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Bradford Strand, Shannon David, Katie J. Lyman and Jay M. Albrecht

The purpose of this original research was to survey high school coaches in four states in the Midwest region of the United States regarding their knowledge of first aid, cardiopulmonary resuscitation (CPR), and use of an Automated External Defibrillator (AED) as well as confidence in managing/treating emergency situations. Responses to general knowledge inquiries revealed that coaches were able to accurately answer questions related to return to play, level of consciousness, external bleeding, and cardiac arrest. However, coaches were unable to correctly answer questions specific to rest, ice, compression, and elevation (RICE) and also misidentified information related to pediatric AED use. Because sudden cardiac death is the leading cause of death and has been linked to lack of bystander intervention, the results of this project should be considered by coaches and administrators to implement certification and continuing education for high school coaches. Finally, coaches who were certified in first aid, CPR, and AED were more confident in treating an individual who required care compared with coaches not certified. Therefore, individuals who coach at all levels of sport and recreational activities should consider formal training and certification.

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Darren P. Morton and Robin Callister

Purpose:

To determine whether changes in lung function are associated with exercise-related transient abdominal pain (ETAP).

Methods:

Twenty-eight subjects susceptible to ETAP performed a flow-volume loop before (pre) and after (post) treadmill exercise. Fourteen of the subjects developed symptoms of ETAP during the exercise and completed the flow-volume loop while the pain was present. The remaining 14 subjects reported no symptoms of ETAP.

Results:

Forced inspiratory vital capacity was essentially unchanged from pre to post in both groups (ETAP group −0.8% ± 5.1%, comparison group −0.9% ± 6.5%). Peak inspiratory-flow rate increased in both the ETAP group (12.4% ± 16.2%) and the comparison group (17.9% ± 16.6%), but the difference between groups (−4.6%, standardized effect size [EF] = −0.17) was trivial. Forced expiratory vital capacity decreased by approximately 4% in both groups (ETAP group −3.9% ± 3.3%, comparison group −4.0% ± 5.1%). Small differences in the mean change from pre to post between groups were recorded for peak expiratory-flow rate (−7.4%, EF = −0.28) and the forced expiratory volume in the first second of the test (−4.4%, EF = −0.44).

Conclusions:

ETAP does not appear to be associated with reduced inspiratory performance, suggesting that the diaphragm is not implicated directly in the etiology of ETAP. Expiratory power might be slightly reduced during an episode of ETAP, but the magnitude of this effect is unlikely to compromise exercise performance.

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Kaitlyn J. Weiss, Sian V. Allen, Mike R. McGuigan and Chris S. Whatman

Purpose:

To establish the relationship between the acute:chronic workload ratio and lower-extremity overuse injuries in professional basketball players over the course of a competitive season.

Methods:

The acute:chronic workload ratio was determined by calculating the sum of the current week’s session rating of perceived exertion of training load (acute load) and dividing it by the average weekly training load over the previous 4 wk (chronic load). All injuries were recorded weekly using a self-report injury questionnaire (Oslo Sports Trauma Research Center Injury Questionnaire20). Workload ratios were modeled against injury data using a logistic-regression model with unique intercepts for each player.

Results:

Substantially fewer team members were injured after workload ratios of 1 to 1.49 (36%) than with very low (≤0.5; 54%), low (0.5–0.99; 51%), or high (≥1.5; 59%) workload ratios. The regression model provided unique workload–injury trends for each player, but all mean differences in likelihood of being injured between workload ratios were unclear.

Conclusions:

Maintaining workload ratios of 1 to 1.5 may be optimal for athlete preparation in professional basketball. An individualized approach to modeling and monitoring the training load–injury relationship, along with a symptom-based injury-surveillance method, should help coaches and performance staff with individualized training-load planning and prescription and with developing athlete-specific recovery and rehabilitation strategies.

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Daniel Martínez-Silván, Jaime Díaz-Ocejo and Andrew Murray

Purpose:

To analyze the influence of training exposure and the utility of self-report questionnaires on predicting overuse injuries in adolescent endurance athletes.

Methods:

Five adolescent male endurance athletes (15.7 ± 1.4 y) from a full-time sports academy answered 2 questionnaires (Recovery Cue; RC-q and Oslo Sports Trauma Research questionnaire; OSTRC-q) on a weekly basis for 1 season (37 wk) to detect signs of overtraining and underrecovery (RC-q) and early symptoms of lower-limb injuries (OSTRC-q). All overuse injuries were retrospectively analyzed to detect which variations in the questionnaires in the weeks preceding injury were best associated. Overuse incidence rates were calculated based on training exposure.

Results:

Lower-limb overuse injuries accounted for 73% of total injuries. The incidence rate for overuse training-related injuries was 10 injuries/1000 h. Strong correlations were observed between individual running exposure and overuse injury incidence (r 2 = .66), number of overuse injuries (r 2 = .69), and days lost (r 2 = .66). A change of 20% or more in the RC-q score in the preceding week was associated with 67% of the lower-limb overuse injuries. Musculoskeletal symptoms were only detected in advance by the OSTRC-q in 27% of the episodes.

Conclusion:

Training exposure (especially running exposure) was shown to be related to overuse injuries, suggesting that monitoring training load is a key factor for injury prevention. Worsening scores in the RC-q (but not the OSTRC) may be an indicator of overuse injury in adolescent endurance runners when used longitudinally.

