Acute obturator internus muscle strain in a rugby player : a case report

A 28-year-old male rugby player presented with severe onset of right hip pain when he fell awkward after a ruck during an international match. A rare case of an acute strain of the obturator internus muscle, a deep muscle of the hip joint, is reported, which resolved completely after a period of rest and intense active physical therapy.http://www.minervamedica.it/en/journals/sports-med-physical-fitness2016-09-30hb2016Sports Medicin

The illness burden of gastrointestinal illness is two times higher if it is associated with systemic symptoms and signs: a cross-sectional study of the super rugby tournament over 5 seasons (102,738 player-days)

BACKGROUND : Gastrointestinal tract illness (GITill) in rugby players is underreported. The incidence, severity (% time loss illness, days lost per illness) and burden of GITill with/without systemic symptoms and signs in professional South African male rugby players during the Super Rugby tournament (2013-2017) are reported. METHODS : Team physicians completed daily illness logs of players (N.=537; 1141 player-seasons, 102738 player-days). The incidence (illnesses/1000 player-days, 95% CI), severity (% ≥1-day time-loss; days until return-to-play [DRTP]/single illness [mean: 95% CI]) and illness burden (IB: days lost to illness/1000 player-days) for the subcategories of GITill with/without systemic symptoms and signs (GITill+ss; GITill-ss), and gastroenteritis with/without systemic symptoms and signs (GE+ss; GE-ss) are reported. RESULTS : The incidence of all GITill was 1.0 (0.8-1.2). Incidence was similar for GITill+ss 0.6 (0.4-0.8) and GITill-ss 0.4 (0.3-0.5; P=0.0603). Incidence of GE+ss 0.6 (0.4-0.7) was higher than GE-ss 0.3 (0.2-0.4; P=0.0045). GITill caused ≥1-day time-loss in 62% of cases (GE+ss 66.7%; GE-ss 53.6%). GITill caused an average of 1.1 DRTP/single GITill, which was similar for subcategories. IB of GITill+ss was higher than GITill-ss (IB Ratio: 2.1 [1.1-3.9; P=0.0253]). IB for GITill+ss is 2 times higher than GITill-ss (IB Ratio: 2.1 [1.1-3.9]; P=0.0253); and GE+ss >3 times higher than GE-ss (IB Ratio: 3.0 [1.6-5.8]; P=0.0007). CONCLUSIONS : GITill accounted for 21.9% of all illnesses during the Super Rugby tournament, with >60% of GITill resulting in time-loss. The average DRTP/single illness was 1.1. GITill+ss and GE+ss resulted in higher IB. Targeted interventions to reduce the incidence and severity of GITill+ss and GE+ss should be developed.https://www.minervamedica.it/en/journals/sports-med-physical-fitnesshj2024Sports MedicineSDG-03:Good heatlh and well-bein

Management of proximal rectus femoris injuries-do we know what we're doing? : A systematic review

Rectus femoris (RF) injury is a concern in sports. The management RF strains/tears and avulsion injuries need to be clearly outlined. A systematic review of literature on current management strategies for RF injuries, and to ascertain the efficacy thereof by the return to sport (RTS) time and re-injury rates. Literature search using Medline via PubMed, WorldCat, EMBASE, SPORTDiscus. Eligible studies were reviewed. Thirty-eight studies involving hundred and fifty-two participants were included. Majority (n = 138; 91%) were males, 80% (n = 121) sustained RF injury from kicking and 20% (n = 31) during sprinting. The myotendinous (MT), (n = 27); free tendon (FT), (n = 34), and anterior-inferior iliac spine (AIIS), (n = 91) were involved. Treatment was conservative (n = 115) or surgical (n = 37) across the subgroups. 73% (n = 27) of surgical treatments followed failed conservative treatment. The mean RTS was shorter with successful conservative treatment (MT: 1, FT: 4, AIIS avulsion: 2.9 months). Surgical RTS ranged from 2–9 months and 18 months with labral involvement. With either group, there was no re-injury within 24 months follow-up. With low certainty of evidence RF injury occurs mostly from kicking, resulting in a tear or avulsion at the FT and AIIS regions with or without a labral tear. With low certainty, findings suggest that successful conservative treatment provides a shortened RTS. Surgical treatment remains an option for failed conservative treatment of RF injuries across all subgroups. High-level studies are recommended to improve the evidence base for the treatment of this significant injury.http://www.termedia.pl/Journal/Biology_of_Sport-78am2024Sports MedicineStatisticsSDG-03:Good heatlh and well-bein

