Sixty seconds of foam rolling does not affect functional flexibility or change muscle temperature in adolescent athletes

Background: Physiotherapists and other practitioners commonly prescribe foam rolling as an intervention, but the mechanistic effects of this intervention are not known. Purpose: The aim of this investigation was to establish if a single bout of foam rolling affects flexibility, skeletal muscle contractility and reflected temperature. Methods: Twelve adolescent male squash players were evaluated on two separate occasions (treatment and control visits) and were tested on both legs for flexibility of the hip flexors and quadriceps, muscle contractility (as measured by tensiomyography) and temperature of the quadriceps (assessed via thermography) at repeated time points pre- and post a 60s rolling intervention (pre-, immediately post, 5, 10, 15, and 30 minutes post). They rolled one leg on the treatment visit and did not perform rolling on the control visit. Results: The main outcome measure was the flexibility of hip flexor and quadriceps at repeated time points up to 30 minutes post intervention. The average foam rolling force was 68% of subject’s body weight. This force affected the combination of hip and quadriceps flexibility (p=0.03; 2.4 degrees total increase with foam rolling) but not each muscle independently (p = 0.05 – 0.98) following a single 60s bout. Muscle contractility is not affected (p = 0.09 – 0.93) and temperature is not increased by foam rolling across time points (p=0.19). Conclusions: A single sixty-second bout of rolling applied to the quadriceps induces a small significant change in flexibility that is of little practical relevance, while muscle contractility and temperature remain unchanged. Investigation of larger doses of rolling is merited in athletic populations to justify current practice

The prevalence of musculoskeletal injuries in junior elite squash players

Background: The dynamics and competitiveness of squash place a high demand on the musculoskeletal system of players, thus increasing the injury risk of youth squash players. Objectives: The purpose of this study was to analyze and report the musculoskeletal injury epidemiology of junior elite squash players. Methods: Twenty-one male adolescent squash players were included in this retrospective analysis of routinely collected data over a period of 6-years. Origin, location, diagnosis and incidence of all injuries are reported. Results: A total of 212 injuries were recorded: 58% of these injuries (n = 124) were squash (on-court) related, 16% (n = 33) were because of other training activities and 26% of these injuries were (n = 55) non-squash related. Most of squash related training injuries were in the lower limbs (67%, n = 105). The most frequently reported diagnosis was “osteochondrosis” (22%, n = 34), followed by “contusion” (13%, n = 20). Time-loss injuries accounted for 103 injuries and the overall injury incidence was 4.78 per 1000 hours of training. Conclusions: It was established that pre-mature squash players are at greater risk of growth related injuries during their peak growth period. A significant number of injuries at junior level are found to occur outside of training time and result in periods of time loss. As a result, skill acquisition is negatively affected which in turn negatively affects development opportunities in junior athletes

Beighton scoring of joint laxity and injury incidence in Middle Eastern male youth athletes : a cohort study

ObjectivesTo examine the association between generalised joint laxity (GJL) and injury rates in Middle Eastern male youth athletes.DesignProspective observational study consisting of GJL screen and injury audit (season 2009/2010).SettingAspire Sports Academy Doha, Qatar.ParticipantsA total of 226 adolescent male athletes (mean age: 14.2 years; SD: 1.7; range: 10–18) involved in 15 sporting activities were grouped into contact and non-contact sports. All available athletes were included in this study.Outcome measuresA seasonal injury audit, athletes’ anthropometric characteristics, for example, weight, height and body mass index and screen for GJL to determine Beighton Score (BS).ResultsThe 226 athletes sustained 596 injuries and 75% reported at least one injury over a seasonal injury audit. Players in contact sports were injured more often than players in non-contact sports (more frequent injuries than injury-free time in contact sports; 127 days (95% CI 93 to 160) vs 176 days in non-contact sports (95% CI 118 to 234) (p<0.001). Survival analysis showed that gradient BS was not associated with injury HR=1.004 (95% CI 0.95 to 1.06) in the overall cohort. However, BS was associated with a greater injury risk in contact sports (HR: 1.29; 95% CI 1.05 to 1.59; p=0.015).ConclusionGreater GJL, defined by gradient BS, plus involvement in contact sports together influence injury risk in youth athletes. Preseason documentation of GJL scoring should be considered specifically for contact sports as injury pre-emptive measure

Can we limit training days lost due to Osgood Schlatters disease in junior squash athletes?

Background: High-intensity sports like Squash expose immature athletes to the risk of developing Osgood-Schlatter's (OSD) disease during critical periods of growth. Acute OSD episodes have been associated with changes in training load and recognized as a common cause of lost training days. Objective: To investigate the influence of periodic OSD monitoring and any subsequent alterations in training load on the number of training days lost. Design: Prospective data analysis over 2 seasons (80 weeks), repeated measures. Setting: Elite youth sports academy. Patients (or Participants): Highly-trained adolescent Squash athletes (n=9) who were identified as being “at risk” based on; previous episodes of OSD, chronological age (12–15 years) and maturity status. Interventions (or Assessment of Risk Factors): On a weekly basis a physiotherapist graded each athlete on a scale of 5 (“free of OSD symptoms”) to 1 (“unable to train”). The grading was based on clinical assessments including; pain level over the tibial tuberosity during palpation, functional movements, and strength assessments of the Quadriceps and Hamstrings. When an athlete was rated ≤3 coaching staff were advised to reduce the training load for the subsequent week. Training load was quantified using Edwards Training Impulse calculated from heart rate data. Main Outcome Measurements: The number of training days lost due to OSD. Any alterations in training load following a rating of ≤3. Results: Over the intervention period there were 24 ratings of ≤3. Weekly training load following a rating of ≤3 was significantly lower than the average weekly load (245.4±231.2 Vs. 658.5±154.7 arbitrary units, P<0.001). Five training days lost due to OSD were recorded during the intervention period. Conclusions: Periodic monitoring of OSD symptoms, with basic clinical tests, appear to alert the medical staff about potential acute onsets. Subsequent recommendations to reduce training load resulted in low training days lost due to OSD

