Asian Journal of Sports Medicine
Volume:5 Issue: 4, Dec 2014

Fast-bowlers in cricket subject their spines to repetitive stress. The aim of this study was to review the prevalence of lumbar spine injuries among fast bowlers. Medline and embase searches were performed. Further, the authors canvassed the reference list of available articles and used other search engines such as Google Scholar to identify a total of nine studies. The prevalence of lumbar disc degeneration in fast-bowlers ranges from 21-65% with an incidence rate of 15% per year, and the prevalence of lumbar spine bony abnormalities ranges from 24-81%. Factors associated with lumbar spine injury in fast-bowlers are classified into un-modifiable (age) and modifiable (more intense bowling workload and mixed-bowling technique). Fast-bowlers have a high prevalence of lumbar spine injuries. Appropriate interventions, such as educational sessions, may be able to modify risk factors such as bowling workload and bowling technique and thus reduce injury prevalence.

Golf is a popular sport with both perceived and real health benefits. However, certain injury risks are also prevalent, particularly to the lower back. Epidemiological studies have shown that lower back pain (LBP) from golf account for between 18% and 54% of all documented ailments, leading many researchers to regard the condition as the most common golf injury. The purpose of this review was to examine the scientific literature to ascertain the risk factors associated with the development of LBP from playing golf and suggest methods to modify or limit these factors. Results of the review indicate that the high frequency of LBP appears multi-factorial although the asymmetrical and forceful nature of the swing along with excessive play and practice, particularly amongst elite players, appear to be common factors. Other factors include swing flaws leading to excessive side-bend and over-rotation of the spine, abnormal muscle recruitment, poor trunk endurance, restricted lead hip internal rotation and the use of unnecessarily stressful club transportation methods. Methods to help control or eliminate excessive stress on the lower back would include reducing the amount spent playing or practicing, seeking professional assistance to assess and adjust swing mechanics, improve trunk and hip flexibility, increase the strength and endurance of the trunk musculature, consider different footwear options and avoid carrying the golf bag. Adopting some or all of these recommendations should allow players to continue to enjoy the sport of golf well into their senior years.

While degenerative lumbar spine conditions are common in the general population, there are unique considerations when diagnosed in high-level athletes. Genetic factors have been identified as a more significant contributor to the development of degenerative disc disease than occupational risks, however, some have postulated that the incessant training of young, competitive athletes may put them at a greater risk for accelerated disease. The evidence-based literature regarding lumbar disc herniation in elite athletes suggests that it is reasonable to expect excellent clinical outcomes and successful return-to-sport after either operative or non-operative treatment regardless of sport played. However, those athletes who require repetitive torque on their lumbar spines may have poorer long-term outcomes if surgical treatment is required for this condition. Painful spondylolysis in the athlete can often be treated successfully with non-operative treatment, however, if surgery is required, pars repair techniques provides a motion-sparing alternative that may lead to successful return to sport.

Research on the effects of exercise on immune function, has a wide range of sporting activities. Study on the long-term effects of regular exercise on serum levels of cytokines such as interleukin-17 have shown that moderate and regular exercise, has an important role in the prevention and treatment of many diseases. Exhaustive exercise has a deep effect on cellular, humoral, innate immunity and the amount of cytokines of an athlete’s immune system. So this study was designed to compare the effect of one course of exhaustive exercise on serum levels of interleukin (IL)-17 in different groups of athletes. Patients and Forty professional athletes with a mean age of 25.1 ± 5.0 years, divided equally in 4 groups (handball, volleyball, Sepak-takraw and climbing) were selected for this purpose. 30 second Wingate test for each athlete was used to assess anaerobic power. Blood samples before, immediately after and 2 hours after exercise was collected and the amount of serum IL-17 was measured. The results showed that the level of IL-17 in the study groups before and after the two hours exercise did not significantly change in all four groups. The results showed that short anaerobic exercise has no effect on the level of IL-17.

Although guidelines based on expert opinions have been developed for the immediate management and return to play of athletes after a concussion, data are lacking on this issue. Evaluate a standardized management of brain concussion among rugby players to prevent the recurrence. Patients and A prospective study was performed from September 2009 to June 2012. All rugby players who had a concussion when playing rugby were included. Patients were managed by a specialized hospital team with a specific protocol developed in collaboration with the medical staff of the rugby clubs included in the study. The series included 35 rugby players, with 23 professionals and 12 high-level players, 30 men and 5 women, mean age 23.1 ± 5.5 years old. The median number of previous concussions was 2 (0-30) episodes. According to the Cantu concussion severity classification, 3 athletes were grade 1, 12 were grade 2 and 20 were grade 3. None of the injured athletes was lost to follow-up. The primary endpoint was the occurrence of a new concussion within 3 months after the first in patients who returned to rugby. Thirty-three patients returned to rugby after a mean 22.1 ± 10 days. The recurrence rate within 3 months was 2/33 (6.1%). The median delay before returning to rugby was 21 (7-45) days. Factors associated with a delayed return to play were young age, initial loss of consciousness, severity Cantu grade 3 and post-concussive syndrome of more than 5 days. Analysis of two failures showed that the initial injury was grade 3 and that both were professional athletes and had a history of concussion. This prospective study validated the study protocol for the management of concussion in rugby players.

