scholarly journals A longitudinal cohort study of adolescent elite footballers and controls investigating the development of cam morphology

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Scott Fernquest ◽  
Antony Palmer ◽  
Mo Gimpel ◽  
Richard Birchall ◽  
John Broomfield ◽  
...  
Keyword(s):  
Femoral Head ◽  
Growth Plate ◽  
Football Players ◽  
Activity Levels ◽  
Lateral Growth ◽  
Male And Female ◽  
Morphology Development ◽  
Head Morphology ◽  
Cam Morphology

AbstractCam morphology describes an asphericity of the femoral head that develops during adolescence, is highly prevalent in athletes, and predisposes individuals to future osteoarthritis. However, it’s aetiology remains poorly understood. The aim of this study was to perform 3-year longitudinal follow-up of a control population and football club academy cohort to compare the change in hip and growth plate anatomy between athletes and controls. MRI and questionnaires were used to characterise change in hip and growth plate anatomy and quantify activity levels. 121 male academy footballers and 107 male and female controls participated at baseline. Footballers experienced significantly greater increases in femoral head asphericity (4.83 degrees (95% CI: 2.84 to 6.82), p < 0.001) than controls. A positive correlation existed between activity levels and change in femoral head morphology (coefficient 0.79, p  ≤  0.001). Greatest morphological change occurred in individuals aged 11–12 years at baseline, with no significant change in individuals aged 14 years and older at baseline. Cam morphology development was secondary to soft tissue hypertrophy and lateral growth plate extension. In conclusion, excessive loading of the hip joint through exercise prior to 14 years of age may result in growth plate adaptations causing cam morphology. Potential interventions may include training type and load modification in young adolescent football players.

scholarly journals Cam morphology in young male football players mostly develops before proximal femoral growth plate closure: a prospective study with 5-yearfollow-up

2018 ◽  
Vol 53 (9) ◽  
pp. 532-538 ◽  
Author(s):  
Pim van Klij ◽  
Marinus P Heijboer ◽  
Abida Z Ginai ◽  
Jan A N Verhaar ◽  
Jan H Waarsing ◽  
...  
Keyword(s):  
Growth Plate ◽  
Alpha Angle ◽  
Football Players ◽  
Growth Plates ◽  
Time Points ◽  
Open Growth Plate ◽  
Morphology Development ◽  
Open Growth ◽  
Cam Morphology

ObjectivesCam morphology is not completely understood. The aim of this study was threefold: (1) to investigate if cam morphology development is associated with growth plate status; (2) to examine whether cam morphology continues to develop after growth plate closure; and (3) to qualitatively describe cam morphology development over 5-year follow-up.MethodsAcademy male football players (n=49) participated in this prospective 5-year follow-up study (baseline 12–19 years old). Anteroposterior and frog-leg lateral views were obtained at baseline (142 hips), 2.5-year (126 hips) and 5-year follow-up (98 hips). Cam morphology on these time points was defined as: (A) visual scores of the anterior head-neck junction, classified as: (1) normal, (2) flattening, and (3) prominence; and (B) alpha angle ≥60°. Proximal femoral growth plates were classified as open or closed. Cam morphology development was defined as every increase in visual score and/or increase in alpha angle from <60° to ≥60°, between two time points. This resulted in 224 measurements for cam morphology development analysis.ResultsCam morphology development was significantly associated with open growth plates based on visual score (OR: 10.03, 95% CI 3.49 to 28.84, p<0.001) and alpha angle (OR: 2.85, 95% CI 1.18 to 6.88, p=0.020). With both definitions combined, cam developed in 104 of 142 hips during follow-up. Of these 104 hips, cam developed in 86 hips (82.7%) with open growth plate and in 18 hips (17.3%) with a closed growth plate. Cam morphology developed from 12 to 13 years of age until growth plate closure around 18 years.ConclusionCam morphology of the hip is more likely to develop with an open growth plate.

scholarly journals Association between Foot Posture Index and Ankle Sprain in Indoor Football Players

2016 ◽  
Vol 8 (10) ◽  
pp. 160 ◽  
Author(s):  
Afsaneh Safar Cherati ◽  
Masoud Dousti ◽  
Shima Younespour
Keyword(s):  
Ankle Sprain ◽  
Football Players ◽  
Male And Female ◽  
Positive History ◽  
Foot Posture Index ◽  
Posture Index ◽  
Foot Posture ◽  
History Of ◽  
The Relationship

