Judgment and Approach for Management of Severe Lower Extremity Injuries

1991 ◽  
Vol 18 (3) ◽  
pp. 525-543 ◽  
Author(s):  
Robert L. Walton ◽  
Douglas M. Rothkopf
2021 ◽  
Vol 9 (5) ◽  
pp. 232596712110034
Author(s):  
Toufic R. Jildeh ◽  
Fabien Meta ◽  
Jacob Young ◽  
Brendan Page ◽  
Kelechi R. Okoroha

Background: Impaired neuromuscular function after concussion has recently been linked to increased risk of lower extremity injuries in athletes. Purpose: To determine if National Football League (NFL) athletes have an increased risk of sustaining an acute, noncontact lower extremity injury in the 90-day period after return to play (RTP) and whether on-field performance differs pre- and postconcussion. Study Design: Cohort study, Level of evidence, 3. Methods: NFL concussions in offensive players from the 2012-2013 to the 2016-2017 seasons were studied. Age, position, injury location/type, RTP, and athlete factors were noted. A 90-day RTP postconcussive period was analyzed for lower extremity injuries. Concussion and injury data were obtained from publicly available sources. Nonconcussed, offensive skill position NFL athletes from the same period were used as a control cohort, with the 2014 season as the reference season. Power rating performance metrics were calculated for ±1, ±2, and ±3 seasons pre- and postconcussion. Conditional logistic regression was used to determine associations between concussion and lower extremity injury as well as the relationship of concussions to on-field performance. Results: In total, 116 concussions were recorded in 108 NFL athletes during the study period. There was no statistically significant difference in the incidence of an acute, noncontact lower extremity injury between concussed and control athletes (8.5% vs 12.8%; P = .143), which correlates with an odds ratio of 0.573 (95% CI, 0.270-1.217). Days (66.4 ± 81.9 days vs 45.1 ± 69.2 days; P = .423) and games missed (3.67 ± 3.0 vs 2.9 ± 2.7 games; P = .470) were similar in concussed athletes and control athletes after a lower extremity injury. No significant changes in power ratings were noted in concussed athletes in the acute period (±1 season to injury) when comparing pre- and postconcussion. Conclusion: Concussed, NFL offensive athletes did not demonstrate increased odds of acute, noncontact, lower extremity injury in a 90-day RTP period when compared with nonconcussed controls. Immediate on-field performance of skill position players did not appear to be affected by concussion.


2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0014
Author(s):  
Danielle A Farzanegan ◽  
Emily Francione ◽  
Nicole Melfi

Background: Artistic competitive gymnastics results in a wide, unique spectrum of injuries. Due to the high number of injuries and the current lack of research related to pre-competitive testing in adolescent gymnasts, it is crucial to find a method to predict the likelihood of an athlete sustaining an in-season injury. Purpose: The purpose of this study was to 1) describe the frequency and type of pre-season and in-season injuries, 2) determine if there were differences in physical performance tests between those who had a lower extremity (LE) injury in-season and those who did not, and 3) determine if there were differences in age, level, sex, BMI, sport modifications, previous injury, and current injury between those who had a LE injury and those who didn’t. Methods: Thirty-seven adolescent gymnasts (average age: 12.81 years) were included with levels ranging from 5 (novice) to 10 (elite). Participants (15 males and 22 females) were surveyed for previous and current injury. The athletes completed a performance battery before the competition season including: Lower Quarter Y-Balance Test (LQYBT), Closed Kinetic Chain dorsiflexion (CKCDF), single hop (SH), triple hop (TH), and the Functional Movement Screen (FMS). Follow-up data was collected at the end of the competitive season for comparison. The data was analyzed using descriptive methods and comparative analyses including chi-square and independent t-tests with an alpha level set at .05. Results: Sixty-five percent reported an injury in the last year and seventy-eight percent reported pre-season injuries at testing day. The most common location for pre-season injury was the ankle/foot (24% and 31% respectively). There were no differences between injured and non-injured athletes when comparing asymmetries in CKCDF, LQYBT posteromedial or posterolateral reach, hop testing, or FMS. The LQYBT-anterior scores were significantly different at p=.049 between the injured versus uninjured groups, with 91% of the in-season injury group having a difference <4cm. Similarly, the LQYBT-composite score using a cut-off of 95% was significant at p=.043 with those >95% category being more likely to get injured. There were no significant differences in demographic information comparing injury occurrence. Conclusion: The tested physical performance battery may be useful in tracking gymnasts over time, but may not be beneficial in forecasting injuries in a sport with high percentages of acute injuries. The collected injury volume may not be reflective of a standard season as COVID-19 decreased the number of competitions. Additional research to identify athletes at risk for injury requires further investigation.


2015 ◽  
Vol 43 (4) ◽  
pp. 802-807 ◽  
Author(s):  
Scott M. Monfort ◽  
R. Dawn Comstock ◽  
Christy L. Collins ◽  
James A. Onate ◽  
Thomas M. Best ◽  
...  

