Kinetic Chain Injuries and Their Relationship to Subsequent ACL Tears

Authors: Jefferson Brand, MD, Richard Hardy, Ed.D., LAT, CSCS, Christopher Butler, Ph.D., Emily Monroe, MD

Corresponding Author:
Richard Hardy Ed.D., LAT, CSCS
111 17th Ave E #101, Alexandria, MN 56308
Fax: 320-589-6428
Office number: 320-589-6443
Cell number: 320-760-2031
Email: rhardy@heartlandorthopedics.com

Richard Hardy is a certified athletic trainer and coordinator of research at Heartland Orthopedic Specialists in Alexandria, MN. He is also contracted to the University of Minnesota Morris where he serves as an instructor and provides athletic training services.

Kinetic chain injuries and their relationship to subsequent ACL tears

ABSTRACT
Purpose: The relationship between previous kinetic chain injuries and the likelihood of anterior cruciate ligament (ACL) injuries remains under-explored. We compared the number of ankle injuries between subjects that had a surgically treated ACL tear to subjects that had a surgically treated shoulder injury (e.g., labral tear). We evaluated if a previous disruption of the lower kinetic chain (e.g., ankle injury) is a predisposing factor for ACL injuries. Our hypothesis was that ACL reconstruction patients will have a higher rate of previous ankle injuries than the control group (surgically treated labral tear).

Methods: Overall, 108 patients have undergone either ACL reconstruction or labral repair surgery. To insure similarity, we assessed Tegner activity level, knee alignment, and Beighton scale. Patients completed a questionnaire about demographics, ankle injury history, and the AOFAS Ankle-Hindfoot scale. ANOVA statistically tested demographic data. Fisher’s exact test was used to determine if differences in previous ankle injury rates existed between groups.

Results: Overall, 63 patients (34 males/29 females) had ACL reconstruction and 45 patients (36 males/9 females) in the control group had surgery for labral lesions. No statistical differences occurred (P>0.05) for demographic data (age, BMI), Tegner activity scale, knee alignment, Beighton scale, or AOFAS Ankle-Hindfoot scores for each ankle. This suggests that the groups were comparable. Previous ankle injuries were common in both groups but not statistically significant.

Conclusions: Comparing surgically ACL injured knees to surgically treated labral tears, there was no significant difference in the rate of previous ankle injury. Therefore, previous ankle injuries may not predispose nor protect against future anterior cruciate ligament injuries.

Applications in sport: The knee is a link in the kinetic chain between the hip and ankle joints. Due to this, dysfunction of the ankle or hip joints could negatively affect the function of the knee joint. Therefore, we set out to see if ankle injury history is a predisposing factor for tears of the ACL of the knee. Through our research, we found that this was not the case; ACL tears occur independently to the kinetic chain. (more…)

2018-11-19T08:47:25+00:00December 6th, 2018|Research, Sports Medicine|Comments Off on Kinetic Chain Injuries and Their Relationship to Subsequent ACL Tears

Influencing Factors and Rationale for the Use of Athletic Trainers in Secondary School Athletic Programs

Authors:
Stephanie H. Clines, PhD, LAT, ATC
Sacred Heart University, Fairfield, CT.

Cailee E. Welch Bacon, PhD, ATC
A.T. Still University, Mesa, AZ.

Christianne M. Eason, PhD, ATC
Lasell College, Newton, MA.

Kelly D. Pagnotta, PhD, LAT, ATC, PES
Jefferson University, Philadelphia, PA.

Robert A. Huggins, PhD, LAT, ATC
Korey Stringer Institute, University of Connecticut, Storrs, CT.

Bonnie L. Van Lunen, PhD, ATC, FNATA
Old Dominion University, Norfolk, VA.

Corresponding author:
Stephanie H. Clines, PhD, LAT, ATC
Sacred Heart University
5151 Park Ave
Fairfield, CT 06825
Phone: 203-365-4475
cliness@sacredheart.edu

Stephanie Clines, PhD, ATC is a Clinical Assistant Professor in the College of Health Professions at Sacred Heart University in Fairfield, CT. She also serves as the Clinical Education Coordinator for both the Bachelor of Science and Master of Science in Athletic Training programs at the University.

