subsequent LEMSKI in a single athletic season. Analyses were performed separately for football and other sports. RESULTS: A total of 31,556 initial injuries were recorded (football: 11,900; other sports: 19,656), which were followed by 0 or 1 injury in the same season. Overall, first injury type was not a significant predictor of subsequent LEMSKI, although certain contrasts yielded significant estimates. In football, the odds of NTL LEMSKI were higher after concussion than after upper extremity MSKI (UEMSKI; adjusted odds ratio [ORAdj], 1.56; 95% CI, 1.06-2.31). In football, the odds of TL LEMSKI were lower after concussion than after UEMSKI (ORAdj, 0.71; 95% CI, 0.51-0.99). No other significant effect estimates were observed for football or other sports. CONCLUSION: First injury type, either concussion or upper extremity, was not associated with an elevated risk of LEMSKI. Specifically, the results of this study did not identify an elevated odds of LEMSKI after a concussion. However, the authors observed greater odds of NTL LEMSKI and lower odds of TL LEMSKI in football.

A multicomponent neuromuscular warm-up program reduces lower-extremity injuries in trained basketball players: a cluster randomized controlled trial.

OBJECTIVE: To assess the effects of a novel multicomponent neuromuscular warm-up program on lower-extremity injury incidence in basketball players competing at the regional level. METHODS: A cluster randomized controlled experimental design was adopted to compare injury incidence between players exposed to the injury prevention warm-up program and those exposed to a typical warm-up program across an entire basketball season. Four teams consisting of 57 players (male: n = 42; female: n = 15) were allocated to the intervention group (age: 21.6 ± 2.5 years; height: 186.2 ± 8.8 cm; body mass: 80.0 ± 10.4 kg) and four teams consisting of 55 players (male: n = 43; female: n = 12) were allocated to the control group (age: 21.6 ± 2.6 years; height: 186.9 ± 9.1 cm; body mass: 81.5 ± 10.9 kg). The novel warm-up combined running exercises with active stretching, plyometrics, balance, strength, and agility drills. Coaching and medical staff provided details on injury incidence each week. Data analyses included the use of poisson regression analyses and the incidence rate ratio (IRR) with 95% confidence intervals (CI). RESULTS: The intervention group experienced a significantly lower ankle sprain incidence rate (IRR = 0.26, 95% CI = 0.05, 0.98, p = 0.02) and a tendency toward a lower knee injury incidence rate (IRR = 0.32, 95% CI = 0.03, 1.78, p = 0.07) compared to the control group. Considering only non-contact lower-extremity injuries of any type, the intervention group experienced a significantly lower incidence rate compared to the control group (IRR = 0.26, 95% CI = 0.05, 0.98, p < 0.001). CONCLUSION: This multi-team study demonstrated a novel multicomponent warm-up program resulted in less lower-extremity injuries, particularly ankle sprains and knee injuries, compared to a typical warm-up program in regional-level male and female basketball players.

Incidence and Severity of Hamstring Injuries in Female Athletes Who Play Field Sports: A Systematic Review With Meta-Analysis of Prospective Studies.

OBJECTIVE: To determine the incidence and severity of hamstring injuries (HSIs) in female athletes who play field sports. DESIGN: Systematic review with meta-analysis of prospective epidemiology studies. LITERATURE SEARCH: We searched the PubMed, EMBASE, OVID Medline, and SPORTDiscus databases from inception to June 30, 2021. STUDY SELECTION CRITERIA: We included prospective epidemiology studies quantifying HSI in female field sport athletes. We excluded retrospective studies, intervention studies and studies that included male athletes only. DATA SYNTHESIS: Risk-of-bias assessments were conducted using a tool for assessing risk of bias in prospective epidemiology studies. The certainty of evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluations (GRADE). Data were pooled to report overall injury risk per 1000 exposure hours using a random-effects meta-analysis. RESULTS: We included 12 studies for quantitative synthesis. There were injury data available from 1070 female athletes with a mean age of 22.7 years. The predominant sport was soccer (50%). The risk of bias was low across the studies. Overall, there was moderate certainty evidence that injury incidence was 0.6 injuries per 1000 exposure hours (95% CI 0.4-0.8). Due to a lack of reporting, we could not estimate the severity of HSIs. CONCLUSION: There was moderate certainty evidence that the incidence of hamstring injuries was 0.6 injuries per 1000 exposure hours in female field sport athletes. Appropriate reporting from those working with female athletes is essential to support understanding and better implement effective injury prevention strategies for female athletes. J Orthop Sports Phys Ther 2022;52(11):740-749. Epub: 5 August 2022. doi:10.2519/jospt.2022.11144.