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Mark Booth, Rhonda Orr and Stephen Cobley

Purpose: To conduct a systematic review into the effect of training load (TL) on both performance measures and injury characteristics in rugby league players. Methods: Based on PRISMA guidelines, a systematic search of electronic databases was performed from the earliest record to December 2016. Five electronic databases (MEDLINE, SPORTDiscus, CINAHL, Web of Science, and AusSportMed) were searched using keywords within the subcategories of population (rugby league players), intervention (training quantification), and outcomes (performance or injury). Original peer-reviewed published manuscripts were considered if they had a clear quantification of TL (eg, session rating of perceived exertion), clear measures of performance (tests of physiological parameters relative to rugby league players [eg, agility]), and/or injury characteristics (eg, injury incidence). Results: Twelve studies met the inclusion criteria. The highest TL was observed in preseason training phases. Higher TL elicited greater improvements in maximal aerobic power, vertical jump (in cm), and agility scores (in s). Higher TL was associated with higher incidence of muscular strains and joint sprains, lower-limb injuries, and overexertion and overuse injuries. Conclusions: Findings suggest a dose–response relationship between TL, physical performance, and injury characteristics. However, due to study and methodological limitations, the precise nature of this relationship is, as yet, inconclusive. Therefore, the development of uniform TL definition and quantification and further research is warranted.

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Leilani Madrigal, Jamie Robbins, Diane L. Gill and Katherine Wurst

Collegiate rugby is a competitive, collision sport, yet insufficient empirical evidence exists regarding participants’ perspectives on pain and injury. This study addressed male and female rugby players’ experiences with injury, and their views about playing through pain and injury. Eleven rugby players (five male; six female) competing in USA Rugby’s National College 7’s tournament participated in semistructured interviews, which were recorded, transcribed, and content-analyzed. Two major themes emerged: passion for sport and sport ethic. Passion for sport was composed of (a) love of the sport, (b) meaning of the sport, and (c) desire to be on the field. Sport ethic included: (a) helping the team, (b) game time sacrifice, (c) personality, (d) minimize, and (e) accepted behavior. The researchers explain these findings and propose strategies for increasing future athletes’ understanding of the dangers associated with playing through pain, and confronting the currently accepted culture of risk.

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Gil Rodas, Lourdes Osaba, David Arteta, Ricard Pruna, Dolors Fernández and Alejandro Lucia

Purpose: The authors investigated the association between risk of tendinopathies and genetic markers in professional team sports. Methods: The authors studied 363 (mean [SD]; 25 [6] y, 89% male) elite players (soccer, futsal, basketball, handball, and roller hockey) from a top-level European team (FC Barcelona, Spain). Of 363, 55% (cases) had experienced 1+ episodes of tendinopathy during 2008–2018 and 45% (controls) remained injury free. The authors first examined the association between single-nucleotide polymorphisms (SNPs) and tendinopathy risk in a hypothesis-free case-control genome-wide association study (495,837 SNPs) with additional target analysis of 58 SNPs that are potential candidates to influence tendinopathy risk based on the literature. Thereafter, the authors augmented the SNP set by performing synthetic variant imputation (1,419,369 SNPs) and then used machine learning-based multivariate modeling (support vector machine and random forest) to build a reliable predictive model. Results: Suggestive association (P < 10−5) was found for rs11154027 (gap junction alpha 1), rs4362400 (vesicle amine transport 1-like), and rs10263021 (contactin-associated protein-like 2). Carriage of 1+ variant alleles for rs11154027 (odds ratio = 2.11; 95% confidence interval, 1.07–4.19, P = 1.01 × 10−6) or rs4362400 (odds ratio = 1.98; 95% confidence interval, 1.05–3.73, P = 9.6 × 10−6) was associated with a higher risk of tendinopathy, whereas an opposite effect was found for rs10263021 (odds ratio = 0.42; 95% confidence interval, 0.20–0.91], P = 4.5 × 10−6). In the modeling approach, one of the most robust SNPs was rs10477683 in the fibrillin 2 gene encoding fibrillin 2, a component of connective tissue microfibrils involved in elastic fiber assembly. Conclusions : The authors have identified previously undescribed genetic predictors of tendinopathy in elite team sports athletes, notably rs11154027, rs4362400, and rs10263021.

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John Heil

Expectations regarding pain tolerance are imbedded in the culture of sport, and bear heavily on pain and injury management. The athlete’s experience of pain is an encounter with core issues in the ethos of sport. As such, pain behavior not only influences performance but also is seen as defining character. This case study looks at the pain experience of a track and field athlete over a several-hour period from initial injury to stabilization, blending the perspective of athlete and sport psychologist. As the injury experience evolved, a complex set of interacting biological, psychological and social factors came into play, which alternately facilitated and inhibited the pain experience and which influenced action taken in response to pain.

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Virginie de Bressy de Guast, Jim Golby, Anna Van Wersch and Fabienne d’Arripe-Longueville

This study presents a complete psychological skills training (PST) program with a wheelchair athlete and examines the program effectiveness using a mixed-method approach. After initial testing, the athlete followed a two-month program of self-confidence building, motivational, visualization/relaxation, and injury management techniques. Quantitative and qualitative methods were used to examine the impacts on performance and psychological abilities. The triangulated results suggest that the PST program was perceived as effective by the athlete in terms of his sporting performances and mental skills. The characteristics and implications of a PST program with this wheelchair athlete are discussed, as well as the study limitations and the perspectives for future research.

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Sadjad Soltanzadeh and Mitchell Mooney

( Gianni, D’Ambrogio, & Tolk, 2014 ; Sage & Armstrong 2000 ), physics ( Makarov 2014 ), science and technology studies ( Latour, 1992 ), and in modelling and evaluating team performance and injury management in sport ( Hulme & Finch 2015 ; Mooney, Charlton, Soltanzadeh, & Drew, 2017 ; Soltanzadeh