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Monna Arvinen-Barrow, Nathan Maresh and Jennifer Earl-Boehm

contacted and met with the potential participant, explained the nature and purpose of the study, and addressed any arising questions prior to obtaining consent. Participants Two student-athletes from the university’s women’s soccer team met the inclusion criteria for this study: (1) they had sustained an

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Jennifer Bricker Bone and Mary D. Fry

Objective:

To determine whether athletes’ perceptions of social support from their certified athletic trainers (ATCs) were related to their beliefs about the rehabilitation process.

Design:

Division I athletes (N = 57) completed a survey including measures of social support and beliefs about rehabilitation.

Participants:

Division I college athletes (35 men, 22 women) who had sustained an injury that caused them to miss no less than 5 consecutive days.

Measurements:

The Social Support Survey (SSS) and the Sports Injury Rehabilitation Beliefs Survey (SIRBS).

Results:

Results revealed significant correlations between the SSS and the SIRBS scales only for athletes who had sustained severe injuries. Multiple-regression analyses revealed that the SSS scales were significant predictors of each of the SIRBS scales.

Conclusions:

Results suggest that when severely injured athletes perceive that their ATCs provide strong social support, they are more likely to believe in their rehabilitation programs.

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Johanna M. Hurtubise, Cheryl Beech and Alison Macpherson

Context:

There is a lack of research on sex differences for severe injuries across a variety of sports at the collegiate level.

Objective:

To compare differences in injury severity and concussion between sexes and collegiate sports.

Design:

Descriptive epidemiological study.

Participants:

1,657 injuries were analyzed from collegiate teams at York University.

Data Collection and Analysis:

Injuries were assessed by a certified or student athletic therapist and were categorized based on degree of tissue and/or joint damage as either severe or nonsevere. Severe injuries included those with third degree damage, while all others were classified as nonsevere. Injury severity was compared between the sexes and across different sports using Pearson chisquare analysis. Logistic regression was used to assess the relative contribution of each covariate.

Results:

Males sustained 1,155 injuries, with 13.3% of them being severe, while females sustained only 502 injuries, 17.7% of which were severe. The odds of sustaining severe injuries among female athletes are 1.4 times the odds of male athletes (OR: 1.40, CI 1.05−1.86). Eleven percent of all female injuries were concussions—significantly more than males (χ2 = 11.03, p = .001). The odds of female athletes having a concussion are 1.9 times the odds of a male athlete (OR: 1.85, CI 1.28−2.67).

Conclusion:

Based on our analysis, females are at an increased risk of sustaining a severe injury, particularly concussions. These findings highlight the need for future research into sex and sport-specific risk factors. This may provide information for health care professionals, coaches, and athletes for the proper prevention, on-field care, and treatment of sport injuries.

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Joseph J. Crisco, Bethany J. Wilcox, Jason T. Machan, Thomas W. McAllister, Ann-Christine Duhaime, Stefan M. Duma, Steven Rowson, Jonathan G. Beckwith, Jeffrey J. Chu and Richard M. Greenwald

The purpose of this study was to quantify the severity of head impacts sustained by individual collegiate football players and to investigate differences between impacts sustained during practice and game sessions, as well as by player position and impact location. Head impacts (N = 184,358) were analyzed for 254 collegiate players at three collegiate institutions. In practice, the 50th and 95th percentile values for individual players were 20.0 g and 49.5 g for peak linear acceleration, 1187 rad/s2 and 3147 rad/s2 for peak rotational acceleration, and 13.4 and 29.9 for HITsp, respectively. Only the 95th percentile HITsp increased significantly in games compared with practices (8.4%, p = .0002). Player position and impact location were the largest factors associated with differences in head impacts. Running backs consistently sustained the greatest impact magnitudes. Peak linear accelerations were greatest for impacts to the top of the helmet, whereas rotational accelerations were greatest for impacts to the front and back. The findings of this study provide essential data for future investigations that aim to establish the correlations between head impact exposure, acute brain injury, and long-term cognitive deficits.

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Gary B. Wilkerson

Context:

Prevention of a lower extremity sprain or strain requires some basis for predicting that an individual athlete will sustain such an injury unless a modifiable risk factor is addressed.

Objective:

To assess the possible existence of an association between reaction time measured during completion of a computerized neurocognitive test battery and subsequent occurrence of a lower extremity sprain or strain.

Design:

Prospective cohort study.

