Do not throw the baby out with the bathwater; screening can identify meaningful risk factors for sports injuries

Verhagen, Evert; Dyk, Nicol van; Clark, Nicholas; Shrier, Ian

doi:10.1136/bjsports-2017-098547

Cited by 50 publications

(64 citation statements)

References 7 publications

(8 reference statements)

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“…A follow-up of at least 6 months has been recommended [15,16], but only seven studies in this systematic review fulfilled this criterion. Furthermore, all included studies assume that biomechanical risk factors remain constant during the time of follow-up, which may not be the case [78]. Given the chronic presentation of many RRIs, a more continuous monitoring at regular intervals may be a better indicator to report overuse injuries [77].…”

Section: Methodological Considerationsmentioning

confidence: 99%

Biomechanical Risk Factors Associated with Running-Related Injuries: A Systematic Review

et al. 2019

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Background Running is a popular form of physical activity with many health benefits. However, the incidence and prevalence of running-related injuries (RRIs) is high. Biomechanical factors may be related to the development of RRIs. Objective This systematic review synthesizes biomechanical risk factors related to the development of RRIs in non-injured runners. Methods PubMed, Web of Science, CINAHL, Embase, and SPORTDiscus were searched in July 2018 for original peerreviewed prospective studies evaluating potential biomechanical factors associated with the development of RRIs. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Two reviewers independently assessed articles for inclusion and methodological quality. Due to methodological heterogeneity across studies, a narrative synthesis of findings was conducted, rather than a meta-analysis. Results Sixteen studies, including 13 of high quality and three of moderate quality, were included. A large number of biomechanical variables were evaluated, producing inconsistent evidence overall. Limited evidence indicated greater peak hip adduction in female runners developing patellofemoral pain and iliotibial band syndrome, but not for a mixed-sex population of crosscountry runners sustaining an RRI. The relationship between vertical loading rate and RRIs was inconsistent. Other kinematic, kinetic and spatiotemporal factors were only studied to a limited extent. Conclusions Current prospective evidence relating biomechanical variables to RRI risk is sparse and inconsistent, with findings largely dependent on the population and injuries being studied. Future research is needed to confirm these biomechanical risk factors and determine whether modification of these variables may assist in running injury prevention and management. Key Points Despite the common belief that biomechanical factors greatly influence running-related injury (RRI) risk, only a limited body of high-quality research, with significant heterogeneity in study populations, methodologies and outcome variables, was identified. Current prospective evidence relating biomechanical variables with the risk to sustain an RRI is inconsistent and largely dependent on the population and injuries being studied. A number of single-study findings related to kinematics, kinetics and spatiotemporal variables require confirmation via further high-quality prospective studies before clinical recommendations can be made.

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Section: Methodological Considerationsmentioning

confidence: 99%

Biomechanical Risk Factors Associated with Running-Related Injuries: A Systematic Review

et al. 2019

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“…Therefore, practitioners need to determine if youths are sufficiently conditioned to compete at increased match demands to avoid additional injury risk. Although the present procedures and analytical approaches may not be able to identify those at increased injury risk due to the complex interaction of many factors (Verhagen et al 2018), these approaches may help identify if youth female soccer players possess sufficiently developed thigh musculature strength to compete in senior match-play.…”

Section: Discussionmentioning

confidence: 96%

“…The choice of outcome measures should also be considered, with measures such as peak torque (PT) and dynamic control ratios (DCR) recently being critiqued due to the lack of consideration for how strength is maintained over an angular range (De Ste Croix et al 2017). These recent criticisms are attributed to the different angle of peak torques for eccKF (~40° of flexion) and conKE (~70° of flexion) (Eustace et al 2017;2018), thus PT and DCR are quantified from different joint angles, and as such, cannot determine co-contraction ability of these musculature. An additional metric that also considers the torque-angle curve is functional range, which quantifies how far 85% of PT can be maintained across range of motion since 15% strength deficits have been previously associated with increased injury risk in soccer (Croisier et al 2008).…”

Section: Introductionmentioning

confidence: 99%

Isokinetic strength differences between elite senior and youth female soccer players identifies training requirements

Eustace

Page

Greig

2019

Physical Therapy in Sport

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Objectives: To compare traditional and angle-specific isokinetic strength of eccentric knee flexors and concentric knee extensors in female senior professional and youth soccer players. Design: Crosssectional study design. Setting: University's Laboratory. Participants: A total of 34 players (17 seniors [age 25.31 ± 4.51 years; height 167.89 ± 7.04cm; mass 63.12 ± 7.79kg] and 17 youths [16.91 ± 1.16 years; height 165.92 ± 4.42cm; mass 60.07 ± 4.48kg]) from the Women's Super League 1 completed strength assessments at 180, 270 and 60°•s-1. Main Outcome Measures: Peak torque (PT), dynamic control ratio (DCR), angle of peak torque (APT), functional range (FR), angle-specific torque (AST) and angle-specific DCR (DCRAST) were compared between age groups. Results: The PT (P = 0.016) AST (P = 0.041) were significantly higher in seniors compared to youths; however APT (P = 0.141), DCR (P = 0.524) FR (P = 0.821) and DCRAST (P = 0.053) were not significant between playing age. Conclusion: The use of absolute and angle-specific strength measures were able to distinguish between female playing ages, whereas DCR and DCRAST was unable to identify differences. The PT and AST metrics may be the most useful metrics to help identify and inform training needs, particularly in youths.

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“…individualised exercise programmes) are also advocated for beneficially modifying injury risk factors in agility-sport athletes (76)(77)(78). Because some players had rightside lower performances and other players had left-side lower performances for different tests (Table 3), individualised interventions may need to be prioritised over generic whole-team training sessions (26,79). Coaches and clinical personnel will need to decide which intervention method best suits their team's logistical needs.…”

Section: Discussionmentioning

confidence: 99%

“…Single-leg balance and SLH tests are popular in clinical environments because they are quick-and-easy to perform and reliable and valid measures of lower-limb functional joint stability (20)(21)(22)(23). The administration of assessments to profile athletes and identify those predisposed to injury is good clinical practice (24)(25)(26) and lower SLB and SLH performance is associated with higher lower-limb injury risk in agility-sport athletes (18,(27)(28)(29)(30).…”

Section: Introductionmentioning

confidence: 99%

Prevalence and magnitude of preseason clinically-significant single-leg balance and hop test asymmetries in an English adult netball club

Clark

Mullally

2019

Physical Therapy in Sport

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Objectives: Side-to-side asymmetry of lower-limb motor-performance is associated with increased noncontact injury risk in agility-sports. Side-to-side symmetry-analyses using singleleg balance and hop tests has not been reported for community-level adult netball players. The purpose of this study was to perform preseason side-to-side symmetry-analyses using eyesclosed-balance (ECB), triple-hop-for-distance (THD), single-hop-for-distance (SHD), and vertical-hop (VH) tests.

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Do not throw the baby out with the bathwater; screening can identify meaningful risk factors for sports injuries

Cited by 50 publications

References 7 publications

Biomechanical Risk Factors Associated with Running-Related Injuries: A Systematic Review

Biomechanical Risk Factors Associated with Running-Related Injuries: A Systematic Review

Isokinetic strength differences between elite senior and youth female soccer players identifies training requirements

Prevalence and magnitude of preseason clinically-significant single-leg balance and hop test asymmetries in an English adult netball club

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