Worldwide sports injury prevention

The number one goal of the sports physical therapist is to make sure that the athlete is in optimal shape to perform, but with a minimal risk for developing an injury at the same time. The aim of this International Federation of Sports Physical Therapy (IFSPT) Perspective is to raise awareness about the importance of contextual and behavioral factors when planning and implementing injury prevention. Also, it outlines the potential role of the IFSPT as a facilitator of data and information exchange among sports physical therapists worldwide

Value of isokinetic strength testing for hamstring injury risk assessment : should the ‘strongest’ mates stay ashore?

Although isokinetic strength testing is commonly used in hamstring strain injury (HSI) rehabilitation and prevention, research findings concerning its predictive value remain inconclusive. Existing research focuses on peak torque (PT) and angle of PT, not analysing the torque behaviour throughout the testing range of motion (ROM). This study intended to assess the value of isokinetic curve evaluation in association with HSI. A sample of 116 male football players with and without a recent HSI history was submitted to bilateral isokinetic assessment of the knee and hip muscles. Raw isokinetic data were filtered and normalized prior to curve analysis submission in MATLAB. Torque development of each muscle group throughout the entire testing ROM was assessed using HSI history as an independent variable. Curve analysis revealed significant differences in torque behaviour in function of injury history. Players with an HSI history demonstrated significantly stronger concentric knee flexion and extension, eccentric knee extension and concentric hip extension patterns compared to the controls and their uninjured limb. HSI history was also associated with lower concentric hip flexion torques and lower mixed H:Q ratios compared to the control group and their contralateral limb. HSI history was associated with altered knee and hip muscle strength profiles, potentially due to isolated focus on local strength training in rehabilitation or mechanisms of neuromuscular inhibition. Because the differences in torque amplitude were range-dependent and did not systematically concur with the point of PT achievement, isokinetic strength evaluation should most probably be conducted using curve analysis

Activity-induced increase in Achilles tendon blood flow is age and sex dependent

Background: Previous research of a young adult population identified a lower increase in Achilles tendon blood flow immediately after a running activity as a significant predictor for the development of Achilles tendinopathy (AT). Furthermore, advancing age is often mentioned as a risk factor for the development of AT, and the highest incidence for AT is reported to occur in middle-aged recreational male athletes. Purpose: To investigate the effect of age, sex, and type of physical activity on the increase in Achilles tendon blood flow. Study Design: Controlled laboratory study. Methods: Blood flow measurements of 33 subjects aged 18 to 25 years and 30 subjects aged 40 to 55 years were obtained before and after 4 physical activities performed in randomized order: running, cycling, dynamic stretching, and rope skipping. Blood flow measurements of the Achilles tendon were performed before, immediately after, 5 minutes after, and 10 minutes after the physical activities. The effect of age, sex, and physical activities on the increase in blood flow was investigated with linear mixed models. Results: The results of this study identified that running, rope skipping, and cycling resulted in a significant increase in tendon blood flow (P <=.001), whereas stretching did not. Prominent was the finding that the increase in blood flow after activity was significantly lower in the older population as compared with the younger population (P<.001). Furthermore, male participants in the older group showed a significantly lower increase in tendon blood flow than did their female counterparts (P=.019). Conclusion: This study identified that sex and age significantly influence the increase in blood flow after activity, possibly explaining the increased risk for AT among middle-aged recreational athletes

Acute effects of warming up on Achilles tendon blood flow and stiffness

The aim of this study was to investigate the acute effect of frequently used warm-up exercises on the Achilles tendon blood flow and stiffness. In doing so, we want to explore which exercises are suitable to properly prepare the athlete's Achilles tendon in withstanding high amounts of loading during sport activities. This knowledge could help sport physicians and physiotherapists when recommending warm-up exercises that are able to improve sport performance while reducing the injury susceptibility. Achilles tendon blood flow and stiffness measurements of 40 healthy subjects (20 men and 20 women) aged between 18 and 25 years were obtained before and immediately after 4 different warm-up exercises: running, plyometrics, eccentric heel drops, and static stretching. The effect of these warm-up exercises and possible covariates (sex, age, body mass index, rate of perceived exertion, and sports participation) on the Achilles tendon blood flow and stiffness was investigated with linear mixed models. The level of significance was set at α = 0.05. The results of this study showed a significant increase in Achilles tendon blood flow and stiffness after 10 minutes of running (p < 0.001 and p < 0.001) and plyometrics (p < 0.001 and p = 0.039). Static stretching and eccentric exercises elicited no significant changes. From these results, it could be suggested that warm-up exercises should be intensive enough to properly prepare the Achilles tendon for subsequent sport activities. When looking at Achilles tendon blood flow and stiffness, we advise the incorporation of highly intensive exercises such as running and plyometrics within warm-up programs

The effect of aquabag use on muscle activation in functional strength training

Context: Although training with an aquabag (AB) has gained popularity, there is a lack of evidence of its effect. This study wanted to evaluate the effect of AB implementation on muscle activity of core and lower limb muscles during 3 functional exercises. Design: Cross-sectional observational study. Methods: Twenty healthy subjects performed a squat, lunge, and step-up, while using a stick and an AB. Surface electromyography signals were recorded from the trunk, pelvis, and thigh muscles in the dominant leg. Linear-mixed models were used to analyze the normalized surface electromyography signals. Results: Results demonstrated a significant increase in muscle activity of the back muscles during all 3 exercises (P < .001 to P = .003), abdominals during squat (P = .034) and step-up (P = .046), hamstrings during lunge (P = .008) and step-up (P = .008), and gluteal muscles during lunge (P < .001 and P = .010, respectively). Conclusions: These results indicate that an AB promotes functional strength training by demanding compensatory/additional activity of both stabilizing muscles (specifically in the core and pelvis regions) and prime movers of the lower limb. The authors recommend the use of an AB to enhance training and rehabilitation effects