Are all hamstring injuries equal? A retrospective analysis of time to return to full training following BAMIC type 'c' and T-junction injuries in professional men's rugby union.

We aimed to determine whether the anatomical location (intramuscular tendon or T-Junction) of hamstring muscle injuries in professional men's rugby union associates with a prolonged time to return to full training and a higher rate of re-injury/subsequent injury. We reviewed the medical records of an Irish professional rugby union club to identify hamstring muscle injuries incurred across five seasons. Clinicians and players were not blinded to MRI results at the time of rehabilitation. A blinded musculoskeletal radiologist re-classified all included injuries (n = 91) according to the British Athletics Muscle Injury Classification framework. Players who sustained an injury with intramuscular tendon involvement required a longer time to return to full training compared to players who sustained an injury without intramuscular tendon involvement (78 days vs. 24 days). Players who sustained a biceps femoris injury with T-junction involvement did not require a longer time to return to full training compared to players who sustained a biceps femoris injury without T-junction involvement (29 days vs. 27 days). Injuries with either intramuscular tendon or T-junction involvement were not associated with an increased rate of re-injury/subsequent injury to the same limb (intramuscular tendon involvement - odds ratio = 0.96, T-junction involvement - odds ratio = 1.03). When a hamstring muscle injury involves the intramuscular tendon, the injured player and stakeholders should be made aware that a longer time to return to full training is likely required. T-junction involvement does not alter the expected clinical course of biceps femoris injuries.

Groin injuries in women's premier league football in Norway: A two-season prospective cohort study describing clinical and imaging characteristics.

OBJECTIVE: To describe the prevalence, incidence, and burden of groin injuries in the Norwegian women's premier football league and to describe their clinical and imaging characteristics. METHODS: During the 2020 and 2021 seasons, players in the Norwegian women's premier league reported groin injuries weekly, using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems (OSTRC-H2). We calculated weekly prevalence, incidence, and burden of groin injuries. The team physical therapists classified the player-reported injuries based on the Doha classification system. Injuries with more than 3 days' time loss or reported in 2 consecutive weeks were eligible for magnetic resonance imaging (MRI). RESULTS: On average, 3.9% (95% CI: 3.4-4.4) of players reported a groin injury at any time; of which 78% caused time loss. The incidence rate was 1.6 injuries/1000 h (95% CI: 1.3-2.0) and their burden was 11 days lost/1000 h. The physical therapists examined 67 of 124 player-reported groin injuries (53%). Adductor-related injury was most common (55%) followed by iliopsoas (15%) and rectus femoris-related (12%). Pubic-related injuries caused most time loss (median: 24 days, IQR: 5-133). In this study, 42 injuries were investigated with MRI; 8 (19%) showed no changes, 6 (14%) an acute musculotendinous lesion, and 32 (76%) a nonacute finding (e.g., central symphyseal disc protrusion, tendinopathies). CONCLUSION: The incidence rate and burden of groin injuries were high. Adductor-related injuries were most common, but pubic-related injuries caused most time loss. Most MRI examinations demonstrated nonacute findings.

Surgical treatment of distal hamstring tendon injuries yield a higher return-to-sports rate: A systematic review.

PURPOSE: The purpose of this study is to compare the patient-reported outcomes and return to sports of the conservative and surgical treatment of distal hamstring tendon injuries. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, two reviewers searched PubMed, Scopus and Virtual Health Library databases in January 2023. Clinical studies evaluating conservative or surgical management outcomes of distal hamstring tendon injuries were considered eligible for this systematic review if predefined criteria were fulfilled: (1) published in English or Spanish; (2) evaluated any of the following: patient-reported outcomes, return-to-sports rate (RTS-R) or return-to-sports time (RTS-T). Data were presented in tables using absolute values from individual studies and derived pooled percentages. RESULTS: Eighteen studies were included for 67 patients and 68 distal hamstring tendon injuries. Initially, 39 patients (58.2%) underwent surgical treatment, whereas 28 (41.8%) were treated conservatively. Among conservative treatment patients, 15 failed and had to be operated on (53.6%), all with distal semitendinosus tendon injuries. Anchor fixation was the technique of choice in 20 lesions (36.4%), tenodesis in 16 (29.1%), tenectomy in 14 (25.5%) and sutures were preferred in five (9%). Thirteen out of 28 patients (46.4%) undergoing initial conservative treatment returned to sports at a mean of 3.6 months (range 1 week to 12 months), in contrast to surgical treatment, in which 36 out of 39 patients (92.3%) returned at a mean of 4.2 months (range 6 weeks to 12 months). Additionally, 14 of 15 patients (93.3%) converted to surgical treatment after failed conservative treatment returned to sports at a mean of 7.6 months after injury. CONCLUSION: Initial surgical treatment of distal hamstring tendon injuries yields a high RTS-R (92.3%) at a mean of 4.2 months. Furthermore, 15 out of 28 patients (53.6%) initially treated conservatively had to be operated on, delaying the RTS-T (mean 7.6 months after injury) without affecting their RTS-R. LEVEL OF EVIDENCE: IV.