Influencing Factors and Rationale for the Use of Athletic Trainers in Secondary School Athletic Programs

ABSTRACT
Purpose: Secondary school student-athletes often lack appropriate medical care during school sponsored sport participation. Athletic trainers (ATs) are qualified healthcare professionals that can fill this need. Barriers to hiring ATs have been identified, however the rationale regarding the use of ATs in schools remains unexplored. Understanding this phenomenon has the potential to guide strategies to improve access to ATs, thus improving athlete safety. Our objective was to explore high school athletic directors’ perceptions of the roles and services provided by ATs working in the secondary school setting and to understand the needs of the athletic program and school regarding the use of athletic training services.

Methods: Following a qualitative methodology, ten high school athletic directors employed by schools with full-time ATs completed telephone interviews. All interviews were recorded and transcribed verbatim. Data analysis followed the consensual qualitative research (CQR) approach.

Results: Procurement of athletic training positions was influenced by various personnel, community organizations, and policy. Rationale for requiring ATs within athletic programs included specialized training by ATs which was perceived to enhance safety and decrease liability. Participants viewed ATs as ideal athletic healthcare providers. Coaches were not supported as appropriate staff to fulfill this role. Financial and logistical challenges to the initiation and maintenance of AT positions were also discussed. Conclusions: The decision to utilize ATs is complex and influenced by multiple factors. Applications in Sport: Consideration of these factors may improve the success of athletic director’s efforts to initiate or maintain athletic training positions to support the safety and well-being of student-athletes within secondary school athletic programs.

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2018-11-19T08:24:55+00:00November 29th, 2018|Research, Sports Medicine|Comments Off on Influencing Factors and Rationale for the Use of Athletic Trainers in Secondary School Athletic Programs

Playing with Pain: Social Class and Pain Reporting among College Student-Athletes

Author: James N. Druckman

Corresponding Author:
Department of Political Science
Northwestern University
601 University Place
Evanston, IL 60208
Phone: 847-491-7450
Fax: 847-491-8985
druckman@northwestern.edu

Jacob E. Rothschild
(JacobRothschild2014@u.northwestern.edu)
Department of Political Science
Northwestern University
601 University Place
Evanston, IL 60208
Phone: 847-491-7450
Fax: 847-491-8985

Playing with Pain: Social Class and Pain Reporting among College Student-Athletes

ABSTRACT
Socio-economic class affects a variety of health outcomes – this includes the experience of pain. Little work, however, explores how class affects pain experiences of college student-athletes. This gap is notable given injuries frequently occur in this population. We argue that lower class student-athletes will ironically be more likely to experience pain but less likely to report it. We find evidence for this claim with a large survey of student-athletes from a major National College Athletic Association conference. We further present evidence that class may influence pain reporting via identity, experiential, and social pathways. Our results highlight how potentially vulnerable student-athletes may “play with pain.” The findings also suggest that practitioners should pay particular attention to self-reports of pain by lower class student-athletes.
(more…)

2018-08-30T16:40:58+00:00October 11th, 2018|Sports Medicine|Comments Off on Playing with Pain: Social Class and Pain Reporting among College Student-Athletes

Academic Accommodations for a Countywide Concussion High School Program

Authors: Ashley D. Lopez, M.S.; Michelle Shnayder; Bryan Pomares, M.H.S.; Jonathan Siegel; Kester Nedd, D.O.; Gillian Hotz, Ph.D.

