Training habits and lower limb injury prevention in parkour practitioners

Parkour consists of overcoming obstacles mostly in an urban landscape. Little is known regarding usual training habits and injury risks of traceurs, i.e., parkour practitioners. In this study, a 20-min survey have been fulfilled by a population of traceurs regarding training load, habits (type of warm up, physical conditioning, stretching), type of footwear, and number and type of ankle- and knee-injuries during their career. A total of 180 responses were analyzed (24.4 ± 5.9 years old, 21.7% female, 6.0 ± 3.9 years of experience). Participants reported to train 1 to 7 times per week for a mean duration of 2.2 h. 76% practiced stretching exercises. 75.6% practiced physical conditioning in addition to their parkour training (weightlifting, functional exercises). Injury rate was 1.7 per 1000 h of training, mostly ankle sprains and knee contusions. Number of injury and training load were positively correlated. The lack of physical conditioning was also a factor of injury. Knee injuries have been more frequent on participants wearing minimalist shoes. Although training appears well auto-organized and the injury rate quite low some pitfalls require attention, notably in training planning, warm-up, stretching and conditioning. Building training and coaching methods specific to parkour appears essential.

The efficiency of proprioceptive training in preventing injuries to team athletes: A systematic review

The aim of this systematic review was to evaluate the effectiveness of proprioceptive training in the prevention of lower extremity injuries, especially the ankle and knee joint, in team athletes. PRISMA recommendations were applied for this research. PubMed, ScienceDirect, and BioMed Central were used to identify relevant studies. The methodological quality of studies was assessed using the Physiotherapy Evidence Database-PEDro scale. Only 7 research met the eligibility criteria, and their outcomes were presented. Proprioceptive training has been shown to be very effective in preventing ankle injuries, especially in recurrent ankle sprains. However, in 3 of 4 studies lacked the effects of proprioceptive training in the prevention of knee and ACL injuries. Based on the results of the analyzed research, I can conclude that proprioceptive training is a very effective training tool in the prevention of ankle sprains in the population of team athletes, but proprioceptive training is not sufficient as the only training component in preventing knee injuries.

The efficacy of kinesio taping in the treatment of ankle sprain: Systematic review and meta-analysis

Review question / Objective: The purpose of this systematic review is to accurately evaluate the efficacy of kinesio tape for ankle sprains. Condition being studied: Ankle sprain may cause a series of problems, such as pain, swelling, and various dysfunctions. As a physical therapy method that has attracted much attention in recent years, kinesio tape has been proven to relieve pain, reduce swelling and promote functional recovery for some diseases. In this way, we can provide a reference for clinical physical therapy. Information sources: PubMed, Cochrane, Scopus, Web of Science, Embase, CNKI, Wanfang Data, Technological periodical database, SinoMed.

Sensitivity of a Subject-specific Ankle Sprain Simulation to Extrinsic Versus Intrinsic Biomechanical Factors

Ankle sprains are the most common musculoskeletal injury in sport and military activity, despite existing prophylactic strategies. The purpose of this report was to develop a probabilistic simulation of lateral ankle sprains during single-limb drop landing, towards accelerating innovation in ankle sprain prevention. A deterministic, subject-specific musculoskeletal model was extended with automation and probabilistic distributions on sprain-related biomechanical factors. Probabilistic simulations were generated using traditional Monte Carlo techniques and the advanced mean value method, a more computationally-efficient approach. Predicted distributions of peak ankle joint rotations, velocities, and moments borne by supporting passive structures agreed favorably with the deterministic model and with reports of real sprain biomechanics. Parameter sensitivities identified that predictions were most strongly influenced by drop height, subtalar joint posture at contact, invertor/evertor co-activation, and passive ankle stiffness. The advanced mean value method predicted confidence bounds comparable to a 1000-trial Monte Carlo simulation, and required only 14 model evaluations and 4-min processing time. The extended probabilistic simulation may be useful to virtually test new prophylactic strategies for ankle sprains, and is made available for open-source use (https://simtk.org/projects/sprain-sim).

