Italian consensus conference on guidelines for conservative treatment on lower limb muscle injuries in athlete.

Provide the state of the art concerning (1) biology and aetiology, (2) classification, (3) clinical assessment and (4) conservative treatment of lower limb muscle injuries (MI) in athletes. Seventy international experts with different medical backgrounds participated in the consensus conference. They discussed and approved a consensus composed of four sections which are presented in these documents. This paper represents a synthesis of the consensus conference, the following four sections are discussed: (i) The biology and aetiology of MIs. A definition of MI was formulated and some key points concerning physiology and pathogenesis of MIs were discussed. (ii) The MI classification. A classification of MIs was proposed. (iii) The MI clinical assessment, in which were discussed anamnesis, inspection and clinical examination and are provided the relative guidelines. (iv) The MI conservative treatment, in which are provided the guidelines for conservative treatment based on the severity of the lesion. Furthermore, instrumental therapy and pharmacological treatment were discussed. Knowledge of the aetiology and biology of MIs is an essential prerequisite in order to plan and conduct a rehabilitation plan. Another important aspect is the use of a rational MI classification on prognostic values. We propose a classification based on radiological investigations performed by ultrasonography and MRI strongly linked to prognostic factors. Furthermore, the consensus conference results will able to provide fundamental guidelines for diagnostic and rehabilitation practice, also considering instrumental therapy and pharmacological treatment of MI. Expert opinion, level IV

The Italian Consensus Conference on FAI Syndrome in Athletes (Cotignola Agreement)

Background. Femoro-acetabular impingement (FAI) is an important topic in literature because of its strong relationship with sport populations. Methods. Sixty-five experts participated in "this Consensus Conference (CC)". They discussed, voted and approved a consensus document on the FAI syndrome in athletes. Results. The CC experts approved document provided suggestions concerning: 1) Epidemiology of FAI; 2) Clinical evaluation; 3) Radiological evaluation; 4) Conserva-tive treatment; 5) Surgical criteria; 6) Surgical techniques; 7) Post-surgical rehabilita-tion; 8) Outcome evaluation; 9) FAI-associated clinical frameworks. Conclusions. The CC offers a multidisciplinary approach to the diagnosis and treat-ment of FAI syndrome in athletes taking into account all the different steps needed to approach this pathology in sport populations

Change of ballistic movement after two different knee anterior cruciate ligament reconstruction techniques

La ricostruzione del legamento crociato anteriore effettuato con tendine rotuleo autologo oppure con semitendini comporta due diversi tipi di adattamento funzionale sia in termini muscolari che propriocettivi. In questo studio sono stati presi in considerazione 2 gruppi composti ciascuno da 15 soggetti di sesso maschile praticanti attività sportiva di cui, il primo, ha subito una ricostruzione di legamento crociato anteriore con tendine rotuleo autologo (GTR), ed, il secondo, con semitendini (GST). Obiettivo dello studio è stato quello di monitorare i deficit esistenti al termine del percorso di recupero (follow up a 150 giorni) tra arto sano ed arto leso nei due differenti gruppi. I risultati del follow up sui due gruppi osservati ha evidenziato una significativa differenza tra arto sano ed arto leso nel parametro relativo alla massima accelerazione negativa (44.99  6.41%, p<0.001) nel GST ed una significativa differenza relativamente al parametro massima forza di impatto al suolo (11.45  3.17%, p<0.001) nel GTR. I due gruppi hanno mostrato un diverso pattern di adattamento funzionale alla fine del periodo riabilitativo post-chirurgico, che suggerisce come le due tecniche ricostruttive necessitino, in tal senso, di un’attenzione particolare nella stesura dei programmi riabilitativi post-chirurgic

Strength ability, endurance and anthropometric parameters in youth football: descriptive analysis and functional relationships

