CPT (P > 0.196 for all time points). Diastolic blood pressure in healthy controls was elevated th... more CPT (P > 0.196 for all time points). Diastolic blood pressure in healthy controls was elevated throughout the CPT and reached a peak increase at 120 seconds (21 ± 4 mmHg, P < 0.001). In concussed athletes, diastolic blood pressure was elevated only at 120 seconds (7 ± 5 mmHg, P = 0.014) of the CPT. CONCLUSIONS: These preliminary data show that recently concussed athletes have a blunted cardiovascular response to the CPT. These data support evidence indicating that concussed patients who are experiencing symptoms have impaired cardiovascular responses to sympathoexcitatory stimuli.
Objectives To identify the prevalence of hip disorders in elite level academy rugby union players... more Objectives To identify the prevalence of hip disorders in elite level academy rugby union players using clinical and radiological investigation comparing findings to active controls. Design Cross-sectional, controlled study. Methods Participants were assessed clinically using validated questionnaire (HAGOS) and physical testing procedures. Active ROM of all hip movements were measured using a goniometer and hipspecific clinical tests including the FABER and the Thomas test examined functional hip motion. Physical tests were compared to age, gender and activity matched controls. The rugby-playing participants underwent dedicated non-arthrographic 3 T MRI imaging of the hip in axial oblique, sagittal and coronal planes to assess anatomical abnormality. Results The rugby cohort had significantly reduced ROM of internal/external rotation, extension and FABER scores compared to the controls. Symptoms were reported by 65% of rugby players (HAGOS symptom score <89.3) versus 15% in controls. There was a 95% prevalence of abnormality on MRI (19 of 20 players); 80% of the elite rugby players had labral pathology, 55% had a cam deformity (45% left sided 30% right-sided) and 25% had either unilateral or bilateral chondral wear. Conclusions The prevalence of abnormality on MRI of the hip is high in rugby players at 95% of study participants. The percentage reporting symptoms was lower at 65% of the cohort although this was significantly higher than (non-rugby) matched controls at 15% of participants. Rugby players demonstrated significantly reduced ROM of the hip compared to controls. Further prospective research is required to investigate the long term sequelae of these findings.
ObjectiveTo investigate the incidence, prevalence, risk factors and morphological presentations o... more ObjectiveTo investigate the incidence, prevalence, risk factors and morphological presentations of low back pain (LBP) in adolescent athletes.DesignSystematic review with meta-analysis.Data sourcesMedline, Embase, CINAHL via EBSCO, Web of Science, Scopus.Eligibility criteria for selecting studiesStudies evaluating the incidence and/or prevalence of LBP in adolescent athletes across all sports.ResultsThere were 80 studies included. The pooled incidence estimate of LBP in adolescent athletes was 11% (95% CI 8% to 13%, I2=0%) for 2 years, 36.0% (95% CI 4% to 68%, I2=99.3%) for 12 months and 14% (95% CI 7% to 22%, I2=76%) for 6 months incidence estimates. The pooled prevalence estimate of LBP in adolescent athletes was 42% (95% CI 29% to 55%, I2=96.6%) for last 12 months, 46% (95% CI 41.0% to 52%, I2=56%) for last 3 months and 16% (95% CI 9% to 23%, I2=98.3%) for point prevalence. Potential risk factors were sport participation, sport volume/intensity, concurrent lower extremity pain, o...
