Context: Male ice hockey players face a high risk of hip and groin symptoms. It is not known how symptoms change over the course of a single season. The purpose of this study was to determine the change in hip and groin symptoms over the course of a season in male ice hockey players and to identify the relationship between a brief preseason physical screen for future hip and groin symptoms. Design: Prospective cohort study. Methods: Members of 2 collegiate male ice hockey clubs (n = 51, 19.47 [1.30] y) underwent preseason physical screens of hip strength and range of motion. They also completed the Quality of Life (QoL) and Sport subscales of the Hip and Groin Outcome Score (HAGOS) preseason and postseason. Paired samples t tests were conducted to determine the change in subscale scores from preseason to postseason. Linear regression models were conducted to identify the relationship between symptoms and the results of the preseason screens. Results: There was a decline in the HAGOS QoL (−3.6; 95% CI, 0.8–6.3; P = .01) and the HAGOS Sport (−4.1; 95% CI, 0.1–8.3; P = .05) over the course of the competitive season. Lower preseason scores were associated with having lower postseason QoL (β = 0.74; 95% CI, 0.43–1.04; P < .01) and Sport (β = 0.58; 95% CI, 0.26–0.89; P < .01) subscale scores. Preseason screens were not significantly associated with end-of-season HAGOS Sport (R 2 = .05, P = .25) or QoL (R 2 = .09, P = .09) scores. Conclusions: Hip and groin symptoms worsened over the course of a competitive season in male ice hockey players without preventative measures in place. Preseason physical screens of hip strength and range of motion were not associated with future disability. Hip and groin symptoms are not self-limiting and are likely to worsen over the course of a single season in male ice hockey players.
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Hip and Groin Symptoms in Collegiate Male Ice Hockey Players Over One Season: A Prospective Study
William H. Suits, Stacie J. Fruth, Paul N. Whitehead, and Kieran J. Fogarty
Measuring Arterial Occlusion Pressure Using Pulse Wave and Continuous Wave Doppler Ultrasound and 2 Methods of Cuff Inflation
Pat R. Vehrs, Shay Richards, Joshua Allen, Rachel Barrett, Tyler Burbank, Ryan B. Lacey, Josh R. Nielsen, and Gilbert W. Fellingham
Context: It is recommended that arterial occlusion pressure (AOP) should be measured prior to the use of blood flow restriction training. Previous studies have not compared measures of AOP when using 2 methods of cuff inflation commonly reported in the literature. Design: A cross-sectional observational study was used to compare the measurement of brachial artery AOP as measured using pulse wave Doppler ultrasound (PWDOP) and continuous wave Doppler ultrasound (CWDOP) devices when inflating the cuff with a research/clinical-grade Hokanson (HOK) rapid cuff inflation system and manually (MAN) with a hand pump and gauge. Methods: We made simultaneous measures of brachial artery AOP in 20 males and 21 females using PWDOP and CWDOP devices when using HOK and MAN cuff inflation methods. Data were analyzed with a linear mixed model analysis of variance and Bland–Altman plots. Results: There was not a significant main effect for the overall differences in AOP as measured using PWDOP (121.7 ± 14.7 mmHg) and CWDOP (121.3 ± 14.5 mmHg; P = .3641). There was a significant overall main effect for AOP measured using the HOK (122.7 ± 14.6 mmHg) and MAN (120.3 ± 14.6 mmHg) cuff inflation methods (P < .0001) and between males (128.2 ± 13.7 mmHg) and females (115.2 ± 12.5 mmHg; P = .0034). Bland–Altman plots revealed minimal bias and reasonable limits of agreement between PWDOP and CWDOP measures of AOP when using HOK (0.8 mmHg; 95% CI, −4.7 to 3.0 mmHg) and MAN (0.4 mmHg; 95% CI, −5.3 to 4.5 mmHg) cuff inflation methods. Conclusions: The cessation of an audible pulse using CWDOP is in agreement with the complete obstruction of the arterial blood flow observed using PWDOP. Although statistically significant, small differences in PWDOP and CWDOP measures of AOP when using HOK and MAN cuff inflation methods are of little practical significance. A hand-held CWDOP device and a handpump/gauge can be used to measure AOP.