Rowing injuries are common, with lower back injuries having the highest incidence. This study was to investigate the major rowing injuries seen at a single high performance rowing sports program over a 5 years training period and establish if any relationship exists between these injuries and the level of competition that the rower is partaking in. Patients and All rowers at the South Australian Sports Institute (SASI) programs were designated as being either international or national level rowers. Injuries that caused greater than 5 days training loss during any one training year were recorded. The number of lower back injuries and rib stress injuries causing training time loss were analysed to assess whether there was any association between the level of rower and the nature and type of injury causing training time loss. Forty-five national rowers (97 training years) had 15 lower back injuries compared to 12 international rowers 35 training years) with 1 lower back injury. Thus a national level rower was more likely to have a lower back injury compared to an international rower P = 0.05. In contrast an international level was more likely to have a rib stress fracture compared to a national rower P = 0.04. 21% of all injuries in this study were a consequence of cycling injuries. Lower back injuries are a significant cause of training time lost in rowers. These injuries are much more likely to occur in national level rowers when compared to international level rowers. In contrast rib stress injuries are associated with international compared to national level rowers.

Low back pain (LBP) is a common cause of lost playing time and can be a challenging clinical condition in competitive athletes. LBP in athletes may be associated with joint and ligamentous hypermobility and impairments in activation and coordination of the trunk musculature, however there is limited research in this area. To determine if there is an association between altered lumbar motor control, joint mobility and low back pain (LBP) in a sample of athletes. Fifteen athletes with LBP were matched by age, gender and body mass index (BMI) with controls without LBP. Athletes completed a questionnaire with questions pertaining to demographics, activity level, medical history, need to self-manipulate their spine, pain intensity and location. Flexibility and lumbar motor control were assessed using: active and passive straight leg raise, lumbar range of motion (ROM), hip internal rotation ROM (HIR), Beighton ligamentous laxity scale, prone instability test (PIT), observation of lumbar aberrant movements, double leg lowering and Trendelenburg tests. Descriptive statistics were compiled and the chi square test was used to analyze results. Descriptive statistics showed that 40% of athletes with LBP exhibited aberrant movements (AM), compared to 6% without LBP. 66% of athletes with LBP reported frequently self-manipulating their spine compared to 40% without LBP. No significant differences in motor control tests were found between groups. Athletes with LBP tended to have less lumbar flexion (63 ± 11°) compared to those without LBP (66 ± 13°). Chi-Square tests revealed that the AM were more likely to be present in athletes with LBP than those without (X2 = 4.66, P = 0.03). The presence of aberrant movement patterns is a significant clinical finding and associated with LBP in athletes.

Low Back Pain (LBP) is one of the most prevalent causes of disability not only in the general population but also in athletes. Despite a large number of self-reported back specific disability questionnaires, there is no specific, well documented, outcome measure for athletes suffering from back pain. This study aimed to identify the main descriptive themes representing functional disability in athletes due to LBP. Patients and We conducted a qualitative study using in-depth interviews to characterize the experiences of athletes with LBP. Twenty athletes with LBP were recruited and the main descriptive elements of their LBP related disability were extracted. Then a preliminary questionnaire using these themes was proposed. The main disability indicators were pain intensity; stretching exercises, strengthening exercises, sport specific skills, back range of motion (ROM), sitting, walking, sleep patterns, self-care, and recreational activities, fear of pain and avoidance behavior, and changes in sexual activity. The findings of this study suggest that apart from non sports items, some sport related items should be included in the assessment of LBP disability levels in athletes. Our results have also been organized as a preliminary LBP disability questionnaire for athletes.

Fatigue seems to have a significant effect on soccer kick performance. However, the duration of these effects has not been previously investigated. The purpose of the present study was to investigate the duration of the acute effects of fatigue on soccer kick performance in males and females.Patients and Ten male (age: 26.3 ± 4.9 years, height: 178.1 ± 5.1 cm, mass: 81.3 ± 8.1 kg) and ten female (age: 24.4 ± 4.2 years, height: 169.7 ± 5.7 cm, mass: 61.8 ± 5.1 kg) amateur soccer players performed three instep kicks prior to and after running on a treadmill till exhaustion. Three-dimensional kinematics were collected pre- and post-fatigue. Analysis of variance indicated a statistically significant decline in ball speed during the first and the second trial after fatigue (P < 0.05), but recovered to pre-fatigue levels during the third post-fatigue kicking trial (P > 0.05). Similarly, maximum ankle, knee and hip linear velocity and ankle angular displacement were significantly lower during the first two trials (P < 0.05), but not during the third trial after fatigue (P > 0.05). Soccer kick parameters recovered to pre-fatigue levels approximately within a minute after the end of the protocol. These findings have a practical meaning for players who have to perform set piece kicks under fatigue conditions and for coaches who have to guide their players.