Frontal plane ankle stiffness increases with axial load independent of muscle activity

ABSTRACTAnkle sprains are the most common musculoskeletal injury, typically resulting from excessive inversion of the ankle. One way to prevent excessive inversion and maintain ankle stability is to generate a stiffness that is sufficient to resist externally imposed rotations. Frontal-plane ankle stiffness increases as participants place more weight on their ankle, but whether this effect is due to muscle activation or axial loading of the ankle is unknown. Identifying whether and to what extent axial loading affects ankle stiffness is important in understanding what role the passive mechanics of the ankle joint play in maintaining its stability. The objective of this study was to determine the effect of passive axial load on frontal-plane ankle stiffness. We had subjects seated in a chair as an axial load was applied to the ankle ranging from 10% to 50% body weight. Small rotational perturbations were applied to the ankle in the frontal plane to estimate stiffness. We found a significant, linear, 3-fold increase in ankle stiffness with axial load from the range of 0% bodyweight to 50% bodyweight. This increase could not be due to muscle activity as we observed no significant axial-load-dependent change in any of the recorded muscle activations. These results demonstrate that axial loading is a significant contributor to maintaining frontal-plane ankle stability, and that disruptions to the mechanism mediating this sensitivity of stiffness to axial loading may result in pathological cases of ankle instability.

Exosomes Derived from Platelet-Rich Plasma Administration in Site Mediate Cartilage Protection in Subtalar Osteoarthritis

Subtalar osteoarthritis (STOA) is often secondary to chronic ankle sprains, which seriously affects the quality of life of patients. Due to its etiology and pathogenesis was not studied equivocally yet, there is currently a lack of effective conservative treatments. Although they have been used for tissue repair, platelet-rich plasma-derived exosomes (PRP-Exo) have the disadvantage of low retention and short-lived therapeutic effects. This study aimed to determine whether incorporation of PRP-Exo in thermosensitive hydrogel (Gel) increased their retention in the joint and thereby playing a therapeutic role on STOA due to chronic mechanical instability established by transecting lateral ligaments (anterior talofibular ligament (ATFL) / calcaneal fibular ligament (CFL)). PRP-Exo incorporated Gel (Exo-Gel) system, composed of Poloxamer-407 and 188 mixture-based thermoresponsive hydrogel matrix in an optimal ratio, was determined by its release ability of Exo and rheology of Gel response to different temperature. The biological activity of Exo-Gel was evaluated in vitro, and the therapeutic effect of Exo-Gel on STOA was evaluated in vivo. Exo released from Exo-Gel continuously for 28 days could promote the proliferation and migration of mouse bone mesenchymal stem cells (mBMSCs) and chondrocytes, at the same time enhance the chondrogenic differentiation of mBMSCs, and inhibit inflammation-induced chondrocyte degeneration. In vivo experiments confirmed that Exo-Gel increased the local retention of Exo, inhibited the apoptosis and hypertrophy of chondrocytes, enhanced their proliferation, and potentially played the role in stem cell recruitment to delay the development of STOA. Thus, Delivery of PRP-Exo incorporated in thermosensitive Gel provides a novel approach of cell-free therapy and has therapeutic effect on STOA.

Perception of stability correlates with objective performance of dynamic stability for people with chronic ankle instability

Purpose Lateral ankle sprains are one of the most prevalent musculoskeletal injuries, with one of the highest recurrence rates. One in five people develops chronic ankle instability (CAI) after a lateral ankle sprain. CAI is mainly described as a subjective phenomenon, but is associated with recurrent symptoms, reduced dynamic stability, and reduced physical activity and quality of life. Understanding the relationship between perception of stability and effect on performance for people with CAI could inform rehabilitative strategies in clinical practice. This study aimed to investigate the relationship between the perception of stability and objective performance of dynamic stability this population. Methods This study is a sub-analysis of data from four separate studies in Australia and the United Kingdom. Participants were screened and categorised as a CAI, coper, or healthy participant. Each participant completed the Star Excursion Balance Test (SEBT) and Cumberland ankle instability tool (CAIT). Distances reached in the anterior, posterior-medial, and posterior-lateral directions, and average, of the SEBT were analysed. Results Data from 95 participants with CAI, 45 copers, and 101 healthy participants was analysed. There was a significant moderate correlation between CAIT score and SEBT reach distance in all directions for the CAI group (p < 0.001). For copers, there was small significant correlation in the posterior-lateral direction (p < 0.05). Conclusion This study highlights the discrepancies between the perception of stability and objective dynamic stability, and reinforces the importance of using both types of measures for continual assessment in practice to optimise selecting rehabilitative strategies.

Bröstrom Repair Review

Since its introduction in 1966, the Bröstrom repair has been the workhorse for the treatment of chronic ankle instability. The procedure has expanded with the advent of arthroscopy, ultrasound, and other techniques. Because chronic ankle sprains/instability pose a barrier to athletes who perform high-level activities for a living, discussions concerning postoperative recovery and return to play criteria are important. Here we present an update on the Bröstrom-Gould procedure from preoperative management to return to play. Level of Evidence: Level V