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Heidi R. Thornton, Jace A. Delaney, Grant M. Duthie and Ben J. Dascombe

Purpose:

To investigate the ability of various internal and external training-load (TL) monitoring measures to predict injury incidence among positional groups in professional rugby league athletes.

Methods:

TL and injury data were collected across 3 seasons (2013–2015) from 25 players competing in National Rugby League competition. Daily TL data were included in the analysis, including session rating of perceived exertion (sRPE-TL), total distance (TD), high-speed-running distance (>5 m/s), and high-metabolic-power distance (HPD; >20 W/kg). Rolling sums were calculated, nontraining days were removed, and athletes’ corresponding injury status was marked as “available” or “unavailable.” Linear (generalized estimating equations) and nonlinear (random forest; RF) statistical methods were adopted.

Results:

Injury risk factors varied according to positional group. For adjustables, the TL variables associated most highly with injury were 7-d TD and 7-d HPD, whereas for hit-up forwards they were sRPE-TL ratio and 14-d TD. For outside backs, 21- and 28-d sRPE-TL were identified, and for wide-running forwards, sRPE-TL ratio. The individual RF models showed that the importance of the TL variables in injury incidence varied between athletes.

Conclusions:

Differences in risk factors were recognized between positional groups and individual athletes, likely due to varied physiological capacities and physical demands. Furthermore, these results suggest that robust machine-learning techniques can appropriately monitor injury risk in professional team-sport athletes.

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Emma Sconce, Paul Jones, Ellena Turner, Paul Comfort and Philip Graham-Smith

Context:

Hamstring injury-risk assessment has primarily been investigated using isokinetic dynamometry. However, practical issues such as cost and availability limit the widespread application of isokinetics for injury-risk assessment; thus, field-based alternatives for assessing eccentric hamstring strength are needed.

Objective:

The aim of this study was to investigate the validity of the angle achieved during Nordic hamstring lowers (break-point angle) as a field-based test for eccentric hamstring strength.

Design:

Exploratory study.

Setting:

Laboratory.

Participants:

Sixteen male (n = 7) and female (n = 9) soccer players (mean ± SD age 24 ± 6 y, height 1.77 ± 0.12 m, and body mass 68.5 ± 16.5 kg) acted as subjects for the study.

Main Outcome Measures:

The authors explored relationships between the Nordic break-point angle (the point at which the subject can no longer resist the increasing gravitational moment during a Nordic hamstring lower) measured from video and isokinetic peak torque and angle of peak torque of right- and left-knee flexors.

Results:

The results revealed a meaningful relationship between eccentric knee-flexor peak torque (average of right and left limbs) and the Nordic break-point angle (r = −.808, r 2 = 65%, P < .00001). However, there was a weak relationship observed (r = .480, r 2 = 23%, P = .06) between break-point angle and the angle of peak torque (average of right and left limbs).

Conclusions:

The results suggest that the break-point angle achieved during Nordic hamstring lowers could be used as a field-based assessment of eccentric hamstring strength.

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Sarah K. Fields and R. Dawn Comstock

Rugby, a fast-paced, aggressive contact sport, has a high incidence of injury. This study examines why US women play rugby given the social stigma surrounding women’s participation in sports in general, particularly contact sports, and despite the high risk of injury. In a survey of their injury history and potential injury risk factors, 339 female rugby players from 14 teams of varied quality and levels of play from a wide geographic area in the United States were asked why they played the sport. Their responses indicate that women play rugby because they enjoy the game, they like the aggressive aspects of the sport, they appreciate the social aspects of the game, and they believe the sport provides them with positive benefits, such as increased fitness, confidence, and strength. The results of this study indicate that many women are willing to risk injury for the positive rewards that they associate with rugby.

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Alasdair R. Dempsey, Bruce C. Elliott, Bridget J. Munro, Julie R. Steele and David G. Lloyd

Anterior cruciate ligament (ACL) injuries are costly. Sidestep technique training reduces knee moments that load the ACL. This study examined whether landing technique training alters knee moments. Nineteen team sport athletes completed the study. Motion analysis and ground reaction forces were recorded before and after 6 weeks of technique modification. An inverse dynamic model was used to calculate three-dimensional knee loading. Pre- and postintervention scores were compared using paired t tests. Maximal knee flexion angle during landing was increased following training. There was no change in valgus or flexion moments, but an increase in peak internal rotation moment. This increase in internal rotation moment may increase the risk of ACL injury. However, the increased angle at which the peak internal rotation moment occurred at follow up may mitigate any increase in injury risk by reducing load transmission.

