Associations Between Initial Clinical Examination and Imaging Findings and Return-to-Sport in Male Athletes With Acute Adductor Injuries: A Prospective Cohort Study.

BACKGROUND: Time to return-to-sport (RTS) after acute adductor injuries varies among athletes, yet we know little about which factors determine this variance. PURPOSE: To investigate the association between initial clinical and imaging examination findings and time to RTS in male athletes with acute adductor injuries. STUDY DESIGN: Cohort study (Prognosis); Level of evidence, 2. METHODS: Male adult athletes with an acute adductor injury were included within 7 days of injury. Standardized patient history and clinical and magnetic resonance imaging (MRI) examinations were conducted for all athletes. Athletes performed a supervised standardized criteria-based exercise treatment program. Three RTS milestones were defined: (1) clinically pain-free, (2) completed controlled sports training, and (3) first full team training. Univariate and multiple regression analyses were performed to determine the association between the specific candidate variables of the initial examinations and the RTS milestones. RESULTS: We included 81 male adult athletes. The median duration for the 3 RTS milestones were 15 days (interquartile range, 12-28 days), 24 days (16-32 days), and 22 days (15-31 days), respectively. Clinical examination including patient history was able to explain 63%, 74%, and 68% of the variance in time to RTS. The strongest predictors for longer time to RTS were pain on palpation of the proximal adductor longus insertion or a palpable defect. The addition of MRI increased the explained variance with 7%, 0%, and 7%. The strongest MRI predictor was injury at the bone-tendon junction. Post hoc multiple regression analyses of players without the 2 most important clinical findings were able to explain 24% to 31% of the variance, with no added value of the MRI findings. CONCLUSION: The strongest predictors of a longer time to RTS after acute adductor injury were palpation pain at the proximal adductor longus insertion, a palpable defect, and/or an injury at the bone-tendon junction on MRI. For athletes without any of these findings, even extensive clinical and MRI examination does not assist considerably in providing a more precise estimate of time to RTS.

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Boys' Lacrosse (2008-2009 Through 2013-2014) and National Collegiate Athletic Association Men's Lacrosse (2004-2005 Through 2013-2014).

CONTEXT: The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of boys' and men's lacrosse injury data. OBJECTIVE: To describe the epidemiology of injuries sustained in high school boys' lacrosse in the 2008-2009 through 2013-2014 academic years and collegiate men's lacrosse in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance. DESIGN: Descriptive epidemiology study. SETTING: Online injury surveillance from lacrosse teams of high school boys (annual average = 55) and collegiate men (annual average = 14). PATIENTS OR OTHER PARTICIPANTS: Boys' and men's lacrosse players who participated in practices and competitions during the 2008-2009 through 2013-2014 academic years in high school or the 2004-2005 through 2013-2014 academic years in college. MAIN OUTCOME MEASURE(S): Athletic trainers collected time-loss (≥24 hours) injury and exposure data. Injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), and injury proportions by body site and diagnosis were calculated. RESULTS: High School Reporting Information Online documented 1407 time-loss injuries during 662 960 AEs. The National Collegiate Athletic Association Injury Surveillance Program documented 1882 time-loss injuries during 390 029 AEs. The total injury rate from 2008-2009 through 2013-2014 was higher in college than in high school (3.77 versus 2.12/1000 AEs; IRR = 1.78; 95% CI = 1.63, 1.94). Most injuries occurred during competitions in high school (61.4%) and practices in college (61.4%). Injury rates were higher in competitions compared with practices in high school (IRR = 3.59; 95% CI = 3.23, 4.00) and college (IRR = 3.38; 95% CI = 3.08, 3.71). Lower limb injuries, muscle strains, and ligament sprains were common at both levels. Concussion was the most frequent competition diagnosis for all high school player positions. CONCLUSIONS: Rates of time-loss injury were higher in college versus high school and in competitions versus practices. Attention to preventing common lower leg injuries and concussions, especially at the high school level, is essential to decrease their incidence and severity.

Risk factors for hamstring injuries in Australian male professional cricket players.

BACKGROUND: Injuries to the hamstring are relatively common in professional cricketers (as they are in many team sports) and have increased in incidence in the "T20 era" (introduction of 20-over matches) of cricket since 2006. METHODS: This study analyzed incidence of hamstring injury in the various elite male match types over a 20-year period (1995-1996 to 2014-2015 seasons). Risk factors for hamstring strain were assessed using a multivariate logistic regression analysis technique. RESULTS: There were 276 match time-loss hamstring injuries recorded over a 20-year period at the Australian state or national player level, of which 170 occurred in one of 40,145 player match sets. The overall rate of match onset rate was 22.5 hamstring injuries per 1000 team days. Fast bowling onset injuries were the highest subcategory at a rate of 10.9 injuries per 1000 team days, although batting onset injuries were particularly common in 50-over (one day) international matches. Significant risk factors in logistic regression analysis, in addition to hamstring injury history, were being a fast bowler relative risk (RR) 2.5 (95% confidence interval (CI): 1.3-4.5) and playing a match in Australia RR 2.3 (95%CI: 1.3-3.9). CONCLUSION: Fast bowlers suffer more hamstring injuries than other playing roles in cricket, particularly in First Class (multi-day) cricket. Batsmen are more likely to get injured in 50-over (one day) cricket. Playing in Australia (compared to overseas venues) leads to increased risk of hamstring injury.