Common injuries among Brazilian Jiu Jitsu practitioners in Medan City

Brazilian Jiu Jitsu (BJJ) is a martial art that focuses on floor fighting and was first popularized in Brazil. The BJJ originally focused on entertainment, health, and self-development. These goals changed when practitioners began participating in competitions in which there was a significant increase in the number of BJJ injuries. A pre-survey in the field indicated that many jiu jitsu practitioners were affected by common injuries. The type of research in this study is a descriptive survey with a cross-sectional approach conducted at Ryu Dojo Martial Arts Center, Musi Jiu Jitsu, and PBJI Medan City in March 2024. Data were collected in the form of questionnaires, interviews, and medical records of practitioners diagnosed with injuries who were sampled. Univariate analysis was used to obtain the frequency distribution of respondents for each variable, namely age, gender, belt level, weight, training frequency, and competitor status. The results of the study were analyzed using SPSS version 27.0. The results showed that the highest number of practitioners was in the late teenage group (53.8%), the highest gender was male (92.3%), and the highest number of practitioners was white belt (69.2%). Based on body weight, the highest number of practitioners was in the Light Feather category (< 64 kg/141 lbs) with a percentage of 26.9%, and the most training hours were 3-5 hours 16 (30.8%). Lower Back Pain was the most common injury with a total of 25 practitioners. A total of 75% of the practitioners stated that their daily activities were disrupted because of their injuries. It can be concluded that the majority of BJJ participants were in their late teens, male was the most common gender, and white belts were the most common practitioners. The most common injury was lower back pain due to the amateur competitor status. Most respondents stated that their injuries interfered with their daily activities

Incidence and risk factors of exercise-related knee disorders in young adult men

Background: Musculoskeletal disorders and injuries are common causes of morbidity and loss of active, physically demanding training days in military populations. We evaluated the incidence, diagnosis, and risk factors of knee disorders and injuries in male Finnish military conscripts. Methods: The study population comprised 5 cohorts of 1000 men performing their military service, classified according to birth year (1969, 1974, 1979, 1984, and 1989). Follow-up time for each conscript was the individual conscript's full, completed military service period. Data for each man were collected from a standard pre-information questionnaire used by defense force healthcare officials and from all original medical reports of the garrison healthcare centers. Background variables for risk factor analysis included the conscripts' service data, i.e., service class (A, B), length of military service, age, height, weight, body mass index (BMI), underweight, overweight, obesity, smoking habit, education, diseases, injuries, and subjective symptoms. Results: Of the 4029 conscripts, 853 visited healthcare professionals for knee symptoms during their military service, and 103 of these had suffered a knee injury. Independent risk factors for the incidence of knee symptoms were: older age; service class A; overweight (BMI 25.0-29.9 kg/m(2)); smoking habit; comprehensive school education only; and self-reported previous symptoms of the musculoskeletal, respiratory, and gastrointestinal system. The majority of visits to garrison healthcare services due to knee symptoms occurred during the first few months of military service. Knee symptoms were negatively correlated with self-reported mental and behavioral disorders. Conclusions: The present study highlights the frequency of knee disorders and injuries in young men during physically demanding military training. One-fifth of the male conscripts visited defense force healthcare professionals due to knee symptoms during their service period. Independent risk factors for the incidence of knee symptoms during military service were age at military service; military service class A; overweight; smoking habit; comprehensive school education only; and self-reported previous symptoms of the musculoskeletal system, respiratory system, or gastrointestinal system. These risk factors should be considered when planning and implementing procedures to reduce knee disorders and injuries during compulsory military service.Peer reviewe

Martial Arts for Health: Translating Research into Practice

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THE RELATIONSHIP BETWEEN MUSCULOSKELETAL STRENGTH, PHYSIOLOGICAL CHARACTERISTICS, AND KNEE KINESTHESIA FOLLOWING FATIGUING EXERCISE

