Privilege and marginalization associated with racial background have been posited as contributors to why Black athletes face disparities within their care, treatment, and recovery from sport-related concussion (SRC). However, empirical findings have limited exploration on how disparate outcomes have emerged, and the interaction with systems of biases, power and disenfranchisement. To understand concussion care disparities, a qualitative content analysis was conducted in three phases: [I] identifying salient literature on racial differences for Black athletes with SRC (N = 29), [II] qualitative analysis of literature to determine salient topics, themes and patterns within the literature, and [III] constructing a novel ecological-systems framework that encapsulates the \'why\' and \'how\' related to psychosocial and sociocultural experiences of power, access, and biases for Black athletes. The content analysis yielded two patterns, where concussion care decisions are influenced by (1) biased, unconscious beliefs that posit Black athletes as uniquely invincible to injury and pain, and (2) inadequate access to concussion knowledge and resources, which both moderate SRC injury risk, diagnosis, recovery and outcomes. Ultimately, our novel framework provides a clear thread on how historical, macro-level policy and perceptions can impact micro-level clinical care and decision-making for Black athletes with SRC.

BACKGROUND: Arachnoid cysts (AC) are associated with a risk of rupture or haemorrhage following head impact and pose a potential predisposing factor for significant complications of sport-related concussion. Despite a recognised association between ACs and intracranial haemorrhage/cyst rupture, the risk profile of participating in contact sports with AC is not well defined. We report a retrospective case series of players presenting to the Birmingham Sports Concussion Clinic between 2017 and 2023 and underwent MRI head, with a comprehensive review of the prior literature.
RESULTS: 432 athletes underwent MRI of which 11 were identified to have AC (middle fossa n = 8; posterior fossa n = 2, intraventricular n = 1). Average maximal diameter was 4.1 ± 1.2 cm. 64% had a protracted recovery (≥ 3 months). 9% experienced an AC specific complication (cyst rupture, complete neurological recovery, maximal diameter 6.5 cm, Galassi II, 4 previous concussions). 91% of patients (mean maximal diameter 3.9 ± 1.0 cm) experienced no complications despite multiple previous accumulated sports-related concussions (mean 3.3, range 1-9). Case studies from the literature are summarised (n = 63), with 98% reporting complications, none of which resulted in adverse or unfavourable neurological outcomes. Across prospective and retrospective cohort studies, 1.5% had a structural injury, and (where outcome was reported) all had a favourable outcome.
CONCLUSIONS: AC is an incidental finding in athletes, with the majority in our cohort having sustained serial concussions without AC complication. The single complication within this cohort occurred in the largest AC, and AC size is proposed as a tentative factor associated with increased risk of contact sports participation. Complications of AC appear to be a rare occurrence. This case series and review has not identified evidence to suggest that participation in sports with AC is of significant risk, though individualised assessment and discussion of the potential risks of contact sports participation should be offered.

(1) Background and objectives: Running-related injuries (RRIs) are commonly attributed to improper running posture and overuse. This study aims to analyze the running motions of individuals with and without RRIs using a sensor-free method, which offers a user-friendly and straightforward approach. (2) Materials and Methods: A total of 155 runners were divided into two groups: the normal runner group (runners who had never been injured, n = 50) and the RRI group (runners who had experience at least one injury while running, n = 105). The forward head posture (FHP), trunk lean, hip rotation, horizontal movement of the center of gravity (COG), vertical movement of the COG, pelvic rotation, hip hike, and type of strike were measured for posture analysis. (3) Results: We found that the left-right balance of the pelvis and the spinal posture during running were associated with RRIs. The difference in hip hike and FHP emerged as key predictors of running-related musculoskeletal injury occurrence from our logistic regression analysis. (4) Conclusions: Identifying pathological movements in runners through running motion analysis without the use of sensors can be instrumental in the prevention and treatment of RRIs.

UNASSIGNED: Pickleball\'s surging popularity has driven an increase in injuries presenting to medical providers. This study seeks to describe the epidemiology of pickleball foot and ankle injuries including patient demographics, diagnoses, and mechanism of injury.
UNASSIGNED: A retrospective review from our institutional database identified patients treated in the foot and ankle clinic whose medical records included the search terms \"pickleball\" and \"pickle ball.\" Only injuries sustained while playing pickleball were included. Patient demographics, diagnosis, mechanism of injury, and treatment were collected. Injury incidence and descriptive analyses were calculated.
UNASSIGNED: A total of 198 patients with pickleball foot and ankle injuries were identified. The incidence of injuries increased 6.5-fold from 2019 to 2023. The mean age of patients was 58.3 years (SD = 12.2). Most patients were male (58.6%) and reported a traumatic injury (77.8%). The most common diagnosis was Achilles tendon rupture (39.4%). The most common mechanisms of injury were running or lunging forward (30.9%), planting the foot (16.5%), and inverting the foot and ankle (15.5%). Most injuries were treated nonoperatively (71.2%); however, 62.8% of Achilles tendon ruptures were treated surgically.
UNASSIGNED: The incidence of pickleball foot and ankle injuries increased dramatically from 2015 to 2023. Injuries occurred more frequently in older, male patients, with Achilles tendon rupture being the most common diagnosis.

