Neurodynamic sliders promote flexibility in tight hamstring syndrome

Hamstring injury prevention puts emphasis on optimizing the muscle's strength?length relationship. To assure appropriate muscle length, flexibility training is imperative. As neurodynamics play an important role herein, the goal of this study was to explore the intervention effect of home-based neurodynamic slider program on hamstring flexibility. Fifty physically active male subjects were randomly assigned to either performing a neurodynamic sliding technique (3???20 reps) or a static stretching protocol (3???30?) on a daily basis for a 6-week period. Hamstring flexibility was assessed by means of the Straight Leg Raise at baseline, immediately after the intervention and after 4 weeks follow up. There was no between group baseline difference in hamstring flexibility. The repeated measure ANOVA showed a significant interaction effect for group???time (p?<?0.001). Independent sample t-test showed a significantly higher increase in flexibility gain in the neurodynamic group immediately after the intervention (p?<?0.001), as well as at 4 weeks retention analysis (p?=?0.001) compared to the static stretch group. In conclusion, neurodynamic sliders might be more efficient than regular static stretching in affecting hamstring flexibility in the long run

Sports injuries aligned to predicted mature height in highly trained Middle-Eastern youth athletes: a cohort study

Objectives To investigate the association of maturity status with injury incidence in Middle-Eastern youth athletes. Design Prospective cohort study. Setting Four consecutive seasons (2010-2014), Aspire Academy, Qatar. Participants Male athletes (age range: 11-18 years) representing four disciplines enrolled and grouped into two categories: Individual sports and racquet sports. Outcome measures Injury data collected over four seasons. Athletes' anthropometric characteristics assessed to calculate age at peak height velocity. Predicted mature heights (PMHs) collected and categorised into four quartiles. Athletes had wrist and hand radiographs for assessment of skeletal age (SA). Early and late maturers with an SA of >1 year older or younger than their chronological age (CA). Results For the sample (n=67) across all groups, 43 (64%) athletes had one or more injuries: Total of 212 injuries, 4.9 injuries per athlete across study. Survival analysis of maturity status using SA found early maturing athletes had two-fold greater injury risk compared with late maturers (HR 2.04, 95% CI 1.15 to 3.61, p=0.015). PMH associated with injury risk (HR 1.05, 95% CI 1.01 to 1.08, p=0.006). Athletes in fourth quartile (≥184 cm) had up to two-fold injury risk (HR 2.41, 95% CI 1.42 to 4.08, p=0.001). Racquet and individual sports involved similar injury risk (HR 1.14, 95% CI 0.86 to 1.52, p=0.37). Conclusion SA early maturity and PMH gradient were significant predictors of injury in youths

Sports injuries in physical education teacher education students

Sports injuries could be highly detrimental to the career of a physical education teacher education (PETE) student. To enable the development of future sports injury prevention programs, sports injuries in 128 first-year academic bachelor PETE students were registered prospectively during one academic year. Common risk factors for sports injuries, taken from the literature, were also evaluated by means of logistic regression analysis. We found an incidence rate of 1.91 and an injury risk of 0.85, which is higher than generally found in a sports-active population. Most injuries involved the lower extremities, were acute, newly occurring injuries, and took place in non-contact situations. More than half of all injuries lead to an inactivity period of 1 week or more and over 80% of all injuries required medical attention. A major part of these injuries happened during the intracurricular sports classes. Few differences were seen between women and men. A history of injury was a significant risk factor (P = 0.018) for the occurrence of injuries, and performance of cooling-down exercises was significantly related to a lower occurrence of ankle injuries (P = 0.031). These data can inform future programs for the prevention of sports injuries in PETE student

Decreased average power of the hip external muscles as a predictive parameter for lower extremity injury in women : a prospective study

Objective: To prospectively identify hip strength associated risk factors contributing to the development of lower extremity (LE) injury. Design: Data were prospectively collected on healthy female physical education students. Setting: This study was conducted in the institution of the University of Ghent. Participants: Eighty-nine female physical education students aged 19.53 +/- 1.07 years. Assessment of Risk Factors: Testing included isokinetic hip strength measurements of abductors, adductors, internal rotators, and external rotators (ERs). Main Outcome Measures: Follow-up of the participants was assessed using a weekly online questionnaire and a 3-month retrospective control questionnaire. Lower extremity injury was diagnosed by an experienced medical doctor. Cox regression was used to identify the potential risk factors for the development of an LE injury. Results: Thirty-four participants were diagnosed with an LE injury during follow-up. This study identified that decreased average power (AP) (P = 0.031) on concentric ER strength was found to be a significant risk factor for LE injury. No other hip strength parameters were found to be significant contributors to the development of LE injury. Conclusions: Decreased AP of the hip ER muscles was identified as a significant predictor for LE injury, whereas no hip abduction weakness or peak torque parameters were found to be predictive. Because controlling LE extremity movements is an important function of the hip muscles, they might be more challenged in a dynamic measure such as AP than in a point measure such as peak torque. Concentric AP of hip ER muscles can therefore be seen as an interesting factor to include in LE injury screening protocols

Contralateral risk factors associated with exertional medial tibial pain in women

