Kevin M. Cross

Short-term effect of muscle energy technique on pain in individuals with non-specific lumbopelvic pain: a pilot study.

Abstract Muscle energy technique (MET) is a form of manual therapy frequently used to correct lumbopelvic pain (LPP), herein the patient voluntarily contracts specific muscles against the resistance of the clinician. Studies on MET regarding magnitude and duration of effectiveness are limited. This study was a randomized controlled trial in which 20 subjects with self-reported LPP were randomized into two groups (MET or control) after magnitude of pain was determined. MET of the hamstrings and iliopsoas consisted of four 5-second hold/relax periods, while the control group received a sham treatment. Tests for current and worst pain, and pain with provocation were administered at baseline, immediately following intervention and 24 hours after intervention. Separate 2x3 ANOVAs were used to assess results as change scores. Visual analog score (VAS) for worst pain reported in the past 24 hours decreased for the MET group (4.3mm±19.9, p=.03) and increased for the sham (control) group (17.1mm±21.2, p=.03). Subjects receiving MET demonstrated a decrease in VAS worst pain over the past 24 hours, thereby suggesting that MET may be useful to decrease LPP over 24 hours.

Training and equipment to prevent athletic head and neck injuries.

Due to the potential for catastrophic neurotraumas and cervical spine injuries in sport, the sports health care professional must take proper measures to prevent such injuries. Strength training of the cervical spine, teaching of proper sporting techniques, and use of protective sports equipment are three primary means of attempting to prevent neurotraumas and cervical spine injuries in sports. There are other avenues to assist in preventing these injuries, such as flexibility programs. The sports health care professional, therefore, must be knowledgeable of the needs of each individual athlete when developing prevention plans.

Comparison of Hamstring Strain Injury Rates Between Male and Female Intercollegiate Soccer Athletes

Background: Hamstring strains are common among soccer athletes, and they have a high incidence of recurrence. Among American collegiate soccer players, men have an overall higher incidence rate of hamstring strains than women. Purpose: This research compares the hamstring strain injury rates in event and athlete characteristics between male and female college soccer athletes. Study Design: Descriptive epidemiology study. Methods: Data describing partial and complete hamstring strains were obtained from the National Collegiate Athletic Association (NCAA) Injury Surveillance System (ISS) for men’s and women’s soccer from 2004 to 2009. Incidence rate ratios (IRRs) comparing the incidence of hamstring strains between the sexes as well as during games versus practices and the preseason versus the in-season were calculated. χ2 tests were used to compare the occurrence of hamstring strains across different event and athlete characteristics. Results: Men were 64% more likely than women to sustain a hamstring strain (IRR, 1.64; 95% CI, 1.37-1.96). Men had significantly higher rates of hamstring strains than women during both games (IRR, 2.42; 95% CI, 1.82-3.23) and practices (IRR, 1.34; 95% CI, 1.06-1.68). There were no differences between men and women in injury rates during the preseason, but men were significantly more likely to sustain a hamstring strain during the in-season (IRR, 1.98; 95% CI, 1.56-2.52). Men had a significantly higher proportion of recurrent hamstring strains compared with women (men, 22%; women, 12%; P = .003). There were no significant differences in the distribution of strains in event or athlete characteristics between men and women for first-time or recurrent hamstring strains. Conclusion: In collegiate soccer, men have significantly higher rates of hamstring strains than women, and regardless of the recurrence status, the event and athlete characteristics were similar for both sexes. Identifying common characteristics may assist in the targeted development of preventive and rehabilitative programs as well as continued research on hamstring strains among collegiate soccer players.