Fatiguing exercise may result in impaired functional joint stability and increased risk of unintentional injury. While there are several musculoskeletal and physiological characteristics related to fatigue onset, their relationship with proprioceptive changes following fatigue has not been examined. The purpose of this study was to establish the relationship between musculoskeletal and physiological characteristics and changes in proprioception, measured by threshold to detect passive motion (TTDPM), following fatiguing exercise. Twenty, physically active females participated (age: 28.65 ± 5.6 years, height: 165.6 ± 4.3 cm, weight: 61.8 ± 8.0 kg, BMI: 22.5± 2.3 kg/m2, BF: 23.3 ± 5.4%). During Visit 1, subjects completed an exercise history and 24-hour dietary questionnaire, and body composition, TTDPM familiarization, isokinetic knee strength, and maximal oxygen uptake/lactate threshold assessments. During Visit 2, subjects completed TTDPM and isometric knee strength testing prior to and following a fatiguing exercise protocol. Wilcoxon signed rank tests determined TTDPM and isometric knee strength changes from pre- to post- fatigue. Spearman’s rho correlation coefficients determined the relationship between strength and physiological variables with pre- to post-fatigue changes in TTDPM and with pre-fatigue and post-fatigue TTDPM in extension and flexion (α=0.05). No significant differences were demonstrated from pre-fatigue to post-fatigue TTDPM despite a significant decrease in isometric knee flexion strength (P<0.01) and flexion/extension ratio (P<0.05) following fatigue. No significant correlations were observed between strength or physiological variables and changes in TTDPM from pre- to post-fatigue in extension or flexion. Flexion/extension ratio was significantly correlated with pre-fatigue TTDPM in extension (r=-0.231, P<0.05). Peak oxygen uptake was significantly correlated with pre-fatigue (r=-0.500, P<0.01) and post-fatigue (r=-0.520, P<0.05) TTDPM in extension. No significant relationships were demonstrated between musculoskeletal and physiological characteristics and changes in TTDPM following fatigue. The results suggest that highly trained individuals may have better proprioception, and that the high fitness level of subjects in this investigation may have contributed to absence of TTDPM deficits following fatigue despite reaching a high level of perceptual and physiological fatigue. Future studies should consider various subject populations, other musculoskeletal strength characteristics, and different modalities of proprioception to determine the most important contributions to proprioceptive changes following fatigue

A Validated Injury Surveillance and Monitoring Tool for Fast Jet Aircrew: Translating Sports Medicine Paradigms to a Military Population

BACKGROUND: Military populations, including fast jet aircrew (FJA - aka fighter aircrew/pilots), commonly suffer from musculoskeletal complaints, which reduce performance and operational capability. Valid surveillance tools and agreed recordable injury definitions are lacking. Our objective was to develop and then evaluate the validity of a musculoskeletal complaints surveillance and monitoring tool for FJA. METHODS: A Delphi study with international experts sought consensus on recordable injury definitions and important content for use in a surveillance and monitoring tool for FJA. Using these results and feedback from end-users (FJA), the University of Canberra Fast Jet Aircrew Musculoskeletal Questionnaire (UC-FJAMQ) was developed. Following its use with 306 Royal Australian Air Force (RAAF) FJA over 4 × five-month reporting periods, validity of the UC-FJAMQ was evaluated via multi-level factor analysis (MFA) and compared with routine methods of injury surveillance. RESULTS: Consensus was achieved for: eight words/descriptors for defining a musculoskeletal complaint; six definitions of recordable injury; and 14 domains important for determining overall severity. The UC-FJAMQ was developed and refined. MFA identified three distinct dimensions within the 11 items used to determine severity: operational capability, symptoms, and care-seeking. MFA further highlighted that symptom severity and seeking medical attention were poor indicators of the impact musculoskeletal complaints have upon operational capability. One hundred and fifty-two episodes of time loss were identified, with the UC-FJAMQ identifying 79% of these, while routine methods identified 49%. Despite modest weekly reporting rates (61%), the UC-FJAMQ outperformed routine surveillance methods. CONCLUSIONS: The UC-FJAMQ was developed to specifically address the complexities of injury surveillance with FJA, which are similar to those noted in other military and sporting populations. The results demonstrated the UC-FJAMQ to be sensitive and valid within a large group of FJA over 4 × five-month reporting periods. Adoption of consistent, sensitive, and valid surveillance methods will strengthen the FJA injury prevention literature, ultimately enhancing their health, performance, and operational capability. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40798-022-00484-1

Correlación de las ratios de fuerza bilateral e ipsilateral con el equilibrio en atletas femeninas de taekwondo