Sequential Changes in Scapular Range of Motion After An Intervention Using the KOJI AWARENESS Original “Wall Angel Slider” Exercise
Koji Murofushi, Sho Mitomo, Kenji Hirohata, Hidetaka Furuya, Hiroshi Akuzawa, Hiroki Katagiri, Koji Kaneoka, and Kazuyoshi Yagishita
Context: We aimed to evaluate the sequential changes in the scapular range of motion (ROM) after an intervention using the KOJI AWARENESS Original Wall Angel Slider exercise in which reverse motion is applied. Design: This study used a single-group, pretest–posttest design to evaluate changes in scapular ROM following an intervention. Methods: Participants (n = 54) underwent a 2-week intervention in this study. Scapular mobility was screened using the KOJI AWARENESS Self-Screening Scapula Mobility test, and participants with scapular mobility restrictions were recruited (n = 48). The participants performed the Wall Angel Slider exercise involving reverse motion tasks with dynamic sliding movements against a wall. They performed 3 sets of 8 repetitions for 6 sessions in 2 weeks, and adherence to the exercise regimen was monitored using a checklist. The scapular upward rotation and glenohumeral joint external rotation ROM were measured before the intervention, immediately after the first session, and after 2 weeks of the intervention. Results: The participants exhibited significant improvements in scapular upward rotation and glenohumeral external rotation ROM after the first session of an intervention using the Wall Angel Slider exercise and after 2 weeks of the intervention. Conclusion: The KOJI AWARENESS Original Wall Angel Slider exercise effectively improves scapular upward rotation and glenohumeral joint external rotation ROM over a 2-week intervention period, suggesting its potential utility in enhancing scapular mobility and function in clinical practice.
Pelvic Rotation Mechanism in Soccer Instep Kicking Toward Angled Directions
Koichiro Inoue and Hiroyuki Nunome
The purpose of the present study was to clarify the dynamic factors that induce pelvic rotation when soccer players kick a ball toward angled directions using an instep kick. Nine experienced, right-footed, male soccer players instep kicked a stationary ball in 3 different angled directions, 15°, 45°, and 75° relative to the run-up direction, and a motion capture system with a force plate recorded the kicking data. Kinematic and kinetic variables of the support leg, associated with pelvic rotation about the vertical axis, were compared among the kicking conditions. The pelvic rotation significantly increased in response to larger kicking angles, and it coincided with increase of the support leg hip joint and foot segment rotation about the vertical axis. The joint torque at the support leg hip joint significantly increased with the kicking angles. Additionally, the interaction torque due to the ground reaction force was the primary factor driving foot segment rotation relative to the force plate in angled kicking conditions, whereas no remarkable action of the free moment existed. Instep kicks toward angled directions involve a mechanism that increases the pelvic rotation about the support leg’s hip joint and foot segment, which differs from the mechanism involved in straight kicks.
Sex-Specific Associations Between Body Mass Index and Knee Flexion Kinematics and Kinetics in Individuals With Anterior Cruciate Ligament Reconstruction
Maxwell D. Smith, Skylar C. Holmes, Caitlyn E. Heredia, Eric J. Shumski, and Derek N. Pamukoff
Context: Anterior cruciate ligament reconstruction (ACLR) is a common surgical procedure after injury. However, ACLR contributes to aberrant biomechanical movement patterns that influence secondary injury or joint degeneration. Higher body size may influence gait and landing biomechanics differently between males and females. The purpose of this study was to investigate the influence of sex on the association between body mass index (BMI) and knee biomechanics long-term after ACLR recovery. Design: Sixteen female (BMI: 27.7 [5.4]) and 14 male (BMI: 24.2 [5.5]) participants who had a history of ACLR performed walking and drop vertical jump tasks. Methods: The knee-flexion angle (KFA), external knee flexion moment, knee abduction moment (landing), and knee adduction moment (gait) were measured using 3D motion capture. Body fat percentage was assessed using a BOD POD. Moderated regression evaluated the influence of sex on the association between BMI and biomechanical outcomes after adjusting for body fat percentage. Results: There was a significant interaction between sex and BMI on the KFA at heel contact (P = .01), peak KFA (P = .04), and peak external knee flexion moment (P = .05) during gait and on the KFA at ground contact during landing (P = .04). Higher BMI was associated with smaller KFAs at heel contact (P = .03), smaller peak KFAs during gait (P = .02), and smaller external knee flexion moments (P = .01) but only in females. Similarly, a higher BMI was associated with a smaller KFA at ground contact during landing (P = .03) but only in females. There was no sex by BMI interaction on the knee adduction moment during gait (P = .657) or on the knee abduction moment during landing (P = .643). Moreover, sex and BMI were not independent predictors of the knee adduction moment during gait or the knee abduction moment during landing (all P > .05). Conclusions: The association between sex and BMI may have implications for posttraumatic knee osteoarthritis and ACL reinjury, and female sex and high BMI should be considered when designing individualized rehabilitation programs. These findings suggest that females with high BMI may benefit from interventions to improve knee flexion during landing and gait.