Purpose To synthesise evidence on low back pain (LBP) in adult rowers and to create a consensus s... more Purpose To synthesise evidence on low back pain (LBP) in adult rowers and to create a consensus statement to inform clinical practice. Methods There were four synthesis steps that informed the consensus statement. In step one, seven expert clinicians and researchers established the scope of the consensus statement and conducted a survey of experienced and expert clinicians to explore current practice. In step two, working groups examined current evidence relating to key scope questions and summarised key issues. In step three, we synthesised evidence for each group and used a modified Delphi process to aid in the creation of the overall consensus statements. Finally, in step four, we combined information from step three with the findings of the clinician survey (and with athlete and coach input) to produce recommendations for clinical practice. Results The scope of the consensus statement included epidemiology; biomechanics; management; the athlete's voice and clinical expertise. Prevention and management of LBP in rowers should include education on risk factors, rowing biomechanics and training load. If treatment is needed, non-invasive management, including early unloading from aggravating activities, effective pain control and exercise therapy should be considered. Fitness should be maintained with load management and progression to full training and competition. The role of surgery is unclear. Management should be athlete focused and a culture of openness within the team encouraged. Conclusion Recommendations are based on current evidence and consensus and aligned with international LBP guidelines in non-athletic populations, but with advice aimed specifically at rowers. We recommend that research in relation to all aspects of prevention and management of LBP in rowers be intensified.
ObjectiveTo summarise the evidence for non-pharmacological management of low back pain (LBP) in a... more ObjectiveTo summarise the evidence for non-pharmacological management of low back pain (LBP) in athletes, a common problem in sport that can negatively impact performance and contribute to early retirement.Data sourcesFive databases (EMBASE, Medline, CINAHL, Web of Science, Scopus) were searched from inception to September 2020. The main outcomes of interest were pain, disability and return to sport (RTS).ResultsAmong 1629 references, 14 randomised controlled trials (RCTs) involving 541 athletes were included. The trials had biases across multiple domains including performance, attrition and reporting. Treatments included exercise, biomechanical modifications and manual therapy. There were no trials evaluating the efficacy of surgery or injections. Exercise was the most frequently investigated treatment; no RTS data were reported for any exercise intervention. There was a reduction in pain and disability reported after all treatments.ConclusionsWhile several treatments for LBP in at...
Objective: To investigate the use of the King-Devick (K-D) test for sideline assessment of concus... more Objective: To investigate the use of the King-Devick (K-D) test for sideline assessment of concussive injuries in a New Zealand amateur women's rugby union team. Design: Prospective cohort observational. Methods: All players were K-D tested during pre-season using a tablet (iPad; Apple Inc., Cupertino, CA). Differences in K-D scores and test-retest reliability were calculated for baseline test scores, baseline, and post-injury (concussion) sideline assessment and baseline and post-season testing scores for tests by year and as a combined score. Results: One training-related (0.3 per 1,000 training-hrs) and nine match-related (16.1 per 1,000 match-hrs) concussions were recorded. The K-D post-injury (concussion) sideline test scores were significantly slower than established baseline (-4.4 [-5.8 to-3.4] s; χ2(1)=42.2; p<0.0001; t(9)=-4.0; p=0.0029; d=-0.8). There was good-toexcellent reliability of the K-D test for baseline (ICC: 0.84 to 0.89), post-injury (concussion) sideline assessment (ICC: 0.82 to 0.97) and post-season evaluation (ICC: 0.79 to 0.83). Discussion: By utilising the baseline to post-injury (concussion) assessment comparisons, any player with a post-injury (concussion) assessment slowing of their K-D test time, regardless of whether the player has, or has not had a witnessed insult, should be withheld from any further participation until they are evaluated by a medical professional trained in the management of concussion. Conclusion: This study has provided additional evidence to support the use of the K-D test as a frontline method of assessing concussion given the good to excellent reliability of the test for baseline, sideline assessment and post-season evaluation.
International Journal of Sports Science & Coaching, 2014
Studies reporting on injuries in rugby league have shown that the injury incidence increases as t... more Studies reporting on injuries in rugby league have shown that the injury incidence increases as the participation level increases. To provide pooled estimates for the incidence of rugby league injuries in match and training activities at all levels of performance and by gender. Searches of PubMed, CINHAL, Ovid, MEDLINE, SCOPUS, ScienceDirect and SportDiscus® databases were performed to identify studies published in English prior to November 2012. Bibliographic searches were also carried out without language restrictions. A pooled analysis of published studies which have reported the incidences of rugby league match and/or training injuries. Two reviewers extracted the study characteristics, numerical data and assessed the quality, by adhering to the protocol for systematic review of observational studies (MOOSE). A total of 34 studies (from 1,422 identified in the initial search) were identified that reported data collection of rugby league injuries that met the inclusion criteria. ...
