The Assessment, Management and Prevention of Calf Muscle Strain Injuries: A Qualitative Study of the Practices and Perspectives of 20 Expert Sports Clinicians

Background Despite calf muscle strain injuries (CMSI) being problematic in many sports, there is a dearth of research to guide clinicians dealing with these injuries. The aim of this study was to evaluate the current practices and perspectives of a select group of international experts regarding the assessment, management and prevention of CMSI using in-depth semi-structured interviews. Results Twenty expert clinicians working in elite sport and/or clinician-researchers specialising in the field completed interviews. A number of key points emerged from the interviews. Characteristics of CMSI were considered unique compared to other muscle strains. Rigor in the clinical approach clarifies the diagnosis, whereas ongoing monitoring of calf capacity and responses to loading exposure provides the most accurate estimate of prognosis. Athlete intrinsic characteristics, injury factors and sport demands shaped rehabilitation across six management phases, which were guided by key principles to optimise performance at return to play (RTP) while avoiding subsequent injury or recurrence. To prevent CMSI, periodic monitoring is common, but practices vary and data are collected to inform load-management and exercise selection rather than predict future CMSI. A universal injury prevention program for CMSI may not exist. Instead, individualised strategies should reflect athlete intrinsic characteristics and sport demands. Conclusions Information provided by experts enabled a recommended approach to clinically evaluate CMSI to be outlined, highlighting the injury characteristics considered most important for diagnosis and prognosis. Principles for optimal management after CMSI were also identified, which involved a systematic approach to rehabilitation and the RTP decision. Although CMSI were reportedly difficult to prevent, on- and off-field strategies were implemented by experts to mitigate risk, particularly in susceptible athletes.

Trauma Surgeon-Led and Funded Injury Prevention Program Decreases Number of All-Terrain Vehicle-Related Admissions

Background All-terrain vehicle (ATV) laws regarding helmet use, alcohol involvement, and roadway riding are poorly enforced or largely ignored. We hypothesized that direct surgeon funding and leadership in injury prevention would decrease ATV crashes. To focus prevention efforts, we reviewed a rural level 1 trauma center 11-year experience with ATV crashes comparing helmeted and unhelmeted rider outcomes. Methods For the latter 6 years of the study period, a trauma surgeon sponsored an injury prevention fund promoting ATV safety using simulators and discussions for area high school students. Helmet use, alcohol avoidance, and safe ATV operating were emphasized. A trauma registry review of ATV admissions from 2009 through 2020 examined demographics, helmet use, and clinical outcomes using chi-square, t-test, and regression analysis. Results Unhelmeted ATV riders suffered more severe head and neck injuries (OR 19, CI 1.5-1.8, P < .001), worse overall Injury Severity Score (ISS), (OR 25, CI 12.1-14.2, P < .001), and higher mortality rates (OR 4.0, CI .02-.05, P < .001). Helmet use corresponded with an average decrease in AIS and increase in GCS status. Although only 15% of riders were helmeted, ATV crash admissions have decreased in the last 5 years ( P < .001). Discussion All-terrain vehicle trauma and mortality is still frequent, especially in unhelmeted riders. The recent decrease in area ATV crashes is encouraging. Trauma surgeons have an opportunity to make a difference in public awareness and education through comprehensive physician-funded and directed injury prevention and research efforts.

The Effectiveness of a School-based Self-injury Prevention Program on Reducing Interpersonal Cognitive Distortion and Fear of Negative Evaluation in Adolescent Girls

Background: Non-Suicidal Self-Injury (NSSI) is a prevalent, harmful, and transdiagnostic behavior that can comprehensively be assessed in daily life studies. Objectives: This study aimed to determine the effectiveness of the student self-injury prevention program in mitigating the Interpersonal Cognitive Distortion (ICD) and the fear of Negative Evaluation (FNE). Materials & Methods: This research is a quasi-experimental study with a pre-test-post-test design, a one-month follow-up, and a control group. The statistical population consisted of all female adolescents studying at the middle schools of Rasht City, Iran, in the 2019–2020 academic years. They must have experienced self-injury at least once. The purposive non-random sampling technique was employed to select 34 self-injuring adolescents, who were then randomly assigned to case and control groups. The interpersonal cognitive distortion scale and the brief fear of negative evaluation scale were adopted to collect data. The case group received 16 sessions of self-injury prevention training for students (twice a week), whereas the control group had no training programs. Analysis of variance and multivariate analysis of variance were then used for data analysis in SPSS v. 25. Results: The results demonstrated the significant effectiveness of the training program in mitigating the ICD (interpersonal rejection: P<0.01; F=21.780, unrealistic relationship expectations: P<0.01; F=51.096, interpersonal misperception: P<0.01; F=20.557), reducing negative meta-emotion, and increasing positive meta-emotion (P<0.05; F=43.591). Conclusion: The student self-injury prevention program effectively reduced the ICD and FNE of female adolescents. Additionally, these two variables have high levels in adolescents struggling with self-injury.

Latest Trends in Neuromuscular Training to Prevent Anterior Cruciate Ligament Injury: A Literature Review

PURPOSE: Anterior cruciate ligament (ACL) injuries are the most common in sports and have doubled in the past 20 years. This study aimed to analyze the latest trends and changes in training programs for ACL injury prevention.METHODS: In this study, literature was searched using academic search sites, such as ‘PubMed’, ‘Google Scholar’, and ‘Wiley Online Library’. The literature published between 2015 and 2021 was used.RESULTS: Eleven papers were selected based on the literature selection criteria. Five warm-up exercise papers and six ACL injury prevention training program papers emphasized neuromuscular training.CONCLUSIONS: The ACL injury prevention program can be applied in warm-up exercises and training programs. It consists of an exercise form that includes multidimensional components such as plyometrics, muscle strength, balance, and agility. The key to the ACL injury prevention program is to reflect multidimensional components in neuromuscular training and to obtain a significant effect, and it is recommended to participate in regular training for 12-18 sessions and at least 6 months. In addition, it is suggested to utilize the ACL injury prevention program presented in this study until an individual study for ACL injury prevention by sports type is conducted.