What Are the Main Risk Factors for Lower Extremity Running-Related Injuries? A Retrospective Survey Based on 3669 Respondents

Background: Despite the many studies on running-related injuries (RRIs), risk factors for injury remain unclear in the literature. Purpose: To investigate the risk factors of RRIs. Study Design: Case-control study; Level of evidence, 3. Methods: An online survey was conducted among 3669 injured and noninjured runners. Injury was defined as pain of various kinds, without attention to its consequences on running practice. The survey included 41 questions on 5 main categories—personal characteristics, daily lifestyle, training and running characteristics, practice of other sporting activities, and prevention habits—as well as information about the occurrence of RRI over the previous 12 months. Continuous and qualitative variables were analyzed by Student t test and chi-square test, respectively. Sixteen variables were selected for multivariate binary logistic analysis. Results: Among the 3669 runners, 1852 (50.5%) reported at least 1 injury over the previous 12 months. Overuse injuries were largely represented (60.6%). The variables associated with RRIs that remained significant in the fully adjusted model were previous injury (odds ratio [OR], 1.62; 95% CI, 1.42-1.86), higher weight (OR, 1.006; 95% CI, 1.00-1.012), competitive running (OR, 1.53; 95% CI, 1.19-1.98), running >2 h/wk (OR, 1.28; 95% CI, 1.01-1.62), running >20 km/wk (OR, 1.25; 95% CI, 1.001-1.55), and stretching before running (OR, 1.46; 95% CI, 1.25-1.71). Conclusion: Previous injury remains the most relevant risk factor for RRIs according to the current study and previous data. Many training characteristics seem to be involved but still have to be confirmed in view of conflicting data in the literature. Further research would help clinicians better understand RRIs and how to prevent them.

A - 28 Mastering Concussion Reporting: Does Previous Injury and Education Play a Role in Reporting Skill?

Objective The purpose of this study was to determine whether previous injury (PI) and/or concussion education (ce) significantly predicted collegiate athlete reporting skill (RS). It was hypothesized that both PI and ce would be significant predictors of RS. Methods A cross-sectional study design was implemented, and collegiate athletes (n = 105; age = 19.77 ± 1.23; sex = 53% female) from two institutions were included in the study. Participants were administered a demographic questionnaire to determine PI and ce prior to enrollment, and the Reporting Skill Scale (5-items) was administered to measure RS. A composite score (range: 1–5) was calculated where higher values indicated greater RS. A stepwise multivariable linear regression was used to determine the predictive value of PI and ce on RS (a priori p < 0.05). Results A high percentage of the sample reported PI (n = 52, 49%), received ce (n = 83, 78%), and had high levels of RS (4.27 ± 0.68). The stepwise multivariable linear regression generated a one predictor model where ce significantly predicted RS (F(1,105) = 4.804, p = 0.03, R2 = 0.05, β = 0.35, 90% CI [0.33, 0.67]), whereas PI did not significantly predict RS (p = 0.83, β = −0.22). Conclusions The study revealed that ce partially predicts RS in collegiate athletes. Although the predicted variance was small, this highlights that educating athletes on the steps needed to report an injury is better suited for influencing the psychomotor domain of concussion reporting than simply experiencing a PI. Determining an athlete’s RS, including the factors that influence it, can aid clinicians in identifying athletes that may not fully understand how to report a concussion following injury.

Pain at the Slaughterhouse in Ruminants with a Focus On the Neurobiology of Sensitisation

We pose, based on a neurobiological examination, that events that occur around the time of slaughter have the potential to intensify the pain response, through the processes of sensitisation and enhanced transmission. Sensitisation, or an enhanced response to painful stimuli, is a well-discussed phenomenon in the human medical literature, which can arise from previous injury to an area, inflammatory reactions, or previous overstimulation of the stress axes. A number of events that occur prior to arrival at, or in the slaughterhouse, may lead to presence of these factors. This includes previous on-farm pathology, injuries arising from transport and handling and lack of habituation to humans. Whilst there is limited evidence of a direct effect of these on the processes of sensitisation in animals at slaughter, by analogy with the human neurobiology literature the connection seems plausible. In this review a neurobiological approach is taken to discuss this hypothesis in the light of basic science, and extrapolations from existing literature on the slaughter of ruminants. To confirm the postulated link between events at slaughter, and processes of hypersensitisation, further dedicated study is required.

Incidence Rate of Musculoskeletal Injuries among Professional Tennis Players during 2019 International Tournaments in Indonesia

Several studies have indicated that musculoskeletal injuries are common during a professional tennis competition. However, data from a tropical country like Indonesia is lacking. This study aimed to obtain the incidence rate and injury characteristics and identify risk factors of musculoskeletal injuries among professional tennis players competing in Indonesia under the International Tennis Federation (ITF). The study was a prospective cohort during professional tennis tournaments in Jakarta, Indonesia in 2019, consisting of the ITF Women’s Circuit Indonesia (two weeks) and ITF Men’s Future Indonesia (three weeks). All athletes were enrolled in this study. Injuries were assessed based on the ITF Consensus Statement. Incidence rate was the number of injuries per 1000 player hours (i.e., the total duration from before the match starts to completion of the match after the final point). The magnitude of risk was expressed as a relative risk (RR) and its 95% confidence interval (CI). Independent risk factors were identified using multivariate analyses. A total of 161 tennis players were enrolled; 71 (44.1%) were men. Their mean age was 22 years old. The incidence rate of musculoskeletal injuries was 30.8 injuries per 1000 player hours (95% CI: 28.2–33.5). The most common onset was acute injuries (61.1%), while the most common location and type of injury was the trunk (38.9%) and muscle strain (61.1%). Risk factors associated with musculoskeletal injury were higher body height, skill level, history of previous injury, and wet bulb globe temperature (WBGT) zone. There was no injury during the doubles matches. Previous injury was an independent risk factor (adjusted RR: 48.1 (95% CI: 11.3–155.0; p < 0.001). The incidence of musculoskeletal injuries among professional tennis player is considerably high. Factors associated with injury are body height, skill level, previous injury, and WBGT zone. Future injury prevention programmes should incorporate the management of previous injuries and take into account the effect of environmental temperature.