Corresponding Author:
Gillian Hotz, Ph.D.
1095 NW 14th Ter
Miami, FL 33136
ghotz@med.miami.edu
302-243-4004

Gillian A. Hotz, PhD is a research professor at the University Of Miami Miller School Of Medicine and a nationally recognized behavioral neuroscientist and expert in pediatric and adult neurotrauma, concussion management, and neurorehabilitation. Dr. Hotz is the director of the KiDZ Neuroscience Center, WalkSafe and BikeSafe programs, and has been co-director of the Miller School of Medicine’s Concussion Program since 1995. She continues to assess and treat many athletes from Miami-Dade County public and private high schools, University of Miami, and from other colleges and the community.
Academic Accommodations for a Countywide Concussion High School Program

ABSTRACT

Purpose
To describe a symptom-based distribution of Return to Learn school academic accommodations for adolescent student-athletes recovering from sports-related concussions that can be facilitated as part of their post-injury clinical care. The aim was also to explore demographic and recovery differences between those patients who received and did not receive accommodations.

Method
Adolescent student-athletes from 35 public high schools were eligible for this study. Data collected included their demographics, clinical assessment, and ImPACT (ImPACT Applications, Inc.) testing performance prior to and following a concussion. Student-athletes receiving accommodations were compared with an age-matched comparison group that did not receive accommodations.

Results
Between January 2014 and January 2017, 308 Miami-Dade County public high school student-athletes were seen at the University of Miami’s UConcussion Clinic. Of these, 72 received school accommodations and 236 did not. The first clinical visit for these athletes was a mean of 14 days post injury with mean recovery time and return to play of 25 days. Significant differences were found among female student-athletes as well as patients reporting more initial symptoms despite similar demographics and baseline ImPACT scores.

Conclusions
Concussed adolescent student-athletes, particularly females, reporting greater symptom complaints during their first clinical encounter, may benefit most from a collaborative treatment approach including school accommodations that are individualized and specifically targeted. Future research should continue to investigate accommodation adherence and long-term concussion recovery.

Applications In Sports
Student-athletes receiving academic accommodations may return to play sooner, as academic accommodations allow them to recover from injuries at a quicker pace.
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2017-12-26T08:43:37+00:00December 28th, 2017|Research, Sports Medicine|Comments Off on Academic Accommodations for a Countywide Concussion High School Program

The Evaluation of Exercise-Induced Hematuria in Endurance Athletes

Authors:
Gregory Marshall, RN, BSN, MSN-S
Devinder Jarial, RN, BSN, MSN-S
Dr. Jessica L. Durbin, DNP, FNP-BC

Corresponding Author:
Devinder Jarial, RN, BSN, MSN-S
8942 Bryant Lane Apartment 1A
Indianapolis, IN 46250
dsjarial@gmail.com
317-213-7904

Gregory Marshall and Devinder Jarial are graduate students at Indiana State University completing their Master of Science in Nursing degrees with a family nurse practitioner concentration. Dr. Jessica Durbin is an Assistant Professor in the Department of Advanced Nursing Practice at Indiana State University.

The Evaluation of Exercise-Induced Hematuria in Endurance Athletes

ABSTRACT
Microscopic hematuria can be defined as the presence of greater (>) than 3 red blood cells per milliliter (mL) detected on a high-powered microscopic field, or > 50 red blood cells per mL of urine present on a urine dipstick (14). Exercise-induced hematuria in healthy young adults is not usually associated with significant morbidity or mortality (15). Moderate exercise-induced hematuria is seen habitually, both in athletes and in the general public (14). However, hematuria can be a signal of more serious diseases (15). In endurance athletes, the microscopic hematuria is often self-limiting and resolves within 48-72 hours (1). The abnormal presence of red blood cells in urine may indicate kidney inflammation, infection or trauma in the urinary tract, or neoplastic diseases in the urogenital tract (6). If hematuria doesn’t resolve within 48-72 hours, providers should consider further evaluation. Diagnostics and interventions should be adapted to the individual based on the history of present illness, age, and past medical history. Future research on this topic could be adapted to evaluating and treating microscopic hematuria in multiple sports and activities.
(more…)

2017-12-11T11:35:50+00:00December 14th, 2017|Sports Medicine|Comments Off on The Evaluation of Exercise-Induced Hematuria in Endurance Athletes