Longitudinal Quantitative Ultrasonic Analysis of Patellar Tendon in a Collegiate Athlete After Bilateral Debridement: A Case Report.

CONTEXT: A National Collegiate Athletic Association Division I female basketball athlete (age = 20 years, height = 190.5 cm, mass = 87 kg) had chronic patellar tendinopathy. INTERVENTION(S): After undergoing unsuccessful conservative treatments, the athlete underwent bilateral open patellar debridement surgery. Pain and dysfunction were assessed via the Victorian Institute of Sport-P (VISA-P) score with concurrently collected B-mode ultrasound images of the patellar tendon throughout a 12-month rehabilitation. RESULTS: Peak spatial frequency radius (PSFR), a quantitative ultrasound measure previously shown to be correlated with collagen organization, was compared with changes in VISA-P scores. Overall increases in PSFR values across 0°, 30°, 60°, and 90° of knee flexion were observed throughout recovery. Despite increased PSFR values and returning to sport, the athlete reported substantial pain. CONCLUSIONS: In this level 3 exploration case report, we provide novel insight into ultrasonically measured structural changes of the patellar tendon after surgery and during rehabilitation of an athlete with chronic tendinopathy. Perceived pain measurements were not necessarily related to structural adaptations.

Predicting Bobsled Pushing Ability From Various Combine Testing Events.

Tomasevicz, CL, Ransone, JW, and Bach, CW. Predicting bobsled pushing ability from various combine testing events. J Strength Cond Res 34(9): 2618-2626, 2020-The requisite combination of speed, power, and strength necessary for a bobsled push athlete coupled with the difficulty in directly measuring pushing ability makes selecting effective push crews challenging. Current practices by USA Bobsled and Skeleton use field combine testing to assess and identify specifically selected performance variables in an attempt to best predict push performance abilities. Combine data consisting of 11 physical performance variables were collected from 75 subjects across 2 winter Olympic qualification years (2009 and 2013). These variables were sprints of 15, 30, and 60 m, a flying 30-m sprint, a standing broad jump, a shot toss, squat, power clean, body mass, and dry-land brake and side bobsled pushes. Discriminant analysis (DA) in addition to principle component analysis (PCA) was used to investigate 2 cases (case 1: Olympians vs. non-Olympians; case 2: National Team vs. non-National Team). Using these 11 variables, DA led to a classification rule that proved capable of identifying Olympians from non-Olympians and National Team members from non-National Team members with 9.33 and 14.67% misclassification rates, respectively. The PCA was used to find similar test variables within the combine that provided redundant or useless data. After eliminating the unnecessary variables, DA on the new combinations showed that 8 (case 1) and 20 (case 2) other combinations with fewer performance variables yielded misclassification rates as low as 6.67 and 13.33%, respectively. Using fewer performance variables can allow governing bodies in many other sports to create more appropriate combine testing that maximize accuracy while minimizing irrelevant and redundant strategies.

Effect of manual compressive therapy on latent myofascial trigger point pressure pain thresholds.

OBJECTIVE: This study compared the effects of 90 s of manual compressive therapy (MCT) on latent myofascial trigger points (LTPs) for 3 sessions per week for 4 weeks to determine changes in individual pressure pain threshold (PPT). A total of 30 (15 males, 15 females; age = 22 ±â€¯4 y/o, height = 175 ±â€¯18 cm, weight = 162.5 ±â€¯57.5 kg) symptomatic subjects with LTPs volunteered for the study. METHODS: PPT was measured at baseline and pre- and post-treatment for all 12 sessions with a pressure algometer across the 4-week treatment time frame. The MCT was applied to the control group on their LTP at pressure intended to provide a sham condition (1/10 on verbalized analog scale (VAS)). Two experimental groups had MCT applied either directly on the LTP (d-TP) or in close-proximity to their LTP (cp-TP) at moderate pressure (7/10 on VAS). RESULTS: There was a significant increase in PPT from the first through twelfth treatment sessions (p < 0.001, partial η2 = 0.914). A significant increase in PPTs between treatment groups was acutely observed from pre- to post-therapy tests (p = 0.001, partial η2 = 0.146). The differences between pre- versus post-treatment PPT measures indicated significant differences (d-TP vs. control, p < 0.001; cp-TP vs. control, p = 0.007). No differences were observed between experimental groups (p = 0.215). CONCLUSIONS: PPT continued to increase after several weeks of MCT when applied directly on or within 2.5 cm of an identified LTP compared to control.

National Athletic Trainers' Association position statement: evaluation of dietary supplements for performance nutrition.

OBJECTIVES: To help athletic trainers promote a "food-first" philosophy to support health and performance, understand federal and sport governing body rules and regulations regarding dietary supplements and banned substances, and become familiar with reliable resources for evaluating the safety, purity, and efficacy of dietary supplements. BACKGROUND: The dietary supplement industry is poorly regulated and takes in billions of dollars per year. Uneducated athletes need to gain a better understanding of the safety, eligibility, and efficacy concerns associated with choosing to take dietary supplements. The athletic trainer is a valuable athletic team member who can help in the educational process. In many cases, athletic trainers are asked to help evaluate the legality, safety, and efficacy of dietary supplements. For this position statement, our mission is to provide the athletic trainer with the necessary resources for these tasks. RECOMMENDATIONS: Proper nutrition and changes in the athlete's habitual diet should be considered first when improved performance is the goal. Athletes need to understand the level of regulation (or lack thereof) governing the dietary supplement industry at the international, federal, state, and individual sport-participation levels. Athletes should not assume a product is safe simply because it is marketed over the counter. All products athletes are considering using should be evaluated for purity (ie, truth in labeling), safety, and efficacy.

