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.

408 The Swiss Cheese Effect: Following Lower Limb Emergency Admissions Through Hospital

Introduction The Swiss cheese model analyses failure in a system: when holes align this creates ‘a trajectory of accident opportunity’. In healthcare this could translate to morbidity and/or mortality of patients. We investigated potential points of failure in treating lower limb injury patients through their hospital journey. Three points were investigated: (1) prescription of venous thrombo-embolism (VTE) prophylaxis, (2) operation note information and legibility (3) time delay in post-operative blood tests. Method A total of 105 patients of emergency lower limb surgical patients were identified retrospectively from two centres across the North West Region between the 31/07/20 and 21/11/20. Data was collected on (1) prescription of thrombo-prophylaxis, (2) information recorded, and legibility of operation notes as per RCSEng and (3) time delay in post-operative full blood count when compared to operation note recommendation. Results We found that between 10-55% of patients were prescribed anti-embolism stockings versus 100% given chemical anti-coagulation on day 1 of admission. Of a total of 23 data points, the mean number of points missing on operative notes was 4.90 (range: 2-10). A total of 82.5% handwritten operation notes were deemed legible. Post-operative full blood counts were ordered in 83.3% of patients, with the first order ranging between 1-5 days post operatively. Conclusions The cumulative effect of having these errors at all three points greatly increases the chance of morbidity/mortality of patients. Our experience demonstrates a failure to meet trust and Royal College of Surgeon’s guidelines. We aim to re-audit this nationally with our planned intervention.

Effect of lumbopelvic control on landing mechanics and lower extremity muscles’ activities in female professional athletes: implications for injury prevention

Background Lumbopelvic control (LPC) has recently been associated with function, kinesiology, and load distribution on the limb. However, poor LPC has not been studied as a risk factor for lower limb injury in sports requiring frequent jump landings. The present study investigated the effects of LPC on landing mechanics and lower limb muscle activity in professional athletes engaged in sport requiring frequent landing. Methods This study was conducted on 34 professional female athletes aged 18.29 ± 3.29 years with the height and body mass of 173.5 ± 7.23 cm and 66.79 ± 13.37 kg, respectively. The landing error scoring system (LESS) and ImageJ software were used to assess landing mechanics. Wireless electromyography was also used to record the activity of the gluteus medius (GMed), rectus femoris, and semitendinosus. Lumbopelvic control was evaluated using the knee lift abdominal test, bent knee fall-out, active straight leg raising, and the PRONE test using a pressure biofeedback unit. Based on the LPC tests results, the participants were divided into two groups of proper LPC (n = 17) and poor LPC (n = 17). Results There were significant differences between the groups with proper and poor LPC in terms of the LESS test scores (P = 0.0001), lateral trunk flexion (P = 0.0001), knee abduction (P = 0.0001), knee flexion (P = 0.001), trunk flexion (P = 0.01), and GMed muscle activity (P = 0.03). There were no significant differences in the activity of the rectus femoris and semitendinosus muscles, and ankle dorsiflexion (P > 0.05). Conclusions Poor lumbopelvic control affects the kinematics and activity of the lower limb muscles, and may be a risk factor for lower limb injuries, especially of the knee.

An Investigation of Differences in Lower Extremity Biomechanics During Single-Leg Landing From Height Using Bionic Shoes and Normal Shoes

Bionic shoes utilizing an actual foot shape sole structure can alter lower limb’s biomechanics, which may help in the development of specific training or rehabilitation programs. The purpose of this study was to investigate the biomechanical differences in the lower limb during a single-leg landing task using bionic shoes (BS) and normal shoes (NS). Fifteen healthy male subjects participated in this study, sagittal, and frontal plane data were collected during the landing phase (drop landing from 35 cm platform). Our study showed that BS depicted a significantly greater minimum knee flexion angle at initial contact (p = 0.000), a significantly greater minimum (initial contact) hip flexion angle at initial contact (p = 0.009), a significantly smaller sagittal plane total energy dissipation (p = 0.028), a significantly smaller frontal plane total energy dissipation (p = 0.008), a significantly smaller lower limb total energy dissipation (p = 0.017) than NS during the landing phase. SPM analysis revealed that BS depicted a significantly smaller knee joint vertical reaction force during the 13.8–19.8% landing phase (p = 0.01), a significantly smaller anterior tibia shear force during the 14.2–17.5% landing phase (p = 0.024) than NS. BS appears to change lower limb kinematics at initial contact and then readjust the landing strategies for joint work and joint reaction force, thereby reducing the risk of lower limb skeletal muscle injury. BS have great potential for future development and application uses, which may help athletes to reduce lower limb injury risk.

Risk Factors for Non-Contact Lower-Limb Injury: A Retrospective Survey in Pediatric-Age Athletes

Background: Risk factors for non-contact lower-limb injury in pediatric-age athletes and the effects of lateral dominance in sport (laterally vs. non-laterally dominant sports) on injury have not been investigated. Purpose: To identify risk factors for non-contact lower-limb injury in pediatric-age athletes. Methods: Parents and/or legal guardians of 2269 athletes aged between 6–17 years were recruited. Each participant completed an online questionnaire that contained 10 questions about the athlete’s training and non-contact lower-limb injury in the preceding 12 months. Results: The multivariate logistic regression model determined that lateral dominance in sport (adjusted OR (laterally vs. non-laterally dominant sports), 1.38; 95% CI, 1.10–1.75; p = 0.006), leg preference (adjusted OR (right vs. left-leg preference), 0.71; 95% CI, 0.53–0.95; p = 0.023), increased age (adjusted OR, 1.21; 95% CI, 1.16–1.26; p = 0.000), training intensity (adjusted OR, 1.77; 95% CI, 1.43–2.19; p = 0.000), and training frequency (adjusted OR, 1.36; 95% CI, 1.25–1.48; p = 0.000) were significantly associated with non-contact lower-limb injury in pediatric-age athletes. Length of training (p = 0.396) and sex (p = 0.310) were not associated with a non-contact lower-limb injury. Conclusions: Specializing in laterally dominant sports, left-leg preference, increase in age, training intensity, and training frequency indicated an increased risk of non-contact lower-limb injury in pediatric-age athletes. Future research should take into account exposure time and previous injury.