No baseline strength differences between female recreational runners who developed an injury and injury free runners during a 16-week formalized training program.

OBJECTIVE: To identify whether baseline differences in hip and knee isometric strength exist among female runners who sustained a running related injury (RRI) and those that remained injury-free during a 16-week formalized training program. DESIGN: Prospective Cohort. SETTING: Laboratory Setting. PARTICIPANTS: 54 healthy female recreational runners enrolled in a formalized training program for half or full marathon. At the conclusion of the program, 50 female runners (age: 39.1 ±â€¯9.4 years; height: 165.3 ±â€¯7.4 cm; mass: 64.8 ±â€¯11.9 kg) were included in analysis. MAIN OUTCOME MEASURES: Peak isometric torque of knee flexion and extension, hip flexion and extension, and hip abduction and external rotation were compared between runners who sustained an RRI and injury-free (INJF) runners. RESULTS: 15 of the 50 participants developed an RRI during the observational period, no between groups differences existed for any demographic variable. Hip and knee isometric strength was not different prior to the start of a 16-week formalized training program between runners who sustained an RRI and those that remained injury-free. CONCLUSIONS: Hip and knee weakness does not appear to be a baseline characteristic among female recreational runners who sustained an RRI or remained uninjured while training for a half or full marathon.

ACUTE LATERAL ANKLE SPRAIN PREDICTION IN COLLEGIATE WOMEN'S SOCCER PLAYERS.

BACKGROUND: Women's soccer has among the highest injury rates in collegiate sports, and lateral ankle sprains (LAS) are among the most commonly occurring injuries in that athletic population. However, no established LAS prediction model exists for collegiate women's soccer players.The purpose of this study was to develop a prediction model for acute LAS injuries in collegiate women's soccer players utilizing previous ankle sprain history, height, mass, and BMI as potential predictors.The authors' hypothesized that collegiate women's soccer players with greater height, mass, and body mass index (BMI), as well as a previous history of ankle sprain would have greater odds of sustaining a LAS. STUDY DESIGN: Prospective cohort study. METHODS: Forty-three NCAA Division I women's soccer players' (19.7 ± 1.1yrs, 166.8 ± 3.7cm, 60.8 ± 4.4kg) height, mass, and BMI were measured one week before beginning preseason practices. Additionally, participants reported whether or not they had sustained a previous ankle sprain. The team athletic trainer tracked LASs over the competitive season. Independent t-tests, binary logistic regression analyses, receiver operating characteristic (ROC) curves, and diagnostic statistics assessed the ability of the variables to differentiate between those that did and did not sustain a LAS. RESULTS: Participants that sustained a LAS (n = 8) were significantly taller than those that did not sustain a LAS (n = 35) (t41 = -2.87, p = 0.01, d = 0.83[0.03,1.60]). A logistic regression analysis (odds ratio=1.30[1.00,1.70]) and area under the ROC curve analysis (AUROC=0.73[0.58,0.89], p=0.04) further exhibited predictive value of height. A height cutoff score of 167.6cm demonstrated excellent sensitivity (0.88), moderate specificity (0.51), and a favorable diagnostic odds ratio (7.5). A logistic regression analysis (odds ratio=1.87[1.22,1.98]) exhibited predictive value of previous ankle sprain history. That variable was also associated with good sensitivity (0.75) and specificity (0.71) within the model, as well as a favorable DOR (7.37). Mass and BMI demonstrated no predictive value for LAS. CONCLUSION: Taller collegiate women's soccer players and those with previous ankle sprain history may have a greater predisposition to LAS. LEVEL OF EVIDENCE: 1b.

Associations Between Functional and Isolated Performance Measures in College Women's Soccer Players.