<p><strong>Objective</strong><strong>: </strong>This study investigated the relationship between foot type and ankle sprain incidence.</p><p><strong>Method</strong><strong>: </strong>In a prospective cohort study using the FPI, 68 adult male and female indoor football (Futsal) players were measured and their feet were classified according to foot posture index (FPI) as neutral, supinated and pronated. They were followed over 6 month as a one competition season and at the end, any injuries at the ankle during this period were detected.</p><p><strong>Result</strong><strong>: </strong>There was no significant association between FPI score (considering the total FPI score and its six components) and occurrence of ankle sprain. Also, no association was existed between gender, age, height, weight, BMI, duration of professional exercise, dominant foot and occurrence of ankle sprain. In this study, the history of previous ankle sprain was the only significant predictor of the occurrence of ankle sprain in the follow-up period. Participants with the positive history of previous ankle sprain were at higher risk of developing new ankle sprain (OR=6.02, 95% CI: (1.93, 18.84), p=0.002).</p><p><strong>Conclusion</strong><strong>: </strong>There was no significant association between FPI score and occurrence of ankle sprain.<strong></strong></p><p><strong>Limitation: </strong>there was scarce of supinated foot in the study so evaluation of relationship between supinated feet and ankle sprain was not applicable.</p>

scholarly journals Quantifying Activity Levels After Sport-Related Concussion Using Actigraph and Mobile (mHealth) Technologies

2019 ◽  
Vol 54 (9) ◽  
pp. 929-938 ◽  
Author(s):  
Daniel L. Huber ◽  
Danny G. Thomas ◽  
Michael Danduran ◽  
Timothy B. Meier ◽  
Michael A. McCrea ◽  
...  
Keyword(s):  
Physical Activity ◽  
Vigorous Physical Activity ◽  
Research Unit ◽  
Mental Activity ◽  
Football Players ◽  
Activity Levels ◽  
Concussion Recovery ◽  
Collegiate Football ◽  
Mental Exertion

Context Interest in identifying the effects of physical and mental activity on recovery after sport-related concussion is growing. Clinical studies of concussed athletes' activities require well-validated methods for tracking their intensity and timing. Objective To develop and validate a novel multimodal approach to monitoring activity postconcussion using mobile (mHealth) technologies. Design Cohort study. Setting Translational research unit. Patients or Other Participants A total of 40 high school and collegiate football players were evaluated at preseason and followed longitudinally after either concussion (n = 25; age = 17.88 ± 1.74 years, height = 182.07 ± 8.08 cm, mass = 98.36 ± 21.70 kg) or selection as a nonconcussed control (n = 15; age = 18.27 ± 1.83 years, height = 180.01 ± 7.19 cm, mass = 93.83 ± 24.56 kg). Main Outcome Measure(s) Participants wore a commercial actigraph and completed a daily mobile survey for 2 weeks. Analyses focused on comparisons between groups for actigraph-based physical activity and self-reported physical and mental activity during the follow-up period. Results For the first 2 days postinjury, objective measures showed fewer daily steps in concussed (6663 ± 2667 steps) than in control (11 148 ± 3381 steps) athletes (P &lt; .001), and both objective and self-reported measures indicated less moderate to vigorous physical activity in concussed (27.6 ± 32.6 min/d and 25.0 ± 43.6 min/d, respectively) than in control (57.3 ± 38.6 min/d and 67.5 ± 40.1 min/d, respectively) athletes (both P values &lt; .05). Correlations between objective and self-reported measures of moderate to vigorous physical activity were moderate across select 1-week and 2-week averages. We observed no group differences in self-reported mental activities. Conclusions Physical activity after sport-related concussion varied widely across athletes but on average was reduced during the acute and early subacute postinjury periods for both objective and self-reported measures. The lack of differences in mental activities between groups may reflect limited change in mental exertion postconcussion or difficulty accurately measuring mental activities. Assessing concussed athletes' activities using actigraphy and self-reported scales may help monitor their compliance with activity recommendations and be useful in studies aimed at better understanding the effects of physical activity on concussion recovery.

scholarly journals Age- and Sex-Specific Morphologic Variations of Capital Femoral Epiphysis Growth in Children and Adolescents Without Hip Disorders

2018 ◽  
Vol 6 (6) ◽  
pp. 232596711878157 ◽  
Author(s):  
Eduardo N. Novais ◽  
Daniel A. Maranho ◽  
Young-Jo Kim ◽  
Ata Kiapour
Keyword(s):  
Children And Adolescents ◽  
Growth Plate ◽  
Childhood And Adolescence ◽  
Male And Female ◽  
Suspected Appendicitis ◽  
Female Patients ◽  
Morphologic Characteristics ◽  
The Mean ◽  
Cam Morphology ◽  
Age And Sex

