Forefoot strikers exhibit lower running-induced knee loading than rearfoot strikers.

AB Purpose: Knee pain and Achilles tendinopathies are the most common complaints among runners. The differences in the running mechanics may play an important role in the pathogenesis of lower limb overuse injuries. However, the effect of a runner's foot strike pattern on the ankle and especially on the knee loading is poorly understood. The purpose of this study was to examine whether runners using a forefoot strike pattern exhibit a different lower limb loading profile than runners who use rearfoot strike pattern. Methods: Nineteen female athletes with a natural forefoot strike (FFS) pattern and pair-matched women with rearfoot strike (RFS) pattern (n = 19) underwent 3-D running analysis …

SELF-REPORTED 12-MONTH OVERUSE INJURY HISTORY IN YOUTH BASKETBALL AND FLOORBALL

Background The popularity of organized sports, especially team sports is growing among youth. High training volume and intensity at early age may predispose young athletes to overuse injuries. Objective To examine the occurrence, nature and severity of overuse injuries in youth basketball and floorball. Design A descriptive retrospective study. Setting Finnish youth basketball and floorball. Participants: 406 athletes (mean age 15.9, SD 2.0) from six basketball and floorball clubs (210 basketball and 196 floorball players). Main outcome measurements Self-reported history of overuse injuries over the preceding 12-month period. Data was obtained from a questionnaire. The severity of injuries …

Acute injuries in Finnish junior floorball league players

Abstract Objectives To investigate the incidence and characteristics of acute time-loss injuries in Finnish junior floorball league players. Design Prospective cohort study with 3-year follow-up. Methods One hundred and eighty-six female and male players (mean age 16.6 ± 1.4) took part in the follow-up study (2011–2014). The training hours and games were recorded on a team diary. Floorball related acute injuries were registered and verified by a research physician. The injury incidence was expressed as the number of injuries per 1000 h of exposure. Incidence rate was calculated separately for games and practices, and for males and females. Results One hundred and forty-four acute time-loss …

sj-docx-2-sph-10.1177_19417381211065443 ��� Supplemental material for Injury History and Perceived Knee Function as Risk Factors for Knee Injury in Youth Team-Sports Athletes

Supplemental material, sj-docx-2-sph-10.1177_19417381211065443 for Injury History and Perceived Knee Function as Risk Factors for Knee Injury in Youth Team-Sports Athletes by Jussi Hietamo, Anni Rantala, Jari Parkkari, Mari Lepp��nen, Marko Rossi, Ari Heinonen, Kathrin Steffen, Pekka Kannus, Ville Mattila and Kati Pasanen in Sports Health: A Multidisciplinary Approach

Salibandyvammojen ilmaantuvuus, vammatyypit ja riskitekijät naispelaajilla

Incidence and risk factors for back pain in young floorball and basketball players : A prospective study

The aim of this study was to investigate the incidence of back pain in young basketball and floorball players under 21 years of age. The secondary aim was to examine risk factors especially for low back pain (LBP). Nine basketball and nine floorball teams (n = 396) participated in this prospective follow‐up study (2011‐2014). Young athletes (mean age 15.8 ± 1.9) performed physical tests and completed a questionnaire at baseline. The follow‐up lasted 1‐3 years per player. During the follow‐up, back pain reported by the players was registered on a weekly basis and verified by a study physician. The exposure time (AE) on team practices and games was recorded by the coach. Altogether back pain …

Low Back Pain in Young Basketball and Floorball Players

Objective The aim of the study was to investigate the prevalence and risk factors of low back pain (LBP) in young female and male basketball and floorball players. Design Cross-sectional study. Setting Nine basketball teams and 9 floorball teams from Tampere city district, Finland. Participants Four hundred one young female and male players (mean age: 15.8 ± 1.9 years). Assessment of risk factors Age, gender, sport, and family history of musculoskeletal disorders were assessed as risk factors for LBP. Adjustment was made on team level to avoid random effects associated with a team. Main outcome measures Information of players' background factors and LBP episodes was collected by a structure…

Predictors of lower extremity injuries in team sports (PROFITS-study): a study protocol.

