Epidemiology of Musculoskeletal Injuries in Adult Athletes: A Scoping Review

Background and Objectives: Sport-related musculoskeletal injuries (MSK-Is) are a common health issue in athletes that can lead to reduced performance. The aim of this scoping review was to synthetize available evidence on injury incidence rates (IIRs), types, and sites that affect the musculoskeletal (MSK) system of adult athletes. Materials and Methods: We performed a scoping review on the Pubmed database limiting our search to 33 Olympic sports. Results: We identified a total of 1022 papers, and of these 162 were examined in full for the purpose of this review. Archery was the sport with the highest risk of injuries to the upper extremities, marathons for the lower extremities, and triathlon and weightlifting for the body bust. In the majority of the sports examined, muscle/tendon strain and ligament sprain were the most common MSK-Is diagnoses, while athletics, karate, and football were the sports with the highest IIRs, depending on the methods used for their calculations. Conclusions: Our scoping review highlighted the general lack and dishomogeneity in the collection of data on MSK-Is in athletes.

Knee pain: Ultrasound and MRI correlation

Background Knee pain incidence is increasing among the community which has different multiple pathologies. Magnetic Resonance Imaging (MRI) is considered the gold standard imaging modality in diagnosing knee soft tissue injury. Ultrasound (US) is another modality which can be used in diagnosing soft tissue injury. Aim of the Work is to detect the reliability of US in diagnosing cases with knee pain as compared to MRI. Patients and Methods A prospective study was conducted on 20 patients with knee pain. They were referred from the Orthopedic and/or Rheumatology Department to Radiology department at Ain Shams University hospitals for MRI and US examination of the knee.The age group were from 19 to 59 years. Results In this study, 20 patients were examined with majority being males (75%). US was tested against MRI for different soft tissue pathologies.including knee effusion, meniscal pathology (tear, degeneration and extrusion), medial collateral ligament sprain, lateral collateral ligament sprain and Baker’s cyst. There was good agreement between US and MRI in most of these pathologies. US showed an overall sensitivity of 61.7% and specificity of 92.7% with accuracy of 86.9%. The overall PPV and NPV were 66.1% and 91.3% respectively. Conclusion Ultrasound can be considered a reliable screening imaging modality in cases of knee pain.

Evaluation of the Effects of Tecar Therapy on Acute Symptoms of Athletes Following Lateral Ankle Ligament Sprain

Background and Objectives: Tecar therapy as a modality has been considered due to its reported effects on reducing pain and swelling and finally increasing range of motion and improving function. The aim of this study was to evaluate the effects of tecar therapy on acute symptoms of athletes following lateral ankle ligament sprain in the treatment and control groups between pre-treatment periods, after 6 sessions, and after 12 sessions of treatment. Methods: In this study, 23 patients in each group including athletes with an acute lateral ankle ligament sprain in the acute stage in Tehran. The participant of this study were divided into 2 groups of control with normal treatment and the second group with normal treatment + tecar treatment. Participants were homogenized in terms of age, height, weight, and level of exercise. To evaluate the pain intensity of patients in the two groups and to measure the swelling of the ankle joint, a tape measure (mm) was used. A goniometer was used to measure the degree of ankle motions. The Foot and Ankle Ability Measure (FAAM) questionnaire was also used to collect data. Results: Statistical analyzes showed that the mean numerical visual criterion of pain in both groups was significantly lower after 6 and 12 sessions of treatment (P<0.001). The results of the analysis of variance showed that the mean swelling in the treatment group and in the control group after 6 and 12 sessions of treatment (P<0.001) was significantly lower than the mean swelling before treatment. Also, the mean swelling after 12 sessions of treatment was significantly lower than after 6 sessions of treatment (P<0.001). Regarding daily life activities and the percentage of athlete satisfaction in performing the activity, the test results showed that the athlete’s scores after 6 and 12 sessions of treatment (P<0.001) were significantly higher than before treatment. Also, their scores after 12 sessions of treatment were significantly higher than 6 sessions (P<0.001). The performance scores in both groups after 6 and 12 sessions of treatment (P<0.001) were significantly higher than performance scores before treatment. Also, the performance scores after 12 sessions of treatment were significantly higher than 6 sessions of treatment (P<0.001). Conclusion: The results of the present study showed that tecar therapy in patients with lateral ligament sprain of the ankle joint improves the condition of symptoms after an injury, including swelling, pain, daily life activities, percentage of athlete satisfaction with daily activities, and finally his performance and it can be used as a complementary treatment along with common therapies.