Costs and 30-day readmission after lower limb fractures from motorcycle crashes in Queensland, Australia: A linked data analysis.

BACKGROUND: Lower limb trauma is the most common injury sustained in motorcycle crashes. There are limited data describing this cohort in Australia and limited international data establishing costs due to lower limb trauma following motorcycle crashes. METHODS: This retrospective cohort study utilised administrative hospitalisation data from Queensland, Australia from 2011-2017. Eligible participants included those admitted with a principal diagnosis coded as lower extremity or pelvic fracture following a motorcycle crash (defined as the index admission). Multiply injured motorcyclists where the lower limb injury was not coded as the primary diagnosis (i.e. principal diagnosis was rather coded as head injury, internal organ injures etc.) were not included in the study. Hospitalisation data were also linked to clinical costing data. Logistic regression was used to determine risk factors for 30-day readmission. Costing data were compared between those readmitted and those who weren't, using bootstrapped t-tests and ANVOA. RESULTS: A total of 3342 patients met eligibility, with the most common lower limb fracture being tibia/fibula fractures (40.8%). 212 participants (6.3%) were readmitted within 30-days of discharge. The following were found to predict readmission: male sex (OR 1.84, 95% CI 1.01-1.94); chronic anaemia (OR 2.19, 95% CI 1.41-3.39); current/ex-smoker (OR 1.60, 95% CI 1.21-2.12); emergency admission (OR 2.77, 95% CI 1.35-5.70) and tibia/fibula fracture type (OR 1.46, 95% CI 1.10-1.94). The most common reasons for readmission were related to ongoing fracture care, infection or post-operative complications. The average hospitalisation cost for the index admission was AU$29,044 (95% CI $27,235-$30,853) with significant differences seen between fracture types. The total hospitalisation cost of readmissions was almost AU$2 million over the study period, with an average cost of $10,977 (95% CI $9,131- $13,059). CONCLUSIONS: Unplanned readmissions occur in 6.3% of lower limb fractures sustained in motorcycle crashes. Independent predictors of readmission within 30 days of discharge included male sex, chronic anaemia, smoking status, fracture type and emergency admission. Index admission and readmission hospitalisation costs are substantial and should prompt health services to invest in ways to reduce readmission.

Prognostic factors of muscle injury in elite football players: A media-based, retrospective 5-year analysis.

OBJECTIVES: Motor function has been demonstrated to be weakly predictive for the occurrence of muscle injury in team sports. This study examined the value of non-motor prognostic factors in elite football (soccer). DESIGN: Retrospective cohort study. SETTING: Analysis of a public data register (Transfermarkt.com). PARTICIPANTS: 1148 players of 38 German and English first-division football clubs. MAIN OUTCOME MEASURES: Binary logistic regression examining the association of prognostic factors (age, height, weight, BMI, playing position, market value, history of injury, number of played matches and minutes) and time-loss muscle injuries sustained during five consecutive seasons (2014/2015 to 2018/2019). RESULTS: A total of 1722 muscle injuries were observed in 619 players. History of general musculoskeletal injury (OR 5.3, 95% CI 3.8-7.5), playing position (OR 2.4-2.5), market value (OR 2.3, 95% CI 1.7-3.1), and history of muscle injury (OR 1.6, 95% CI 1.1-2.2) were associated with muscle injury. Sub-analyses revealed location-specific patterns. Playing position was not predictive for adductor injury and, except for one weak association (defender vs. goalkeeper: OR 1.05, 95%CI 0.42-2.62), the same applied to the calf. Contrary to other locations, thigh re-injury was not predicted by previous muscle injury. CONCLUSIONS: Non-motor factors display significant associations with injury risk in elite football players. Conditioning coaches may use this information to improve primary and secondary prevention, while scouting departments may benefit during recruitment.