Acute Hand Injury in Surfing: A Case Report.

Hand injuries from surfing tend to be severe and require medical attention. Follow-up of a surfing injury is difficult because many patients are visiting and go home after treatment. We report a case of a surfing hand injury sustained abroad, which was treated upon the patient's return, allowing for follow-up. The mechanism of injury was traction and torsion from the surfboard leash while surfing. The patient was initially treated for nailbed injury but presented later back home after persistent pain, for which an unstable distal phalanx fracture in their right ring finger was found by x-ray. This was surgically reduced with K-wire insertion and nailbed repair. Postoperatively, the injured finger was kept in a splint, and the patient had physiotherapy. Pain was significantly reduced, and the patient regained sufficient function. Considering a fracture as a differential for finger injury caused by the surfboard leash may prevent management delays. Injury may be prevented through education and redesign of the surfboard leash.

EVALUATION OF THE HEALING STATUS OF LATERAL ANKLE LIGAMENTS SIX WEEKS AFTER AN ACUTE ANKLE SPRAIN.

We aimed to investigate whether there is clinical and MRI evidence of healing of lateral ligaments 6 weeks after acute lateral ankle sprain (LAS). We prospectively enrolled 18 participants (age 32.7 ± 7.5 years) who sustained an acute LAS and underwent conservative treatment. An ankle MRI was acquired up to 48 hours and 6 weeks following the LAS. A partial tear of the anterior talofibular ligament (ATFL) was observed in 10/18 and a complete tear in 8/18 of the patients. The calcaneofibular ligament (CFL) was partially torn in 11/18 and completely torn in 1/18 of the patients. The healing status, intensity, and thickness of the ligaments, Anterior Drawer Test (ADT), and FAOS scale were assessed. A control group (CG) was composed by 17 participants (age 40 ± 13.9 years). Six weeks after the LAS, 89% of the participants presented MRI evidence of ATFL healing. The repaired ATFL was thicker in comparison with the CG (p<0.001). The cut-off of 2.5 mm for ATFL thickness in the 6th week maximized sensitivity (62.5%) and specificity (100%). CFL and PTFL presented 94% and 100% of healing signs, respectively. In the 6th week, 11/18 (61%) participants showed mild residual instability and a mean FAOS of 80 ± 11. The MRI revealed signs of the repair process in 89% of ATFL and 94% of CFL tears, 6 weeks after a moderate or severe LAS. The MRI findings were concomitant with enhancements in mechanical ankle stability and function. Level of Clinical Evidence: III (Case-control observational study).

Gender Differences in Achilles Tendon Ruptures-A Retrospective Study and a Review of the Literature.

Achilles tendon ruptures are common injuries typically sustained during sport with higher incidence in men, though little is understood regarding sex-specific risk factors or outcomes following injury management. This cross-sectional clinical study and systematic review aimed to examine sex-specific Achilles tendon rupture incidence and outcomes following intervention. This study included patients who sustained a rupture between 2011-2021, were ≥18 years old, and who had a minimum follow-up of at least six months, and evaluated age, sex, sport involvement, mechanism of injury, and postoperative complications and revision. Separately, a systematic literature review in the PubMed, EMBASE, and Cochrane databases was performed. A total of 705 male and 158 female patients were included in this retrospective study. 71.1% of men and 52.5% of women sustained a sports-related rupture (p < .001), with sport involvement demonstrating a positive correlation with revision rate (coefficient = 0.09, p = .02). A total of 21 studies with 250,907 patients (87,514 male, 35,792 female) were included in the systematic review. All studies revealed an increased incidence of ATR in men. Functional outcomes were worse in women, and female sex was an independent risk factor for postoperative complications and need for revision surgery. This study demonstrated a higher incidence of sports-related ATR in men than women, likely related to their higher ball sport participation. Although the retrospective analysis did not find a significant difference in complication or revision rates, the systematic review demonstrates poorer functional outcomes, with increased likelihood for postoperative complication and revision surgery in women as compared to men.

