Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, USA.
Screening for red flags in individuals with low back pain (LBP) has been a historical hallmark of musculoskeletal management. Red flag screening is endorsed by most LBP clinical practice guidelines, despite a lack of support for their diagnostic capacity. We share four major reasons why red flag screening is not consistent with best practice in LBP management: (1) clinicians do not actually screen for red flags, they manage the findings; (2) red flag symptomology negates the utility of clinical findings; (3) the tests lack the negative likelihood ratio to serve as a screen; and (4) clinical practice guidelines do not include specific processes that aid decision-making. Read More
Background/aim: To evaluate the association of genetic polymorphisms APOE, APOE G-219T promoter, microtubule associated protein(MAPT)/tau exon 6 Ser(53)Pro, MAPT/tau Hist(47)Tyr, IL-6572 G/C and IL-6R(Asp)358(Ala) with the risk of concussion in college athletes.
Methods: A 23-centre prospective cohort study of 1056 college athletes with genotyping was completed between August 2003 and December 2012. All athletes completed baseline medical and concussion questionnaires, and post-concussion data were collected for athletes with a documented concussion. Read More
Background: Hamstring injury with intramuscular tendon involvement is regarded as a serious injury with a delay in return to play (RTP) of more than 50 days and reinjury rates up to 63%. However, this reputation is based on retrospective case series with high risk of bias.
Objective: Determine whether intramuscular tendon involvement is associated with delayed RTP and elevated rates of reinjury. Read More
Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.
Background: Trail running is popular worldwide, but there is no preventive intervention for running-related injury (RRI).
Aim: To evaluate the effectiveness of adding online tailored advice (TrailS6 ) to general advice on (1) the prevention of RRIs and (2) the determinants and actual preventive behaviour in Dutch trail runners.
Methods: Two-arm randomised controlled trial over 6 months. Read More
The Central Governor Model (CGM) ignited a paradigm shift from concepts of catastrophic failure towards central regulation of exercise performance. However, the CGM has focused on the central integration of afferent feedback in homeostatic control. Accordingly, it neglected the important role of volitional self-regulatory control and the integration of affective components inherently attached to all physiological cues. Read More
Lahey Health and the Wilson Institute of Neurobiology, Burlington, USA.
In animal studies, sugar has been found to produce more symptoms than is required to be considered an addictive substance. Animal data has shown significant overlap between the consumption of added sugars and drug-like effects, including bingeing, craving, tolerance, withdrawal, cross-sensitisation, cross-tolerance, cross-dependence, reward and opioid effects. Sugar addiction seems to be dependence to the natural endogenous opioids that get released upon sugar intake. Read More
Pain is a common problem among elite athletes and is frequently associated with sport injury. Both injury and pain interfere with peak performance. Pain management should be based on the physiological, anatomical and psychosocial influences on the individual's pain and is not equivalent to injury management, which focuses on musculoskeletal recovery and return-to-play. Read More
Pain is a common problem among elite athletes and is frequently associated with sport injury. Both pain and injury interfere with the performance of elite athletes. There are currently no evidence-based or consensus-based guidelines for the management of pain in elite athletes. Read More
Introduction: Cam morphology is a strong risk factor for the development of hip pain and osteoarthritis. It is increasingly thought to develop in association with intense physical activity during youth; however, the aetiology remains uncertain. The study aim was to characterise the effect of physical activity on morphological hip development during adolescence. Read More
Background: The association between bone mineral density (BMD) and serum25-hydroxyvitamin D (25(OH)D) concentration is weak, particularly in certain races (eg, BlackAfrican vs Caucasian) and in athletic populations. We aimed to examine if bioavailable vitamin D rather than serum 25(OH)D was related to markers of bone health within a racially diverse athletic population.
Methods: In 604 male athletes (Arab (n=327), Asian (n=48), Black(n=108), Caucasian (n=53)and Hispanic (n=68)), we measured total 25(OH)D, vitamin D-binding protein and BMD by DXA. Read More
Background: Previous injury is a strong risk factor for recurrent lower limb injury in athletic populations, yet the association between previous injury and a subsequent injury different in nature or location is rarely considered.
Objective: To systematically review data on the risk of sustaining a subsequent lower limb injury different in nature or location following a previous injury.
Methods: Eight medical databases were searched. Read More
Background: Shoulder injuries are common among handball players and predominantly characterised by overuse characteristics. Reduced total glenohumeral rotation, external rotation weakness and scapular dyskinesis have been identified as risk factors among elite male handball players.
Aim: To assess whether previously identified risk factors are associated with overuse shoulder injuries in a large cohort of elite male and female handball players. Read More
Objective: Healthcare-oriented design in hospitals can promote better clinical outcomes. Creating optimal facilities may increase treatment effects. We investigated the influence of the treatment room on effects of exercise therapy. Read More