Hamstring injuries in England and Wales elite men's domestic cricket from 2010 to 2019.

OBJECTIVES: Describe hamstring injury incidence across competition formats, activity at time of injury, and time of season, facilitating the identification of injury risk factors in elite men's senior First-Class County Cricket. DESIGN: Prospective cohort. METHODS: Hamstring time loss injury incidence (between format, activity, and time of season) calculated for elite men's senior First-Class County Cricket seasons 2010 to 2019. RESULTS: The diagnosis with the highest seasonal incidence was 'Biceps femoris strain grade 1-2' (2.5 injuries/100 players). Hamstring injury incidence was highest in One-Day cricket (mean 27.2 injuries/1000 team days). Running between wickets when batting was the activity associated with the highest incidence in the shorter competition formats (8.4 and 4.8 injuries/1000 team days for One-Day and T20, respectively). Bowling delivery stride or follow through was the activity with the highest incidence for longer multi-day Test format (mean 2.3 injuries/1000 team days), although similar incidence was observed across all formats for this activity. Most injuries were sustained at the start of the season (April; 22.7 injuries/1000 team days), with significantly fewer injuries at end of the season (September; 4.1 injuries/1000 team days). CONCLUSIONS: Similar bowling injury incidence across formats suggests hamstring injury risk is associated more with the activity itself, whereas injury risk when batting was susceptible to changes in match intensity. The notably higher (albeit non-significant) incidence in April may allude to a lack of preparedness to meet the physical demands of the start of the season. The findings have practical relevance for practitioners, identifying potential opportunities for preventative strategies.

Trampoline Injuries in a Statewide Trauma System.

INTRODUCTION: It is well known that trampolines can be a particular source of danger, especially in children. We sought to examine the profile of those patients with trampoline injuries. We hypothesized there would be certain injury patterns predicative of trampoline injuries. METHODS: All patients submitted to Pennsylvania Trauma Outcome Study database from 2016 to 2018 were analyzed. Trampoline injury was determined by ICD-10 activity code. Injury patterns in the form of abbreviated injury scale body regions were examined. Patient demographics and clinical variables were compared between those with trampoline injury vs those without. RESULTS: There were 107 patients with a trampoline injury. All of these patients were discharged alive and had a blunt mechanism of injury. The most common injury type was injury to the extremities (n=90,[84.1%]) with 54(50.5%) upper extremity injuries and 36(33.6%) lower extremity injuries. Ten (9.35%) patients had injury to the spine and five (4.67%) had head injury. Those with trampoline injuries were significantly younger (13y vs. 48.6y) and more likely to be white or of Hispanic ethnicity. Almost half of the patients injured (49.5%) were under 10 years. Patients with trampoline injuries had significantly lower Injury Severity Scores and significantly higher shock index. DISCUSSION: The majority of patients with trampoline injuries had injury to an extremity. These results help better understand the demographic, physiologic, and anatomic patterns surrounding trampoline injuries. Current government standards recommend that no child under age six should use a full-sized trampoline; however, based of this study, we advise that this age be increased to ten.

Lower extremity injuries in U.S. national fencing team members and U.S. fencing Olympians.