An in-depth analysis of wound incidence and injury status among professional athletes: A comprehensive review.

This review aims to synthesize current knowledge on the incidence, characteristics and management of wounds and injuries among professional ice hockey athletes, with the specific focus on the emerging population of Chinese female players. An extensive literature search was conducted across several databases to gather data on injury patterns and wounds, causes, severity and prevention strategies in ice hockey. Special attention was given to studies involving female athletes and unique challenges faced by players in developing regions like China. The review also examined the impact of training modalities, protective equipment and medical interventions on injury rates. The findings reveal a significant seasonal fluctuation in wound incidence, with marked reduction following the preseason period. This trend underscores the effectiveness of adjusted training programmes and essential role of medical teams in injury prevention and rehabilitation. Analysis did not show significant difference in wound rates between technical and physical training sessions, suggesting that injuries are pervasive risk across all training activities. Skating, collisions and inadequate warm-ups were identified as the leading causes of wounds, highlighting areas for targeted preventive measures. The distribution of wounds across various body regions pointed to knee, lower back and wrist as the most vulnerable sites, necessitating focused protection and training adjustments. Ice hockey, particularly among female athletes in China, presents complex injury landscape characterized by the wide range of wounds. The study emphasizes the necessity of comprehensive, multidisciplinary approach to injury prevention that includes training modifications, enhanced protective gear and strategic medical oversight. By addressing the specific causes and patterns of injuries identified, stakeholders can better protect athletes from the inherent risks of the sport, promote safer play and extend career longevity.

Clotting factor activity levels and bleeding risk in people with haemophilia playing sports.

BACKGROUND: Improved treatment options for people with haemophilia (PWH) have increased the possibilities for sports participation, but the risk of sports-induced bleeding (SIB) is still considered considerable by many. AIM: To assess sports associated injury- and bleeding risk in PWH and to assess clotting levels associated with safe sports participation. METHODS: Sports injuries and SIBs were prospectively collected for 12 months in PWH aged 6-49 without inhibitors playing sports at least once weekly. Injuries were compared according to factor levels, severity, joint health, sports risk category and sports intensity. Factor activity at the time of injury was estimated using a pharmacokinetic model. RESULTS: 125 participants aged 6-49 (41 children, 90% haemophilia A; 48% severe, 95% severe on prophylaxis) were included. Sports injuries were reported by 51 participants (41%). Most participants (62%) reported no bleeds at all and only 16% reported SIBs. SIBs were associated with factor levels at time of injury (OR: 0.93/%factor level (CI 0.88-0.99); p = .02), but not with haemophilia severity (OR: 0.62 (CI 0.20-1.89); p = .40), joint health, sports risk category or sports intensity. PWH with factor levels <10% during sports injury had a bleeding risk of 41% versus 20% in those with higher (>10%) factor levels. CONCLUSION: The results of this study emphasize the importance of clotting factor levels in prevention of bleeds. This information is vital for patient counselling and tailoring prophylactic treatment with clotting factors and non-replacement therapy.

MRI-based automated multitask deep learning system to evaluate supraspinatus tendon injuries.