Days to Return to Participation After a Hamstrings Strain Among American Collegiate Soccer Players

CONTEXT Among US collegiate soccer players, the incidence rate and the event characteristics of hamstrings strains differ between sexes, but comparisons in the return-to-participation (RTP) time have not been reported. OBJECTIVE To compare the RTP time between male and female collegiate soccer players and analyze the influence of event characteristics on the RTP time for each sex. DESIGN Descriptive epidemiology study. SETTING Data were collected from collegiate teams that voluntarily participated in the National Collegiate Athletic Association Injury Surveillance System. PATIENTS OR OTHER PARTICIPANTS Collegiate soccer athletes who sustained 507 hamstrings strains (306 men, 201 women) during the 2004 through 2009 fall seasons. MAIN OUTCOME MEASURE(S) Nonparametric statistics were used to evaluate RTP time differences between sexes and among categories of each event characteristic (ie, time of season, practice or competition, player position). Negative binomial regression was used to model the RTP time for each sex. All analyses were performed separately for first-time and recurrent strains. RESULTS We found no differences in the RTP time between sexes for first-time (median: men = 7.0 days, women = 6.0 days; P = .07) or recurrent (median: men = 11 days, women = 5.5 days; P = .06) hamstrings strains. For male players with first-time strains, RTP time was increased when the strain occurred during competition or the in-season/postseason and varied depending on the division of play. Among female players with first-time strains, we found no differences in RTP time within characteristics. For male players with recurrent hamstrings strains, the RTP time was longer when the injury occurred during the in-season/postseason. Among female players with recurrent strains, RTP time was longer for forwards than for midfielders or defenders. CONCLUSIONS Although we found no differences in the RTP time after hamstrings strains in male and female collegiate soccer players, each sex had unique event characteristics that influenced RTP time.

Injury-Related Fear in Acutely Injured Interscholastic and Intercollegiate Athletes

Unrecognized and unaddressed injury-related fears may hinder the rehabilitation process in injured athletes. Currently, 3 scales have been reported to measure injury-related fears in general orthopedic patient populations: the Tampa Scale of Kinesiophobia-11 (TSK-11), the Fear-Avoidance Beliefs Questionnaire (FABQ), and the Re-Injury Anxiety Inventory (RIAI). However, these instruments have not been studied extensively in athletes with musculoskeletal injuries. The purpose of this case series was to describe changes in injury-related fear in intercollegiate and interscholastic athletes with acute musculoskeletal injuries. Twenty-six athletes completed the 3 questionnaires at 48 hours, 1 week, and 3 weeks postinjury. Responses to all 3 questionnaires and their subscales, except for the RIAIRehab subscale, changed signifi cantly over the course of the study. In addition, signifi cant correlations were found among most measures, as each appears to be measuring diff erent constructs of the same phenomena. Following acute musculoskeletal injury, injury-related fear scores decreased as the athletes’ condition improved. [Athletic Training & Sports Health Care. 2013;x(x):xxx-xxx.]

Comparison of Thigh Muscle Strain Occurrence and Injury Patterns between Male and Female High School Soccer-Athletes

CONTEXT Thigh muscle strains are among the most common injuries in high school soccer for both males and females. Similar results have been reported among college soccer players, specifically for hamstring strains. In college soccer, males have a higher injury rate than women, although they share common injury characteristics. Currently, no studies exist comparing the injury rate or injury characteristics of thigh muscle strains between sexes playing high school soccer. OBJECTIVE To compare thigh muscle strain injury rates and injury event characteristics among sexes participating in high school soccer. DESIGN Descriptive epidemiology study. SETTING A total of 100 nationally representative high schools that participated in the High School Sports-Related Injury Surveillance System, Reporting Information Online. PARTICIPANTS High school soccer athletes who had a thigh muscle strain. MAIN OUTCOME MEASURES Injury rates of thigh muscle strains were calculated between sexes. The occurrence of the following variables during a thigh muscle injury was compared between sexes: grade level, age, level of play, event type, time of practice, time of competition, basic injury mechanism, soccer activity, player position, field location, practice type, and time of season. RESULTS Males had a lower injury rate of thigh muscle strains during competition than females (rate ratio = 0.66; 95% confidence interval, 0.47-0.93). No differences between sexes existed in the distribution of first-time or recurrent event characteristics. When combining sexes, recurrent strains (93%) occurred more frequently on the offensive side of the field than first-time strains (59%), P < .001. The majority of strains occurred among the varsity players (71%), during running activities (60%) and practices (58%). CONCLUSIONS Males were less likely to sustain a thigh muscle strain during competitions, but no other differences existed between sexes. The events surrounding all thigh muscle strains may be described with some common properties. Consideration of these characteristics may assist in the development of preventive and rehabilitative programs as well as direct future research on thigh muscle strains among high school soccer players.