Objectives:
(1) Assess medial collateral ligament (MCL) laxity differences in nonoperatively treated acute MCL and anterior cruciate ligament (ACL)–MCL injuries with 2 range of motion (ROM) knee brace settings. (2) Describe knee ROM, brace satisfaction, overall knee score, adherence, pain, quality of life, and knee function. (3) Assess feasibility of larger trial.
Design:
Prospective, randomized, single-blinded feasibility clinical trial.
Participants:
Sixty-four adults with acute moderate-to-severe isolated MCL or combined ACL–MCL injuries at the University of Calgary Sport Medicine Centre.
Intervention:
Random assignment to the protected (0–90 degrees) or restricted (30–90 degrees) brace group. Four weeks of constant brace wearing, followed by daytime wear until 6 weeks. Rehabilitation exercises prescribed from 2 weeks onward. Follow-up for 12 weeks.
Main Outcome Measures:
Clinical outcomes included side-to-side difference (SSD) MCL laxity (mm) at 30 degrees knee flexion and 0 degree, ROM, patient-reported pain, overall knee ratings, brace satisfaction, daily adherence, international knee documentation committee subjective, and ACL-quality of life (QOL) collected throughout 12 weeks (baseline, 2, 4, 6, 8, and 12 weeks). The outcome assessor was masked to treatment group allocation.
Results:
At 12 weeks, 73% had 
Objectives:
(1) To estimate adherence to brace wearing for medial collateral ligament (MCL) injuries across 3 phases of conventional treatment and (2) to explore predictors of adherence for each phase.
Design:
Exploratory cohort study.
Setting:
Primary care center.
Patients:
Fifty-nine patients aged 18 to 65 (27 men, 32 women) from a randomized clinical trial examined the effectiveness of 2 bracing techniques (0–90 degrees or 30–90 degrees) for acute isolated MCL or combined anterior cruciate ligament injuries. Patients were prescribed a 6-week bracing protocol and were followed for 12 weeks.
Interventions:
Patients were prescribed constant brace wearing for 4 weeks (∼23 h/d), then daytime wear only (∼15 h/d) until brace discontinuation at 6 weeks. Rehabilitation exercises were prescribed from 2 weeks onward. Adherence to the protocol was assessed through daily self-reported logs. Clinical and patient-reported outcomes were collected throughout the randomized clinical trial (baseline, 2, 4, and 6 weeks). This study interpreted them as predictor variables of treatment adherence alongside patient and treatment characteristics.
Main Outcome Measures:
Adherence to each 2-week phase, interpreted dichotomously (adherer or nonadherer). Adherers were identified as those who wore their brace according to the protocol.
Results:
Adherence and pain decreased, while overall knee ratings improved throughout the treatment. Pain, affected knee, and brace range-of-motion settings were significant predictors of adherence in the exploratory logistic regressions.
Conclusions:
Pain, affected knee, and brace range-of-motion settings were the primary predictors of brace wearing in the first 4 weeks of treatment. This study is the first to provide insight into MCL bracing adherence, potentially aiding clinicians in treatment management. 
Objective:
The objective of this study was to evaluate whether percussive massage reduces the intensity of quadriceps pain and perceived fatigue and improves perceived recovery and vertical jump after habitual running.
Design:
Randomized clinical trial.
Settings:
Road race.
Participants:
Eighty-four runners aged 18 to 60 years, 1-year experience in running and a training frequency of twice a week, were included (experimental group: n = 39, 34.33 ± 1.61 years, 61% M, 5.68 ± 1.16 years of running experience; control group: n = 45; 34.51 ± 1.50 years; 71% M; 6.01 ± 1.02 years of running experience).
Interventions:
The experimental group received 10 minutes of percussive massage on the quadriceps, and the control group received sham hip and knee joint mobilization.
Main Outcome Measures:
Quadriceps pain intensity and fatigue (visual analog scale), perceived recovery (perceived global effect scale), and vertical jump after habitual running.
Results:
The experimental group showed better results for quadriceps pain intensity (0.98; 95% confidence interval [CI], −1.63 to −0.34), fatigue (0.7; 95% CI, −1.45 to −0.05) and perceived recovery (0.54; 95% CI, 0.02-1.07), but not for vertical jump performance (0.95; 95% CI, −1.57-3.47).
