- Email: [email protected]
lower limb injury in Australian first class cricketers: A 3 year prospective study
Abstracts / Journal of Science and Medicine in Sport 12 (2010) e1–e232
Methodology: The study employed a balanced three group cross-over randomised experimental design. Three levels of exercise intervention were employed; No Exercise/Rest (NE), Moderate Intensity Exercise (ME) and, High Intensity Exercise (HE). Blood lactates, heart-rate and “perceived-exertion” (Borg Scale) were recorded to verify the level of exercise intensity. Ninety asymptomatic participants (45♂:45♀) performed timed motor performance tasks; Finger-to-Nose (FTN), Tandem Gait (TG) and Single Leg Stance (SLS). The tasks were administered pre- and postexercise and 15-min after exercise (recovery). Linear mixed models with adjusted means and contrasts were used to compare exercise effects. Data were log-transformed with the analyses accounting for clustering. Results: When task change-scores were contrasted to NE; HE caused a significant decrease in SLS (p < 0.05) andTG (p < 0.05) performance but facilitated FTN (p < 0.05). Fifteen-minutes of recovery improved TG (p = 0.01) and SLS (p < 0.05) but decreased performance of FTN (p < 0.05). Fifteen-minutes of ME caused a significant decrease in performance in SLS (p = 0.03) but not in the other tasks. No significant change occurred in any tasks after 15-min recovery following ME. Conclusions: Changes in the performance of motor tasks after exercise has implications for the immediate assessment of SRC, given that measures of motor performance are commonly utilised in concussion assessment instruments. doi:10.1016/j.jsams.2009.10.090 90
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to evaluate the relationships between morphology, physical capacity, skill and overall football performance. Results: Most tests of physical capacity were positively correlated, as were many tests of football skill. There was minimal correlation between physical capacity and skill; however, balance was positively correlated to overall football performance and many skill and physical capacity measures. Conclusions: Football-specific skills are a stronger predictor of football performance than general measures of athletic ability. This highlights the need for exercise programs for the training and rehabilitation football players to be designed to improve football-specific skills in order to optimally impact on football performance and facilitate return to sport. Balance exercises are also important to include in this population. Balance has been shown to be affected following injury and it has been suggested that decreased balance increases risk of injury. Therefore, it is necessary to address deficits in balance in order to decrease risk of future injures and avoid negatively impacting on football performance. doi:10.1016/j.jsams.2009.10.091 91 Links between musculoskeletal screening and lower back/lower limb injury in Australian first class cricketers: A 3 year prospective study K. Sims 1,∗ , M. Portus 1 , M. Pfitzner 2 , P. Farhart 1,2,3 , J. Orchard 3 1 Cricket
Australia practitioner, Adelaide 3 Cricket New South Wales 2 Private
What is the relationship between physical capacity, skill and performance among football players? M. Smith 1,∗ , R. Wilson 2 , T. Russell 1 1 The
University of Queensland, School of Health and Rehabilitation Sciences 2 The University of Queensland, School of Integrative Biology Introduction: Training to improve sporting performance typically involves prescription of exercises to challenge and progress physical capacity and skill. However, when an individual is recovering from an injury, it is common for more emphasis to be placed on improving physical capacity than sport-specific skill, and the relationship between physical capacity and skill is not always clear. The primary aim of this study was to investigate the relationship between physical capacity, skill and performance measures in football players. Methodology: Thirty male football players aged 17–31 years participated in 16 different physical capacity and skill tasks which included tests of power, endurance, balance, flexibility, agility, ball control and accuracy. Morphology measurements were also taken and players participated in one-on-one football games which were used as a measure of overall football performance. Statistical models were used
Introduction: The aim of this research was to investigate whether a battery of musculoskeletal tests could be used to prospectively identify injuries in Australian first class cricketers. Methodology: Musculoskeletal physiotherapy screening procedures consisting primarily of measures of joint range of motion were standardized across 6 states. These were then performed pre-season over 3 consecutive seasons from 2006–2008 giving 121,102 and 123 screens respectively. This information was then collated with injury surveillance data over the course of the three seasons and univariate (one way ANOVA) and multivariate (discriminant analysis) statistics were performed to determine whether it was possible to predict lower back/lower limb injury based on the screening results. Results/Conclusions: Players who suffered from lower back or lower limb injury were found to have significantly reduced left hip external rotation (p = 0.002) and left ankle dorsiflexion (p = 0.005) compared to the non injured group. They also exhibited significantly increased right 1st metatarsophalangeal extension (p = 0.01) and shoulder/thoracic extension in prone (p = 0.002). Using these