OBJECTIVE: To establish an automated, multitask, MRI-based deep learning system for the detailed evaluation of supraspinatus tendon (SST) injuries. METHODS: According to arthroscopy findings, 3087 patients were divided into normal, degenerative, and tear groups (groups 0-2). Group 2 was further divided into bursal-side, articular-side, intratendinous, and full-thickness tear groups (groups 2.1-2.4), and external validation was performed with 573 patients. Visual geometry group network 16 (VGG16) was used for preliminary image screening. Then, the rotator cuff multitask learning (RC-MTL) model performed multitask classification (classifiers 1-4). A multistage decision model produced the final output. Model performance was evaluated by receiver operating characteristic (ROC) curve analysis and calculation of related parameters. McNemar's test was used to compare the differences in the diagnostic effects between radiologists and the model. The intraclass correlation coefficient (ICC) was used to assess the radiologists' reliability. p < 0.05 indicated statistical significance. RESULTS: In the in-group dataset, the area under the ROC curve (AUC) of VGG16 was 0.92, and the average AUCs of RC-MTL classifiers 1-4 were 0.99, 0.98, 0.97, and 0.97, respectively. The average AUC of the automated multitask deep learning system for groups 0-2.4 was 0.98 and 0.97 in the in-group and out-group datasets, respectively. The ICCs of the radiologists were 0.97-0.99. The automated multitask deep learning system outperformed the radiologists in classifying groups 0-2.4 in both the in-group and out-group datasets (p < 0.001). CONCLUSION: The MRI-based automated multitask deep learning system performed well in diagnosing SST injuries and is comparable to experienced radiologists. CLINICAL RELEVANCE STATEMENT: Our study established an automated multitask deep learning system to evaluate supraspinatus tendon (SST) injuries and further determine the location of SST tears. The model can potentially improve radiologists' diagnostic efficiency, reduce diagnostic variability, and accurately assess SST injuries. KEY POINTS: • A detailed classification of supraspinatus tendon tears can help clinical decision-making. • Deep learning enables the detailed classification of supraspinatus tendon injuries. • The proposed automated multitask deep learning system is comparable to radiologists.

CNN sensor based motion capture system application in basketball training and injury prevention.

Basketball is a high-intensity sport, and sports injuries often occur. Therefore, how to monitor the sports status of basketball players in real time, discover and prevent the occurrence of sports injuries in time, has become an urgent problem for athletes and coaches. In this paper, a motion capture system based on CNN sensor is proposed. Through the application of sensor, real-time monitoring of athletes' motion state, the system can collect athletes' movement track, speed, acceleration, stride frequency, heart rate, energy consumption and other parameters in real time. By analyzing the movement data, it can timely warn and deal with the occurrence of sports injuries. In this paper, convolutional neural network (CNN) is used to process and analyze motion data, so that the motion capture system has higher precision and accuracy. Through the training and optimization of CNN, the system can identify and analyze motion data more accurately, and improve the performance and effect of the motion capture system. The motion capture system based on CNN sensor can realize real-time monitoring and prevention of sports injuries for basketball players, provide more comprehensive, scientific and real-time sports data for athletes and coaches, help them better conduct training and adjust tactics, and improve the competitive level and safety of basketball games.

MRI findings of closed hand injuries in adolescent goalkeepers: a case-based review.

Soccer-related injuries in youth goalkeepers are underrepresented in epidemiological studies, despite goalkeepers experiencing distinct types of upper limb injuries and training loads compared to outfield players. Digit injuries are particularly prevalent, with up to five times more upper extremity injuries reported in this position. Such injuries can lead to interphalangeal joint instability and an increased risk of reinjury. Mechanisms of injury include falls, axial loading of digits, and rotational force due to grasping activities. The proximal interphalangeal joint is the most frequently injured in sports, followed by the metacarpophalangeal joint of the thumb. Achieving precise diagnosis can be challenging due to the complex soft-tissue anatomy of the hand. Radiologists play a crucial role in accurate diagnosis through imaging studies, enabling timely treatment. This article focuses on closed traumatic finger and thumb injuries in adolescent goalkeepers, describing injury mechanisms and outlining relevant MRI features to facilitate proper clinical approaches for diagnosis based on imaging findings.

Imaging-detected sports injuries and imaging-guided interventions in athletes during the 2022 FIFA football (soccer) World Cup.