Purpose: To prospectively analyse the role of factors on the contralateral side of the kinetic chain in the development of exertional medial tibial pain (EMTP). Methods: Eighty-one female physical education students were tested at the beginning of their first academic year. Within the testing protocol, contralateral isokinetic hip muscle strength and full-body kinematic parameters during a single-leg drop jump (SLDJ) were evaluated. Online questionnaires were administered weekly and personal interviews were conducted every 3 months to assess injury follow-up. EMTP was diagnosed by an experienced MD (Doctor of Medicine). Cox regression analysis was used to identify the potential risk factors for the development of EMTP. Results: After exclusion of subjects with diagnosed bilateral EMTP, 11 subjects were included in the EMTP group. Fifty-three subjects did not develop any lower extremity overuse injury and were included in the control group. The leg not at risk within subjects who developed EMTP, was compared with an uninjured leg of the control group. Increased transverse plane motion for the contralateral lower leg segment during landing phase was found to be a significant predictor (P=0.012) for EMTP. Analysis of the isokinetic data did not reveal altered hip muscle strength parameters for the leg not at risk within the EMTP group. Conclusions: Impaired dynamic joint stability (DJS) or accessory movements were found in the transverse plane of the contralateral lower leg segment of EMTP subjects. This contralateral instability might have contributed to altered movement patterns within the kinetic chain function of EMTP subjects. No contralateral hip muscle strength parameters were found to predict EMTP in this study

Contribution of a muscle fatigue protocol to a dynamic stability screening test for exertional medial tibial pain

Background: Enhancing the accuracy of a risk factor screening test is an important element of sports injury prevention. Purpose: To determine the impact of muscle fatigue on a screening tool for those at risk of exertional medial tibial pain (EMTP). Study Design: In this cohort study, 3D-kinematic parameters in frontal and transverse plane were prospectively evaluated during a single-leg drop jump (SLDJ) in both non-fatigued and fatigued state. Methods: Sixty-nine female students in physical education aged 19.24±0.86 years, were tested at the beginning of their first academic year and followed 1-2 years. A weekly online questionnaire and a 3-monthly retrospective control questionnaire were used to assess injury follow-up. EMTP was diagnosed by an experienced MD (Doctor of Medicine). Cox regression analysis was used to identify the potential risk factors, by comparing pre- and post-fatigue data between uninjured and EMTP subjects. Both the leg which developed EMTP and the contralateral leg were compared with a matched control group. Results: During injury follow-up, 21 female subjects were diagnosed with EMTP. The results identified that for the leg at risk in non-fatigued state, only increased range of motion in the transverse plane (ROMT) of the hip during landing (8.44±2.94 vs 11.69±3.41, P=.002) could be identified as a risk factor. In the fatigued state, increased ROMT of hip and pelvis (8.04±2.34 vs 9.36±3.22, P=0.038 and 6.99±2.20 vs 8.58±3.13, P=.040 respectively) during landing and increased ROMT of thorax (8.83±2.74 vs 10.69±3.20, P=.036) during push-off could be identified. For the leg not at risk for EMTP, increased ROMT of the knee (10.96±3.12 vs 14.07±4.88, P=.023) during landing and decreased ROMT of the pelvis (8.16±3.48 vs 6.47±2.47, P=.034) during push-off were identified in the non-fatigued state, but were not significant in the fatigued state. Conclusions: It can be concluded that adding a muscle fatigue protocol to the SLDJ as screening test for EMTP risk factors, may enhance the possibility to identify the leg at risk in a predisposed athlete and might determine the proximal risk factors for that leg at risk more thoroughly

The role of proximal dynamic joint stability in the development of exertional medial tibial pain: a prospective study

Objective: To prospectively determine risk factors contributing to the development of exertional medial tibial pain (EMTP). Methods: Data were prospectively collected on healthy female students in physical education, who were freshmen in 2010–2011 and 2011–2012. Eighty-six female students aged 19.38±0.85 years, were tested at the beginning of their first academic year. Kinematic parameters in the frontal and transverse plane were measured during a single-leg drop jump (SLDJ). For further analysis, the SLDJ task was divided in two phases: touchdown until maximal knee flexion (MKF) and then MKF until take-off, representing landing and push-off phase, respectively. The injury follow-up of the students was assessed using a weekly online questionnaire and a 3-monthly retrospective control questionnaire. EMTP was diagnosed by an experienced medical doctor. Cox regression analysis was used to identify the potential risk factors for the development of EMTP. Results: During injury follow-up (1–2 years), 22 participants were diagnosed with EMTP. The results of this study identified that increased range of motion (ROM) in the transverse plane of hip and thorax during landing (p=0.010 and 0.026, respectively) and during push off (p=0.019 and 0.045, respectively) are predictive parameters for the development of EMTP in women. Conclusions: Increased ROM values of hip and thorax in the transverse plane, which can be interpreted as impaired ability to maintain dynamic joint stability resulting in increased accessory movements, are significant contributors to the development of EMTP in women

The role of hip abductor and external rotator muscle strength in the development of exertional medial tibial pain : a prospective study

Objective: To prospectively identify proximal risk factors contributing to the development of exertional medial tibial pain (EMTP). Methods: Data were prospectively collected on healthy female students in physical education, who were freshmen in 2010-2011 and 2011-2012. Ninety-five female students aged 18.15±0.84, were tested at the beginning of their first academic year. Testing included isokinetic hip strength measurements of abductors, adductors, internal rotators and external rotators. The follow-up of the subjects was assessed using a weekly online questionnaire and a three-monthly retrospective control questionnaire. EMTP was diagnosed by an experienced M.D. (Doctor of Medicine). Cox regression analysis was used to identify the potential risk factors for the development of EMTP. Results: Twenty-one subjects were diagnosed with EMTP during follow-up. The results of this study identified that decreased hip abductor concentric strength is a predictive parameter for the development of EMTP in females. More specific, total work (P=0.010) and average power (P=0.045) for concentric abduction strength were found to be significant predictors for this lower leg overuse injury. Conclusions: Hip abductor weakness is a significant predictor for EMTP in females. Preventive screening methods for EMTP should therefore include this proximal contributing factor