Direct impacts with the head (linear acceleration or pressure) and inertial loading of the head (... more Direct impacts with the head (linear acceleration or pressure) and inertial loading of the head (rotational acceleration or strain) have been postulated as the 2 major mechanisms of head-related injuries such as concussion. Although data are accumulating for soccer and American football, there are no published data for nonhelmeted collision sports such as rugby union. To quantify head impacts via instrumented mouthguard acceleration analyses for rugby union players over a season of matches. Descriptive epidemiology study. Data on impact magnitude and frequency were collected with molded instrumented mouthguards worn by 38 premier amateur senior rugby players participating in the 2013 domestic season of matches. A total of 20,687 impacts >10g (range, 10.0-164.9g) were recorded over the duration of the study. The mean ± SD number of impacts per player over the duration of the season of matches was 564 ± 618, resulting in a mean ± SD of 95 ± 133 impacts to the head per player, per m...
Australian journal of science and medicine in sport, 1997
Evidence with regard to the incidence of injury to forwards and backs in the game of rugby league... more Evidence with regard to the incidence of injury to forwards and backs in the game of rugby league is extremely limited. A four year prospective study of all the injuries from one professional Rugby League club was conducted. All injuries that were received during match play were recorded, and those for forwards and backs compared. Forwards had a higher overall rates of injury than backs (139.4 [124.2-154.6] vs. 92.7 [80.9-104.6] per 1000 player hours, P < 0.00006). Forwards had a higher rate of injuries to all body sites with the exception of the ankle and the 'others' category of injury. They had significantly higher rates for the arm (11.6 [6.9-16.3] vs. 3.9 [1.4-6.4] per 1000 player hours, P = 0.005) and, the head and neck (53.9 [43.9-63.8] vs. 25.0 [18.7-31.4] injuries per 1000 player hours, P < 0.00006). Forwards had significantly more injuries than backs for contusions (17.1 vs. 7.3 per 1000 player hours, z = 2.85, P = 0.0044), lacerations (26.7 vs. 13.8 per 1000...
In 1996, the professional rugby league moved its playing season from the autumn and winter months... more In 1996, the professional rugby league moved its playing season from the autumn and winter months to the spring and summer. To determine whether the change in playing season altered the risk of player injury. Prospectively collected data comparing two cohorts. Injuries incurred by all players in one club during match play were recorded over 9 seasons: 4 winter (138 games) and 5 summer (144 games). Each injury was classified according to site, type, player position, activity at the time of injury, and number of games missed as a result of injury. The total exposure time during this study was 4876 player-hours (winter, 2386, summer, 2490). The relative risk of injury doubled after the move from winter to summer. Winter rugby accounted for 72 injuries, and summer rugby, for 150 injuries. Risk of injury to players in a professional rugby league club greatly increased as a result of changing the playing calendar, possibly as a result of environmental factors. However, other factors, such...
Sport-related concussions are a subset of mild traumatic brain injuries and are a concern for man... more Sport-related concussions are a subset of mild traumatic brain injuries and are a concern for many sporting activities worldwide. To review and update the literature in regard to the history, pathophysiology, recognition, assessment, management and knowledge of concussion. Searches of electronic literature databases were performed to identify studies published up until April 2013. 292 publications focussing on concussion met the inclusion criteria, and so they were quality rated and reviewed. Concussion is hard to recognize and diagnose. Initial sideline assessment via the Sports Concussion Assessment Tool 3 (SCAT3), Child-SCAT3 or King-Devick test should be undertaken to identify athletes with concussion as part of a continuum of assessment modalities and athlete management. Sports medicine practitioners should be cognisant of the definition, extent and nature of concussion, and should work with coaches, athletes and trainers to identify and manage concussions. The most common reason for variations in management of concussion is lack of awareness of-and confusion about-the many available published guidelines for concussion. Future research should focus on better systems and tools for recognition, assessment and management of concussion. Sport participants&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; knowledge of concussion should be evaluated more rigorously, with interventions for sports where there is little knowledge of recognition, assessment and appropriate management of concussion.