By providing sports organizations with electronic records and instruments that can be accessed at any time or place, specialized care can be offered to athletes regardless of injury location, and this makes the follow-up from first aid through to full recovery more efficient. The aim of this study was to develop an electronic personal health record for professional Iranian athletes. Patients and First, a comparative study was carried out on the types of professional athletes’existing handheld and electronic health information management systems currently being used in Iran and leading countries in the field of sports medicine including; Australia, Canada and the United States. Then a checklist was developed containing a minimum dataset of professional athletes’ personal health records and distributed to the people involved, who consisted of 50 specialists in sports medicine and health information management, using the Delphi method. Through the use of data obtained from this survey, a basic paper model of professional athlete's personal health record was constructed and then an electronic model was created accordingly. Access to information in the electronic record was through a web based, portal system. The capabilities of this system included: access to information at any time and location, increased interaction between the medical team, comprehensive reporting and effective management of injuries, flexibility and interaction with financial, radiology and laboratory information systems. It is suggested that a framework should be created to promote athletes’ medical knowledge and provide the education necessary to manage their information. This would lead to improved data quality and ultimately promote the health of community athletes.

Wrestling was an important part of the ancient Olympic Games and is still one of the most popular events of the modern Olympic Games. Studies indicate that general physiologic profile of successful wrestlers is high anaerobic power and capacity, muscular strength, above average aerobic power, exceptional flexibility, fat free mass, and a mesomorphic somatotype. The objective of the present study was to evaluate anthropometric characteristics and physical performance of elite male wrestlers.Patients and The Colombian Wrestling Team was evaluated while in preparation for the Olympic Games (n = 21; age, 27.9 ± 6.7 years). Athletes were tested on anthropometric and fitness parameters: body composition, somatotype distribution according to Heath-Carter, aerobic capacity, vertical jump, and anaerobic power. The evaluations showed a mean body fat percentage of 13.6% ± 3.0% (95% CI, 12.2%-15%), muscle mass of 46.4% ± 2.2% (95% CI, 45.4%-47.4%), Ponderal index of 41.0 ± 1.8 (95% CI, 40.2-41.8), body adiposity index (BAI) 25.1 ± 3.6 (95% CI, 23.5-26.8), and somatotype distribution mesomorphic-ectomorph (5.3-1.6-3.8). Mean aerobic capacity was 45.9 ± 6.6 mL/kg/min (95% CI, 42.8-48.9), vertical jump was 36.4 ± 6.6 cm (95% CI, 11.8-16.6), and anaerobic power was 92.6 ± 19.5 kg/s (95% CI, 83.7-101.5). These results provided a profile of elite wrestlers that could be used as training targets for developing athletes. The results may also provide information for training and tactical planning.

Regular physical activity (PA) enhances health and is an important factor in disease prevention and longevity. The 2008 U.S. Physical Activity Guidelines recommends that all healthy adults attain at least 150 minutes per week of moderate intensity aerobic PA (e.g., brisk walking) to maintain and promote PA. This study determined the effects of a 6-month pedometer-based worksite walking intervention with participants focusing on a goal of achieving 10,000 steps per day, on body composition in adults with a wide range of body mass index (BMI) values and compares the changes with outcomes of similar studies. The design was a single group, quasi-experimental study. All participants received a pedometer and were asked to register the daily number of steps. Men and women (n = 142; age = 41 ± 11.5 years; BMI = 27.2 ± 7.25 kg.m-2) received body composition measures at 1, 3, and 6 months. A multilevel growth modeling approach was used to explore change over time and to predict change by steps, age, gender, and fat category categorized as normal and overweight/obese. Significant individual differences in linear slopes and change over time were observed for waist circumference (WC) (-3.0 cm) only in unconditional model (t = -0.67, P = 0.02). A 3.0 cm loss in WC shows that a 10,000 step per day walking program has the potential to influence changes in body composition measures that are correlated with adverse health outcomes. While significant changes did occur there are some limitations. The analysis did not consider the data regarding completing of 10,000 steps per day and other potential factors that could influence the results. Compliance to the walking dose and initial physical activity and body composition levels are important to consider when studying body composition changes in such programs.

The self-administration intake of anabolic-androgenic steroids (AAS) is a widespread practice in competitive bodybuilders. Structural changes within the myocardium following AAS abuse including hypertrophy, restricted diastolic function as well as systolic dysfunction and impaired ventricular inflow have been reported. We present the case of a 39-year-old bodybuilder with a more than 20-year history of anabolic-androgenic steroids (AAS) abuse presenting with increasing exertional dyspnoea and fatigue. Diagnostic work-up of the patient’s current symptoms included a cine cardiovascular magnetic resonance (CMR). Using a T1-weighted inversion-recovery sequence 10 minutes after application of 0.1 mmol/kg gadolinium with diethylenetriaminepentaacetic acid (gadolinium DTPA), patchy midwall enhancement in the septal and posterolateral region of the left ventricle was demonstrated. This enhancement pattern is different from the enhancement pattern found in patients with ischemic heart disease. The present case illustrates for the first time, by CMR, myocardial scarring with severe left ventricular hypertrophy in a patient with normal coronary arteries after long lasting abuse of AAS. With that finding we could demonstrate a link between AAS abuse and the occurrence of myocardial scarring in humans. This finding may help raise awareness of the consequences of AAS use.