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0011
Author(s):  
Katie Kim ◽  
Michael Saper

Background: Gymnastics exposes the body to many different types of stressors ranging from repetitive motion, high impact loading, extreme weight bearing, and hyperextension. These stressors predispose the spine and upper and lower extremities to injury. In fact, among female sports, gymnastics has the highest rate of injury each year. Purpose: The purpose of this study was to systematically review the literature on location and types of orthopedic injuries in adolescent (≤20 years) gymnasts. Methods: The Pubmed, Medline, EMBASE, EBSCO (CINAHL) and Web of Science databases were systematically searched according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to identify all studies reporting orthopedic injuries in adolescent and young adult gymnasts. All aspects of injuries were extracted and analyzed including location, type and rates of orthopedic injuries. Results: Screening yielded 22 eligible studies with a total of 427,225 patients. Twenty of 22 studies reported upper extremity injuries of which four specifically focused on wrist injuries. Eight studies reported lower extremity injuries. Nine studies reported back/spinal injuries. Seven studies investigated each body location of injury; one study reported the upper extremity as the most common location for injury and six studies reported the lower extremity as the most common location for injury. Of those seven studies, five (23%) reported sprains and strains as the most common injury. One study reported fractures as the most common injury. Conclusion: There is considerable variation in reported injury location. Some studies focused specifically on the spine/back or wrist. The type of gymnastics each patient participated in was also different, contributing to which area of the body was more heavily stressed, or lacking. Current literature lacks data to fully provide evidence regarding which body region is more frequently injured and the type of injury sustained.


1990 ◽  
Vol 83 (Supplement) ◽  
pp. 2S-78
Author(s):  
Shelby K. Brantley ◽  
Suman K. Das

2016 ◽  
Vol 30 (12) ◽  
pp. e377-e383 ◽  
Author(s):  
Robert J. Wetzel ◽  
Laurence B. Kempton ◽  
Edwin S. Lee ◽  
Michael Zlowodzki ◽  
Todd O. McKinley ◽  
...  

2016 ◽  
Vol 37 (03) ◽  
pp. e10-e10 ◽  
Author(s):  
H. van der Does ◽  
M. Brink ◽  
A. Benjaminse ◽  
C. Visscher ◽  
K. Lemmink

Author(s):  
You-jou Hung ◽  
Jenna Boehm ◽  
Morgan Reynolds ◽  
Kallee Whitehead ◽  
Kaylyn Leland

Ankle injuries are common among young ballet dancers. These injuries may be attributed to ankle instability, insufficient lower extremity strength, and poor balance control. The purpose of this study was to explore whether these dancers exhibit functional ankle instability and if their single-leg balance control and lower extremity muscle strength correlate with functional ankle instability and leg injuries. Twenty-one ballet dancers (aged 10 to 17 years) participated in the study. The Cumberland Ankle Instability Tool (CAIT) questionnaire was used to examine functional ankle stability. Isometric muscle strength of the major lower extremity muscles was measured with a digital hand-held dynamometer. Single-leg balance was evaluated with the Y-Balance Test (YBT) and three Athletic Single-leg Stability Test (ASLST) protocols. Lower extremity injuries (self-reported) within 6 months after testing were recorded for correlation analyses. Both dominant and non-dominant ankles of the subjects exhibited functional ankle instability (26.71 and 25.71, respectively). Raising the center of mass (passé and first arm position) during the ASLST did not significantly affect balance performance (p = 0.104). However, removing extrinsic visual feedback significantly decreased single-leg balance (p < 0.001). In general, there was low correlation (r ≤ 0.49) between muscle strength, CAIT, YBT, and ASLST scores with lower extremity injuries. It is concluded that for young ballet dancers lower extremity muscle strength and single-leg balance control may not be strong contributing factors to leg injuries. This study also suggests that functional ankle stability may not have a direct impact on single-leg balance, and ballet dancers rely heavily on extrinsic visual feedback for single-leg balance control. Teachers might consider minimizing extrinsic feedback to challenge ballet dancers when implementing training protocols for single-leg balance control.


2018 ◽  
Vol 4 (1) ◽  
pp. e000425 ◽  
Author(s):  
Vincent Gouttebarge ◽  
Victor Zuidema

ObjectiveThis article describes the systematic development of an intervention for the prevention of lower extremity injuries in field hockey and the assessment of its feasibility.MethodsThe intervention was developed according to the first four steps of the intervention mapping and knowledge transfer scheme processes, mostly based on focus group interviews with experts in field hockey and injury prevention (needs assessment; objective and target groups; content selection; development). Subsequently, a quasi-experimental research (one-group post-test design) was conducted among 35 young field hockey players and 7 coaches. Participants were asked to use the intervention for 3 weeks, and the degrees of relevancy, suitability, satisfaction and usability of the intervention were assessed by means of a questionnaire and a group interview.ResultsFirst, the needs assessment conducted among the main actors within recreational field hockey revealed that an injury prevention intervention was needed, ideally delivered through videos via an application for smartphone/tablet or website. Second, the objective and target groups of the intervention were defined, namely to prevent or reduce the occurrence of lower extremity injuries among both young and adult recreational field hockey players. Third, warming-up exercises were selected as preventive measures and strategies (eg, core stability, strength, coordination). Last, the ‘Warming-Up Hockey’ intervention was developed, consisting of a warm-up programme (delivered by coaches including more than 50 unique exercises). The relevancy, satisfaction and usability of ‘Warming-Up Hockey’ were positively evaluated, but two main alterations were made: the duration of the ‘Warming-up Hockey’ was reduced from 16 to 12  min and a match-specific warm-up was added.ConclusionThe feasibility of ‘Warming-Up Hockey’ was positively assessed by players and coaches. Prior to its nationwide implementation, the effectiveness of the intervention on injury reduction among field hockey players should be conducted.


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