UNASSIGNED: Metatarsal stress fracture is common in people engaged in repetitive weight-bearing activities, especially athletes and recruits. Identifying risk factors in these contexts is crucial for effective prevention.
UNASSIGNED: A systematic search on Web of Science, PubMed, EBSCO, SPORTDiscus, MEDLINE, and Cochrane Library was conducted and the date range for the retrieval was set from January 1984 to April 2024.
UNASSIGNED: 32 eligible studies were selected from 1,728 related research. Anatomical and biomechanical factors, such as higher foot arch, abnormal inversion/eversion of foot, and longer metatarsal length or larger angles, relatively influence stress fracture risk. However, given that there is no standardized measurement, the results remain to be examined. Soccer is associated with fifth metatarsal fractures, while long-distance running and recruit training often lead to fractures of the second or third metatarsals. High exercise intensity, non-adaptive training, and inadequate equipment heighten fracture risk.
UNASSIGNED: This review highlights the complex interplay of anatomical, biomechanical, and sports-related factors in the risk of metatarsal stress fractures. Relatively, high arches, specific metatarsal morphologies, and foot inversion/eversion patterns are significant risk factors, particularly among athletes. Sports type also correlates with metatarsal stress fracture locations. Despite extensive research, study heterogeneity and inherent biases necessitate cautious interpretation. Comprehensive, multifactorial approaches and personalized injury prevention strategies are essential for reducing the incidence of these injuries and improving the health and performance of athletes.

BACKGROUND: Literature suggests a high prevalence of mental health disorders among athletes practicing elite and extreme sports. One of the most commonly encountered disorders in this group of individuals is depression.
OBJECTIVE: The aim of this study was to examine the prevalence, severity, and risk factors of symptoms of self-reported depression among ultra-distance runners.
METHODS: Data was collected using an online survey (February to April 2023) and included 265 (age 48.35 ± 10.52 years) adult ultra-runners. The Beck Depression Inventory-II (BDI-II) was used to measure self-reported depression. Additional variables comprised basic sociodemographic information and information regarding training, ultramarathon experience, and previous injury. Descriptive and interferential statistics were performed using JASP Version 0.16.4.
RESULTS: We found that 21.9 % (n = 58) of ultra-runners suffered from self-reported depression (i.e., BDI-II score ≥ 14) with an average BDI-II score of 22.7 ± 7.1 (moderately severe symptoms). Female ultra-runners had a higher prevalence (30.8 %) of self-reported depression than males (16.2 %, p = .001). Logistic regression revealed that ultra-runners without previous sports injury (p = .01) and those of increasing age (p = .003) had a significantly lower risk of self-reported depression. Similarly, linear regression showed the absence of injury (p < .001) and increasing age (p = .02) resulted in significantly lower BDI-II scores. Training volume in distance and hours per week as well as ultra-running experience did not show any significant association.
CONCLUSIONS: Affecting more than one-fifth of our collective, depressive symptoms appear to be highly prevalent among ultra-runners. Our findings underline the importance of screening for clinical depression, especially among injured athletes. However, the previously assumed peculiarities of the sport in the area of high training volume do not appear to be a significant factor.

OBJECTIVE: Adolescent wrestlers undergo intense physical combat. While guidelines are effective in keeping the sport safer, concerns specific to the adolescent wrestler may be missed at primary care visits without knowledge of the unique challenges faced by these athletes. The following review highlights important characteristics of the adolescent wrestler which are of interest to primary care providers.
RESULTS: Recommendations for concussion management are evolving to gradual return-to-sport after physician clearance rather than total sport removal. Prolonged skin-to-skin contact also places athletes at greater risk of dermatologic infections, which often require removal from competition, treatment, and/or coverage. Finally, adolescent nutritional literature recommends limiting pre-match weight loss to 3-5% body weight due to noted kidney damage that may result from larger deficits. Adolescent wrestlers are more prone to acute injuries than chronic overuse injuries, with most injuries occurring above the trunk. Primary care providers should consider obtaining imaging to rule out severe injuries or referring to specialist providers. Current guidelines for skin infections require frequent pre-match skin checks and mandatory waiting periods when certain infections are identified. However, the primary care provider is well-equipped for more in-depth skin examination, discussion of skin hygiene, and appropriate treatment of skin infections. Athletes attempting to meet lower weight classes may put themselves at risk of acute kidney damage, under-fueling, and eating disorders. Current guidelines attempt to mitigate excessive weight changes in the adolescent wrestler during competition season, but primary care providers should emphasize healthier methods of weight fluctuation and look for indicators of physiological or psychological effects.