Introduction Several intrinsic risk factors for lower extremity injuries have been proposed, including lack of proper knee and body control during landings and cutting manoeuvres, low muscular strength, reduced balance and increased ligament laxity, but there are still many unanswered questions. The overall aim of this research project is to investigate anatomical, biomechanical, neuromuscular, genetic and demographic risk factors for traumatic non-contact lower extremity injuries in young team sport athletes. Furthermore, the research project aims to develop clinically oriented screening tools for predicting future injury risk. Methods Young female and male players (n=508) from nine basket…

5 Frontal plane femoral adduction during single-leg landing and low back pain in young athletes: a prospective profits cohort study

Introduction Prospective studies investigating risk factors for low back pain (LBP) in young athletes are limited. The aim of this prospective cohort study was to investigate the association between LBP and selected biomechanical factors and postural stability during dynamic movement tasks in young athletes. Materials and methods 396 young floorball and basketball players (mean age 15.8±1.9) were included and followed prospectively for 1–3 years (2011–2014). In the beginning of every study year the players were tested. The physical tests included single-leg squat (SLS), single-leg vertical drop jump (SLVDJ), vertical drop jump (VDJ) and Star Reach Excursion Balance Test (SEBT). Individual e…

Adherence to an Injury Prevention Warm-Up Program in Children’s Soccer : A Secondary Analysis of a Randomized Controlled Trial

This study examined the impact of high adherence to a neuromuscular training (NMT) warm-up on the risk of lower extremity (LE) injuries in children’s soccer. Twenty U11–U14 youth clubs (n = 92 teams, 1409 players) were randomized into intervention (n = 44 teams) and control (n = 48 teams) groups. The intervention group was advised to perform an NMT warm-up 2 to 3 times a week for 20 weeks. Team adherence, injuries, and exposure were registered throughout the follow-up. Primary outcomes were the incidence of soccer-related acute LE injuries and the prevalence of overuse LE injuries. Intervention teams conducted mean 1.7 (SD 1.0) NMT warm-ups weekly through follow-up. The seasonal trend for a…

Epidemiology of Overuse Injuries in Youth Team Sports: A 3-year Prospective Study

AbstractProspective studies on overuse injuries and their impact on athletic training among youth team sports are scarce. The purpose of this study was to investigate the incidence, severity and player related risk factors of overuse injuries among young (12–20 years) basketball and floorball players. A total of 387 players participated in a 3-year prospective study. Each player completed a baseline questionnaire regarding their background information. Overuse injuries that prevented players to fully or partly participate in their regular training were collected. In all, 204 overuse injuries were registered (injury incidence 1.51 injuries/1 000 h of exposure; 95% CI 1.35–1.78). Most of the …

Knee Control and Jump-Landing Technique in Young Basketball and Floorball Players

Poor knee alignment is associated with increased loading of the joints, ligaments and tendons, and may increase the risk of injury. The study purpose was to compare differences in knee kinematics between basketball and floorball players during a vertical drop jump (VDJ) task. We wanted to investigate whether basketball players, whose sport includes frequent jump-landings, exhibited better knee control compared with floorball players, whose sport involves less jumping. Complete data was obtained from 173 basketball and 141 floorball players. Peak knee valgus and flexion angles during the VDJ were analyzed by 3D motion analysis.Larger knee valgus angles were observed among basketball players …

Test−Retest Reliability of Isokinetic Ankle, Knee and Hip Strength in Physically Active Adults Using Biodex System 4 Pro