Cost and Treatment Characteristics for Sport-Related Knee Injuries Managed by Athletic Trainers: A Report from the Athletic Training Practice-Based Research Network

ABSTRACT Context: Knee injuries are common during sport participation. However, little is known about the overall management and estimated direct cost of care associated with these injuries when under the care of athletic trainers. Objective: To describe treatment characteristics and direct costs of care for athletic training services provided for patients with knee injuries. Design: Descriptive. Setting: Ninety-five athletic training facilities across 24 states. Participants: One hundred and seventeen athletic trainers (female=56.4%, age=29.4±8.7 years, years certified=4.7±6.0, years employed at site=1.6±4.1). Interventions: Complete patient cases were identified using ICD-10 diagnostic codes between 2009–2020. Main Outcome Measures: Summary statistics were calculated for patient demographics, treatment characteristics, and direct costs of care. Treatment characteristics included type of athletic training service, duration, amount (eg, number of visits), and direct cost of care. Results: Four hundred forty-one patient cases were included in this study. The most common injuries reported were cruciate ligament sprain (18.1%, n=80), medial collateral ligament sprain (15.4%, n=68), and knee pain (14.1%, n=62). Injuries occurred most frequently during football (35.4%, n=156), basketball (14.7%, n=65) and soccer (12.7%, n=56). A total of 8,484 athletic training services were recorded over 4,254 visits, with therapeutic exercise (29.8%, n=2,530), hot/cold pack (25.8%, n=2,189), and therapeutic activities (11.2%, n=954) being the most frequently reported services. The median duration of care was 23 days and number of visits was 8. The median total cost of care was $564 per injury and $73 per visit. Conclusions: Knee injuries have demonstrated greater time-loss when compared to other lower extremity injuries. Thus, it is unsurprising that knee injuries are associated with higher duration of care and higher cost of care as compared to other lower extremity injuries such as ankle sprains. Future efforts should seek to understand the effectiveness of common treatment strategies and aim to identify treatments that can reduce costs and improve patient outcomes.

Accompanying Injuries of Ankle Joint Among the Fifth Metatarsal Basis Fractures

Background: Fifth metatarsal basis fractures are the most commonly seen fractures of the foot. Ankle sprains occur with inversion and plantar flexion mechanisms, like most of the fifth metatarsal basis fractures. Our aim was to investigate the possible accompanying ankle injuries about the fifth metatarsal basis fractures.Methods: Hospital's digital database was searched for the ICD 10 codes of the metatarsal bone fractures such as 'S92.30 and S92.35' between January 2015 and January 2018. Thirty nine patients with fifth metatarsal basis fracture who had an ankle magnetic resonance imaging (MRI) within 14 days of the injury were included in the study. MRI findings were evaluated and comparison was performed according to the fracture zones, gender and age.Results: The most common finding on MRI was talocrural joint effusion (TTJE) which was observed in 28 patients (71.8%). Bone marrow edema was observed in 16 patients (41%). Chondral injury at the medial dome of talus was observed in three patients (7.7%). Grade 1 ligament sprain was observed in 6 of the patients (15.4%). Lateral ligament sprain was observed only in two patients, while four of the sprains were about the deltoid ligament.Conclusions: Although most of the fifth metatarsal basis fractures and ankle sprains occur as a result of a common mechanism, physical examination and patients' complaints are very important. Routine MRI imaging should be unnecessary for most patients. If a patient with a fifth metatarsal basis fracture has complaints about his/her ankle joint, one should be aware of bone marrow edema which was observed in 41% of our study population.