OBJECTIVE: To describe imaging-detected musculoskeletal injuries and image-guided interventional procedures during the 2022 FIFA football (soccer) World Cup. MATERIALS AND METHODS: Retrospective analysis of all radiologic examinations performed in a central medical facility for athletes was performed by two board certified musculoskeletal radiologists. Data on muscle, tendon, ligament, cartilage, and bone injuries were collected according to imaging modality and body part. RESULTS: A total of 143 radiology examinations in 94 athletes were evaluated at the central medical facility. Magnetic resonance imaging (MRI) was the most utilized modality (67%), followed by radiography (12%), ultrasonography (9%), and computed tomography (4%). Image-guided interventions corresponded to 8% of all radiological examinations. There were 112 injuries described, affecting muscles and tendons (42%), ligaments (25%), cartilage (21%), and bone (12%). Most injured body parts were thigh (27%), foot and ankle (23%), knee (23%), and hip/groin (8%). Most injured players were within the age range of 24-35 years old (71%). CONCLUSION: Imaging was utilized in 11% of players who participated in the 2022 FIFA World Cup in Qatar. MRI was the most utilized modality, and acute muscle tears were the most diagnosed type of injury. Diagnostic imaging played an important role in diagnosing sports-related injuries during the 2022 FIFA World Cup.

Imaging of muscle injuries in soccer.

Accurate diagnosis of muscle injuries is a challenge in everyday clinical practice and may have profound impact on the recovery and return-to-play decisions of professional athletes particularly in soccer. Imaging techniques such as ultrasound and magnetic resonance imaging (MRI), in addition to the medical history and clinical examination, make a significant contribution to the timely structural assessment of muscle injuries. The severity of a muscle injury determined by imaging findings has a decisive influence on therapy planning and affects prognosis. Imaging is of high importance when the diagnosis or grade of injury is unclear, when recovery is taking longer than expected, and when interventional or surgical management may be needed. This narrative review will discuss ultrasound and MRI for the assessment of sports-related muscle injuries in the context of soccer, including advanced imaging techniques, with the focus on the clinical relevance of imaging findings for the prediction of return to play.

Epidemiology of Hand and Wrist Injuries in Collegiate-Level Athletes in the United States.

PURPOSE: Hand and wrist injuries are common among competitive athletes and can have a substantial impact on playing time and future participation. The purpose of this study was to provide epidemiological data from the National Collegiate Athletic Association Injury Surveillance Program to correlate injury diagnosis with the need for surgery and time loss. METHODS: Using the National Collegiate Athletic Association Injury Surveillance Program, this retrospective study extracted data of hand and wrist injuries for all 25 National Collegiate Athletic Association sports from the academic years 2004-2005 to 2013-2014. The "severe" category was defined as injuries resulting in the following: (1) surgery, (2) season-ending status, or (3) more than 30 days of playing time loss. The epidemiologic data included injury rate per 100,000 athlete exposures (defined as 1 athlete participating in 1 practice or competition) based on diagnoses and demographic information such as sports and sex. We used a Poisson regression model to estimate the incidence rate and 95% confidence interval. RESULTS: Overall, 4,851 hand injuries were identified, with an injury rate of 41.2 per 100,000 athlete exposures. The most common diagnoses were metacarpal or phalangeal fractures (19.9%), lacerations or contusions (15.4%), and wrist sprains (14.7%). The surgical rate was 9.6%, and the season-ending rate was 5.8%. Severe injuries occurred in 17.5% of the hand and wrist injuries; within this subset, the most common diagnoses included metacarpal or phalangeal fractures (43.8%), scaphoid fractures (12.8%), and thumb ulnar collateral ligament tears (8.7%). Scaphoid fractures and metacarpal or phalangeal fractures had the highest surgical rate and season-ending rate among all the injuries. CONCLUSIONS: The injury rate of hand and wrist injuries is comparable with those of other common sports injuries. Approximately one fifth of the injuries were considered severe, which led to a high surgical rate, and these had a considerable impact on the athletes' ability to finish the season. TYPE OF STUDY/LEVEL OF EVIDENCE: Outcome research level II.

Use of mouthguards in Latin American field hockey athletes during the ODESUR 2022 Games.