Objective To evaluate the MRI findings in the lumbar spines of asymptomatic elite junior tennis p... more Objective To evaluate the MRI findings in the lumbar spines of asymptomatic elite junior tennis players. Materials and Methods The lumbar spine MRI studies of 98 asymptomatic junior elite tennis players (51 male, 47 female) with a mean age of 18 years (age range 11.2-26.3 years; standard deviation 3.1) was reviewed by two consultant musculoskeletal radiologists using consensus opinion. Images were assessed using accepted classification systems. Results Four players (4 %) had no abnormality. Facet joint arthropathy occurred in 89.7 % of the players, being mild in 84.5 % of cases. There were 41 synovial cysts in 22.4 % of the cohort all occurring in the presence of facet arthropathy. Disc degeneration was noted in 62.2 % of players, being mild in 76.2 % of those affected. Disc herniation was noted in 30.6 % of players, with 86.1 % of these being broad based and 13.9 % being focal. There was nerve root compression in 2 %. There were 41 pars interarticularis abnormalities in 29.6 % of patients, 63.4 % of these being grades 1-3. There was grade 1 spondylolisthesis in 5.1 % of players. The prevalence of facet joint arthropathy, disc degeneration, disc herniation and pars interarticularis fracture was lower in female players than in male and lower in the under 16-year-olds compared with the over 20-year-olds. Conclusion There is a significant amount of underlying pathology that would normally go undetected in this group of asymptomatic elite athletes. Whilst these findings cannot be detected clinically, their relevance is in facilitating appropriate prehabilitation to prevent loss of playing time and potentially career-ending injuries.
CPT (P > 0.196 for all time points). Diastolic blood pressure in healthy controls was elevated th... more CPT (P > 0.196 for all time points). Diastolic blood pressure in healthy controls was elevated throughout the CPT and reached a peak increase at 120 seconds (21 ± 4 mmHg, P < 0.001). In concussed athletes, diastolic blood pressure was elevated only at 120 seconds (7 ± 5 mmHg, P = 0.014) of the CPT. CONCLUSIONS: These preliminary data show that recently concussed athletes have a blunted cardiovascular response to the CPT. These data support evidence indicating that concussed patients who are experiencing symptoms have impaired cardiovascular responses to sympathoexcitatory stimuli.
Objectives To identify the prevalence of hip disorders in elite level academy rugby union players... more Objectives To identify the prevalence of hip disorders in elite level academy rugby union players using clinical and radiological investigation comparing findings to active controls. Design Cross-sectional, controlled study. Methods Participants were assessed clinically using validated questionnaire (HAGOS) and physical testing procedures. Active ROM of all hip movements were measured using a goniometer and hipspecific clinical tests including the FABER and the Thomas test examined functional hip motion. Physical tests were compared to age, gender and activity matched controls. The rugby-playing participants underwent dedicated non-arthrographic 3 T MRI imaging of the hip in axial oblique, sagittal and coronal planes to assess anatomical abnormality. Results The rugby cohort had significantly reduced ROM of internal/external rotation, extension and FABER scores compared to the controls. Symptoms were reported by 65% of rugby players (HAGOS symptom score <89.3) versus 15% in controls. There was a 95% prevalence of abnormality on MRI (19 of 20 players); 80% of the elite rugby players had labral pathology, 55% had a cam deformity (45% left sided 30% right-sided) and 25% had either unilateral or bilateral chondral wear. Conclusions The prevalence of abnormality on MRI of the hip is high in rugby players at 95% of study participants. The percentage reporting symptoms was lower at 65% of the cohort although this was significantly higher than (non-rugby) matched controls at 15% of participants. Rugby players demonstrated significantly reduced ROM of the hip compared to controls. Further prospective research is required to investigate the long term sequelae of these findings.