Background: The isokinetic dynamometry is considered a gold standard in muscle strength testing. The reliability of lower limb isokinetic strength measurements has not been thoroughly evaluated. Objective: To examine the test−retest reliability of isokinetic ankle plantar and dorsiflexion, ankle inversion and eversion, knee extension and flexion and hip abduction and adduction strength in physically active adults using Biodex System 4 Pro. Methods: Peak torques (PTs) and average peak torques (APTs) of the dominant and nondominant lower limbs were tested twice in 19 physically active adults 7 to 14 days apart. Results: The intraclass correlation coefficients (ICC) values varied from excellen…

Overuse injuries in youth basketball and floorball

Mari Leppänen,1 Kati Pasanen,1 Urho M Kujala,2 Jari Parkkari,1 1Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, Tampere, 2Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland Background: The popularity of team sports is growing among young people. High training volume and intensity may predispose young athletes to overuse injuries. Research to date has tended to focus on acute injuries rather than overuse injuries. The purpose of this study was to examine the occurrence, nature, and severity of overuse injuries in youth basketball and floorball, with the hypothesis that overuse injuri…

Association between lower extremity muscle strength and acute ankle injury in youth team-sports athletes

Abstract Objectives To investigate lower extremity muscle strength as risk factor for an acute ankle injury in youth athletes. Design Cohort study. Setting Basketball and floorball clubs. Participants 188 youth (≤21) male and 174 female athletes. Main outcome measures 1RM leg press, maximal concentric isokinetic quadriceps and hamstrings as well as maximal isometric hip abductor strength were measured and athletes were followed for an acute ankle injury up to three years. Cox regression models were used in statistical analyses. Results In males, greater 1RM leg press and maximal quadriceps strength increased the risk of any type of acute ankle injury (Hazard ratio [HR] for 1 SD increase, 1.…

Sagittal Plane Hip, Knee, and Ankle Biomechanics and the Risk of Anterior Cruciate Ligament Injury: A Prospective Study

Background: Stiff landings with less knee flexion and high vertical ground-reaction forces have been shown to be associated with an increased risk of anterior cruciate ligament (ACL) injury. The literature on the association between other sagittal plane measures and the risk of ACL injuries with a prospective study design is lacking. Purpose: To investigate the relationship between selected sagittal plane hip, knee, and ankle biomechanics and the risk of ACL injury in young female team-sport athletes. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 171 female basketball and floorball athletes (age range, 12-21 years) participated in a vertical drop jump test usin…

Association between frontal plane knee control and lower extremity injuries : a prospective study on young team sport athletes

Background/aimPoor frontal plane knee control can manifest as increased dynamic knee valgus during athletic tasks. The purpose of this study was to investigate the association between frontal plane knee control and the risk of acute lower extremity injuries. In addition, we wanted to study if the single-leg squat (SLS) test can be used as a screening tool to identify athletes with an increased injury risk.MethodsA total of 306 basketball and floorball players participated in the baseline SLS test and a 12-month injury registration follow-up. Acute lower extremity time-loss injuries were registered. Frontal plane knee projection angles (FPKPA) during the SLS were calculated using a two-dimen…

High ankle injury rate in adolescent basketball: A 3-year prospective follow-up study.

This prospective study investigated the incidence and pattern of acute time-loss injuries in young female and male basketball players. Eight basketball teams (n=201; mean age 14.85±1.5) participated in the follow-up study (2011-2014). The coaches recorded player participation in practices and games on a team diary. A study physician contacted the teams once a week to check new injuries and interviewed the injured players. In total, 158 injuries occurred. The overall rate of injury (per 1000 hours) was 2.64 (95% CI 2.23-3.05). Injury rate was 34.47 (95% CI 26.59-42.34) in basketball games and 1.51 (95% CI 1.19-1.82) in team practices. Incidence rate ratio (IRR) between game and practice was …

Stiff landings are associated with increased ACL injury risk in young female basketball and floorball players