A review of the performance requirements of squash

Squash is a sport characterised by complex physical, technical and tactical demands. Despite its increased popularity, there is presently no synthesis of the literature pertaining to the performance requirements of squash. As such, it is difficult to generate evidence-based guidelines for applied practitioners working with squash athletes. The purposes of this review were to a) identify the most important aspects of squash performance with reference to junior and senior athletes, b) identify and discuss the available methods of assessment of squash performance and c) identify areas where further research efforts are needed so that the performance requirements of the squash game are understood. Critical analysis of literature pertaining to movement characteristics and time motion analyses, physiological demands, methods of assessing physical qualities, psychological demands and injury epidemiology were conducted. A summary of the physical characteristics of squash athletes of varying ages and playing standards is presented. Time motion analysis studies present consistent information on the game demands. There are limited data on game demands evolution from youth to senior. There appears to be usable testing protocols available for practitioners supporting squash athletes, although further work is needed to determine the applicability of these measures in junior athletes. Furthermore, better controlled studies are required to establish the injury risks associated with squash

The reproducibility of fatigue-related indices of the shoulder rotator muscles: A clinical perspective

BACKGROUND: Extensive research has been conducted related to muscle fatigue, but little attention has been given to shoulder rotator muscles. Many different formulas have been used to calculate fatigue. Therefore, there is a need for establishing a reliable fatigue assessment protocol to further assess shoulder rotators using a suitable fatigue formula. OBJECTIVE: To study the reproducibility of two different isokinetic set-ups for assessing shoulder rotators fatigability properties and explore a possible clinical implication when different fatigue calculation formulas are used. METHODS: Forty sedentary subjects took part in this study. They were randomly assigned to either the “45∘ group” or the “90∘ group”, where the upper limb was either abducted to an angle of 45∘ or 90∘ in the frontal plane, respectively. All participants completed two testing sessions, consisting of 30 maximal concentric contractions on dominant shoulder IR and ER muscles at 180∘/s. Relative reproducibility, absolute reproducibility and fatigue indices were assessed. RESULTS: ER was different (p< 0.05) between trials (5%). Relative reproducibility was high for both muscles (ICC 0.97–0.99). Absolute reproducibility remained homogeneous with a SEM of 4–6% while the MDC varied between 11% and 16%. Fatigue formulas estimated no difference between trials (0–2%) for any muscle groups. CONCLUSIONS: Based on this study of reproducibility, both abduction set-ups may be used for assessing fatigue performance without indicating a superiority for either

Compelling overuse injury incidence in youth multisport athletes

The present investigation was carried out to examine the incidence and pattern of injuries in adolescent multisport athletes from youth sports academy. Injury data were prospectively collected from 166 athletes during the seasons from 2009 to 2014. A total of 643 injuries were identified, 559 (87.0%) were time-loss injuries. The overall injury incidence was 5.5 (95% confidence interval CI: 5.1-6.0), the incidence of time-loss injuries was 4.8 (95% CI: 4.4-5.2), the incidence of growth conditions was 1.2 (95% CI: 1.0-1.4) and incidence of serious injuries was 0.6 (95% CI: 0.5-0.8) per 1000h of exposure. The prevalence of overuse injuries was 50.3%. Growth conditions represented 20.0%. Most of the injuries (67.0%) involved the lower extremities, and both foot and ankle were the most predominant injured body parts (22.0%). Knee injuries were mostly from overuse (50 vs. 23, p=.02), whereas foot and ankle injuries resulted from an acute mechanism (94 vs. 31, p<.0001). Minor and moderate injuries accounted for 87.0%. Muscle, tendon and osteochondrosis injuries accounted for 52.0% of all injuries. Comparing groups, squash sport was having the highest injury incidence (8.5 injuries per athlete). Higher exposure was associated with greater overuse relative risk (RR=1.03, 95% CI: 1.01-1.014, p<.001). In conclusion, the results of this study identified a high incidence of injuries in this youth sports population. Striking was the prevalence of overuse injuries of 50%, which suggests the need for injury prevention protocols for adolescent highly trained athletes

Involving research‐invested clinicians in data collection affects injury incidence in youth football

It is well established that differences in injury definition and recording methodology restrict comparisons between injury surveillance programmes. There is, however, little documentation of the variation that can exist between data recorders. The aim of this study was, therefore, to explore the effect on reported injuries when team recorders or supervisors are involved in research. Injury data collected prospectively over five seasons for the U16, U17, and U18 age groups in a youth football (soccer) academy were used to compare different recording settings based on the research involvement of the clinicians. A research‐invested team physiotherapist reported an 8.8 times greater incidence (P < 0.001) of non‐time‐loss injuries and a 2.5 times greater incidence (P < 0.001) of minimal injuries (1‐3 days lost) compared to a setting where neither the team physiotherapists nor the supervisor relied on the collected data for research purposes. When team physiotherapists were not invested in research themselves but were supervised by a researcher, the incidence of non‐time‐loss injuries and minimal injuries was 2.5 times (P < 0.001) and 2.0 times greater (P < 0.01) than in the non‐invested setting, respectively. However, there were no differences between recording settings for overall incidence of time‐loss injuries. The results from this study demonstrate that involving clinicians that are relying on the collected data for research purposes can significantly affect the reported rates of non‐time‐loss and minimal injuries. Time‐loss injuries overall were not affected by research investment, and should therefore be preferred for comparisons between teams and seasons