Corticosteroids in sports-related injuries : friend or foe

Corticosteroids act as potent anti-inflammatory drugs and have been used in various sport settings for the treatment of both acute and chronic injuries. Basic physiology and mechanisms of action for gluco- and mineralocorticoids are discussed. Methods of administration, the action on the inflammatory response, and potential short and long-term side effects of corticosteroid use are also deliberated. More specifically, corticosteroid use in the treatment and management of sport-related injuries are discussed, elucidating on the ethical boundaries and anti-doping regulations pertaining to corticosteroid use in sports, as well as putting forth suggestions for the use of local steroid injections and their contraindications. In conclusion, it was found that, despite some controversy in the use of corticosteroid treatment in the sports environment, little empirical evidence exists that could conclusively rule for or against its use. It is however clear that, if clinically justified, there is a significant role for corticosteroid treatment in the realm of sports injury and notably with a relatively low risk profile, if administered correctly.http://www.safpj.co.za/index.php/safpjhttp://www.tandfonline.com/oemdam2017Sports Medicin

Evidence-based prescription for cyclo-oxygenase-2 inhibitors in sports injuries

Healthcare professionals are increasingly under pressure to return athletes to play in the shortest possible time. There is limited choice in providing treatment that speeds up tissue repair, while simultaneously maintaining good quality of healing. Inflammation forms a fundamental part in the process of tissue repair. However, excessive inflammation may cause more pain, and limit functional restoration. Although the use of anti-inflammatory treatment in the form of a cyclo-oxygenase-2 inhibitor (coxibs) has been widely recognised as being effective, the potential detrimental effect on tissue repair, as described mainly in animal model studies, needs to be taken into account. The side-effects profile on the gastrointestinal tract favour coxibs over non-traditional NSAIDs. The possible effects on the renal and cardiovascular systems also need to be considered. The prescription of coxibs should be pathology and situation specific. There are no clear guidelines on the correct time of administration and the duration of the course, but it seems that the literature is in agreement that they should be administered for a limited time at the lowest effective dose possible.http://medpharm.tandfonline.com/loi/ojfp20am201

Delayed onset muscle soreness : no pain, no gain? The truth behind this adage

The purpose of this article is to provide brief insight into delayed onset muscle soreness (DOMS), a phenomenon that is often experienced by recreational and elite athletes. The negative implications of DOMS include pain, decreased motivation to continue training, and decreased performance. While performance issues may be more relevant to the elite athlete, pain and decreased motivation are particularly relevant to recreational athletes wishing to sustain a regular level of physical activity. The article is aimed at general practitioners (GPs) who may encounter athletes presenting with DOMS, and who will benefit from understanding the proposed mechanisms, signs and symptoms of the condition. Numerous researchers have hypothesised that certain interventions may prevent or minimise the symptoms thereof, and all GPs could benefit from understanding the available options for athletes, and the scientific evidence that supports these options.http://www.safpj.co.za/index.php/safpjhttp://medpharm.tandfonline.com/loi/ojfp20#.VgJFAVQaJHgam201

The assessment and management of lateral ankle ligament injuries

The assessment and management, as well as the clinical examination, special investigations and treatment of sports-related lateral ankle ligament injuries, are summarised for the general practitioner. Practical advice is discussed, when identifying and diagnosing chronic ankle injuries, and subsequent referral for specialist involvement.http://creativecommons.org/licenses/by-nc-nd/4.0am201

Subjective sleep patterns and jet-lag symptoms of junior netball players prior to and during an international tournament : a case study

