OBJECTIVE: The aim of this study was to quantify changes in peak bending moments at the distal tibia, peak patellofemoral joint contact forces and peak Achilles tendon forces during a high-intensity run to fatigue at middle-distance speed.
METHODS: Observational study.
METHODS: 16 high-level runners (7 female) ran on a treadmill at the final speed achieved during a preceding maximum oxygen uptake test until failure (~3 min). Three-dimensional kinetics and kinematics were used to derive and compare tibial bending moments, patellofemoral joint contact forces and Achilles tendon forces at the start, 33 %, 67 % and the end of the run.
RESULTS: Average running speed was 5.7 (0.4) m·s-1. There was a decrease in peak tibial bending moments (-6.8 %, p = 0.004) from the start to the end of the run, driven by a decrease in peak bending moments due to muscular forces (-6.5 %, p = 0.001), whilst there was no difference in peak bending moments due to joint reaction forces. There was an increase in peak patellofemoral joint forces (+8.9 %, p = 0.026) from the start to the end of the run, but a decrease in peak Achilles tendon forces (-9.1 %, p < 0.001).
CONCLUSIONS: Running at a fixed, high-intensity speed to failure led to reduced tibial bending moments and Achilles tendon forces, and increased patellofemoral joint forces. Thus, the altered neuromechanics of high-intensity running to fatigue may increase patellofemoral joint injury risk, but may not be a mechanism for tibial or Achilles tendon overuse injury development.

UNASSIGNED: Sport specialization is associated with increased risk of overuse injuries. However, the effects of sport specialization on the risk of overuse injury may differ by specific sport and sociocultural parameters. This study aimed to determine the associations of sport participation and training volume with previous overuse injuries in Japanese male youth soccer players.
UNASSIGNED: Being highly specialized before the age of 12 years and high training volume relative to participant age would be associated with a history of serious overuse injury.
UNASSIGNED: Cross-sectional study.
UNASSIGNED: Level 3.
UNASSIGNED: Survey data were collected from male youth soccer players (seventh-ninth grade) during midseason of the 2020-2021 academic year. Participants completed a questionnaire regarding their status of sport participation (single- and multisport athletes), weekly sports volume in first- sixth grade and injury history in the previous year. Odds ratio (OR) was calculated to identify associations of specialization and training volume with a history of serious overuse injury.
UNASSIGNED: A total of 841 players (mean age, 13.7 ± 0.9 years) participated; 11% reported serious overuse injury in the previous year, and 64% participated in other sports before the age of 12 years. Players who participated in other sports at <12 years old (OR, 1.79; 95% CI, 1.09-2.94; P = 0.02) and those who trained for more weekly hours than their age in fifth to sixth grade (OR, 1.70; 95% CI, 1.07-2.72; P = 0.03) had greater odds of reporting serious overuse injuries.
UNASSIGNED: Multisport athletes and high training volume in fifth-sixth grade were associated with previous serious overuse injuries.
UNASSIGNED: Coaches and parents of male youth soccer players should be aware of the increased risk of serious overuse injury participating in multiple sports simultaneously, and youth athletes should adhere to age-appropriate volume recommendations.

OBJECTIVE: To identify the potential role of humeral retrotorsion (HRT) and range of motion (ROM) as a risk factor for shoulder overuse injury in elite youth handball players. The hypothesis was that increased HRT is associated with an increased risk of shoulder overuse injury.
METHODS: Over two seasons, 258 elite youth handball players (52% boys; age:14±0.8years) were included. Pre-season assessment included HRT and glenohumeral internal (IR) and external (ER) rotational ROM using ultrasound and a manual goniometer. Sports-specific adaptations between male and female athletes and the dominant and nondominant shoulder were calculated. In addition, players completed standardized questionnaires over the 2018-2019 or 2019-20 season and reported any shoulder overuse symptoms using the Western Ontario Shoulder Index questionnaire.
RESULTS: Comparing male and female players showed significantly decreased HRT and decreased internal ROM in the dominant side of male athletes (p≤0.027). No other difference was found. Significant side-to-side differences between the dominant and non-dominant shoulder were found for HRT, IR, and ER, regardless of sex (p<0.001). For total range of motion (TROM), only female athletes showed a significant increase in the dominant arm (p=0.032). The dominant side showed a significantly higher glenohumeral internal rotation deficit (GIRD) in male athletes than in female athletes (10°±17° vs. 5°±10°, p=0.011). Adaptations in HRT, ER gain, and TROM gain were not significant. Over the course of the two seasons, 20 athletes reported shoulder overuse injuries. Although GIRD was borderline non-significant (p=0.056), none of the parameters tested were significantly associated with shoulder overuse injuries.
CONCLUSIONS: Despite significant side-to-side differences and sport-specific adaptations, individual pre-season screening of humeral retrotorsion and soft tissue adaptations does not identify elite youth handball athletes at increased risk of shoulder overuse injury.