[ES] Este estudio tuvo como objetivo analizarla fuerza isocinética de la rodilla de la pierna dominante (PL) y no dominante (NPL), las ratios de asimetría lateral y examinar su correlación con el equilibrio estático. Dieciséis mujeres atletas de taekwondo (TKD) participaron voluntariamente en el estudio. La fuerza de extensión (Ex) y flexión (Flx) isocinética de la rodilla se midieron en contracciones concéntricas/concéntricas (Con/Con) a velocidades angulares de 60°/s, 180°/s y 240°/s. Se calcularon las ratios ipsilaterales (H/Q) y bilaterales (H/H y Q/Q)isquiotibiales / cuádriceps. Los equilibrios estáticos se determinaron tomando el centro de presión corporal en los ejes X (COPX) e Y (COPY). El análisis estadístico se realizó mediante t-test de muestras pareadas y las tests de correlación de Pearson. Cuando se examinó la fuerza isocinética de la rodilla, se encontró que el parámetro de velocidad angular de 60°/s era significativamente diferente en la fase de Flx, mientras que las velocidades angulares de 180°/s y 240°/s eran significativamente diferentes en la fase de Ex a favor de las PLs. No hubo diferencias significativas en las ratios de fuerza bilateral e ipsilateral de todas las velocidades angulares. Hubo una correlación significativa entre HQ a 240°/s y COPX en términos de ratios de asimetría ipsilateral, y se encontró una correlación significativa entre HH a 60 °/s y COPX en términos de ratios de asimetría bilateral. Se encontró que había diferencias de fuerza entre las PL y NPL, pero no se observó asimetría. No se halló un alto nivel de correlación entre las ratios de asimetría lateral y el equilibrio en atletas femeninas de TKD.[EN] This study aimed to analyze preferred leg (PLs) and non-preferred leg (NPLs)isokineticknee strength, lateralasymmetry ratios and to examine their correlation with static balance. Sixteen female taekwondo (TKD) athletesvoluntarily participated in the study. Kneeisokinetic extension (Ex) and flexion (Flx) strength were measured in concentric / concentric (Con / Con) contractions at angular velocities of 60°/s, 180°/s, and 240°/s. Ipsilateral hamstring/ quadriceps (H/Q) and bilateral (H/H and Q /Q) ratios were calculated. Static balances were determined bytaking thecenter of body pressure in X (COPX) and Y (COPY) axis. Paired samplet-test and Pearson correlation tests were used in statistical analysis. When theisokineticknee strength was examined, it was found that 60°/s angular velocity parameterwas significantly different in Flx phase while 180°/s and 240°/s angular velocities were found to be significantlydifferent in Ex phase in favor of PLs. There was no significance in bilateral and ipsilateral strength ratios of all angularvelocities. There was a significant correlation between 240°/s HQ and COPX in terms of ipsilateral asymmetry ratioswhereas a significant correlation was found between 60°/s HH and COPX in terms of bilateral asymmetry ratios. It wasfound that therewere differences in strength between PL and NPLs, but no asymmetry was observed. There was no high level of correlation between lateral asymmetry ratios and balance in female TKD practitioners.[PT] Este estudo teve como objetivo analisar a força isocinética do joelho da perna preferida (PLs) e da perna não preferida (NPLs), as razões de assimetria lateral e examinar a sua correlação com o equilíbrio estático. Dezesseis mulheres atletas de taekwondo (TKD) participaram voluntariamente no estudo. A força de extensão (Ex) e flexão (Flx) isocinética do joelho foram medidas em contrações concêntricas / concêntricas (Con/Con) em velocidades angulares de 60°/s, 180°/s e 240°/s. Foram calculadas as rácios isquiotibiais / quadríceps ipsilaterais (H/Q) e bilaterais (H/H e Q/Q). Os equilíbrios estáticos foram determinados tomando o centro de pressão corporal nos eixos X (COPX) e Y (COPY). O teste t de amostra emparelhada e os testes de correlação de Pearson foram usados na análise estatística. Quando a força isocinética do joelho foi examinada, verificou-se que o parâmetro de velocidade angular de 60°/s foi significativamente diferente na fase Flx, enquanto as velocidades angulares de 180°/s e 240°/s foram significativamente diferentes na fase Ex em favor de PLs. Não houve significância nas rácios de força bilateral e ipsilateral de todas as velocidades angulares. Houve uma correlação significativa entre HQ de 240°/s e COPX, em termos de rácios de assimetria ipsilateral, enquanto uma correlação significativa foi encontrada entre HH de 60°/s e COPX em termos de rácios de assimetria bilateral. Verificou-se que havia diferenças de força entre PL e NPLs, mas nenhuma assimetria foi observada. Não houve um alto nível de correlação entre as rácios de assimetria lateral e equilíbrio em mulheres praticantes de TKD

