A proposed algorithm for the treatment of core muscle injuries

ABSTRACT In recent years, there has been increased awareness and treatment of groin injuries in athletes. These injuries have been associated with various terminologies including sports hernia, core muscle injury (CMI), athletic pubalgia and inguinal disruption, among others. Treatment of these injuries has been performed by both orthopaedic and general surgeons and may include a variety of procedures such as rectus abdominis repair, adductor lengthening, abdominal wall repair with or without mesh, and hip arthroscopy for the treatment of concomitant femoroacetabular impingement. Despite our increased knowledge of these injuries, there is still no universal terminology, diagnostic methodology or treatment for a CMI. The purpose of this review is to present a detailed treatment algorithm for physicians treating patients with signs and symptoms of a CMI. In doing so, we aim to clarify the various pathologies involved in CMI, eliminate vague terminology, and present a clear, stepwise approach for both diagnosis and treatment of these injuries.

5-A-SIDE SOCCER: PREVALENCE OF SPORTS INJURIES IN BRAZILIAN TEAM PLAYERS

ABSTRACT Introduction: 5-a-side soccer is a sports modality exclusively for athletes with vision impairment (VI) classified as blind - B1 (Blind 1) by the visual classification process. Type of impairment and high-performance training are factors that contribute to the development of sports injuries. Objective: The purpose of this study was to characterize the prevalence of sports-related injuries in visually disabled athletes of the Brazilian 5-a-side soccer team. Methods: The method was defined as a descriptive, longitudinal, epidemiological study. The sample was composed of ten male athletes, members of the Brazilian 5-a-side soccer team, including two athletes without VI and eight athletes with the B1 visual classification, who participated in competitions in 2014. The questionnaire for the data collection was based on the Sport Injuries Protocol for Paralympic Sports (PLEEP), expressing quantitative data analyzed by descriptive statistics. Results: The results showed that, in 2014, five athletes with VI had seven sports injuries, with a prevalence of 62.5%, clinical incidence of 0.87 injuries per athlete per year, and 1.4 injuries per injured athlete. The main sports injuries were muscle strain (28.6%), groin pull (athletic pubalgia) (28.6%), and shin splints (periostitis) (28.6%). All sports injuries occurred in the lower limbs, affecting legs (71.4%) and hips (28.6%). Overload was the most frequent mechanism (57%), reported after the technical kick movement and linked to the muscle imbalance between dominant and supporting lower limbs, in addition to the postural misalignment typical of people with visual impairments. Conclusions: In summary, the Brazilian 5-a-side soccer athletes presented a pattern of overload injuries resulting from the repetition of the technical kick movement, occurring predominantly in sports competitions. Epidemiological data can contribute to the development of strategies to prevent injuries in this sport. Level of evidence II, Progressive prognostic study.

Resisted adduction sit-up test (RASUT) as a screening tool for pelvic versus hip pathology

ABSTRACT Groin pain is a common symptom in hip and pelvic pathology and differentiating between the two remains a challenge. The purpose of this study was to examine whether a test combining resisted adduction with a sit-up (RASUT) differentiates between pelvic and hip pathology. The RASUT was performed on 160 patients with complaints of hip or groin pain who subsequently had their diagnosis confirmed by magnetic resonance imaging (MRI) or surgery. Patients were categorized as having pelvic pathology (athletic pubalgia or other) or hip pathology (intra-articular or other). Athletic pubalgia was defined as any condition involving the disruption of the pubic aponeurotic plate. Sensitivity, specificity, positive predictive accuracy, negative predictive accuracy and diagnostic odds ratios were computed. Seventy-one patients had pelvic pathology (40 athletic pubalgia), 81 had hip pathology and 8 had both. The RASUT was effective in differentiating pelvic from hip pathology; 50 of 77 patients with a positive RASUT had pelvic pathology versus 29 of 83 patients with a negative test (P < 0.001). RASUT was diagnostic for athletic pubalgia (diagnostic odds ratio 6.08, P < 0.001); 35 of 45 patients with athletic pubalgia had a positive RASUT (78% sensitivity) and 73 of 83 patients with a negative RASUT did not have athletic pubalgia (88% negative predictive accuracy). The RASUT can be used to differentiate pelvic from hip pathology and to identify patients without athletic pubalgia. This is a valuable screening tool in the armamentarium of the sports medicine clinician.