ObjectiveTo investigate the incidence, prevalence, risk factors and morphological presentations o... more ObjectiveTo investigate the incidence, prevalence, risk factors and morphological presentations of low back pain (LBP) in adolescent athletes.DesignSystematic review with meta-analysis.Data sourcesMedline, Embase, CINAHL via EBSCO, Web of Science, Scopus.Eligibility criteria for selecting studiesStudies evaluating the incidence and/or prevalence of LBP in adolescent athletes across all sports.ResultsThere were 80 studies included. The pooled incidence estimate of LBP in adolescent athletes was 11% (95% CI 8% to 13%, I2=0%) for 2 years, 36.0% (95% CI 4% to 68%, I2=99.3%) for 12 months and 14% (95% CI 7% to 22%, I2=76%) for 6 months incidence estimates. The pooled prevalence estimate of LBP in adolescent athletes was 42% (95% CI 29% to 55%, I2=96.6%) for last 12 months, 46% (95% CI 41.0% to 52%, I2=56%) for last 3 months and 16% (95% CI 9% to 23%, I2=98.3%) for point prevalence. Potential risk factors were sport participation, sport volume/intensity, concurrent lower extremity pain, o...
Purpose To synthesise evidence on low back pain (LBP) in adult rowers and to create a consensus s... more Purpose To synthesise evidence on low back pain (LBP) in adult rowers and to create a consensus statement to inform clinical practice. Methods There were four synthesis steps that informed the consensus statement. In step one, seven expert clinicians and researchers established the scope of the consensus statement and conducted a survey of experienced and expert clinicians to explore current practice. In step two, working groups examined current evidence relating to key scope questions and summarised key issues. In step three, we synthesised evidence for each group and used a modified Delphi process to aid in the creation of the overall consensus statements. Finally, in step four, we combined information from step three with the findings of the clinician survey (and with athlete and coach input) to produce recommendations for clinical practice. Results The scope of the consensus statement included epidemiology; biomechanics; management; the athlete's voice and clinical expertise. Prevention and management of LBP in rowers should include education on risk factors, rowing biomechanics and training load. If treatment is needed, non-invasive management, including early unloading from aggravating activities, effective pain control and exercise therapy should be considered. Fitness should be maintained with load management and progression to full training and competition. The role of surgery is unclear. Management should be athlete focused and a culture of openness within the team encouraged. Conclusion Recommendations are based on current evidence and consensus and aligned with international LBP guidelines in non-athletic populations, but with advice aimed specifically at rowers. We recommend that research in relation to all aspects of prevention and management of LBP in rowers be intensified.
ObjectiveTo summarise the evidence for non-pharmacological management of low back pain (LBP) in a... more ObjectiveTo summarise the evidence for non-pharmacological management of low back pain (LBP) in athletes, a common problem in sport that can negatively impact performance and contribute to early retirement.Data sourcesFive databases (EMBASE, Medline, CINAHL, Web of Science, Scopus) were searched from inception to September 2020. The main outcomes of interest were pain, disability and return to sport (RTS).ResultsAmong 1629 references, 14 randomised controlled trials (RCTs) involving 541 athletes were included. The trials had biases across multiple domains including performance, attrition and reporting. Treatments included exercise, biomechanical modifications and manual therapy. There were no trials evaluating the efficacy of surgery or injections. Exercise was the most frequently investigated treatment; no RTS data were reported for any exercise intervention. There was a reduction in pain and disability reported after all treatments.ConclusionsWhile several treatments for LBP in at...
