Normative values for internal and external glenohumeral rotation strength in rugby players: A systematic review with meta-analysis.

This systematic review aims to provide normative values for internal and external glenohumeral rotation strength in rugby players. From the inception to March 2021, the search strategy was (strength OR torque) AND shoulder AND rugby using PubMed, Scopus, Web of Science, and SPORTDiscus databases, with no language restrictions. This systematic review includes 15 articles involving 573 rugby players and presenting internal or external glenohumeral rotation strength values. Two main methods are used to assess glenohumeral rotation strength in rugby players: isokinetic and isometric methods; in the isometric method, the upper arm is abducted at either 0° or 90°. Owing to differences in isokinetic procedures and a lack of studies assessing isometric strength when the upper arm is in a neutral position, normative internal or external glenohumeral rotation strength values are only provided for isometric contractions when the upper arm is abducted at 90° based on 311 shoulders of 163 male rugby union players, with 2.04 ± 0.15 N.kg-1 and 2.11 ± 0.13 N.kg-1 for internal and external glenohumeral rotation strength, respectively. These findings may help strength and conditioning coaches and physical therapists, provide objective evidence when deciding whether or not rugby union players should return to sport.

Impact of the national prevention policy and scrum law changes on the incidence of rugby-related catastrophic cervical spine injuries in French Rugby Union.

BACKGROUND AND AIMS: Catastrophic cervical spine injuries are rare in rugby union but require close monitoring. The aim of this study was to analyse the incidence of severe cervical spine injuries and determine the impact of a national prevention programme and new scrum rules implemented by the French Rugby Union. METHODS: A prospective study was performed between 2006 and 2013 including all players affiliated to the French Rugby Union. All cervical spine injuries resulting in death, tetraplegia or a permanent neurological deficit were included. Prevention programmes were implemented from 2007 to 2013 and a change in scrum rules in 2010. To measure the impact of rule changes, results between 2006-2010 and 2010-2013 were compared using a Poisson regression. RESULTS: Altogether, 31 injuries were observed and the mean annual incidence was 1.6 per 100 000 players. There were significantly more injuries in senior players compared to junior players (3.5 vs 0.6 per 100 000 players; CI 95% (2.1 to 4.9) vs (0.1 to 1.0)). Incidence decreased from 1.8 in 2006 to 1.0 per 100 000 players in 2013 (p<0.0001). After 2010, there were significantly fewer injuries during scrums (p=0.02). In contrast, there were significantly more injuries in backs during 2010-2013 compared to 2006-2010 (p=0.003). CONCLUSIONS: The incidence of catastrophic cervical spine injuries has declined in French Rugby Union. The implementation of specific prevention programmes and scrum law changes has notably resulted in a decrease in scrum injuries in forwards. This prospective study should be continued to monitor the future progression of injuries and adapt prevention programmes accordingly.

Meniscal ossicle in a professional soccer player.

Meniscal ossicles are an unusual finding and a rare cause for knee pain. They are often initially diagnosed as a loose body, chondrocalcinosis or meniscal calcification within the knee joint. Few cases have been reported in the literature. We present a case of a meniscal ossicle with an associated femoral cartilage lesion in a healthy 26-year-old male professional soccer player who presented with swelling and pain. The purpose of this article is to discuss the origins, radiological features, clinical symptoms and prognosis of meniscal ossicles.

Isolated posterior cruciate ligament reconstruction: is non-aggressive rehabilitation the right protocol?

INTRODUCTION: Reconstruction Surgery of the posterior cruciate ligament (PCL) has not yet been fully standardized, and associated rehabilitation protocols have not been clearly defined. The aim of this study is to report the results of a consecutive series of patients who underwent the same surgical technique for isolated PCL reconstruction and were submitted to the same specific rehabilitation protocol. A non-aggressive rehabilitation protocol which protects the graft from excess mechanical stress produces satisfying and reproducible clinical and laxity results in the knee. MATERIALS AND METHODS: Our series included 17 patients who underwent single bundle arthroscopic reconstruction of the PCL with an autologous quadriceps tendon graft and who followed the same non-aggressive rehabilitation protocol. All patients were followed up for an average of 30 months (range 12-60 months). The preoperative evaluation and the last follow-up included objective and subjective IKDC scores as well as the Tegner & Lysholm knee scales. The side to side laxity was measured radiologically with the Telos stress testing device. A statistical analysis was performed to compare preoperative and postoperative results. RESULTS: Preoperatively, no patients were classified as A or B on the IKDC objective score. At last follow-up visit, 88.2% of patients were classified as A or B. Average side to side anteroposterior laxity was 11.9 mm (range 8-18) in the preoperative evaluation and 3.8mm (range 1-7) in the final follow-up (p=0.01) The average subjective IKDC score was 37.7 before surgery and 74.7 at last follow-up (p< 0.01). The Tegner & Lysholm scores were significantly improved by surgery. DISCUSSION: Although the results are still less successful than ACL reconstruction, successful PCL reconstruction results were obtained with a standardized single bundle reconstruction technique and an adapted specific postoperative rehabilitation protocol. A non-aggressive rehabilitation protocol can limit postoperative mechanical stress on the graft. TYPE OF STUDY: Retrospective Level IV.

Peak power output predicts rowing ergometer performance in elite male rowers.

The aim of the present study was to test the hypothesis that peak power output (Ppeak) sustained during maximal incremental testing would be an overall index of rowing ergometer performance over 2000 m (P2000), and to study the influence of selected physiological variables on Ppeak. A group of 54 highly trained rowers (31 heavyweight [HW] and 23 lightweight [LW] rowers) was studied. Body mass, maximal oxygen uptake ((.-)VO(2max)), oxygen consumption corresponding to a blood lactate of 4 mmol. l (-1) expressed in percentage of (.-)VO(2max) (V.O (2)La4 %), and rowing gross efficiency (RGE) were also determined during the incremental test. In the whole group Ppeak was the best predictor of P2000 (r = 0.92, p < 0.0001). Body mass (r = 0.65, p < 0.0001), V.O (2max) (r = 0.84, p < 0.0001), (.-)VO 2)La4 % (r = 0.49, p < 0.0001) and RGE (r = 0.35, p < 0.01) were significantly correlated with P2000 as well. To take the influence of body mass into account, (.-)VO(2max) was related to kg (0.57). Ppeak was significantly related to body mass (r = 0.56, p < 0.0001), (.-)VO(2max) x kg (-0.57) (r = 0.63, p < 0.0001), (.-)VO(2)La4 % (r = 0.45, p < 0.001) and RGE (r = 0.34, p < 0.05). Multiple regression analysis indicated that the above parameters taken together explained 82.8 % of Ppeak variation in the whole group. It was also demonstrated that Ppeak was the best predictor of P2000 when LW and HW groups were considered separately. It was concluded that, by integrating the main physiological factors of performance, Ppeak is an overall index of physiological rowing capacity and rowing efficiency in heterogeneous as well as in homogeneous groups. It presents the further advantage of being easily measured in the field.