How evidence based is the management of two common sports injuries in a sports injury clinic?

Abstract

Objectives: To examine the diagnosis and management of adults attending a sports injury clinic, to establish to what extent the management of the two most common injuries treated at this clinic is evidence based, and to explore factors that affect management. Methods: A retrospective examination of 100 random case notes extracted age, sex, sport, type and site of injury, treatment, and outcome. Systematic literature reviews examined the extent and quality of scientific evidence for the management of the two most commonly presenting injuries. A clinical attachment period and practitioner interviews allowed recognition of factors impinging on management decisions. Results: Patellofemoral pain syndrome (PFPS; 10% of all injuries) and Achilles tendinopathy (6% of all injuries) were the most commonly presenting injuries. The mean (SD) number of treatments used for PFPS was 2.8 (0.9). The mean number of treatments used for Achilles tendinopathy was 3.7 (1.0). Clinicians reported that personal experience formed the basis of management plans in 44% of PFPS cases and 59% of Achilles tendinopathy cases, and that primary research evidence only accounted for 24% of management plans in PFPS and 14% in Achilles tendinopathy. Practitioners were unaware of literature supporting over 50% of the treatment modalities they used. However, clinicians were often using evidence based treatments, unaware of the supporting research data. Conclusions: This study highlights a lack of evidence base, a lack of knowledge of the research evidence, and a lack of management based on the current evidence that is available for these conditions. Practitioners practised evidence based medicine in under 50% of cases.

The Basic Science of Tendinopathy

“…Tendon injuries are common and affect a substantial portion of recreational and professional athletes and those in many occupations involving repetitive work [16,37,60,79,102]. Tendinopathy (often called tendinitis or tendinosis) is the most common tendon disorder [86,99].…”

Efficacy of Nonsurgical Interventions for Anterior Knee Pain

“…[1][2][3][4][5][6][7][8] It affects an individual's ability to perform routine daily activities such as stair ambulation, walking and running, and thus impacts on work-related activities and participation in physical activity. Findings from prospective studies in active populations [9][10][11] reflect the chronicity of AKP, with a randomised controlled trial (RCT) reporting no recovery in half of the no-treatment control group at 12 months.…”

Effects of Medially Wedged Foot Orthoses on Knee and Hip Joint Running Mechanics in Females With and Without Patellofemoral Pain Syndrome

“…3,4 Murray et al 2 reported that PFPS accounted for 34% of knee injuries and 10% of all injuries among individuals seeking treatment at a sports injury clinic. Due to the high recurrence rate of PFPS and a potential association with the future development of patellofemoral osteoarthritis this condition warrants further study.…”

“…Patellofemoral pain syndrome (PFPS) is one of the most common orthopedic conditions, [1][2][3] particularly in active, young females. 3,4 Murray et al 2 reported that PFPS accounted for 34% of knee injuries and 10% of all injuries among individuals seeking treatment at a sports injury clinic.…”