The effects of early physiotherapy treatment on musculoskeletal injury outcomes in military personnel: A narrative review

The risks and incidence rates of musculoskeletal injuries among military personnel are high, and the importance of physiotherapy in treating these injuries is well established. However, what is less clear is whether the timing of commencement of physiotherapy treatment affects musculoskeletal injury outcomes in military personnel. This lack of clarity is exacerbated by the known underreporting of injuries among military personnel, and the resulting self-management of musculoskeletal injuries using analgesics, non-steroidal anti-inflammatories and other means. This narrative review was designed to identify and synthesize current evidence regarding the effects of timing of physiotherapy treatment on musculoskeletal injury outcomes, focusing on potential benefits of early versus typical or delayed commencement of physiotherapy treatment. Overall, current evidence suggests early physiotherapy treatment of musculoskeletal injuries offers distinct advantages over typical or delayed commencement of physiotherapy treatment in military settings. Specifically, it appears early treatment expedites recovery in early phases following injury onset and benefits longer term mental health and well-being. It may also reduce the need for more invasive and costly health care interventions and enable earlier return to training and operational service. Importantly, a cultural shift within military contexts to ensure early reporting of musculoskeletal injuries is required if the benefits of early commencement of physiotherapy treatment are to be achieved

Does a SLAP lesion affect shoulder muscle recruitment as measured by EMG activity during a rugby tackle?

Background: The study objective was to assess the influence of a SLAP lesion on onset of EMG activity in shoulder muscles during a front on rugby football tackle within professional rugby players. Methods: Mixed cross-sectional study evaluating between and within group differences in EMG onset times. Testing was carried out within the physiotherapy department of a university sports medicine clinic. The test group consisted of 7 players with clinically diagnosed SLAP lesions, later verified on arthroscopy. The reference group consisted of 15 uninjured and full time professional rugby players from within the same playing squad. Controlled tackles were performed against a tackle dummy. Onset of EMG activity was assessed from surface EMG of Pectorialis Major, Biceps Brachii, Latissimus Dorsi, Serratus Anterior and Infraspinatus muscles relative to time of impact. Analysis of differences in activation timing between muscles and limbs (injured versus non-injured side and non injured side versus matched reference group). Results: Serratus Anterior was activated prior to all other muscles in all (P = 0.001-0.03) subjects. In the SLAP injured shoulder Biceps was activated later than in the non-injured side. Onset times of all muscles of the noninjured shoulder in the injured player were consistently earlier compared with the reference group. Whereas, within the injured shoulder, all muscle activation timings were later than in the reference group. Conclusions: This study shows that in shoulders with a SLAP lesion there is a trend towards delay in activation time of Biceps and other muscles with the exception of an associated earlier onset of activation of Serratus anterior, possibly due to a coping strategy to protect glenohumeral stability and thoraco-scapular stability. This trend was not statistically significant in all cases

An Exploratory Study of Military Management Practices, Physical activity, and the Prevalence of Shin Splints in ROTC Cadets

Medial Tibial Stress Syndrome (MTSS, Shin splints) is very common in military personnel accounting for up to 35% of incidences, which is almost twice the incidence seen in the average active individual. Each year there is in increase number of injuries in Army recruits. Though Army Reserve Officer Training Corps (ROTC) programs are known for commissioning approximately 60% of 2nd Lieutenants and 40% of generals on active Army duty, no research has been done examining MTSS occurrences in relation to military management practices. Therefore, the purpose of this study is to explore the relationship between military management practices and the prevalence of shin splints in Army ROTC cadets. The study consisted of 63 Army ROTC cadets. The data was explored by addressing frequencies, descriptive statistics, crosstabs and correlations of the data. MTSS incidences had a significant relationship with days missed, endurance training, ROTC classification and ROTC club participation