CONTEXT: The Star Excursion Balance Test (SEBT) and Functional Movement Screen (FMS) are functional performance measures capable of predicting lower-extremity injury risk. While suboptimal SEBT and FMS performances are influenced by multiple factors, the contribution of hip strength and flexibility to these tests is mostly unknown. Examination of hip strength and flexibility influences on the SEBT and FMS may direct clinicians to better methods of correcting functional deficits. OBJECTIVE: Determine the relationships of isometric hip strength and hip passive range of motion (PROM) with functional performance measures. DESIGN: Cross-sectional. SETTING: Athletic training facility. PARTICIPANTS: 43 NCAA Division I women's soccer players (19.65 ± 1.12 y; 166.93 ± 3.84 cm; 60.99 ± 4.31 kg) volunteered. DATA COLLECTION AND ANALYSIS: All participants were tested bilaterally in the SEBT; the deep squat, in-line lunge, hurdle step, and straight leg raise, comprising a lower-extremity FMS (FMS-LE); hip internal and external rotation PROM; and isometric hip extension strength (HEXT). The mean of the 3 averaged, normalized SEBT scores was used as a composite score. Pearson product moment correlations assessed relationships of SEBT and FMS-LE scores with PROM and HEXT. Significance was set a priori at P < .05. RESULTS: Pearson correlations revealed anterior (ANT) SEBT scores had a low negative association with HEXT (r = -0.33,P = .004) and a low positive association with hip internal rotation PROM (PROM-IR) (r = .43,P = .003). All other correlations were negligible. CONCLUSIONS: Flexibility training aimed at PROM-IR may contribute to improved ANT scores. Targeting HEXT and hip external rotation PROM are likely not preferred means of correcting deficits in SEBT and FMS-LE performance.

Prediction of Lateral Ankle Sprains in Football Players Based on Clinical Tests and Body Mass Index.

BACKGROUND: The lateral ankle sprain (LAS) is the most common injury suffered in sports, especially in football. While suggested in some studies, a predictive role of clinical tests for LAS has not been established. PURPOSE: To determine which clinical tests, focused on potentially modifiable factors of movement patterns and body mass index (BMI), could best demonstrate risk of LAS among high school and collegiate football players. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: A total of 539 high school and collegiate football players were evaluated during the preseason with the Star Excursion Balance Test (SEBT) and Functional Movement Screen as well as BMI. Results were compared between players who did and did not suffer an LAS during the season. Logistic regression analyses and calculated odds ratios were used to determine which measures predicted risk of LAS. RESULTS: The LAS group performed worse on the SEBT-anterior reaching direction (SEBT-ANT) and had higher BMI as compared with the noninjured group (P < .001). The strongest prediction models corresponded with the SEBT-ANT. CONCLUSION: Low performance on the SEBT-ANT predicted a risk of LAS in football players. BMI was also significantly higher in football players who sustained an LAS. Identifying clinical tools for successful LAS injury risk prediction will be a critical step toward the creation of effective prevention programs to reduce risk of sustaining an LAS during participation in football.

Variations in Star Excursion Balance Test Performance Between High School and Collegiate Football Players.

The Star Excursion Balance Test (SEBT) is a reliable inexpensive tool used to assess dynamic postural control deficits and efficacy in the prediction of musculoskeletal injuries, but with little previous consideration for performance differences across age and skill levels. The purpose of this study was to examine differences in SEBT scores between high school and collegiate football players. Three-hundred eighteen high school football players and 180 National Collegiate Athletic Association Division I collegiate football players volunteered to participate. Star Excursion Balance Test scores were obtained bilaterally for anterior (ANT), posterolateral (PL), and posteromedial (PM) directions, and for an overall composite (COMP) score. The mean of 3 trials from each leg was normalized to stance leg length and presented as a percentage score. Bilaterally averaged scores were compared between high school and collegiate football players using separate independent t-tests. A multiple linear backward regression determined the amount of variance in SEBT scores explained by age, mass, and height. Compared with collegiate athletes, high school athletes had lower PL (72.8 ± 11.4% vs. 77.1 ± 10.2%; p < 0.001), PM (83.5 ± 10.2% vs. 86.7 ± 10.7%; p = 0.001), and COMP (75.4 ± 8.5% vs. 78.0 ± 7.4%; p = 0.001) scores. Anterior scores did not differ between high school (69.9 ± 7.9%) and collegiate (70.3 ± 7.1%) athletes (p = 0.545). Age, mass, and height were not meaningful contributors to ANT (R = 0.089; p < 0.001), PL (R = 0.032; p < 0.001), PM (R = 0.030; p = 0.002), and COMP (R = 0.048; p < 0.001) variances. Disparity between high school and collegiate athletes should be considered when using the SEBT to identify risk of or deficits related to lower extremity injury in football players.