Background: Few prospective studies have investigated the biomechanical risk factors of anterior cruciate ligament (ACL) injury. Purpose: To investigate the relationship between biomechanical characteristics of vertical drop jump (VDJ) performance and the risk of ACL injury in young female basketball and floorball players. Study Design: Cohort study; Level of evidence, 3. Methods: At baseline, a total of 171 female basketball and floorball players (age range, 12-21 years) participated in a VDJ test using 3-dimensional motion analysis. The following biomechanical variables were analyzed: (1) knee valgus angle at initial contact (IC), (2) peak knee abduction moment, (3) knee flexion angle at …

973 Knee control and jump-landing technique in young basketball and floorball players

Background Poor knee alignment is associated with increased loading of the joints, ligaments and tendons, and may increase the risk of injury. The study purpose was to compare differences in knee kinematics between basketball and floorball players during a vertical drop jump (VDJ) task. We wanted to investigate whether basketball players, whose sport includes frequent jump-landings, exhibited better knee control compared with floorball players, whose sport involves less jumping. Methods Players (aged 12–21 years) were recruited from six basketball and floorball clubs of the Tampere City district, Finland. Complete data was obtained from 173 basketball and 141 floorball players. Peak knee va…

Low back and neck and shoulder pain in members and non-members of adolescents' sports clubs : the Finnish Health Promoting Sports Club (FHPSC) study

Background The objective of this study was to investigate the prevalence of self-reported low back pain (LBP) and neck and shoulder pain (NSP), and the related factors in members and non-members of adolescents’ sports clubs. Methods This cross-sectional study was based on surveys of 14–16-year-olds as a part of the Finnish Health Promoting Sports Club (FHPSC) Study. The surveys on self-reported health behaviours, injuries, and musculoskeletal health were conducted among sports club members (n = 962) and non-members (n = 675). Binary logistic regression analysis was applied to study the associations between dependent variables of LBP and NSP, and the independent factors. Results The prevalen…

477 Injury risk in finnish youth floorball: a one-year prospective follow-up study

Background Floorball is a popular team sport in Finland. Previous studies have revealed that injuries are a significant problem in adult floorball. However, epidemiological studies of injuries in youth floorball are lacking. The aim of this study was to investigate the incidence, type, and severity of injuries in young floorball players. Methods One-hundred-fifty-six female (n = 57) and male players (n = 99) (mean age 17.1 ± 1.6 years) from nine floorball teams participated in the study. Injury data as well as practice and game exposures were collected over the 12-months period (from May 2013 to April 2014). An injury was defined as having occurred in an organised floorball practice or game…

Prevalence of adolescent physical activity-related injuries in sports, leisure time, and school: the National Physical Activity Behaviour Study for children and Adolescents

Background The purpose of this study was to investigate the prevalence of adolescent physical activity-related injuries in sports club activities, leisure time physical activity and school-based physical activity. The secondary aim was to investigate the differences in the prevalence of physical activity -related injuries between years 2014 and 2016. In addition, we set out to study the associations between age, sex and the frequency of physical activity and injury prevalence. Methods This cross-sectional study is based on the National Physical Activity Behaviour Study for Children and Adolescents (LIITU in Finnish) conducted in years 2014 and 2016. The subjects completed an online question…

Injury History and Perceived Knee Function as Risk Factors for Knee Injury in Youth Team-Sports Athletes

Background: The identification of risk factors for sports injuries is essential before injury prevention strategies can be planned. Hypothesis: Previous acute knee injury and lower perceived knee function measured by Knee injury and Osteoarthritis Outcome Score (KOOS) will increase the risk of acute knee injury in youth team-sports athletes. Study Design: Prospective cohort study. Level of Evidence: Level 3. Methods: At baseline, youth (≤21 years old) male and female basketball and floorball athletes completed a questionnaire on previous acute knee injuries and perceived knee function (KOOS). A total of 211 male and 183 female athletes were followed for an acute knee injury up to 3 years. U…

Association between lower extremity muscular strength and acute knee injuries in young team‐sports athletes