Dancers and musicians have unique physical demands that can lead to injury of the peripheral nerves. Specific dance movements and specific instrument positions, combined with countless hours of practice and repetition, create an environment for potential nerve injury. Familiarity with these variables and recognition of the common presentations of neuropathic syndromes are essential in the evaluation of a performing artist with a suspected peripheral nerve injury. Assessment should include an understanding and analysis of their dance style or instrument playing posture, particularly in the position or motion that recreates the symptoms if possible. Practice and performance schedules should also be considered. Diagnosis may require electrodiagnostic testing, imaging, or diagnostic injections. Treatment should be comprehensive and may include modifications in practice schedule, posture/position, and technique in addition to consideration of medications, splints/orthoses, physical therapy, and injections. The instructor/teacher should be involved in the treatment plan if applicable. Complete rest in this population may not be realistic or necessary. Early and accurate diagnosis of nerve injury is important for safe return to dance or instrumental music.

Patellar tendon (PT) complaints are frequent in competitive alpine skiers and such complaints are characterized by a long-lasting affection. Since PTs are subject to maturation up to 1-2 years after growth spurt, this early career stage may be decisive for the further course of complaints. The aim of this study was to investigate the evolution of PT complaints and shear wave velocity patterns among competitive alpine skiers during a 4-year post-growth spurt follow-up. The PT complaints and SWV patterns of forty-seven skiers were analysed at baseline (i.e., immediately after their peak height growth at 13-15 years of age) and were re-analysed at 4-year follow-up. The PTs were scanned via three-dimensional SWE. Symptomatic skiers were identified based on pain sensation under loading and pressure-induced pain around the PT. The prevalence of PT complaints decreased from 29.8% at baseline to 12.8% at follow-up (Pearson\'s χ2 = 9.429; p = 0.002). SWV decreased from the baseline assessment to the follow-up in the proximal and distal regions (p < 0.05). SWV coefficient of variation (CV) in the distal and mid-portion regions was greater at baseline than at follow-up (p < 0.05). At the follow-up assessment, compared to \"healthy\" skiers, \"healed\" skiers who recovered from PT complaints had lower SWVs in the proximal region (p = 0.020) and greater SWV CVs in the proximal region (p = 0.028). Moreover, symptomatic skiers had significantly greater SWV CVs in the mid-portion region than did \"healthy\" subjects with no history of PT complaints (p = 0.020). The average SWV was negatively correlated with the SWV (proximal: r = -0.74, p < 0.001; mid-portion: r = -0.37 p = 0.011; and distal: r = -0.58, p < 0.001). The occurrence of PT complaints decreased over a 4-year post-growth spurt follow-up. \"Healed\" skiers who were symptomatic at baseline had an even greater average decrease in the proximal and mid-portion SWV than \"healthy\" skiers with no history of PT complaints. This may lead to the hypothesis that PT complaints in adolescent skiers are not self-eliminating towards the end of adolescence, as at least structural irregularities appear to persist for several years after the onset of initial symptoms. Furthermore, \"healed\" and symptomatic tendons exhibited increased SWV variability, supporting the hypothesis that SWV CV may provide additional valuable information on the mechanical properties of PTs affected by overuse-related complaints.

The aim of the present study was to compare the coordination patterns and levels of coordination variability of healthy and injured runners with iliotibial band syndrome (ITBS). Sixty runners divided into four groups (15 healthy males, 15 healthy females, 15 males with ITBS and 15 females with ITBS) ran at a steady and freely chosen pace on an over-ground track, and their coordination patterns of the lower limbs were calculated during 10 running stances using the vector coding technique. Both male and female runners with ITBS showed a greater dominance of the pelvis segment and the anti-phase patterns in the frontal plane thigh-pelvis coupling (p = 0.001, η2 = 0.36). In addition, injured female runners showed a greater hip adduction dominance, whereas injured males presented a greater anti-phase pattern in the transverse plane-frontal plane hip coupling (p = 0.003, η2 = 0.08). The levels of coordination variability during running stance did not change between ITBS injured and healthy runners in any of the couplings. Currently injured runners with ITBS appeared to present altered coordination patterns on the hip couplings that were partly dependent on gender but did not lead to changes in the coordination variability levels.

OBJECTIVE: To develop and validate the Youth Overuse Injury Questionnaire (YOvIQ).
METHODS: A cross-sectional study.
METHODS: Online platforms.
METHODS: Two content experts (in sports injury epidemiology and in sports science and medicine) and seven end-users (youth volleyball athletes) provided feedback during development of the YOvIQ. 227 competitive youth athletes across 14 different sports assessed the psychometric properties of the YOvIQ.
METHODS: Participants completed both YOvIQ and the Oslo Sports Trauma Research Centre Overuse Injury Questionnaire (OSTRC-O2) for anatomical areas of the shoulder, elbow, lower back, knee, and ankle/foot. Validity was assessed via convergent validity. Reliability was assessed using internal consistency estimation and interclass correlation coefficient.
RESULTS: Following feedback from content experts, examples and quantitative symbolization were added to the options in YOvIQ, with positive feedback from end-users. Convergent validity between YOvIQ and the OSTRC-O2 was demonstrated with non-significant differences (P ≥ .05) and significant correlations (P < 0.001) for prevalence and severity scores. YOvIQ demonstrated internal consistency for prevalence (Cronbach\'s alpha coefficient >0.70) and moderate-to-good reliability for severity scores (ICC: 0.51 to 0.88) for shoulder, lower back, and knee.
CONCLUSIONS: The YOvIQ is a valid and reliable instrument to identify overuse injuries to the shoulder, lower back, and knee in youth athletes.

