The incidence of anterior cruciate ligament (ACL) injury remains high in young athletes. Because female athletes have a much higher incidence of ACL injuries in sports such as basketball and team handball than male athletes, the IOC Medical Commission invited a multidisciplinary group of ACL expert clinicians and scientists to (1) review current evidence including data from the new Scandinavian ACL registries; (2) critically evaluate highquality studies of injury mechanics; (3) consider the key elements of successful prevention programmes; (4) summarise clinical management including surgery and conservative management; and (5) identify areas for further research. Risk factors for female athletes suffering ACL injury include: (1) being in the preovulatory phase of the menstrual cycle compared with the postovulatory phase; (2) having decreased intercondylar notch width on plain radiography; and (3) developing increased knee abduction moment (a valgus intersegmental torque) during impact on landing. Well-designed injury prevention programmes reduce the risk of ACL for athletes, particularly women. These programmes attempt to alter dynamic loading of the tibiofemoral joint through neuromuscular and proprioceptive training. They emphasise proper landing and cutting techniques. This includes landing softly on the forefoot and rolling back to the rearfoot, engaging knee and hip flexion and, where possible, landing on two feet. Players are trained to avoid excessive dynamic valgus of the knee and to focus on the ''knee over toe position'' when cutting.The incidence of anterior cruciate ligament (ACL) injury remains high, especially in young athletes aged 14-19 years. In spite of the fact that some successful prevention programmes have been introduced, ACL injury continues to be the largest single problem in orthopaedic sports medicine, with the incidence of non-contact ACL tears being much higher in female athletes in sports such as basketball and team handball than in male athletes.As ACL injury remains a significant problem, especially in young female athletes, procedures for improved prevention and management are needed. The mechanism of ACL injury is an important focus of discussion, as an ACL tear is more often a non-contact event with a deceleration or a change of direction manoeuvre than a contact or direct blow injury. A prophylactic neuromuscular and proprioceptive training programme may reduce the number of ACL injuries in female athletes.The President of the International Olympic Committee (IOC) Jacques Rogge stated in 2001 that ''the most important goal of the IOC Medical Commission is to protect the health of the athlete''. The IOC Medical Commission therefore invited a group of physicians, physical therapists, biomechanists and scientists active in ACL research to review current evidence relating to risk factors, prevention programmes and the need for further research concerning non-contact ACL injury in young female athletes.
EPIDEMIOLOGY OF ANTERIOR CRUCIATE LIGAMENT INJURIESThe incidence of ACL ...
ObjectiveTo provide a clear terminology and classification of muscle injuries in order to facilitate effective communication among medical practitioners and development of systematic treatment strategies.MethodsThirty native English-speaking scientists and team doctors of national and first division professional sports teams were asked to complete a questionnaire on muscle injuries to evaluate the currently used terminology of athletic muscle injury. In addition, a consensus meeting of international sports medicine experts was established to develop practical and scientific definitions of muscle injuries as well as a new and comprehensive classification system.ResultsThe response rate of the survey was 63%. The responses confirmed the marked variability in the use of the terminology relating to muscle injury, with the most obvious inconsistencies for the term strain. In the consensus meeting, practical and systematic terms were defined and established. In addition, a new comprehensive classification system was developed, which differentiates between four types: functional muscle disorders (type 1: overexertion-related and type 2: neuromuscular muscle disorders) describing disorders without macroscopic evidence of fibre tear and structural muscle injuries (type 3: partial tears and type 4: (sub)total tears/tendinous avulsions) with macroscopic evidence of fibre tear, that is, structural damage. Subclassifications are presented for each type.ConclusionsA consistent English terminology as well as a comprehensive classification system for athletic muscle injuries which is proven in the daily practice are presented. This will help to improve clarity of communication for diagnostic and therapeutic purposes and can serve as the basis for future comparative studies to address the continued lack of systematic information on muscle injuries in the literature.What are the new thingsConsensus definitions of the terminology which is used in the field of muscle injuries as well as a new comprehensive classification system which clearly defines types of athletic muscle injuries.Level of evidenceExpert opinion, Level V.
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