Setting:

Preparticipation screening conducted in a computer laboratory on the day prior to initiation of preseason practice sessions.

Participants:

76 NCAA Division I-FCS football players.

Main Outcome Measures:

Lower extremity sprains and strains sustained between initiation of preseason practice sessions and the end of an 11-game season. Receiver operating characteristic analysis identified the optimal reaction time cut-point for discrimination between injured versus noninjured status. Stratified analyses were performed to evaluate any differential influence of reaction time on injury incidence between starters and nonstarters.

Results:

A total of 29 lower extremity sprains and strains were sustained by 23 of the 76 players. A reaction time cut-point of ≥ .545 s provided good discrimination between injured and noninjured cases: 74% sensitivity, 51% specificity, relative risk = 2.17 (90% CI: 1.10, 4.30), and odds ratio = 2.94 (90% CI: 1.19, 7.25).

Conclusions:

Neurocognitive reaction time appears to be an indicator of elevated risk for lower extremity sprains and strains among college football players, which may be modifiable through performance of exercises designed to accelerate neurocognitive processing of visual input.

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Gail M. Ronchetti, Christopher A. Welch, Brent I. Smith and Danielle E. Blair

A 19-year-old female basketball athlete sustained a right shoulder injury during collegiate competition resulting from a collision causing severe pain and discomfort. The patient was diagnosed with a unique type IV acromioclavicular (AC) separation. Surgical stabilization of the AC joint and slow progression in rehabilitation with immobilization assisted in protecting the reconstruction. Accurate diagnosis and appropriate intervention helped to lead to the successful recovery and return to play for this patient. There are few cases of type IV acromioclavicular separation reported in the literature and none related to basketball. This case presents the challenges related to the diagnosis and rehabilitation following surgical reconstruction of a type IV acromioclavicular separation.

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David J. Pezzullo

Plantar fasciitis is one of the most common foot injuries athletes sustain. The painful heel is the result of overloading and inflammation of the plantar fascia at its insertion into the medial process of the tuberosity of the calcaneus. Many different treatment approaches have been used to address this overuse problem. Treatment for plantar fasciitis has included decreased weight bearing, nonsteroidal anti-inflammatory drugs (NSAIDs), orthotics, arch taping, weight loss, steroid injections, ultrasound, ice, physical therapy, and surgical release. Clinically the use of night splints has been found to be very successful in the treatment of plantar fasciitis, as described in this case study.

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Danny Pincivero, Joe H. Gieck and Ethan N. Saliba

A treatment and rehabilitation protocol was implemented on a university football player sustaining a second-degree lateral ankle sprain. The initial treatment plan involved the application of the RICE principle (rest, ice, compression, and elevation). This particular rehabilitation protocol was aimed at restoring range of motion and function at the earliest possible time with the use of a cryokinetic technique developed by Knight and with progressive exercise. The subject in this case study returned to full participation 6 days postinjury. The results from this report indicate that a program of cryokinetics and functional progressive exercise performed within pain-free limits can greatly enhance the return of an athlete to competition.

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Anna R. Cruz and Kenneth Mautner

In this case series, three elite college-level female volleyball players between 21 and 22 years old experienced acute abdominal pain during an overhead swinging motion. All three athletes were diagnosed with acute rectus abdominis (RA) muscle strain using musculoskeletal ultrasound, without the need for MRI. Each athlete sustained severe RA injury resulting in substantial loss of playing time and warranted a focused rehabilitation program, which emphasized core strengthening, physical modalities, and altering athletes’ hitting technique. RA muscle strain is a relatively infrequent, yet potentially severe, injury in elite volleyball players that necessitates early diagnosis and treatment to avoid prolonged or incomplete recovery.

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Brandon C. Platt, Sue Falsone and Kenneth C. Lam,

A 21-year-old male baseball catcher sustained an injury to the right testicle from a foul ball that ricocheted from the ground to his groin. The athlete was removed from competition when testicular pain began to increase. Ice was applied to the affected area and nonsteroidal anti-inflammatory drugs (NSAIDs) were utilized through the evening. Further diagnosis and treatment were warranted the following morning. Diagnostic ultrasound revealed a fracture to the right testicle, necessitating surgical repair. The athlete followed a return-to-play progression and returned to play 20 days postinjury. This case describes evaluation and treatment of a rare acute condition and the need for early recognition and diagnosis.