PURPOSE : To assess the impact of long-haul transmeridian travel on subjective sleep patterns and jet lag symptoms in youth athletes around an international tournament. METHODS : An observational descriptive design was used. Subjective sleep diaries and perceived responses to jet lag were collected and analyzed for a national junior netball team competing in an international tournament. Sleep diaries and questionnaires were completed daily prior to and during travel, and throughout the tournament. Results were categorized into pretravel, travel, training, and match nights. Means were compared performing a paired Student t test with significance set at P < .05. Data are presented as mean (SD) and median (minimum, maximum). RESULTS : Athletes reported significantly greater time in bed on match days compared with training (P < .001) and travel (P = .002) days, and on pretravel days compared with travel (P < .001) and training (P = .028) days. Sleep ratings were significantly better on pretravel days compared with match (P = .013) days. Perceived jet lag was worse on match (P = .043) days compared with pretravel days. Significant differences were also observed between a number of conditions for meals, mood, bowel activity, and fatigue. CONCLUSION : Youth athletes experience significantly less opportunity for sleep during long-haul transmeridian travel and face disruptions to daily routines during travel which impact food intake. Young athletes also experience disturbed sleep prior to and during competition. These results highlight the need for practices to alleviate jet lag symptoms and improve the sleep of young athletes traveling for tournaments in an effort to optimize recovery and performance.https://journals.humankinetics.com/view/journals/ijspp/ijspp-overview.xmlhj2023Sports Medicin

Virtual training with real-life benefits : a survey investigating online fitness communities during lockdown level 5 in South Africa

In response to the COVID-19 pandemic, the South African government enforced a strict lockdown during March and April 2020. Strategies to assist people with maintaining physical activity (PA) became important, and online fitness communities (OFC) offered virtual assistance. This study aimed to investigate the benefits of participating in OFC on physical and mental health during lockdown level 5 in South Africa. The study utilised an online survey which included the Godin Leisure-Time Questionnaire. Participants maintained PA before and during lockdown (n=335; p=0.5). However, significant declines in PA were reported for those who did not find an OFC helpful in achieving exercise goals (p=0.004), nor motivating in pursuing fitness (p=0.001), and not helpful in alleviating perceived feelings of depression and/or anxiety (p=0.001). Participants who indicated that lockdown positively impacted motivation and that OFC were motivating in achieving fitness goals showed a significant improvement in PA (p=0.003). The proven effectiveness of OFC should encourage all health and fitness practitioners to integrate them for current and future use.https://journals.nwu.ac.za/sajrsperSports MedicineSDG-03:Good heatlh and well-bein

MRI findings in chronic exertional compartment syndrome of the forearm : using signal intensity ratio as a diagnostic tool

BACKGROUND : Chronic exertional compartment syndrome (CECS) of the forearm is a rare but important cause of morbidity amongst athletes involved in strenuous upper limb activities. The diagnosis remains challenging due to the absence of objective, reproducible diagnostic studies. OBJECTIVES : To assess and quantify signal intensity (SI) changes of involved muscles in patients with CECS of the forearm compared to healthy control subjects competing in similar sporting disciplines. Also, to objectively measure MRI SIs within muscle compartments when using a pre- and post-exercise regime and calculating a signal intensity ratio (SIR) between post- and pre-exercise studies. METHOD : The study retrospectively examined MRI scans of patients treated for CECS of the forearm and compared these to the MRI scans of asymptomatic high-level rowers. A specific, reproducible pre- and post-exercise MRI scanning protocol was utilised in both patient and control subjects between 2011 and 2020. Signal intensities were evaluated pre- and post- exercise in involved muscle groups and ratios were calculated. RESULTS : A total of 86 SIs were measured (43 pre- and 43 post-exercise) in nine study participants (five patients and four controls). After post:pre-exercise comparisons, a statistically significant difference was found between control and patient groups (p = 0.0010). The extensor carpi radialis, flexor digitorum profundus and flexor digitorum superficialis muscles were most commonly involved. CONCLUSION : This study confirms that significant SI changes are apparent in patients with CECS of the forearm when making use of a standardised pre- and post-exercise MRI protocol. Furthermore, SIR may be used to accurately diagnose CECS of the forearmThe Capital Radiology Practice and the Pretoria MR Trust.http://www.sajr.org.zahj2022RadiologySports MedicineStatistic