This month we will look at three studies that attempt to answer questions on specific sports injuries and how they affect athletes.
Several common scenarios inevitably occur when dealing with runners. One provides a suggestion to the runner concerning the prognosis of an Achilles tendon problem. Certainly, the distinction between an insertional tendinopathy versus a pure tendinopathy has led to some speculation about evaluation and management. However, the distinction between the histopathological changes of a peritendinitis versus a tendinosis seems to have questionable correlation to clinical signs and symptoms. Further complicating the prognosis prediction is whether findings on palpation, such as tenderness, nodules or swelling, have any bearing on future pain or dysfunction.
This current study takes a look at the natural history of tendinopathy (insertional tendinitis was excluded whenever it was identified). Following 83 patients over eight years gives a glimpse into some possible characteristics of the long-term status of Achilles tendinopathy patients. Although the distinction between "conservative" versus surgical is made, it is also made clear that conservative measures include a variety of inconsistently applied therapies, including: nonsteroidals; intravenous injections of heparin; local corticosteroid injections; and strength and flexibility exercises, among others. With this limitation in mind, 29 percent of patients went on to surgery, while the remainder opted to not have surgery. For all patients, 84 percent had a full recovery (i.e., back to pre-injury activity level). Ninety-four percent were asymptomatic or had mild pain with strenuous activity.
Not surprisingly, 41 percent of patients developed overuse symptoms in the uninvolved Achilles tendon. Although long-term follow-up demonstrated mild to moderate changes with ultrasonagraphic examination and tenderness and nodules were often found, these findings were poorly correlated to pain or dysfunction. It will be important to determine in future studies who is more likely to require surgery, what types of "conservative" care are most effective, and perhaps develop a better distinction between those at risk for bilateral involvement.
Guskiewicz KM, Weaver NL, Padua DA, Barrett WE Jr. Epidemiology of concussion in collegiate and high school football players. Am J Sports Med 2000;28(5):643-650.
Studies have indicated that the incidence of concussion in high school football was 2.8-3.6 percent, and for collegiate football, 4-4.8 percent annually. This study indicates that the incidence may be higher. The researchers also attempted to identify some of the epidemiological factors related to concussion. There are several categorizations schemes for concussion in use. This study used the Cantu concussion rating scale:
The incidence of concussion at the high school level was 5.6 percent; at the collegiate division III level, the incidence was 5.5 percent. Players who sustained one concussion during the season were three times as likely to sustain a second injury. About 60 percent occurred during games. The most common injury mechanisms were:
Heidt RS, Sweeterman LM, Carlonas RL, et al. Avoidance of soccer injuries with preseason conditioning. Am J Sports Med 2000;28(5):659-662.
The injury rate in soccer for females is thought to be twice that of males. There are many factors that have been suggested, most notably that of conditioning. This study compared the injury rates of a group of female soccer players that were given a protocol called the Frappier Acceleration Training Program.1 This combines sports-specific cardiovascular training; plyometrics; and coordination and strength training. The program was followed for seven weeks by one group of high school female soccer players (42 out of a group of 300), while the control group did not follow this training method. All athletes were followed through two separate seasons. All injuries reported were of the lower extremities, and 61 percent occurred at the knees or ankles. The injury rate for trained athletes was significantly lower than for the untrained group (14 percent versus 34 percent). Although there was also a lower rate of anterior cruciate injury in the trained group, it was not statistically significant.
Reference
When sports chiropractors first appeared at the Olympic Games in the 1980s, it was alongside individual athletes who had experienced the benefits of chiropractic care in their training and recovery processes at home. Fast forward to Paris 2024, where chiropractic care was available in the polyclinic for all athletes, and the attitude has now evolved to recognize that “every athlete deserves access to sports chiropractic."
It is estimated that 61% of patients with CTS avoid taking surgical options due to postoperative complications and costly surgical procedures. Chiropractic care offers a comprehensive and effective treatment for carpal tunnel syndrome, addressing the condition from multiple angles. Recent studies also have unveiled a game-changing adjunct to chiropractic treatments for CTS: nerve flossing.
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
