Does choice of athletic footwear affect musculoskeletal injury risk in US Coast Guard recruits? A retrospective cohort study.

Context: Musculoskeletal injuries (MSKIs) are ubiquitous during initial entry military training, with overuse injuries in the lower extremities the most frequent. A common mechanism for overuse injuries is running, an activity that is an integral part of United States Coast Guard (USCG) training and a requirement for graduation. Objective: Assess the effects of athletic footwear choice on lower quarter MSKI risk in USCG recruits. Design: Descriptive Epidemiological Study Setting: USCG Training Center, Cape May, NJ Participants: A retrospective cohort study was performed in which 1229 recruits (1038 males, 191 females) were allowed to self-select athletic footwear during training. A group of 2876 recruits (2260 males, 616 females) who trained under a policy that required obligatory wear of prescribed athletic shoes served as a control. Main Outcome Measures: Demographic data and physical performance were derived from administrative records. Injury data were abstracted from a medical tracking database. Multivariable logistic regression was used to assess group, age, sex, height, body mass, and run times on MSKI outcomes. Results: Ankle-foot, leg, knee and lumbopelvic-hip complex diagnoses were ubiquitous in both groups (experimental: 20.37 to 29.34 per 1000 recruits; control: 18.08 to 25.59 per 1000 recruits). Group was not a significant factor for any of the injuries assessed. Sex was a significant factor in all injury types, with female recruits demonstrating ~2.00 greater odds of experiencing running-related injuries (RRIs), overuse injuries, or any MSKI in general. When considering ankle-foot or bone stress injuries, the risk in female recruits was 3.73 to 4.11 greater odds than their male counterparts. Run time was a significant predictor in RRI, all overuse injuries, and for any MSKI in general. Conclusion: While footwear choice did not influence MSKI risk in USCG recruits, female sex was a primary, nonmodifiable intrinsic risk factor.

Torsional deformities and overuse injuries: what does the literature tell us

Overuse injuries imply the occurrence of a repetitive or an increased load on a specific anatomical segment which is unable to recover from this redundant microtrauma, thus leading to an inflammatory process of tendons, physis, bursa, or bone. Even if the aetiology is controversial, the most accepted is the traumatic one. Limb malalignment has been cited as one of the major risk factors implicated in the development of overuse injuries. Many authors investigated correlations between anatomical deviations and overuse injuries, but results appear mainly inconclusive. Establishing a causal relationship between mechanical stimuli and symptoms will remain a challenge, but 3D motion analysis, musculoskeletal, and finite element modelling may help in clarifying which are the major risk factors for overuse injuries.

Psychosocial Risk Factors for Overuse Injuries in Competitive Athletes: A Mixed-Studies Systematic Review

Background While the psychosocial risk factors for traumatic injuries have been comprehensively investigated, less is known about psychosocial factors predisposing athletes to overuse injuries. Objective The aim of this review was to systematically identify studies and synthesise data that examined psychosocial risk factors for overuse injuries in athletes. Design Systematic review. Data Sources MEDLINE, Web of Science and PsycINFO databases, supplemented by hand searching of journals and reference lists. Eligibility Criteria for Selecting Studies Quantitative and qualitative studies involving competitive athletes, published prior to July 2021, and reporting the relationship between psychosocial variables and overuse injury as an outcome were reviewed. This was limited to academic peer-reviewed journals in Swedish, English, German, Spanish and French. An assessment of the risk of bias was performed using modified versions of the RoBANS and SBU Quality Assessment Scale for Qualitative Studies. Results Nine quantitative and five qualitative studies evaluating 1061 athletes and 27 psychosocial factors were included for review. Intra-personal factors, inter-personal factors and sociocultural factors were found to be related to the risk of overuse injury when synthesised and reported according to a narrative synthesis approach. Importantly, these psychosocial factors, and the potential mechanisms describing how they might contribute to overuse injury development, appeared to be different compared with those already known for traumatic injuries. Conclusions There is preliminary evidence that overuse injuries are likely to partially result from complex interactions between psychosocial factors. Coaches and supporting staff are encouraged to acknowledge the similarities and differences between traumatic and overuse injury aetiology.