Rugby World Cup 2019 injury surveillance study

Background: Full contact team sports, such as rugby union, have high incidences of injury. Injury surveillance studies underpin player welfare programmes in rugby union. Objective: To determine the incidence, severity, nature and causes of injuries sustained during the Rugby World Cup 2019. Methods: A prospective, whole population study following the definitions and procedures recommended in the consensus statement for epidemiologic studies in rugby union. Output measures included players’ age (years), stature (cm), body mass (kg), playing position, and group-level incidence (injuries/1000 player-hours), severity (days- absence), injury burden (days absence/1000 player-hours), location (%), type (%) and inciting event (%) of injuries. Results: Overall incidences of injury were 79.4 match injuries/1000 player-match-hours (95% CI: 67.4 to 93.6) and 1.5 training injuries/1000 player-training-hours (95% CI: 1.0 to 2.3). The overall mean severity of injury was 28.9 (95% CI: 20.0 to 37.8) days absence during matches and 14.8 (95% CI: 4.1 to 25.5) days absence during training. The most common locations and types of match injuries were head/face (22.4%), posterior thigh (12.6%), ligament sprain (21.7%) and muscle strain (20.3%); the ankle (24.0%), posterior thigh (16.0%), muscle strain (44.0%) and ligament sprain (16.0%) were the most common locations and types of injuries during training. Tackling (28.7%), collisions (16.9%) and running (16.9%) were responsible for most match injuries and non-contact (36.0%) and contact (32.0%) rugby skills activities for training injuries. Conclusion: The incidence, severity, nature and inciting events associated with match and training injuries at Rugby World Cup 2019 were similar to those reported for Rugby World Cups 2007, 2011 and 2015.

Skateboarding Injuries in Spain: A Web-Based Survey Approach

Background: The inclusion of skateboarding in the Tokyo 2020 Olympic Games reinforces this activity as a sport. As the number of skateboarders around the world and the difficulty of skateboarding maneuvers continue to increase, the number of skateboarding injuries may also rise. Thus, there is a need for more comprehensive investigations into the practice habits and injuries of skateboarders. Purpose: To describe the sports habits and skateboarding injuries of a sample of skateboarders in Spain. Study Design: Descriptive epidemiology study. Methods: A web-based survey was shared among skateboarders in Spain. The survey collected data related to sports habits, skateboarding practice habits, and injury history. Comparisons between subgroups of sex, age, and experience were also conducted. Results: The survey was completed by 197 participants (89.3% male) with a mean age of 24.4 ± 7.1 years and a mean experience of 9.7 ± 7.2 years. Most respondents (87.8%) reported not participating in any type of skateboarding-specific physical training program. Only 27.4% took part in skateboarding competitions, with a larger number of respondents younger than 18 years participating in competitive events. The mean number of sessions per week was 3.3 ± 1.7, and the mean length of sessions was 3.3 ± 1.5 hours. The majority of participants (87.8%) reported having suffered injuries (n = 323) as a result of skateboarding, mainly affecting the lower limbs (69.7%). The most common injury type was a ligament sprain (39.6%), especially of the ankle (39.3%). This injury was also reported as the most likely to recur (70.1%). A large number of injuries (54.2%) were considered severe (ie, >21 days to recover). Most injuries occurred while skateboarding gaps or stairs, including any type of a jump that involved a difference in height between the take-off and landing surfaces (25.7%). Female participants accounted for a larger number of ligament sprains than expected, and experienced skateboarders were more likely to suffer more severe injuries and head/trunk injuries. Conclusion: Respondents to this survey were mainly young male adults who practiced skateboarding recreationally. Respondents of different sexes, ages, and experiences demonstrated different habits and injury patterns. The greater number of severe injuries highlights the need for injury surveillance in skateboarding to inform better prevention and rehabilitation practices.