This paper seeks to develop understanding of both clinician-patient encounters within sport and Elias’s sociology of knowledge. Premised on a belief that there is a relatively high degree of consensus between figurational and “non-figurational” research on the social organization of sport medicine, and that such a consensus contrasts with the rather acrimonious relations which have characterized similar perspectival relations in the past, a review of literature is undertaken to highlight aspects of implicit agreement. Using a range of Elias’s concepts, this paper argues that there is broad agreement between researchers that clinician-patient relations are fundamentally structured according to mutually coexisting bodies of knowledge, and that there is cross-theoretical acceptance that such bodies of knowledge are shaped by, and make sense within, the distinct social context in which the respective parties are located. In examining aspects of Elias’s theoretical perspective which have hitherto received relatively little attention in the sociology of sport, this paper invites a revision of readings of this theoretical approach within the subdiscipline.
This case study examines the relationship between the “culture of risk” and the negotiation of treatment between sport medicine clinicians and student-athletes at a large Canadian university. The evidence acknowledges that a “culture of risk” was reinforced under certain circumstances during negotiation, but was also tempered by the existence of a “culture of precaution” that worked to resist those influences. The dialectic between the cultures of risk and precaution reveals some of the tensions inherent in negotiations between clinicians and patient-athletes, and helps to complicate the notion of a “culture of risk.” Another aspect (one that has rarely if ever been examined) of the negotiation of treatment is also considered—the promotion of “sensible risks” by clinicians to injured athletes.
Daniel Martínez-Silván, Jaime Díaz-Ocejo and Andrew Murray
To analyze the influence of training exposure and the utility of self-report questionnaires on predicting overuse injuries in adolescent endurance athletes.
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.
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.
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.
Billy T. Hulin, Tim J. Gabbett, Rich D. Johnston and David G. Jenkins
Purpose: To determine (1) how change-of-direction (COD) workloads influence PlayerLoad (PL) variables when controlling total distance covered and (2) relationships among collision workloads and PL variables during rugby league match play. Methods: Participants completed 3 protocols (crossover design) consisting of 10 repetitions of a 60-m effort in 15 s. The difference between protocols was the COD demands required to complete 1 repetition: no COD (straight line), 1° × 180° COD, or 3° × 180° COD. During rugby league matches, relationships among collision workloads, triaxial vector-magnitude PlayerLoad (PLVM), anteroposterior + mediolateral PL (PL2D), and PLVM accumulated at locomotor velocities below 2 m·s−1 (ie, PLSLOW) were examined using Pearson correlations (r) with coefficients of determination (R 2). Results: Comparing 3° × 180° COD to straight-line drills, PLVM·min−1 (d = 1.50 ± 0.49, large, likelihood = 100%, almost certainly), PL2D·min−1 (d = 1.38 ± 0.53, large, likelihood = 100%, almost certainly), and PLSLOW·min−1 (d = 1.69 ± 0.40, large, likelihood = 100%, almost certainly) were greater. Collisions per minute demonstrated a distinct (ie, R 2 < .50) relationship from PLVM·min−1 (R 2 = .30, r = .55) and PL2D·min−1 (R 2 = .37, r = .61). Total distance per minute demonstrated a very large relationship with PLVM·min−1 (R 2 = .62, r = .79) and PL2D·min−1 (R 2 = .57, r = .76). Conclusions: PL variables demonstrate (1) large increases as COD demands intensify, (2) separate relationships from collision workloads, and (3) moderate to very large relationships with total distance during match play. PL variables should be used with caution to measure collision workloads in team sport.
Mary Lynn Manduca and Stephen J. Straub
Clinical Scenario: Hamstring strains are common athletic injuries, with a high-recurrence rate (34%). Recently, platelet-rich plasma (PRP) injections have gained popularity as a potential treatment option to accelerate healing of hamstring injury. Focused Clinical Question: Does the combination of PRP injection and rehabilitation decrease recovery time of acute hamstring injury as compared to rehabilitation alone in college athletes? Summary of Key Findings: A literature search resulted in 3 randomized controlled trials. One study showed benefits in various outcome measures with PRP, compared to rehabilitation alone, while 2 showed no benefits. One study reported improved pain, ultrasonography regenerative indications, and recovery time with PRP injection following acute hamstring injury; however, larger studies have shown no benefits. The literature demonstrates conflicting evidence regarding benefits of PRP injections in hamstring injuries. Clinical Bottom Line: At this time, PRP injections cannot be recommended as having value for hamstring injuries, compared to rehabilitation alone. Strength of Recommendation: Due to inconsistent or limited quality patient-oriented evidence in existing literature, the strength of this recommendation is grade B, based on the strength of recommendation taxonomy.