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Parissa Safai, Jay Johnson and John Bryans

While research and scholarship on the dynamic interconnections between sport and health has steadily grown in the sociocultural study of sport in the past few decades, this paper focuses more directly on the politics of health within sport. Drawing on a small study of the lived experiences and understandings of health, pain/injury, risk and precaution among 12 male and female high performance youth (16–19 years of age) triathletes and three coaches, we outline the ways in which health becomes depoliticized among high performance athletes as our participants made no connection to health as a political phenomenon—within or outside of sport—or to their own right to health as members of the high performance sport community. We conclude by offering some suggestions as to why health was (and is) rendered apolitical in high performance youth triathlon.

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Evangelos Pappas, Karl F. Orishimo, Ian Kremenic, Marijeanne Liederbach and Marshall Hagins

Retrospective studies have suggested that dancers performing on inclined (“raked”) stages have increased injury risk. One study suggests that biomechanical differences exist between flat and inclined surfaces during bilateral landings; however, no studies have examined whether such differences exist during unilateral landings. In addition, little is known regarding potential gender differences in landing mechanics of dancers. Professional dancers (N = 41; 14 male, 27 female) performed unilateral drop jumps from a 30 cm platform onto flat and inclined surfaces while extremity joint angles and moments were identified and analyzed. There were significant joint angle and moment effects due to the inclined flooring. Women had significantly decreased peak ankle dorsiflexion and hip adduction moment compared with men. Findings of the current study suggest that unilateral landings on inclined stages create measurable changes in lower extremity biomechanical variables. These findings provide a preliminary biomechanical rationale for differences in injury rates found in observational studies of raked stages.

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Monna Arvinen-Barrow, Kelsey DeGrave, Stephen Pack and Brian Hemmings

The purpose of this study was to document the lived experiences of professional cricketers who had encountered a career-ending non-musculoskeletal injury. Three male cricketers each with over nine years of playing experience in professional cricket representing England and Wales participated in retrospective in-depth semi-structured interviews. The Interpretative Phenomenological Analysis revealed that at the time of the injury, the participants were at the “final stretch” of their professional sporting careers and that despite a range of unpleasant reactions to injury, all participants experienced a healthy career transition out of sport. To best prepare athletes for a life outside of sport, ensuring athletes have sufficient plans in motion early on in their careers can reduce external and internal stressors, which if not addressed, can increase sport injury risk and have a negative effect on athletes’ reactions post-injury.

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Irene S. McClay, John R. Robinson, Thomas P. Andriacchi, Edward C Frederick, Ted Gross, Philip Martin, Gordon Valiant, Keith R. Williams and Peter R. Cavanagh

Basketball is a sport that involves multiple impacts with the ground through a variety of moves such as running Jumping, and cutting. Repetitive impacts have been associated with stress-related injuries in other sports such as running. The purpose of this investigation was to gain an understanding of the typical stresses the body experiences during common basketball moves. To this end, the ground reaction forces from 24 players from five professional basketball teams were studied. In addition, a game analysis was performed to determine the frequency of selected moves. These data indicated that certain common movements, such as jump landings and shuffling, resulted in absolute and relative forces much greater than many of those reported previously in studies of other sports. These movements were also identified in a companion paper as being associated with large angular excursions and velocities. Findings are discussed with respect to injury risks, and suggestions for future study are made.

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Urban Johnson, Johan Ekengren and Mark B. Andersen

This study examined the effectiveness of a prevention intervention program to lower the incidence of injury for soccer players with at-risk psychosocial profiles. The Sport Anxiety Scale, the Life Event Scale for Collegiate Athletes, and the Athletic Coping Skills Inventory-28 were used to screen for psychosocial risk factors outlined in the stress and injury model (Williams & Andersen, 1998). Thirty-two high injury-risk players were identified and randomly assigned to treatment and control groups. Injuries of participants were reported by their coaches. The intervention program consisted of training in 6 mental skills distributed in 6 to 8 sessions during 19 weeks of the competitive season. The results showed that the brief intervention prevention program significantly lowered the number of injuries in the treatment group compared with the control group.

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Elizabeth C. J. Pike and Joseph A. Maguire

This paper provides a development from previous conceptual frameworks related to the risk/pain/injury nexus in sporting subcultures (Hughes & Coakley, 1991; Maguire & Roberts, 1998; Nixon, 1992; Young, 1991). To do this, we have developed a model of factors contributing to injury risk in sport. In outlining our framework we seek to trace the enabling and coercive social forces that combine to act upon athletes and consequently promote participation to the extent of risking injury. This paper is grounded in a two-year study of female rowers in the United Kingdom. Several dimensions of sporting activities are mapped out, including the physical and structural settings, or “stage” upon which the sport takes place; preparation and participation in the sport itself; and the athletes’ attitudes toward, and actions on, receiving an injury. The themes identified in the model are used to “make sense” of the substantive insights drawn from the rowers’ stories.