Injuries in New Zealand Army Recruits

Musculoskeletal injuries are a major concern for the military resulting in substantial burdens for both recruits and the service. Recruits report high incidence of musculoskeletal injuries with the majority occurring to the lower limbs. Consequences of recruit injuries can be considerable for the individual including reduced participation, injury chronicity, training time loss and career pathway change due to backsquad or discharge. For the military, recruit injuries can result in increased health care expenditure, additional costs related to training, and recruitment and retention to replace injured recruits. Potentially, deployment capability may be impacted as fewer recruits progress from basic training to trade training or operational units, whereby they gain essential skills to become deployable. Injury incidence data were limited for New Zealand Army recruits with a current understanding of the recruit injury problem unknown. It was unknown whether recruits present for basic training with pre-existing injuries or risk factors that could predispose them to injury, and if a prevention program using neuromuscular training could lower recruit injury incidence. The aim of the current program of research was to establish the extent of the New Zealand Army recruit injury problem, the profile and aetiology of recruit injuries and the effect of six weeks neuromuscular training compared to usual training on incidence of lower limb injury of New Zealand Army recruits undertaking basic training. Additionally, this program of research investigated if baseline personal, lifestyle and physical performance characteristics could predict actual injury sustained during training. This program of research comprised four studies based on the sequence of injury prevention model. The first study explored the extent of the New Zealand Army recruit injury problem through surveillance of four years of physiotherapy provisions for injuries sustained during basic training. Commencing basic training were 1896 recruits (1697 males, 199 females), who required 1683 physiotherapy provisions for injury sustained during training, across four years. Lower limb injuries accounted for more than 75% (n = 1285) of the total demand for physiotherapy service and injuries sustained at the knee and below accounted for 67% of all injury presentations. Studies 2, 3 and 4 investigated injury risk and injury outcomes in 248 New Zealand Army recruits (228 male, 20 female). Study 2 investigated personal profiles, lifestyle and physical performance characteristics of recruits presenting to basic training to identify if pre-existing conditions or risk factors for injury existed at the commencement of training. Recruits were predominantly male (91.9%) with an average age of 20.3 ± 2.8 years. Approximately 30% of recruits reported injury in the year prior to training commencing, with 44.8% of those injuries in the lower limbs. Approximately one fifth of recruits were self-reported current smokers. Recruits who passed the 2.4 km timed run for distance were 53.8% of males and 28.6% of females. Weight-bearing dorsiflexion lunge test performance was within a normal range (left = 10.2 ± 3.2 cm); although, 30.9% of recruits had limb asymmetry (>1.5 cm). Outcomes of the Y Balance TestTM for dynamic lower limb stability, found 70% of female recruits had high posterolateral reach asymmetry (8.1 ± 6.0 cm), while normalised composite reach scores were low (right) for male (92.2 ± 8.1%) and female recruits (89.0 ± 7.5%). Findings from Studies 1 and 2 informed the development of a neuromuscular injury prevention intervention program for army recruit injuries occurring at the knee and below. Study 3, a cluster randomised controlled trial design, was used to investigate if a six-week neuromuscular training program led to fewer lower limb injuries in basic training army recruits, across two intakes compared to usual training. Neuromuscular exercises did not change recruit injury incidence but did lower health care encounters for overall lower limb per recruit (control 4.83 ±7.58, intervention 3.45 ± 5.79, p = 0.041), and overall number of knee injuries (control 262, intervention 120) (p < 0.010) during basic training. Additionally, more intervention recruits completed training on time (p = 0.026). Study 4 considered whether personal, lifestyle, and physical performance characteristics can predict actual injuries sustained by recruits during training. From 248 participants commencing basic training, 46 (18.5%) recruits had missing data, which resulted in 202 (81.5%) remaining for the regression analysis. Backwards stepwise logistic regression had two variables associated with injury risk in the final model: passing the 2.4 km timed run and right Y Balance TestTM posterolateral reach. This model accurately predicted 60.9% of recruits with 36 correctly assigned as not injured and 87 correctly assigned as injured. Findings support the use of physical performance injury screening to identify recruits at risk of injury at entry to training so that mitigation measures could be taken to reduce this risk. This program of research identified several clinical implications and recommendations for future directions. Firstly, knee injuries are common in army recruits and need to be targeted by prevention programs. Secondly, recruits enter training with injury risk factors and therefore screening is important to identify individuals at higher risk so that measures could be taken to lower this risk. Thirdly, neuromuscular training reduces health care burdens associated with common lower limb injuries. Future recommendations include investigation of recruit injury risk factors and neuromuscular training over longer study durations and with larger samples. Investigation of the effectiveness of neuromuscular training delivered prior to basic training or as part of a recruit preconditioning program to lower injury and associated burdens requires consideration. Finally, injury consensus statements are required to improve consistency and accuracy reporting military recruit injury and to improve comparability of findings across military recruit research