Background: Understanding the development of the capital femoral epiphysis is essential to identify pathologic variations that may lead to cam morphology. Purpose/Hypothesis: The purpose of this study was to investigate the development of the capital femoral epiphysis during childhood and adolescence, with specific morphologic analysis of the peripheral growth and the metaphyseal surface of the growth plate. We hypothesized that age- and sex-dependent morphologic variations of the peripheral growth (cupping) and surface anatomy (epiphyseal tubercle) of the epiphysis would be evident with increasing age. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Pelvic computed tomography scans of 80 children and adolescents (range, 8-15 years; n = 10 per age group; 50% male), imaged because of suspected appendicitis, were used to reformat the proximal femur. All patients had asymptomatic hips with no signs or history of hip disorder. We measured the peripheral cupping of the epiphysis and the epiphyseal tubercle dimensions from 3-dimensional models. All measurements were normalized to the epiphyseal diameter. The effect of age on these parameters was evaluated by use of linear regression analysis. A 2-way analysis of variance (ANOVA) was used to compare these parameters between males and females. Results: The mean epiphyseal cupping increased with increasing age ( R2 = 0.54; P < .001). The mean normalized epiphyseal cupping was consistently higher in the anterior and posterior directions compared with the inferior and superior locations. Male patients aged 10 and 11 years had lower ( P = .002) mean epiphyseal cupping compared with female patients of the same age. We observed no difference between male and female participants after 12 years of age ( P > .3). The normalized epiphyseal tubercle height ( R2 = 0.08; P = .009), width ( R2 = 0.13; P = .001), and length ( R2 = 0.45; P < .001) decreased with increasing age, with no differences between male and female patients. On average, a 2.6-fold increase was found in epiphyseal cupping from 8 to 15 years of age, whereas normalized tubercle height decreased by 0.4-fold. Conclusion: Peripheral cupping of the epiphysis over the metaphysis increases with age, while the relative epiphyseal tubercle dimensions decrease. Females have an earlier onset of rapid increase in the peripheral cupping compared with males; however, no differences in epiphyseal tubercle dimensions were found between male and female patients. These findings may guide future studies investigating the development of cam morphology, which should consider the surface morphologic characteristics of the capital femoral epiphysis, the growth plate, and the differences in morphologic characteristics according to age and sex.

scholarly journals Clinical and radiological hip parameters do not precede, but develop simultaneously with cam morphology: a 5-year follow-up study

2020 ◽  
Author(s):  
P. van Klij ◽  
M. P. Heijboer ◽  
A. Z. Ginai ◽  
J. A. N. Verhaar ◽  
J. H. Waarsing ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Alpha Angle ◽  
Level Of Evidence ◽  
Neck Shaft Angle ◽  
Time Points ◽  
Center Edge ◽  
Morphology Development ◽  
Hip Internal Rotation ◽  
Cam Morphology

Abstract Purpose The aim of this study was to (1) investigate whether radiographic and clinical parameters, which influence how stresses during sporting activities act on the proximal femur, are associated with cam morphology or (2) precede cam morphology development. Methods Young male football players participated at baseline (n = 89, 12–19 years of age), 2.5-year (n = 63) and 5-year follow-up (n = 49). Standardized anteroposterior pelvic and frog-leg lateral radiographs were obtained at each time point. Cam morphology was quantified an alpha angle ≥ 60°, and large cam morphology ≥ 78°. The neck–shaft angle (NSA), epiphyseal extension (EE), lateral center–edge angle (LCEA) and hip internal rotation (IR) were also measured. Cross-sectional associations between NSA, EE, LCEA and IR and (large) cam morphology were studied at all time points. To study whether these variables preceded cam morphology development, hips without cam morphology at baseline were studied prospectively. Results A lower NSA, a higher EE and limited IR were consistently associated with cam morphology at all three time points. These differences were more pronounced in hips with large cam morphology. No association between wcam morphology and the LCEA was found. None of the parameters studied preceded cam morphology development. Conclusion Cam morphology developed simultaneously with a varus orientation, growth plate extension toward the femoral neck and limited hip internal rotation. These parameters did not precede cam morphology development. The hip parameters studied cannot be used to identify individuals at risk of developing cam morphology. Level of evidence Level II.

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