Scapular-Stabilization Exercises: Early-Intervention Prescription
Effect of Therapeutic Exercise Versus Manual Therapy on Athletes With Chronic Low Back Pain
Haley Dvorak, Christina Kujat, and Jason Brumitt
Injury Prevention for High School Female Cross-Country Athletes
Edited by Tricia Hubbard
Preseason Functional Performance Test Measures Are Associated With Injury in Female College Volleyball Players
Jason Brumitt, Alma Mattocks, Jeremy Loew, and Phil Lentz
Context: Preseason functional performance test measures have been associated with noncontact time-loss injury in some athletic populations. However, findings have been equivocal with many studies consisting of heterogeneous populations. Objective: To determine if preseason standing long jump and/or single-leg hop test scores are associated with a noncontact time-loss injury to the lower quadrant (LQ = low back or lower-extremities) in female Division III college volleyball (VB) players. Design: Prospective cohort study. Setting: National Collegiate Athletic Association Division III female VB teams. Patients: A total of 82 female college VB players (age = 18.9 [1.0] y). Main Outcome Measures: Standing long jump and single-leg hop test measures were collected at the start of the official preseason. Athletic trainers tracked all time-loss injuries and their mechanisms. Athletes were categorized as at risk if their preseason standing long jump <80% height, bilateral single-leg hop <70% height, and had a SLH side-to-side asymmetry >10%. Results: The noncontact time-loss overall injury rate for the LQ region in at-risk athletes was 13.5 (95% confidence interval [CI], 4.3–31.5) per 1000 athletic exposures. At-risk athletes were significantly more likely to experience a noncontact time-loss injury than VB players in the referent group (rate ratio = 6.2; 95% CI, 1.9–17.2; P = .008). The relative risk of sustaining a noncontact time-loss injury to the LQ was 4 times greater in the at-risk group (relative risk = 4.6; 95% CI, 2.1–10.1; P = .01). At-risk athletes were 6 times more likely to experience a foot or ankle injury (relative risk = 6.3; 95% CI, 2.1–19.2; P = .008). Conclusion: Suboptimal performance on a battery of functional performance tests is associated with a significantly greater risk of noncontact time-loss injury to the LQ in female Division III college VB players.
Functional Rehabilitation Exercise Prescription for Golfers
Jason Brumitt and R. Barry Dale
Edited by Gary B. Wilkerson
The Lower-Extremity Functional Test and Lower-Quadrant Injury in NCAA Division III Athletes: A Descriptive and Epidemiologic Report
Jason Brumitt, Bryan C. Heiderscheit, Robert C. Manske, Paul Niemuth, Alma Mattocks, and Mitchell J. Rauh
The Lower-Extremity Functional Test (LEFT) has been used to assess readiness to return to sport after a lowerextremity injury. Current recommendations suggest that women should complete the LEFT in 135 s (average; range 120–150 s) and men should complete the test in 100 s (average; range 90–125 s). However, these estimates are based on limited data and may not be reflective of college athletes. Thus, additional assessment, including normative data, of the LEFT in sport populations is warranted.
To examine LEFT times based on descriptive information and off-season training habits in NCAA Division III (DIII) athletes. In addition, this study prospectively examined the LEFT’s ability to discriminate sport-related injury occurrence.
189 DIII college athletes (106 women, 83 men) from 15 teams.
Main Outcome Measures:
LEFT times, preseason questionnaire, and time-loss injuries during the sport season.
Men completed the LEFT (105 ± 9 s) significantly faster than their female counterparts (117 ± 10 s) (P < .0001). Female athletes who reported >3–5 h/wk of plyometric training during the off-season had significantly slower LEFT scores than those who performed ≤3 h/wk of plyometric training (P = .03). The overall incidence of a lower-quadrant (LQ) time-loss injury for female athletes was 4.5/1000 athletic exposures (AEs) and 3.7/1000 AEs for male athletes. Female athletes with slower LEFT scores (≥118 s) experienced a higher rate of LQ time-loss injuries than those with faster LEFT scores (≤117 s) (P = .03).
Only off-season plyometric training practices seem to affect LEFT score times among female athletes. Women with slower LEFT scores are more likely to be injured than those with faster LEFT scores. Injury rates in men were not influenced by performance on the LEFT.
Preseason Y Balance Test Scores are Not Associated With a Lower Quadrant Sports Injury in a Heterogeneous Population of Division III Collegiate Athletes
Jason Brumitt, Jill Sikkema, Saiko Mair, CJ Zita, Victor Wilson, and Jordan Petersen
Functional performance tests, such as the Y Balance Test–Lower Quarter (YBT-LQ), hold promise as screening tools to identify athletes at risk for injury. The ability of the YBT-LQ to discriminate injury risk in Division III collegiate athletes is unknown. The purpose of this study was to determine if preseason YBT-LQ scores are associated with noncontact time-loss lower-quadrant (low back or lower extremities) injury in a heterogeneous population of Division III collegiate athletes. Two hundred and fourteen athletes (females = 104) performed the YBT-LQ test. Preseason YBT-LQ scores, analyzed by the total population, were not associated with noncontact time-loss lower-quadrant injury. Females with greater reach scores in some directions did have a significantly greater risk of injury. This study adds to a growing body of research demonstrating that the YBT-LQ should not be used as a preseason screening tool.
Blood Flow Restriction Training for the Rotator Cuff: A Randomized Controlled Trial
Jason Brumitt, Marcey Keefer Hutchison, Dan Kang, Zach Klemmer, Mike Stroud, Edward Cheng, Neil Patrick Cayanan, and Sheldon Shishido
Context: Blood flow restriction (BFR) training utilizes a tourniquet, applied to the proximal portion of one or more extremities, to occlude blood flow during exercise. Significant gains in strength and cross-sectional area can be achieved in muscles, both distal and proximal to BFR cuff application. Purpose: To compare strength gains of the rotator cuff and changes in tendon size in subjects who performed side-lying external-rotation exercise with or without BFR. Methods: Forty-six subjects (mean age 25.0 [2.2] y) were randomized to either a BFR + exercise group or to the exercise-only group. Subjects performed 4 sets of the exercise (30/15/15/15 repetitions) at 30% 1-repetition maximum 2 days per week for 8 weeks. Results: Subjects in both groups experienced strength gains in the supraspinatus and the external rotators (P = .000, P = .000). However, there was no difference in strength gains between groups for the supraspinatus (P = .750) or the external rotators (P = .708). Subjects in both groups experienced increases in supraspinatus tendon thickness (BFR P = .041, exercise only P = .011). However, there was no difference between groups (P = .610). Conclusions: Exercise with BFR applied to the proximal upper extremity did not augment rotator cuff strength gains or tendon thickness when compared with subjects who only exercised. This study did demonstrate that performing multiple sets of high repetitions at a low load led to significant increases in rotator cuff strength and tendon size in the dominant upper extremity.