Objective: To investigate the use of the King-Devick (K-D) test for sideline assessment of concus... more Objective: To investigate the use of the King-Devick (K-D) test for sideline assessment of concussive injuries in a New Zealand amateur women's rugby union team. Design: Prospective cohort observational. Methods: All players were K-D tested during pre-season using a tablet (iPad; Apple Inc., Cupertino, CA). Differences in K-D scores and test-retest reliability were calculated for baseline test scores, baseline, and post-injury (concussion) sideline assessment and baseline and post-season testing scores for tests by year and as a combined score. Results: One training-related (0.3 per 1,000 training-hrs) and nine match-related (16.1 per 1,000 match-hrs) concussions were recorded. The K-D post-injury (concussion) sideline test scores were significantly slower than established baseline (-4.4 [-5.8 to-3.4] s; χ2(1)=42.2; p<0.0001; t(9)=-4.0; p=0.0029; d=-0.8). There was good-toexcellent reliability of the K-D test for baseline (ICC: 0.84 to 0.89), post-injury (concussion) sideline assessment (ICC: 0.82 to 0.97) and post-season evaluation (ICC: 0.79 to 0.83). Discussion: By utilising the baseline to post-injury (concussion) assessment comparisons, any player with a post-injury (concussion) assessment slowing of their K-D test time, regardless of whether the player has, or has not had a witnessed insult, should be withheld from any further participation until they are evaluated by a medical professional trained in the management of concussion. Conclusion: This study has provided additional evidence to support the use of the K-D test as a frontline method of assessing concussion given the good to excellent reliability of the test for baseline, sideline assessment and post-season evaluation.
International Journal of Sports Science & Coaching, 2014
Studies reporting on injuries in rugby league have shown that the injury incidence increases as t... more Studies reporting on injuries in rugby league have shown that the injury incidence increases as the participation level increases. To provide pooled estimates for the incidence of rugby league injuries in match and training activities at all levels of performance and by gender. Searches of PubMed, CINHAL, Ovid, MEDLINE, SCOPUS, ScienceDirect and SportDiscus® databases were performed to identify studies published in English prior to November 2012. Bibliographic searches were also carried out without language restrictions. A pooled analysis of published studies which have reported the incidences of rugby league match and/or training injuries. Two reviewers extracted the study characteristics, numerical data and assessed the quality, by adhering to the protocol for systematic review of observational studies (MOOSE). A total of 34 studies (from 1,422 identified in the initial search) were identified that reported data collection of rugby league injuries that met the inclusion criteria. ...
Direct impacts with the head (linear acceleration or pressure) and inertial loading of the head (... more Direct impacts with the head (linear acceleration or pressure) and inertial loading of the head (rotational acceleration or strain) have been postulated as the 2 major mechanisms of head-related injuries such as concussion. Although data are accumulating for soccer and American football, there are no published data for nonhelmeted collision sports such as rugby union. To quantify head impacts via instrumented mouthguard acceleration analyses for rugby union players over a season of matches. Descriptive epidemiology study. Data on impact magnitude and frequency were collected with molded instrumented mouthguards worn by 38 premier amateur senior rugby players participating in the 2013 domestic season of matches. A total of 20,687 impacts >10g (range, 10.0-164.9g) were recorded over the duration of the study. The mean ± SD number of impacts per player over the duration of the season of matches was 564 ± 618, resulting in a mean ± SD of 95 ± 133 impacts to the head per player, per m...
Australian journal of science and medicine in sport, 1997
Evidence with regard to the incidence of injury to forwards and backs in the game of rugby league... more Evidence with regard to the incidence of injury to forwards and backs in the game of rugby league is extremely limited. A four year prospective study of all the injuries from one professional Rugby League club was conducted. All injuries that were received during match play were recorded, and those for forwards and backs compared. Forwards had a higher overall rates of injury than backs (139.4 [124.2-154.6] vs. 92.7 [80.9-104.6] per 1000 player hours, P < 0.00006). Forwards had a higher rate of injuries to all body sites with the exception of the ankle and the 'others' category of injury. They had significantly higher rates for the arm (11.6 [6.9-16.3] vs. 3.9 [1.4-6.4] per 1000 player hours, P = 0.005) and, the head and neck (53.9 [43.9-63.8] vs. 25.0 [18.7-31.4] injuries per 1000 player hours, P < 0.00006). Forwards had significantly more injuries than backs for contusions (17.1 vs. 7.3 per 1000 player hours, z = 2.85, P = 0.0044), lacerations (26.7 vs. 13.8 per 1000...