Continuing Education Assessment
Volume 30 (2025): Issue 3 (May 2025)
Volume 34 (2025): Issue 4 (May 2025)
Determinates of Knowledge of Signs, Symptoms, and Consequences as Well as Attitudes Toward Musculoskeletal Injury Disclosure
Kelly Cheever, Aliza K. Nedimyer, Johna K. Register-Mihalik, Melissa K. Kossman, and Derek Dewig
Despite known consequences of musculoskeletal (MSK) injury during adolescence, appropriate interventions to reduce MSK-related pain and disability are limited. A proposed solution would be to improve early care seeking following a suspected MSK injury to prevent development of a more severe injury. Previous research has determined knowledge of signs and symptoms and consequences of MSK injury and attitudes toward disclosure affect intention to disclose future MSK injury. The purpose of this survey of 564 athletes (male = 58.2%, age = 15.8 [1.8]) was to explore determinants of adolescent athletes’ knowledge of MSK injury signs and symptoms as well as attitudes toward MSK injury disclosure such as age, gender, race, socioeconomic status as a means for identifying target populations that may benefit from educational programing to increase MSK injury intentionality. Older athletes (β = 0.36, p = .033), those with a history of injury (β = 1.58, p = .045) and higher socioeconomic status had greater knowledge of signs and symptoms and consequences of MSK injury. Meanwhile, black respondents had more positive attitudes toward disclosure (β = 2.30, p = .030). Younger athletes and those without a history of MSK injury benefit from future educational programming targeting young athletes with potential focus on those without a previous MSK injury to try and improve early help-seeking following MSK injury.
What If You Cannot See and Do Not Know? The Effects of Vision and Knowledge of Landing Heights on Single-Leg Prelanding and Early Landing Mechanics
Ling Li, Yu Song, Peyton Hatcher, Raychl Fairbanks, Gerwyn Hughes, and Boyi Dai
Anterior cruciate ligament (ACL) injuries commonly occur during unbalanced single-leg landings, where inadequate anticipation and response to ground contact might increase risk. Vision and knowledge of landing heights may influence how athletes anticipate and respond to landings. This study examined the effects of the removal of visual input and knowledge of landing heights on knee biomechanics associated with ACL injury risk. Thirty-three recreational athletes performed single-leg landings from 3 different heights (11, 22, and 33 cm) under 3 conditions: with both vision and knowledge, with knowledge but without vision, and without both. The no vision and no knowledge condition resulted in an intermediate strategy that produced similar landing mechanics for 22 cm but significantly different kinematics and kinetics for 11 and 33 cm. Slower knee flexion angular velocities, increased peak vertical ground reaction forces, and greater knee internal rotation and abduction angles suggested increased ACL loading for 33 cm. Landing patterns with knowledge but without vision closely matched those with both. Removing both vision and knowledge significantly altered landing mechanics, emphasizing the need to train athletes to accurately anticipate initial contact of landings and adopt safe landing strategies under restricted visual and uncertain or perturbed conditions.