The purpose of this study was to investigate LE muscular strength variables as potential risk factors for all and non‐contact acute knee and ACL injuries in young athletes. A total of 188 young (≤21) male and 174 female basketball and floorball players participated in LE muscular strength tests and were followed up to three years. The strength test battery consisted of 1RM leg press, maximal concentric isokinetic (60°/s) quadriceps and hamstrings and maximal isometric hip abductor strength. The outcomes were a new acute knee or ACL injury and a new acute non‐contact knee or ACL injury. A total of 51 (17 in males and 34 in females) new acute knee injuries registered and 17 (one in males and …

Performance in dynamic movement tasks and occurrence of low back pain in youth floorball and basketball players

Abstract Background Prospective studies investigating risk factors for low back pain (LBP) in youth athletes are limited. The aim of this prospective study was to investigate the association between hip-pelvic kinematics and vertical ground reaction force (vGRF) during landing tasks and LBP in youth floorball and basketball players. Methods Three-hundred-and-eighty-three Finnish youth female and male floorball and basketball players (mean age 15.7 ± 1.8) participated and were followed up on for 3 years. At the beginning of every study year the players were tested with a single-leg vertical drop jump (SLVDJ) and a vertical drop jump (VDJ). Hip-pelvic kinematics, measured as femur-pelvic angl…

The standing knee lift test is not a useful screening tool for time loss from low back pain in youth basketball and floorball players

Abstract Objectives The aim of this study was to investigate the association between pelvic kinematics during the standing knee lift (SKL) test and low back pain (LBP) in youth floorball and basketball players. Design A prospective cohort study. Setting Finnish elite youth floorball and basketball players. Participants Finnish elite youth female and male floorball and basketball players (n = 258, mean age 15.7 ± 1.8). Main outcome measures LBP resulting in time loss from practice and games was recorded over a 12-month period and verified by a study physician. Associations between LBP and sagittal plane pelvic tilt and frontal plane pelvic obliquity during the SKL test as measured at baselin…

sj-docx-1-sph-10.1177_19417381211065443 ��� Supplemental material for Injury History and Perceived Knee Function as Risk Factors for Knee Injury in Youth Team-Sports Athletes

Supplemental material, sj-docx-1-sph-10.1177_19417381211065443 for Injury History and Perceived Knee Function as Risk Factors for Knee Injury in Youth Team-Sports Athletes by Jussi Hietamo, Anni Rantala, Jari Parkkari, Mari Lepp��nen, Marko Rossi, Ari Heinonen, Kathrin Steffen, Pekka Kannus, Ville Mattila and Kati Pasanen in Sports Health: A Multidisciplinary Approach

EFFECTS OF STRIKING STRATEGY ON LOWER EXTREMITY LOADING DURING RUNNING

Backround It is expected that every second runner has a running-related overuse injury each year. The knee joint and Achilles tendon are the most commonly injured sites covering both about one fifth of all running related injuries. 1 Runners can be categorized into rearfoot strikers, mid-foot strikers or forefoot strikers based on the landing strategy at the instant of initial ground contact. Forefoot or mid-foot striking has been shown to reduce impact peak and loading rate of the ground reaction force during early stance phase. 2 Furthermore, the finding of the recent study suggest that forefoot striking may potentially decrease the risk of running-related injuries. 3 However, the effect …

Neuromuscular Training Warm-up Prevents Acute Noncontact Lower Extremity Injuries in Children’s Soccer : A Cluster Randomized Controlled Trial

Background: Prevention of sports injuries is essential in youth, as injuries are associated with less future physical activity and thus greater all-cause morbidity. Purpose: To investigate whether a neuromuscular training warm-up operated by team coaches is effective in preventing acute lower extremity (LE) injuries in competitive U11-U14 soccer players. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Twenty top-level U11 to U14 soccer clubs in Finland were randomized into intervention and control groups and assessed for 20 weeks. Participants included 1403 players (280 female, 1123 male; age range, 9-14 years): 673 players (44 teams) in the intervention group and …

sj-docx-2-sph-10.1177_19417381211065443 ��� Supplemental material for Injury History and Perceived Knee Function as Risk Factors for Knee Injury in Youth Team-Sports Athletes