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Abstracts / Journal of Science and Medicine in Sport 12 (2010) e1–e232
variables it was possible to correctly classify 72% of the players into the injury and non injury groups. These results suggest that reduced range of hip and ankle motion may adversely affect the lower kinetic chain. In contrast, the excessive motion in the foot and through the thoracic region may represent an adaptation to reduced motion in other regions. These results also provide direction for rehabilitation programs designed to reduce injury and provide a means for monitoring the physical status of cricket athletes over the course of a season. doi:10.1016/j.jsams.2009.10.092 92 Groin pain and hip range of motion is different in Indigenous compared to non-Indigenous young Australian football players C. Taylor 1,2,∗ , J. Cook 2 , T. Pizzari 1 , N. Ames 3,4 , T. Wood 5 , B. Gabbe 6 , M. Makdissi 7 , E. Scase 8 , J. McNeil 6 , J. Orchard 9 1 School
of Physiotherapy, LaTrobe University and Nutritional Sciences, Deakin University 3 AIS-AFL Academy 4 Geelong Football Club 5 AFL Medical Officers Association 6 Epidemiology and Preventive Medicine, Monash University 7 Centre for Health, Exercise and Sports Medicine, University of Melbourne 8 Australian Institute of Sport 9 School of Public Health, University of Sydney 2 Exercise
Introduction: Anecdotally, Indigenous (I) Australian football (AF) players are more likely to suffer from soft tissue injuries compared with their non-Indigenous (non-I) teammates, and there is some evidence that being of Aboriginal descent is associated with an increased risk of hamstring injury. The current study aimed to investigate if standard hip and groin screening tests would reveal differences between Indigenous and non-Indigenous players. Methods: Two hundred and seventy elite junior Australian football players at the Under 16 National Championships and AFL Draft Camp were screened using a battery of musculoskeletal tests. The following hip and groin tests were undertaken: supine passive hip internal rotation at 90◦ , supine active hip internal rotation and external rotation in neutral, prone passive hip internal rotation, adductor squeeze test at 90◦ and 0◦ knee flexion (measuring pressure (mmHg) and pain rating (1–10)). Results: Thirty three players (12%) were Indigenous and of these players, 58% (n = 19) played in the Northern Territory. Independent groups t-test, Mann–Whitney U and Person Chi-Square tests comparing means and rankings of the Indigenous group to the non-Indigenous group demonstrated significant differences between the two groups
for right prone hip internal rotation (I X = 27.60 ± 9.16, non-I X = 33.39 ± 8.88, p = .00) and left prone hip internal rotation (I X = 25.83 ± 10.25, non-I X = 31.36 ± 8.75, p = .00), pressure on squeeze test with knees at 90◦ (I X = 165.71 ± 40.32, non-I X = 188.17 ± 62.32 p = .001) and pressure on squeeze tests with knees at 0◦ (I X = 172.57 ± 35.98, non-I X = 202.57 ± 49.14 p = .049), and pain provocation during squeeze test with knees at 90◦ (I X = 3.19 ± 2.26, non-I X = 1.03 ± 1.78). There were no significant differences between groups for supine passive hip internal rotation at 90◦ , or supine active hip internal and external rotation in neutral. Conclusion: The Indigenous players screened displayed significantly less range of hip passive hip internal rotation with the hip in neutral, reduced adductor squeeze force and higher levels of groin pain with the squeeze test at 90◦ . The differences observed between Indigenous and nonIndigenous players may indicate that the Indigenous players are at greater risk of hip and groin injuries in AF. This increased risk may be a result of training, playing, environmental or genetic differences between the groups. Based on this preliminary evidence, young Indigenous players should be screened and managed for hip and groin injury. Further research is needed to confirm if Indigenous players are more at risk during senior football. doi:10.1016/j.jsams.2009.10.093 93 In season shoulder instability episodes in professional Australian Rules football P. Jarman 1,∗ , G. Hoy 1,2 1 Australian 2 Melbourne
Orthopaedic Association Orthopaedic Group
Introduction: It has been well documented that the natural history of shoulder dislocation is to encounter further shoulder instability, especially in the young male playing a contact sport. Further, it has been documented that glenohumeral arthritis is a consequence of repeated shoulder dislocation in a third of more of cases. Australian Rules Football is the dominant winter sport at a national level. It is also unique in being a largely overhead, contact sport. We present an audit of in-season shoulder instability at AFL Level. We sought to determine the true incidence of shoulder instability injuries (including non-dislocation instability episodes) at 15 of 16 AFL clubs during season 2007. Method: We contacted all participating team doctors weekly to determine the cases of shoulder instability and dislocation episodes. We prospectively followed players who returned to elite level football following treatment, profiling performance after return to play post therapy. We compared their pre injury performance indicators to their performance after their return, and that of the following season.