In 1996, the professional rugby league moved its playing season from the autumn and winter months... more In 1996, the professional rugby league moved its playing season from the autumn and winter months to the spring and summer. To determine whether the change in playing season altered the risk of player injury. Prospectively collected data comparing two cohorts. Injuries incurred by all players in one club during match play were recorded over 9 seasons: 4 winter (138 games) and 5 summer (144 games). Each injury was classified according to site, type, player position, activity at the time of injury, and number of games missed as a result of injury. The total exposure time during this study was 4876 player-hours (winter, 2386, summer, 2490). The relative risk of injury doubled after the move from winter to summer. Winter rugby accounted for 72 injuries, and summer rugby, for 150 injuries. Risk of injury to players in a professional rugby league club greatly increased as a result of changing the playing calendar, possibly as a result of environmental factors. However, other factors, such...
Sport-related concussions are a subset of mild traumatic brain injuries and are a concern for man... more Sport-related concussions are a subset of mild traumatic brain injuries and are a concern for many sporting activities worldwide. To review and update the literature in regard to the history, pathophysiology, recognition, assessment, management and knowledge of concussion. Searches of electronic literature databases were performed to identify studies published up until April 2013. 292 publications focussing on concussion met the inclusion criteria, and so they were quality rated and reviewed. Concussion is hard to recognize and diagnose. Initial sideline assessment via the Sports Concussion Assessment Tool 3 (SCAT3), Child-SCAT3 or King-Devick test should be undertaken to identify athletes with concussion as part of a continuum of assessment modalities and athlete management. Sports medicine practitioners should be cognisant of the definition, extent and nature of concussion, and should work with coaches, athletes and trainers to identify and manage concussions. The most common reason for variations in management of concussion is lack of awareness of-and confusion about-the many available published guidelines for concussion. Future research should focus on better systems and tools for recognition, assessment and management of concussion. Sport participants&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; knowledge of concussion should be evaluated more rigorously, with interventions for sports where there is little knowledge of recognition, assessment and appropriate management of concussion.
Objective To evaluate the MRI findings in the lumbar spines of asymptomatic elite junior tennis p... more Objective To evaluate the MRI findings in the lumbar spines of asymptomatic elite junior tennis players. Materials and Methods The lumbar spine MRI studies of 98 asymptomatic junior elite tennis players (51 male, 47 female) with a mean age of 18 years (age range 11.2-26.3 years; standard deviation 3.1) was reviewed by two consultant musculoskeletal radiologists using consensus opinion. Images were assessed using accepted classification systems. Results Four players (4 %) had no abnormality. Facet joint arthropathy occurred in 89.7 % of the players, being mild in 84.5 % of cases. There were 41 synovial cysts in 22.4 % of the cohort all occurring in the presence of facet arthropathy. Disc degeneration was noted in 62.2 % of players, being mild in 76.2 % of those affected. Disc herniation was noted in 30.6 % of players, with 86.1 % of these being broad based and 13.9 % being focal. There was nerve root compression in 2 %. There were 41 pars interarticularis abnormalities in 29.6 % of patients, 63.4 % of these being grades 1-3. There was grade 1 spondylolisthesis in 5.1 % of players. The prevalence of facet joint arthropathy, disc degeneration, disc herniation and pars interarticularis fracture was lower in female players than in male and lower in the under 16-year-olds compared with the over 20-year-olds. Conclusion There is a significant amount of underlying pathology that would normally go undetected in this group of asymptomatic elite athletes. Whilst these findings cannot be detected clinically, their relevance is in facilitating appropriate prehabilitation to prevent loss of playing time and potentially career-ending injuries.
Uploads
Papers by Conor Gissane