Normative measures of hip strength and relation to previous injury in collegiate cross-country runners

Context: Running related injury occurs frequently in collegiate cross-country runners. Hip strength is one factor that may be important in the rehabilitation and training of cross-country runners. However, no normative values exist to inform these strategies. Objective: Establish normative values for hip abduction and external rotation isometric strength in collegiate cross-country runners and explore the association between strength and previous injury. Design: Mixed methods using descriptive epidemiology and retrospective cross-sectional designs. Setting: University Laboratory Patients or Other Participants: Eighty-two NCAA Division III cross-country runners (38 males, 44 females) participated in this study. Main Outcome Measure(s): Isometric hip strength and reported injury Results: Males demonstrated greater absolute hip strength than females. Measures of hip strength were not different between sexes when normalized to height and mass. Hip abduction asymmetry was associated with previous injury in males. A combination of at least one leg with hip abduction weakness and bilateral external rotation weakness was associated with previous injury in females. Conclusions: Knowledge of normative values of hip strength may help inform rehabilitation strategies in collegiate cross-country runners. Males and females may demonstrate differing strength profiles following running related injury.

Control of waterhemp (Amaranthus tuberculatus) regrowth after failed applications of glufosinate or fomesafen

Foliar herbicide applications to waterhemp can result in inadequate control, leading to subsequent regrowth that often necessitates a second herbicide application to prevent crop interference and seed production. The most effective herbicides and application timings are unknown in situations where waterhemp has regrown from previous injury, such as failed applications of glufosinate or fomesafen. The objective of this research was to determine the optimum combination of herbicide and time from the first failed herbicide application to a sequential herbicide application for control of waterhemp regrowth. Reduced rates of either glufosinate or fomesafen were applied to 30-cm waterhemp plants to mimic failure of the initial herbicide application in separate bare-ground experiments. Respray treatments of glufosinate, fomesafen, lactofen, 2,4-D, or dicamba were applied 3, 7, or 11 d after the initial application. Glufosinate and fomesafen as respray treatments resulted in 90% to 100% control of waterhemp regardless of application timing following a failed glufosinate application. After a failed application of fomesafen, applying glufosinate or 2,4-D resulted in 87% to 99% control of waterhemp. Waterhemp control with fomesafen and lactofen was 13% to 21% greater, respectively, when those treatments followed glufosinate compared with fomesafen as the initial herbicides. On the basis of these results, glufosinate and fomesafen should be used for respray situations after inadequate control from glufosinate; and 2,4-D or glufosinate should be used for respray situations following inadequate control from fomesafen where crop tolerance and herbicide product labels allow. Although glufosinate followed by glufosinate was very effective for controlling waterhemp regrowth, caution should be exercised to avoid sequential application of herbicide with the same site of action.

Fear Avoidance Following Musculoskeletal Injury in Male Adolescent Gaelic Footballers

Context: Participating in Gaelic football provides a wealth of benefits, but a risk of musculoskeletal injury also exists. Injury is associated with physical consequences, including pain, discomfort, loss of function, time absent from school/sport, and considerable medical expenses, along with placing undue pressure on emergency services and hospital staff. Concurrent psychological consequences, such as fear avoidance, can also occur, causing psychological distress. There is a current dearth of available research examining the psychology of injury in male adolescent Gaelic footballers. Objective: To examine fear avoidance postinjury in male adolescent Gaelic footballers, the effect of pain, time loss, injury severity, and previous injury on the extent of fear avoidance, and the usefulness of a modified Athlete Fear Avoidance Questionnaire (AFAQ) as a screening tool for predicting injury. Design: Prospective cohort study. Setting: Recreational clubs. Participants: A total of 97 male adolescent club Gaelic footballers (13.4 [1.1] y). Interventions: Musculoskeletal injuries sustained during participation in Gaelic football, defined as any injury sustained during training or competition causing restricted performance or time lost from play, were assessed and recorded weekly by a certified athletic and rehabilitation therapist. Injuries requiring time loss from participation were classed as time-loss injuries. Injury characteristics that included type, nature, location, severity, and pain were recorded. Main Outcome Measures: Injured players completed the AFAQ, a measure of injury-related fear avoidance following injury assessment (AFAQ1). With time-loss injuries, the AFAQ was completed again (AFAQ2) prior to return to play. Modified AFAQ was completed at baseline. Results: Twenty-two injuries were recorded during the season with fear avoidance evident postinjury that significantly decreased before returning to play. Fear avoidance postinjury was higher in those with greater pain but time loss, injury severity, and previous injury did not significantly affect the extent of fear avoidance. Baseline fear avoidance did not predict injury. Conclusions: Psychological rehabilitation is recommended for managing postinjury psychological distress in male adolescent Gaelic footballers.