Methodology: The study employed a balanced three group cross-over randomised experimental design. Three levels of exercise intervention were employed; No Exercise/Rest (NE), Moderate Intensity Exercise (ME) and, High Intensity Exercise (HE). Blood lactates, heart-rate and “perceived-exertion” (Borg Scale) were recorded to verify the level of exercise intensity. Ninety asymptomatic participants (45♂:45♀) performed timed motor performance tasks; Finger-to-Nose (FTN), Tandem Gait (TG) and Single Leg Stance (SLS). The tasks were administered pre- and postexercise and 15-min after exercise (recovery). Linear mixed models with adjusted means and contrasts were used to compare exercise effects. Data were log-transformed with the analyses accounting for clustering. Results: When task change-scores were contrasted to NE; HE caused a significant decrease in SLS (p < 0.05) andTG (p < 0.05) performance but facilitated FTN (p < 0.05). Fifteen-minutes of recovery improved TG (p = 0.01) and SLS (p < 0.05) but decreased performance of FTN (p < 0.05). Fifteen-minutes of ME caused a significant decrease in performance in SLS (p = 0.03) but not in the other tasks. No significant change occurred in any tasks after 15-min recovery following ME. Conclusions: Changes in the performance of motor tasks after exercise has implications for the immediate assessment of SRC, given that measures of motor performance are commonly utilised in concussion assessment instruments. doi:10.1016/j.jsams.2009.10.090 90
e43
to evaluate the relationships between morphology, physical capacity, skill and overall football performance. Results: Most tests of physical capacity were positively correlated, as were many tests of football skill. There was minimal correlation between physical capacity and skill; however, balance was positively correlated to overall football performance and many skill and physical capacity measures. Conclusions: Football-specific skills are a stronger predictor of football performance than general measures of athletic ability. This highlights the need for exercise programs for the training and rehabilitation football players to be designed to improve football-specific skills in order to optimally impact on football performance and facilitate return to sport. Balance exercises are also important to include in this population. Balance has been shown to be affected following injury and it has been suggested that decreased balance increases risk of injury. Therefore, it is necessary to address deficits in balance in order to decrease risk of future injures and avoid negatively impacting on football performance. doi:10.1016/j.jsams.2009.10.091 91 Links between musculoskeletal screening and lower back/lower limb injury in Australian first class cricketers: A 3 year prospective study K. Sims 1,∗ , M. Portus 1 , M. Pfitzner 2 , P. Farhart 1,2,3 , J. Orchard 3 1 Cricket
Australia practitioner, Adelaide 3 Cricket New South Wales 2 Private
What is the relationship between physical capacity, skill and performance among football players? M. Smith 1,∗ , R. Wilson 2 , T. Russell 1 1 The
University of Queensland, School of Health and Rehabilitation Sciences 2 The University of Queensland, School of Integrative Biology Introduction: Training to improve sporting performance typically involves prescription of exercises to challenge and progress physical capacity and skill. However, when an individual is recovering from an injury, it is common for more emphasis to be placed on improving physical capacity than sport-specific skill, and the relationship between physical capacity and skill is not always clear. The primary aim of this study was to investigate the relationship between physical capacity, skill and performance measures in football players. Methodology: Thirty male football players aged 17–31 years participated in 16 different physical capacity and skill tasks which included tests of power, endurance, balance, flexibility, agility, ball control and accuracy. Morphology measurements were also taken and players participated in one-on-one football games which were used as a measure of overall football performance. Statistical models were used
Introduction: The aim of this research was to investigate whether a battery of musculoskeletal tests could be used to prospectively identify injuries in Australian first class cricketers. Methodology: Musculoskeletal physiotherapy screening procedures consisting primarily of measures of joint range of motion were standardized across 6 states. These were then performed pre-season over 3 consecutive seasons from 2006–2008 giving 121,102 and 123 screens respectively. This information was then collated with injury surveillance data over the course of the three seasons and univariate (one way ANOVA) and multivariate (discriminant analysis) statistics were performed to determine whether it was possible to predict lower back/lower limb injury based on the screening results. Results/Conclusions: Players who suffered from lower back or lower limb injury were found to have significantly reduced left hip external rotation (p = 0.002) and left ankle dorsiflexion (p = 0.005) compared to the non injured group. They also exhibited significantly increased right 1st metatarsophalangeal extension (p = 0.01) and shoulder/thoracic extension in prone (p = 0.002). Using these