BACKGROUND/AIMS: Athletes are susceptible to oral injuries. To reduce the incidence and severity of oral trauma, a custom-made mouthguard, a device positioned in the mouth to prevent damage to teeth and surrounding structures, is recommended. In field hockey, according to the international rules of this sport, using mouthguards is not mandatory, but it is recommended to wear them at all times while practicing this discipline. We aimed to determine characteristics and differences regarding mouthguard usage among field hockey players from different countries participating in the XII ODESUR Games. METHODS: We conducted a cross-sectional study that included 78 voluntary hockey athletes that met the inclusion criteria. The questionnaire used was validated by Panam Sports, collecting information on the type of mouthguard (custom-made or prefabricated), and the time of use of the mouthguard (range of 5 years). RESULTS: Of the total number of athletes, 96% used mouthguards, of which 64% were custom-made type, and 32% were prefabricated (p < .001). Custom-made mouthguards were used by 100%, 89%, and 64% of athletes in Argentina, Chile, and Peru, respectively, while only 40% of athletes in Paraguay and Uruguay used them. It has also been observed that more than 50% of the individuals have not controlled and replaced their intraoral devices for more than 10 years. CONCLUSIONS: Our results reveal a problem with a public health dimension and thus invite the standardization of guidelines with an educational approach to promoting and adopting good sports practices. This report is the first on using mouthguards in high-performance athletes during an international multisport event.

Ossification of the posterior capitellum: description of a new pathology and its radiological appearance.

BACKGROUND: Boxer elbow and handball goalkeeper elbow are causes of impingement characterized by osteophytes formation at the olecranon and coronoid tip as well as their corresponding fossae. Herein, we present another distinct pathology in these patients: the formation of an exostosis at the posterolateral aspect of the elbow. METHODS: Between April 2016 and May 2020, 12 athletes with boxer elbow and handball goalkeeper elbow (mean age of 22 years) suffering from elbow pain were enrolled in the present study. Plain radiography, magnetic resonance imaging (MRI), and computer tomography (CT) scans were used to evaluate the bone conformation of the posterolateral aspect of the elbow. Assessment and staging of the ossification was performed by two independent fellowship-trained elbow surgeons. RESULTS: Bone marrow edema of the posterior aspect of the elbow at the origin of the anconeus muscle was initially detected in MRI scans. With the progression of the condition, imaging revealed an ossification posterior to the capitellum with bony bridges. In the advanced stage of the disease, the exostoses was unstable as the ossification had no adherence to the posterior capitellum during surgical excision. Plain radiographs are limited in their ability to detect the condition, whereas MRI and CT scans allow to identify a signal enhancement at the posterolateral aspect of the elbow. CONCLUSION: In patients without history of elbow trauma, bony irregularities of the posterior aspect of the capitellum may indicate ossification of the posterolateral aspect of the elbow, most likely caused by repetitive hyperextensions.

Functional and Sport-Specific Outcome Following Traumatic First-Time Shoulder Dislocation and Arthroscopic Surgical Repair in Rock Climbers.

INTRODUCTION: Traumatic shoulder dislocations rank among the most common shoulder injuries in climbers, with rising numbers over the last years. The objective of this study was to analyze the outcome following traumatic first-time shoulder dislocation and subsequent surgical treatment in this population. METHODS: In a retrospective study, climbers who experienced a traumatic shoulder dislocation were treated with an arthroscopic repair of the labrum-ligament complex (LLC). The functional outcome was assessed with a standardized questionnaire and clinical examination, including the Constant Murley and Single Assessment Numeric Evaluation scores. The sport-specific outcome was analyzed using the Union Internationale des Associations d'Alpinisme (UIAA) scale of difficulty and a sport-specific outcome score. RESULTS: The functional and sport-specific outcome for 27 climbers (20 men; 7 women; 3 with bilateral injuries; age, 34±11 [17-61] y; data presented as mean±SD [range]) was assessed 53±29 (12-103) mo after surgery. The postoperative Constant Murley score was 95±8 (67-100) points. At follow-up, 93% (n=25) of patients had started climbing again. Twenty-one climbers (78%) reached a climbing level within the range of ±0.33 UIAA grades of their initial capability or even exceeded their preinjury grade. Only 7% (n=2) of the patients had a recurrent shoulder dislocation, leading to a secondary surgery, and, therefore, required ongoing postoperative treatment at the time of follow-up. CONCLUSIONS: Arthroscopic repair of the LLC following first-time traumatic shoulder dislocation in climbers shows a good outcome and a low recurrence rate. After surgery, most patients are able to regain a high level of rock-climbing ability.

MAINTAINING COMPETITIVE ACTIVITY IN ELITE SPORTS WITH ACUTE PLANTAR FASCIITIS.