Surfing on the world stage: a narrative review of acute and overuse injuries and preventative measures for the competitive and recreational surfer

Surfing has rapidly grown in popularity as the sport made its debut at the Tokyo 2020 Olympic Games. Surfing injuries are becoming more relevant with the globalisation and increasing risks of the sport, but despite this, little is known about surfing injuries or prevention strategies in either the competitive or recreational surfer. Prior research demonstrates that surfers are injured at a frequency of 0.74–1.79 injuries per 1000 hours of surfing. We reviewed the literature for the incidence, anatomical distribution, type and underlying mechanism of acute and overuse injuries, and discuss current preventative measures. This review finds that skin injuries represent the highest proportion of total injuries. Acute injuries most frequently affect the head, neck and face, followed by the lower limbs. Being struck by one’s own board is the most common mechanism of injury. Non-contact acute ligament injuries have increased as surfing manoeuvres have become more acrobatic and overuse musculoskeletal injuries are highly correlated with paddling. However, there is a paucity of research for surfing injuries, and studies on overuse musculoskeletal injuries and prevention are disproportionally under-represented. Most of the prior studies are limited by small sample sizes, poor data collection methodology and geographical constraints. Further research is needed to establish preventative measures for both acute and overuse surfing injuries and to ensure the increasing popularity of surfing is met with an improved understanding of sport risks and safety. Specifically, we recommend research be prioritised regarding the efficacy of training programmes to prevent surfing-related overuse musculoskeletal injuries.

Foot and Lower Limb Clinical and Structural Changes in Overuse Injured Recreational Runners Using Floating Heel Shoes: Preliminary Results of a Randomised Control Trial

Foot-strike and the associated load rate are factors related to overuse injuries in runners. The purpose of this study was to analyse structural and functional changes in runners using floating heel running shoes, compared with runners using conventional footwear. A randomised control trial was conducted. Twenty runners with overuse injuries were followed over a 12-week gait retraining programme using floating heel running shoes or their conventional footwear. Pain was measured with pressure pain thresholds (PPTs), structural changes were measured with ultrasonography, and severity and impact of injury was scored on the Oslo Sports Trauma Research Centre Overuse Injury Questionnaire (OSTRC-O). Statistical differences were found between groups after the intervention (p < 0.001), with a medium size effect SE = 0.8, and the floating heel running shoes group reached higher PPTs values. Participants using floating heel running shoes showed higher OSTRC-O scores than those using their conventional footwear (p < 0.05), with higher scores after the intervention (p < 0.05). A 12-week gait retraining programme using floating heel running shoes had positive effects on the injury recovery process when compared to the use of conventional footwear, with significant differences in terms of pain and impact on sports activity.

Lumbopelvic-Hip Complex Contribution During Lower Extremity Screening Tests in Elite Figure Skaters

ABSTRACT Context: Figure skating requires power and stability for take-off and landing from multi-rotational jumps and various on-ice skills. Repetitive forces may cause overuse injuries distally making lumbopelvic-hip endurance, strength, and neuromuscular control imperative. Objective: The purpose was to compare lumbopelvic-hip endurance and neuromuscular control in elite figure skaters between sex and limbs using common screening tests. Design: Cross-sectional study. Setting: U.S. Olympic and Paralympic Training Center. Participants: Forty elite figure skaters (23.2±4.3 years, 169.1±12.2 cm, 20F, 40R landing limb) performed the Y-balance test, single leg squat (SLS), single leg squat jump (SLSJ), and unilateral hip bridge endurance test. Main Outcome Measures: Normalized reach difference (% of leg length) and composite scores (((Anterior + Posteromedial + Posterolateral)/Limb length x 3) x100) were calculated for Y-balance test. Skaters held the unilateral hip bridge until failure with a maximum allotted time of 120s. Participants performed 5 SLS and SLSJ, barefooted with the contralateral limb held behind them to mimic a landing position. Both tests were scored by the number of times the patella moved medially to the first ray (medial knee displacement (MKD)). MANOVA with post-hoc independent t-tests were performed between groups and sex. Paired t-tests were used to analyze limb differences. Results: Females had a larger composite Y-balance score (R:+10.8, p=.002; L:+10.5, p=.001) and hip bridge hold time (R:+26.4 sec, p=.004; L:+28.2 sec, p=.002) on both limbs compared to males. Males held the hip bridge longer on their landing limb. During the SLS and SLSJ, 6 skaters performed worse on their non-landing limb during the SLS, and 11 skaters had no MKD with either test. Conclusions: Females performed better on the Y-balance and unilateral hip bridge tests. Increased MKD for some skaters in the SLS and SLSJ may indicate hip abductor weaknesses. Understanding proximal lumbopelvic-hip variables during take-off and landing may elucidate contributing factors to distal overuse injuries.