e44
Abstracts / Journal of Science and Medicine in Sport 12 (2010) e1–e232
variables it was possible to correctly classify 72% of the players into the injury and non injury groups. These results suggest that reduced range of hip and ankle motion may adversely affect the lower kinetic chain. In contrast, the excessive motion in the foot and through the thoracic region may represent an adaptation to reduced motion in other regions. These results also provide direction for rehabilitation programs designed to reduce injury and provide a means for monitoring the physical status of cricket athletes over the course of a season. doi:10.1016/j.jsams.2009.10.092 92 Groin pain and hip range of motion is different in Indigenous compared to non-Indigenous young Australian football players C. Taylor 1,2,∗ , J. Cook 2 , T. Pizzari 1 , N. Ames 3,4 , T. Wood 5 , B. Gabbe 6 , M. Makdissi 7 , E. Scase 8 , J. McNeil 6 , J. Orchard 9 1 School
of Physiotherapy, LaTrobe University and Nutritional Sciences, Deakin University 3 AIS-AFL Academy 4 Geelong Football Club 5 AFL Medical Officers Association 6 Epidemiology and Preventive Medicine, Monash University 7 Centre for Health, Exercise and Sports Medicine, University of Melbourne 8 Australian Institute of Sport 9 School of Public Health, University of Sydney 2 Exercise
Introduction: Anecdotally, Indigenous (I) Australian football (AF) players are more likely to suffer from soft tissue injuries compared with their non-Indigenous (non-I) teammates, and there is some evidence that being of Aboriginal descent is associated with an increased risk of hamstring injury. The current study aimed to investigate if standard hip and groin screening tests would reveal differences between Indigenous and non-Indigenous players. Methods: Two hundred and seventy elite junior Australian football players at the Under 16 National Championships and AFL Draft Camp were screened using a battery of musculoskeletal tests. The following hip and groin tests were undertaken: supine passive hip internal rotation at 90◦ , supine active hip internal rotation and external rotation in neutral, prone passive hip internal rotation, adductor squeeze test at 90◦ and 0◦ knee flexion (measuring pressure (mmHg) and pain rating (1–10)). Results: Thirty three players (12%) were Indigenous and of these players, 58% (n = 19) played in the Northern Territory. Independent groups t-test, Mann–Whitney U and Person Chi-Square tests comparing means and rankings of the Indigenous group to the non-Indigenous group demonstrated significant differences between the two groups
for right prone hip internal rotation (I X = 27.60 ± 9.16, non-I X = 33.39 ± 8.88, p = .00) and left prone hip internal rotation (I X = 25.83 ± 10.25, non-I X = 31.36 ± 8.75, p = .00), pressure on squeeze test with knees at 90◦ (I X = 165.71 ± 40.32, non-I X = 188.17 ± 62.32 p = .001) and pressure on squeeze tests with knees at 0◦ (I X = 172.57 ± 35.98, non-I X = 202.57 ± 49.14 p = .049), and pain provocation during squeeze test with knees at 90◦ (I X = 3.19 ± 2.26, non-I X = 1.03 ± 1.78). There were no significant differences between groups for supine passive hip internal rotation at 90◦ , or supine active hip internal and external rotation in neutral. Conclusion: The Indigenous players screened displayed significantly less range of hip passive hip internal rotation with the hip in neutral, reduced adductor squeeze force and higher levels of groin pain with the squeeze test at 90◦ . The differences observed between Indigenous and nonIndigenous players may indicate that the Indigenous players are at greater risk of hip and groin injuries in AF. This increased risk may be a result of training, playing, environmental or genetic differences between the groups. Based on this preliminary evidence, young Indigenous players should be screened and managed for hip and groin injury. Further research is needed to confirm if Indigenous players are more at risk during senior football. doi:10.1016/j.jsams.2009.10.093 93 In season shoulder instability episodes in professional Australian Rules football P. Jarman 1,∗ , G. Hoy 1,2 1 Australian 2 Melbourne
Orthopaedic Association Orthopaedic Group
Introduction: It has been well documented that the natural history of shoulder dislocation is to encounter further shoulder instability, especially in the young male playing a contact sport. Further, it has been documented that glenohumeral arthritis is a consequence of repeated shoulder dislocation in a third of more of cases. Australian Rules Football is the dominant winter sport at a national level. It is also unique in being a largely overhead, contact sport. We present an audit of in-season shoulder instability at AFL Level. We sought to determine the true incidence of shoulder instability injuries (including non-dislocation instability episodes) at 15 of 16 AFL clubs during season 2007. Method: We contacted all participating team doctors weekly to determine the cases of shoulder instability and dislocation episodes. We prospectively followed players who returned to elite level football following treatment, profiling performance after return to play post therapy. We compared their pre injury performance indicators to their performance after their return, and that of the following season.