Kanako Shimoura, Yasuaki Nakayama, Yuto Tashiro, Takayuki Hotta, Yusuke Suzuki, Seishiro Tasaka, Tomofumi Matsushita, Keisuke Matsubara, Mirei Kawagoe, Takuya Sonoda, Yuki Yokota and Tomoki Aoyama
Context: The functional movement screen (FMS) is an assessment tool for movement dysfunction, which is used to reduce the risk of injury. Although the relationship between the FMS composite score and injuries has been extensively studied, the association between FMS scores and injuries in only college basketball players remains unknown. Objective: To examine the relationship between the FMS score and injuries in basketball players. Design: Cross-sectional study. Setting: University research laboratory. Participants: Eighty-one male college basketball players (average age 20.1 [1.3] y) participated. Main Outcome Measures: The FMS composite score was calculated from 7 movement tests. The incidence of injuries over a 1-year period prior to the test day was determined based on a questionnaire. Individuals were categorized into 2 groups: injury (with a serious basketball-related injury resulting in the loss of practice and game time for at least 4 wk) and noninjury groups. Mann–Whitney U and chi-square tests were used to evaluate group differences in the composite FMS and 7 movement scores, respectively. Furthermore, the scores significant on univariate analyses were submitted to a multivariate logistic analysis, adjusting for participant characteristics. Results: The composite FMS scores of the 2 groups were not significantly different (P = .38). Among the 7 tasks, only the deep squat and hurdle step showed significant group differences (P = .03 and P = .001, respectively). The multivariate logistic analysis revealed that deep squat (odds ratio, 6.48; 95% confidence interval, 1.23–34.01; P = .03) and hurdle step scores (odds ratio, 25.80; 95% confidence interval, 1.81–368.73; P = .02) were significantly associated with injuries, even after adjustment for participant characteristics. Conclusions: Deep squat and hurdle step scores may be associated with injuries in basketball players. Further research should be conducted to confirm that these 2 scores can predict the incidence of injuries in basketball players.
Matthew K. Seeley, Ryan P. Sandberg, Joshua F. Chacon, Merrill D. Funk, Neil Nokes and Gary W. Mack
Individuals using traditional axillary crutches to ambulate expend approximately twice as much energy as individuals who perform able-bodied gait. A relatively novel spring-loaded crutch now being marketed may reduce metabolic energy expenditure during crutch ambulation. This idea, however, had not yet been tested.
To determine whether the novel spring-loaded crutch reduces oxygen consumption during crutch ambulation, relative to traditional-crutch ambulation. A secondary purpose was to evaluate the design for subject-perceived comfort and ease of use.
10 able-bodied men and 10 able-bodied women.
The independent variable was crutch design. Each subject ambulated using 3 different crutch designs (traditional, spring-loaded, and modified spring-loaded), in a randomized order.
Main Outcome Measures:
The primary dependent variable was oxygen consumption. Secondary dependent variables were subject-perceived comfort and ease of use, as rated by the subjects using a 100-mm visual analog scale. Dependent variables were compared among the 3 crutch designs using a 1-way repeated-measures ANOVA (α = .05).
Oxygen consumption during spring-loaded-crutch ambulation (17.88 ± 2.13 mL · kg−1 · min−1) was 6.2% greater (P = .015; effect size [ES] = .50) than during traditional axillary-crutch ambulation (16.84 ± 2.08 mL · kg−1 · min−1). There was no statistically significant difference (P = .068; ES = −.45) for oxygen consumption between spring-loaded-crutch ambulation and ambulation using the modified crutch (17.03 ± 1.61 mL · kg−1 · min−1). Subjects perceived the spring-loaded crutch to be more comfortable (P < .001; ES = .56) than the traditional crutch. There was no difference (P = .159; ES = −.09) between the spring-loaded and traditional crutches for subject-perceived ease of use.
Compared with traditional axillary crutches, the novel spring-loaded crutch may be more comfortable but does not appear to benefit subjects via reduced metabolic energy expenditure.
Derwin K. C. Chan, Vanessa Lentillon-Kaestner, James A. Dimmock, Robert J. Donovan, David A. Keatley, Sarah J. Hardcastle and Martin S. Hagger
We applied the strength-energy model of self-control to understand the relationship between self-control and young athletes’ behavioral responses to taking illegal performance-enhancing substances, or “doping.” Measures of trait self-control, attitude and intention toward doping, intention toward, and adherence to, doping-avoidant behaviors, and the prevention of unintended doping behaviors were administered to 410 young Australian athletes. Participants also completed a “lollipop” decision-making protocol that simulated avoidance of unintended doping. Hierarchical linear multiple regression analyses revealed that self-control was negatively associated with doping attitude and intention, and positively associated with the intention and adherence to doping-avoidant behaviors, and refusal to take or eat the unfamiliar candy offered in the “lollipop” protocol. Consistent with the strength-energy model, athletes with low self-control were more likely to have heightened attitude and intention toward doping, and reduced intention, behavioral adherence, and awareness of doping avoidance.