INTRODUCTION: Fencing is growing rapidly in popularity and competitiveness with fencers beginning at a younger age and competing in more tournaments. Even though fencing has a low risk of time-loss injury, fencers are inevitably going to experience injuries if proper athletic training and prevention does not occur. We aim to describe and compare the lower extremity injuries experienced by fencers that have trained at the highest level in the sport. We hypothesized that athletes who fenced longer would suffer more knee and hip injuries and report lower IKDC and HOS scores. METHODS: This is an epidemiology study distributed to members of the U.S. national team and Olympic team from 1980 to 2018. The electronic survey included questions regarding age, weapon, number of years fencing, number of national and Olympic teams, injuries on the dominant and nondominant hip and knee, time missed due to injury, and methods for treatment. The survey also included the International Knee Demographic Committee (IKDC) and Hip Outcome Score (HOS). RESULTS: There were 153 national team members between July 1980 and July 2018, 110 with contact information. A total of 77 athletes submitted the survey, consisting of 30 females and 47 males. Female fencers had more hip injuries and lower IKDC and HOS scores than their male counterparts. In total, there were 71 injuries to the dominant (front) knee and 28 injuries to the nondominant (back) knee. There were 32 dominant hip injuries and 5 nondominant hip injuries. Saber fencers reported the most dominant and nondominant hip and knee injuries. CONCLUSION: The intense, repetitive and asymmetrical movements involved in fencing affect the weight bearing leg and the nondominant leg in all weapons. Special attention should be paid to female fencers as they experience more hip and knee injuries resulting in impaired joint function.

Distance travelled by military recruits during basic training is a significant risk factor for lower limb overuse injury.

INTRODUCTION: Military initial training results in a high incidence of lower limb overuse injuries (stress fractures and medial tibial stress syndrome). This study aimed to determine whether the distance travelled by recruits, both on and off duty, was a risk factor for overuse injury. METHODS: 14 male airborne infantry recruits from three training platoons carried global positioning system receivers throughout the first 19 weeks of basic military training. Total distance travelled each day was recorded. This was compared with time of clinical manifestation of 52 lower limb overuse injuries (stress fractures and medial tibial stress syndrome) collected from the 276 airborne infantry recruits in the period immediately preceding the study. RESULTS: Recruits travelled significantly farther than the UK average male population in 17 of 18 measured weeks. Pearson correlation between distance travelled per week and injuries was not significant (p=0.4448); however, correlation between distance travelled per week and injuries two weeks later was significant (p=0.0263). A generalised linear model found distance travelled as a significant covariate (p=0.0144) to the expected number of injuries two weeks later. CONCLUSION: Recruits travel long distances during basic training, particularly in the first few weeks when they are not yet conditioned. This distance travelled is likely a contributing risk factor to the high incidence of overuse injuries seen during training, and strategies to reduce this distance should be explored.

Hamstring Injury Prevention for Elite Soccer Players: A Real-World Prevention Program Showing the Effect of Players' Compliance on the Outcome.

ABSTRACT: Chebbi, S, Chamari, K, Van Dyk, N, Gabbett, T, and Tabben, M. Hamstring injury prevention for elite soccer players: A real-world prevention program showing the effect of players' compliance on the outcome. J Strength Cond Res 36(5): 1383-1388, 2022-The aim of this study was to determine the effect of implementing the Nordic hamstring exercise (NHE) to prevent hamstring injuries in soccer. A professional team was followed by the same medical team during 5 successive seasons (2012/2013 through 2016/2017). During the first and last seasons (2012/2013 and 2016/2017), no hamstring preventive action was implemented. For the seasons 2013/2014, 2014/2015, and 2015/2016, a noncompulsory (few players refusing to participate) NHE prevention program was implemented with accurate recording of the players' training and match exposure and attendance to the prevention sessions. The first 10 weeks of the season were used to progressively increase the volume and intensity of the NHE exercises, and at the end of the season, players were split in low-, moderate-, and high-attendance groups to the prevention sessions. Overall, 35 time-loss hamstring strain injuries were accounted for. The injury incidence was 0.30 per player per season, and the injury rate was 0.95 injury/1000 hour of exposure. A nonstatistically significant higher risk of hamstring injury was observed in the control, low, and moderate attendance groups compared with the high-attendance group. The greatest risk of hamstring injury was observed in the low-attendance group (odds ratio 1.77, confidence interval 0.57-5.47, p = 0.32). Implementing a NHE prevention program has a positive effect on the injury rate in a soccer team; however, the compliance of players with such interventions may be critical for its success.