In recent years, the surge in sport and exercise participation, particularly in running, has coincided with the widespread adoption of running-related technology, such as fitness trackers. This study investigates the correlation between the use of running-related technology and running-related injuries among recreational and elite long-distance runners. We conducted a quantitative, cross-sectional online survey of 282 adult runners. Data were analyzed using descriptive statistics and a multivariable logistic regression analysis. Participants, with an average age of 37.4 years, reported varied running experience, with 90.07% utilizing running-related technology during their runs to some degree, primarily smartwatches like Garmin and Apple Watch. Running-related technology users showed a higher likelihood of experiencing running-related injuries compared to non-users (OR = 0.31, p < 0.001). However, those who utilized the metrics obtained from running-related technology to guide their training decisions did not exhibit a higher risk of injury. This nuanced relationship highlights the importance of considering individual training behaviors and the potential psychological impacts of technology on running practices. The study underscores the need for future research integrating biomechanical and psychosocial factors into running-related technology to enhance injury prevention strategies.

BACKGROUND: Osteitis pubis (OP), which occurs as a result of excessive use of the symphysis pubis and parasymphysis bones, is more common in long-distance runners and kicking athletes, especially football players. Due to the poor results of commonly used treatments for OP, there is a need for investigation of more effective treatments, such as ozone therapy. Ozone therapy is used to treat a variety of diseases, including musculoskeletal conditions.
METHODS: A 30-year-old amateur soccer player diagnosed with OP received conservative treatment with traditional physiotherapy and analgesic medications. After 6 months and no resolution of symptoms, the patient presented to the sports medicine outpatient clinic seeking alternative therapy options.
METHODS: The patient received ozone injections in 3 sessions administered at 10-day intervals. At 1, 3, 6 and 12 months after the treatment, the patient\'s complaints and pain levels were re-evaluated and examined. The patient was able to return to competition at the same level after the first injection. No recurrence was revealed at a minimum of 12 months of follow-up.
CONCLUSIONS: In this article, we present a case in which OP was successfully treated with ozone injection.

OBJECTIVE: To examine the prevalence of mental health problems (depression, anxiety, and stress), sleep quality, and disability due to overuse injuries in advanced and elite rock-climbers. The rock-climbers were compared to a group of non-climbing controls.
METHODS: A self-selected sample of advanced and elite Swedish rock-climbing athletes was recruited through the Swedish Rock-climbing Federation, local rock-climbing gyms and through social media. A control group, matched in size was recruited. Participants in the control group answered an online survey of validated questionnaires, examining symptoms of stress, anxiety, depression, sleep quality. The climbing participants answered the same survey as the non-climbing controls but with additional questions regarding musculoskeletal problems and disabilities related to these. Outcome measures used were the Depression Anxiety Stress Scale, Pittsburgh Sleep Quality Index and The Oslo Sports Trauma Research Center Overuse Injury Questionnaire.
RESULTS: A total of 183 participants were included in the rock-climbing group, and 180 participants in the control group. In the rock-climbing group the mean age (SD) was 28.2 (8.3) years among women and 30.5 (9.6) years in men. The mean BMI of women was 21.2 (2.2) and 22.8 (2.1) in men. A total of 30.6% of the rock-climbing group (26.7% of men, 35.9% of women) reported at least moderate levels of symptoms of depression and 23.1% (17.2% men, 30.8% women) at least moderate levels of symptoms of anxiety. A total of 48.4% of rock-climbers (39.1% men, and 61.6% women) reported at least moderate levels of symptoms of stress. Among the rock-climbers, 45.0% reported having poor sleep quality. There were no statistical significant differences (p = 0.052-0.96) in mental health problems or sleeping problems between the rock-climbers and the controls. Among rock-climbers, reports of one-week prevalence of injury related problems was: Finger and hand (49.5%), Shoulder (35.2%), Knee (29.1%), Lumbar back (26.4%), Arm (25.3%), Thoracic back and neck (17.0%), and Foot and lower leg (12.1%).
CONCLUSIONS: The overall results indicate high levels of symptoms of mental health problems and poor sleep quality in both rock-climbers and controls. Although no significant differences between the climbing group and the control group was displayed, symptoms that warrant clinical attention is high. Overuse injuries were commonly reported among the rock-climbers in all examined injury locations. Previous studies reporting mental health problems to be more prevalent among athletes were contradicted in this study. The results display the need for a broader perspective regarding climbers general health and the need to provide structured care and adequate support in order to come to terms with these concerns.