Competition in the modern pentathlon in the new 2024 Olympic program are tense and high intensity. Before reaching the final the athlete must go through 8 types of events in 4 days performs before 5 events in final competitions. It's quit difficult to restore the function of damaged link of the musculoskeletal system during competition in a short time. The time of breaks for rest and recovery in the competitive activity of an all-around athlete in the modern pentathlon is limited. The presented rehabilitation program after an acute injury was implemented at modern pentathlon competitions. A distinctive feature of the effects is the practice of rehabilitation and recovery after physical exertion. The peculiarity was in short periods of rest during intense multi-day competitive activity. There was a clear organization in the procedures, a strict sequence of methods and techniques. The presented material rather as an exception confirms the possibilities of the applied systemic rehabilitation techniques. This made it possible to continue competitive activity in modern pentathlon after an acute injury without compromising the athlete's health.

Players with high physical fitness are at greater risk of injury in youth football.

The aim of this study was to investigate physical fitness, football-specific skills, and their association with injury risk in youth football. Altogether 447 male and female players aged 9-14 years (median 12 years) participated in performance tests and prospective follow-up. The physical fitness tests included five-jump test for distance, 30-m sprint, football-specific figure of eight agility, countermovement jump, and Yo-Yo intermittent endurance test level 1. The football-specific skill tests included dribbling and passing tests. Injuries and exposure were registered during the 20-week follow-up. Our candidate risk factors were low/high level of physical fitness measured with a composite score of physical fitness tests and low/high level of football-specific skills measured with a composite score of dribbling and passing tests. Secondarily, we investigated performance in individual tests and their association with injury risk. During the follow-up, players reported 565 injuries (264 acute and 301 overuse injuries). High level of physical fitness was associated with increased rate of all injuries (age-, sex-, and mean team exposure-adjusted IRR: 1.28, 95% CI: 1.04-1.58). The level of football-specific skills had no influence on the overall injury rate. Burden of overuse injuries, but not acute injuries was significantly higher in most fit players compared with the players in the reference group (IRR: 2.09, 95% CI: 1.04-4.24). In conclusion, most fit players were at greater risk of sustaining injuries in youth competitive football.

Soccer players show the highest seasonal groin pain prevalence and the longest time loss from sport among 500 athletes from major team sports.

PURPOSE: Groin pain is a widely recognized medical issue among athletes. Groin pain can affect both player and team performance and sometimes can be a career-ending injury. The aim of this study was to assess seasonal groin pain prevalence and the average seasonal time loss from sport for each injury in different team sport athletes. The hip and groin functionality at the beginning of the following season was also investigated. METHODS: A cross-sectional study was undertaken on 600 team sport athletes (soccer, futsal, basketball, volleyball, and water polo players). The seasonal prevalence of groin pain, level of competition (professional and non-professional), time loss, and concomitant injuries in addition to groin pain were reported and analyzed. The Copenhagen Hip and Groin Outcome Score (HAGOS) was used to assess hip and groin pain and function related to sport and activity. RESULTS: Among the 506 (84%) players included, 123 players (24.3%) reported groin pain. Overall, soccer players reported the highest groin pain prevalence (32.5%) followed by futsal (25.5%), basketball (25.2%), water polo (17.6%) and volleyball players (13.6%). Professional soccer, futsal and basketball athletes showed higher groin pain prevalence in comparison with non-professional athletes (p = 0.02, p = 0.005 and p = 0.004, respectively). The mean time loss from sport due to groin pain was 60.3 ± 66 days in soccer, 41.1 ± 16.6 days in futsal, 31.5 ± 18 days in water polo, 37.2 ± 14.2 days in basketball and 50.8 ± 24.6 days in volleyball. Significantly lower HAGOS values were found in athletes with groin pain for all sports evaluated compared to athletes with no groin pain history (p = 0.0001). Longer time loss from sport was correlated with lower HAGOS values in soccer (p = 0.002) and futsal (p = 0.002) players with groin pain. Concomitant injuries were correlated with lower HAGOS values in water polo players (p = 0.03). CONCLUSIONS: Seasonal groin pain occurs in as many as one in four team sport athletes. Soccer players show the highest groin pain prevalence and the longest time loss from sport. Professional athletes report higher prevalence of groin pain in comparison with non-professional athletes. HAGOS appears to be a valid outcome instrument to measure groin pain, correlating with both time loss from sport and concomitant injuries in athletes. LEVEL OF EVIDENCE: Level IV.