UNASSIGNED: While several clinical factors have independently been linked to anterior cruciate ligament (ACL) injury risk factors, their collective impact on knee loading during the sidestep maneuver is unknown. To better understand these factors, we assessed the relationship between strength, balance, and sprint kinetics and external knee abduction moments during sidestepping on each leg.
UNASSIGNED: Sixteen male academy-level rugby union athletes (age, 20 ± 3 years; body-height, 186 ± 9 cm; body-mass, 99 ± 14 kg) were bilaterally assessed in single-leg: isokinetic concentric and eccentric knee and concentric hip strength, balance at 2 difficulty levels, vertical and horizontal force production during maximal sprinting, and 3-dimensional motion capture while sidestepping on the preferred and non-preferred leg. A hierarchical multiple regression analysis based on this theoretical approach of the mechanics of ACL injury risk was performed.
UNASSIGNED: When sidestepping on the preferred leg, larger abduction moments were explained by less concentric hip extension strength and vertical force production during maximal sprinting (R 2 = 41%; ES = 0.64); when sidestepping on the non-preferred leg, larger abduction moments were explained by more concentric hip flexion strength (R 2 = 8%; ES = 0.29). Larger symmetry scores between the legs (representing greater abduction moments) were explained by more horizontal force production during maximal sprinting and less eccentric knee flexion strength (R 2 = 32%; ES = 0.56).
UNASSIGNED: Independently, the preferred and non-preferred legs contribute to increased knee abduction moments via unique distributions of strength and/or sprint kinetics. The allocations of strength and sprint kinetics appear interrelated through weaker posterior muscular strength and may be modifiable through a targeted strength training approach.

UNASSIGNED: Acromioclavicular joint (ACJ) injury is a common orthopaedic condition accounting for over 40 % of all shoulder injuries. The purpose of this study is to assess the research trends and characteristics of the top 50 cited articles on ACJ instability.
UNASSIGNED: A systematic search was conducted in Web of Science to identify articles primarily related to ACJ injury or instability. Characteristics including citation number, country of origin, journal and institution of publication, impact factor, authorship, level of evidence, patient demographics, and study type were analyzed and recorded.
UNASSIGNED: Research output on ACJ instability has been steadily increasing, with the top 50 cited studies predominantly presenting Level IV evidence. These studies primarily focused on treatment outcomes which included predominantly male patients and exhibited a large variation in citation counts. The American Journal of Sports Medicine was the most productive journal, and the USA was the most productive nation.
UNASSIGNED: There is an increasing number of publications in the ACJ instability literature, primarily concentrated in a few institutions and journals, and focusing mainly on treatment outcomes. A significant portion of these publications are of low scientific quality, and there is a notable lack of research on outcomes for females.

OBJECTIVE: We aimed to investigate the effects of ankle taping on lower extremity biomechanics related to injury development and how these effects change after sports-specific use.
METHODS: Randomized, repeated measures design with three conditions: Barefoot, tape applied fresh, and tape after sports-specific use (between-subject factor: sex).
METHODS: Twenty-five healthy participants (ten female) performed sports-specific movements, including running, drop jumping, and 180° change of direction, under the three conditions. Kinetic and kinematic data were collected using 3D motion capturing and force platforms.
RESULTS: Tape applied fresh and tape after sports-specific use significantly reduced peak ankle inversion. Biomechanical risk factors for anterior cruciate ligament or running overuse injuries were either unchanged or decreased with tape applied fresh, except for the peak loading rate of the resultant ground reaction force, which increased between 4% and 18% between movement types. After 15 minutes of sports-specific use of the tape, the alterations induced by tape applied fresh remained for some biomechanical risk factors while they became closer to barefoot again for others, indicating a differential response to prolonged use of taping for different biomechanical variables.
CONCLUSIONS: Ankle taping protects the ankle joint by reducing biomechanical risk factors associated with ankle sprains, and most biomechanical risk factors for anterior cruciate ligament or running overuse injuries are not increased. Further research is needed to explore the duration of protective effects, variations across sports, and its impact on patients with chronic ankle instability, contributing to a more comprehensive understanding of ankle taping\'s influence on lower extremity biomechanics.