Supplemental material, sj-docx-2-sph-10.1177_19417381211065443 for Injury History and Perceived Knee Function as Risk Factors for Knee Injury in Youth Team-Sports Athletes by Jussi Hietamo, Anni Rantala, Jari Parkkari, Mari Lepp��nen, Marko Rossi, Ari Heinonen, Kathrin Steffen, Pekka Kannus, Ville Mattila and Kati Pasanen in Sports Health: A Multidisciplinary Approach

Intrarater Reliability and Analysis of Learning Effects in the Y Balance Test

While the general reliability of the Y balance test has been previously found to be excellent, earlier reviews highlighted a need for a more consistent methodology between studies. The purpose of this test–retest intrarater reliability study was to assess the intrarater reliability of the YBT using different methodologies regarding normalisation for leg length, number of repetitions, and score calculation. Sixteen healthy adult novice recreational runners aged 18–55 years, both women and men, were reviewed in a laboratory environment. Mean calculated scores, intraclass correlation coefficient, standard error of measurement, and minimal detectable change were calculated and analysed between …

LOW BACK PAIN IN YOUNG TEAM SPORT PLAYERS: A RETROSPECTIVE STUDY

Background Low back pain (LBP) is a common complaint in general population affecting both genders and almost all age-groups. LBP is a common problem in sports as well, even in younger populations. LBP is prone to recur, thus there is a need for studies on the early phases of the problem in different sports. Objective To investigate the prevalence, nature, severity and risk factors of self-reported LBP in young team sport players. Design A retrospective cross-sectional study. Setting Finnish female and male basketball, floorball, ice hockey and volleyball teams. Participants This study is a part of an ongoing cohort study exploring risk factors for sports injuries. Players from 22 teams, a t…

Change of Direction Biomechanics in a 180-Degree Pivot Turn and the Risk for Noncontact Knee Injuries in Youth Basketball and Floorball Players.

Background: Studies investigating biomechanical risk factors for knee injuries in sport-specific tasks are needed. Purpose: To investigate the association between change of direction (COD) biomechanics in a 180-degree pivot turn and knee injury risk among youth team sport players. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 258 female and male basketball and floorball players (age range, 12-21 years) participated in the baseline COD test and follow-up. Complete data were obtained from 489 player-legs. Injuries, practice, and game exposure were registered for 12 months. The COD test consisted of a quick ball pass before and after a high-speed 180-degree pivot turn o…

Players with high physical fitness are at greater risk of injury in youth football.

The aim of this study was to investigate physical fitness, football-specific skills and their association with injury risk in youth football. Altogether 447 male and female players aged 9 to 14 years (median 12 years) participated in performance tests and prospective follow-up. The physical fitness tests included five-jump test for distance, 30-m sprint, football-specific figure of eight agility, countermovement jump, and Yo-Yo intermittent endurance test level 1. The football-specific skill tests included dribbling and passing tests. Injuries and exposure were registered during the 20-week follow-up. Our candidate risk factors were low/high level of physical fitness measured with a composi…

Altered hip control during a standing knee-lift test is associated with increased risk of knee injuries

Few prospective studies have investigated hip and pelvic control as a risk factor for lower extremity (LE) injuries. The purpose of this study was to investigate whether deficits in hip and lumbopelvic control during standing knee lift test are associated with increased risk of acute knee and LE injuries in youth team sports. At baseline, 258 basketball and floorball players (aged 12‒21 y.) participated in a standing knee lift test using 3‐dimensional motion analysis. Two trials per leg were recorded from each participant. Peak sagittal plane pelvic tilt and frontal plane pelvic drop/hike were measured. Both continuous and categorical variables were analysed. New non‐contact LE injuries, an…