Descriptive epidemiology of collegiate men's wrestling injuries: National Collegiate Athletic Association Injury Surveillance System, 1988-1989 through 2003-2004.

OBJECTIVE: To review 16 years of National Collegiate Athletic Association (NCAA) injury surveillance data for men's wrestling and identify potential areas for injury prevention initiatives. BACKGROUND: From 1988-1989 through 2003-2004, 17% of NCAA schools sponsoring varsity men's wrestling programs participated in annual Injury Surveillance System (ISS) data collection. MAIN RESULTS: Patterns of injury were consistent with the person-to-person, combative contact between wrestlers. The musculoskeletal system and head were the most vulnerable areas during competitions; skin infections are a continuing concern in the practice environment. The incidence of injuries in practices exhibited no significant increase over time, a positive trend that may be consistent with the influence of the recent NCAA weight management rules. RECOMMENDATIONS: Expansion of the present ISS to include indirect causes of injury, such as weight loss practices, would strengthen the analysis of data. Efforts by referees to be vigilant for potentially dangerous holds and by athletic trainers to improve wrestler and mat hygiene should be continued.

Physical activity and its relationship to rodeo injury and success.

The purpose of this study was to determine the interrelationship among physical activity, injury, and success of rodeo athletes. Seventy-two male Professional Rodeo Cowboys' Association members served as participants and were grouped into timed, steer-wrestling, saddle-bronc, bareback, bull-riding, and multiple rough-stock events. Participants completed demographic and overall physical activity questionnaires. Sixty-two percent of the subjects participated in regular exercise for a minimum of 2 days per week. Pearson bivariate correlation coefficients revealed weak correlations (r = 0.151, -0.188, and -0.074; p > 0.05) among metabolic (MET) level, earnings rate, and injury rate. A 1-way between-subjects analysis of variance indicated no differences in MET level among groups. Physical activity did not affect performance or injury rate, and competitors in various events did not have different levels of energy expenditure. Therefore, rodeo sports-medicine personnel should encourage athletes to engage in other sport-specific training activities to help prevent rodeo injuries.

Body-Weight Fluctuation in Collegiate Wrestlers: Implications of the National Collegiate Athletic Association Weight-Certification Program.

OBJECTIVE: To determine fluctuations in total body weight of the elite collegiate wrestler during the competitive season. DESIGN AND SETTING: The study period lasted 2 competitive seasons, beginning 1 month before the 1999-2000 and 2000- 2001 competitive seasons and ending 1 month after the National Championships. SUBJECTS: Seventy-eight male subjects (age = 21.3 +/- 1.5 years, height = 154.1 +/- 0.5 cm) from 4 major universities whose teams finished in the top 5 at both the 2000 and 2001 National Collegiate Athletic Association Division I National Wrestling Championships. MEASUREMENTS: Each subject was asked to report to the testing area 24 hours before, 1 hour before, and 24 hours after a competitive wrestling match, and weight was recorded to the nearest 0.1 lb (0.45 kg). Comparisons among the prematch weights, official weigh-ins, and postmatch weights were made using a randomized, 1-group, repeated-measures factorial analysis of covariance with an alpha level of.05. RESULTS: A significant difference (F(2,154) = 229.99, P <.0001) existed in subjects' weights 24 hours (73.93 +/- 11.62 kg) and 1 hour (72.53 +/- 11.66 kg) before a competitive match and 24 hours after (73.65 +/- 13.58 kg) a competitive match. Additionally, we computed 2 t tests to determine the difference among weight changes 24 hours and 1 hour before and 24 hours after a competitive wrestling match. A significant difference was noted between body-weight changes 24 hours and 1 hour before the match (t(77) = 56.21, P <.0001). CONCLUSIONS: Elite collegiate wrestlers, like novice wrestlers, significantly reduce weight immediately before and gain weight after the competition.

The effect of beta-hydroxy beta-methylbutyrate on muscular strength and body composition in collegiate football players.

This study assesses the effects of daily beta-hydroxy beta-methylbutyrate (HMB) supplementation on muscular strength (bench press, squats, and power cleans) and body composition (body weight and body fat) among collegiate football players undergoing a strenuous exercise program. Subjects were collegiate football players (n = 35) training under the supervision of certified strength coaches averaging 20 hours of weekly exercise. In the first supplementation period, 16 of the 35 subjects were supplemented with 3 g of HMB per day for 4 weeks; the other 19 received a placebo followed by a 1-week washout period and then a second supplementation period in a randomized double-blind crossover, placebo design. There were no significant changes (p > 0.05) in muscular strength, including bench press, squats, and power cleans, among the subjects. There were also no significant changes (p > 0.05) in body composition, including body fat and body weight. Very little clinical evidence exists for supplementing HMB in athletic populations.