Aim. Defining and identifying the motor abilities which contribute to outlining the potential footballer allows to train the young person with increased specificity and with sessions suited to the age and sporting discipline which he will have to practice, above all with reference to the principal youth categories. The study aims to: 1) outline the anthropometric (stature and weight) and functional (explosive strength with reuse of elastic energy, MAS and aerobic power) profile in the different youth categories, Under 15 (U15), Under 17 (U17), Under 20 (U20) of professional teams; 2) verify and describe any differences in the anthropometric and functional variables in the different youth categories observed.Methods. The study was conducted on a sample of 328 young footballers belonging to the under 20 (N.=64), under 17 (N.=142), under 15 (N.=122) categories. The anthropometric weight and height parameters were measured as well as the height of the centre of gravity by CMJ, and the maximal aerobic speed (MAS) and VO2max (indirect estimate) value determined by means of the Leger & Boucher incremental test, in the shuttle version.Results. The weight and stature values increase in a statistically significant manner in the passage from under 15 to under 20 (P<0.001). The VO2max and MAS values tend to identify a performance and statistically significant peak in the U20 category compared with the U15 category. The vertical jump values increase in a statistically significant manner (P<0.001) in the comparison U15 vs. U17, and in the comparison U15 vs. U20. The weight is correlated with the CMJ in all age groups; in the U15 category the height is significantly correlated with the CMJ (r=0.57, P<0.01) and with VO2max (r=0.298, P<0.01). The CMJ in the U20 category is negatively correlated with the VO2max (r=-0.367, P<0.01).Conclusion. This study confirms the need to monitor the specific performance conditions in the process of training the young talented sportsperson, to describe the performance levels of several football specific motor abilities. Consequently, the description of the functional levels of strength ability and aerobic power in youth categories allows to select and determine the contents of the training, useful to the footballer as he is being formed, to achieve those prerequisites he will soon need to possess when he moves into the professional or top level championships

Comparison of physical and technical performance in European soccer match-play: FA Premier League and La Liga

The aim of this study was to compare match performance in professional soccer players across two major European championships: Spanish La Liga and English FA Premier League (FAPL). Data were collected using a computerized match analysis system. A total of 5938 analyses were recorded during the 2006-2007 season. The players were classified into six positional roles: central defenders, full backs, central defensive midfielders, wide midfielders, central attacking midfielders, and forwards. The match performance variables analysed included: (i) physical activity - total distance covered, distances covered at high-intensities both with and without possession of the ball; (ii) technical actions - heading and ground duels, passing, time in possession, and ball touches. Comparison of the total distance covered by FAPL and La Liga players showed no difference across individual playing positions but FAPL players generally covered greater distances in sprinting. In contrast, more of the total distance in sprinting was covered by La Liga players when their team was in possession (values from P 0.05 to P 0.001), while an equal total sprint distance, irrespective of possession, was observed in FAPL players. La Liga players won more heading duels (49.32% vs. 48.68%) and performed the same proportion of successful passes (76.17%). FAPL wide midfielders had similar to 20% more ball touches per possession than their La Liga counterparts (2.24 +/- 0.54 vs. 2.03 +/- 0.55, P 0.001). In conclusion, our results show that FAPL and La Liga teams present differences in various physical and technical aspects of match-play, suggesting that cultural differences may exist across professional soccer leagues and playing positions.111515

Cam morphology and inguinal pathologies: is there a possible connection?

Background: To analyse the prevalences of the cam and pincer morphologies in a cohort of patients with groin pain syndrome caused by inguinal pathologies. Materials and methods: Forty-four patients (40 men and 4 women) who suffered from groin pain syndrome were enrolled in the study. All the patients were radiographically and clinically evaluated following a standardised protocol established by the First Groin Pain Syndrome Italian Consensus Conference on Terminology, Clinical Evaluation and Imaging Assessment in Groin Pain in Athlete. Subsequently, all of the subjects underwent a laparoscopic repair of the posterior inguinal wall. Results: The study demonstrated an association between the cam morphology and inguinal pathologies in 88.6% of the cases (39 subjects). This relationship may be explained by noting that the cam morphology leads to biomechanical stress at the posterior inguinal wall level. Conclusions: Athletic subjects who present the cam morphology may be considered a population at risk of developing inguinal pathologies. Level of evidence: Level IV, Observational cross-sectional study