Conclusions:
Percussive massage improved pain intensity, fatigue, and perceived recovery after running but had no effect on vertical jump. 
Objective:
Treadmill test protocols for concussion assessment have been validated for patients aged 13 years and older; however, no evidence-based guidelines exist for younger children. We designed and assessed the safety and utility of the Morahan Pediatric Concussion Exercise Tolerance Test (MPCETT) for assessing exercise tolerance in symptomatic children (SC) and recovered, asymptomatic children (AC) from 6 to 12 years of age.
Design:
Retrospective case series.
Setting:
Secondary care center.
Participants:
Children were diagnosed with concussion using consensus guidelines. At assessment, SC [n = 17; median (range) 10 (6–12) years; 18% female; 28 (13–50) days since injury] had persistent concussive symptoms, while AC [n = 24; 9 (7–12) years; 21% female; 21 (8–37) days since injury] required assessment for return to activity.
Interventions:
The MPCETT is a modified Buffalo Concussion Treadmill Test for pediatric populations. The test was administered to establish exercise tolerance and was terminated for increased symptoms or self-reported exhaustion.
Main outcome measures:
Presence of adverse events and exercise intolerance.
Results:
The number of adverse events was 0 in both groups. Exercise intolerance occurred in 64.7% (95% CI, 38.3%–85.8%) of children within the SC group versus 12.5% (95% CI, 2.7%–32.4%) within the AC group (P 
Objective:
This study investigated the role of specialty concussion care on the clinical course of recovery in adolescent patients who initiated care beyond 3 weeks from their injury.
Design:
Retrospective analysis of protracted recovery groups was based on the number of days in which a patient presented for care postinjury: early (22-35 days), middle (36-49 days), and late (50+ days).
Setting:
Sports medicine and orthopedics clinic.
Patients:
101 patients aged 12 to 18 years.
Independent variables:
Age, race/ethnicity, sex, concussion or migraine history, neurodevelopmental or psychiatric diagnosis, King-Devick, Trails Making, Vestibular Ocular Motor Screening (VOMS), and Postconcussion Symptom Scale (PCSS).
Main Outcome Measures:
Days since injury to evaluation, recovery days from evaluation, and total recovery days.
Results:
There were no significant differences between groups for PCSS, average K-D scores, and Trails B-A. Vestibular Ocular Motor Screening change score was significantly different between groups such that the late group had less change in VOMS score compared with the early group (F = 3.81, P = 0.03). There were significant differences between groups in terms of days since injury to evaluation (F = 399.74, P 
Objective:
Evaluate the influence of sleep duration and concussion history on postconcussion symptoms in adolescent athletes.
Design:
Observational retrospective study using the Immediate Post-Concussion Assessment and Cognitive Testing and Post-Concussion Symptom Scale (PCSS). Multivariable linear regression assessed sleep hours against 22 PCSS symptoms, controlling for demographic and health variables.
Setting:
Urban concussion centers in Colorado and Florida, 2009 to 2019.
Participants:
11 564 student-athletes aged 12 to 22, categorized by concussion history.
Interventions:
Analysis of sleep duration and concussion history in relation to neurocognitive and psychiatric symptom severity.
Main Outcome Measures:
Primary outcomes included neurocognitive, psychiatric, and total symptom scores. Secondary outcomes were specific PCSS symptoms.
Results:
Among 5349 student-athletes, 2671 (49.9%) had no prior concussions and 2678 (50.1%) had 1 or more. For those without prior concussions, sleep was negatively associated with age (β = −0.18, 95% confidence interval [CI], −0.22 to −0.13, P 
Objective:
To assess sports-related concussion (SRC) knowledge levels in US collegiate student-athletes (S-As) and athletic trainers (ATs) and identify factors that influence reporting of SRC by S-As.
Design:
Cross-sectional, retrospective study.
Setting:
University training room/clinic visits.
Participants:
National Collegiate Athletics Association Division 1 S-As and ATs.
Interventions:
A survey consisting of demographics, SRC knowledge, prior SRC history, and reporting habits.
Main outcome measures:
Sports-related concussion knowledge scores, SRC reporting habits.
Results:
Response rates were 67% (350/520) for S-As and 100% (11/11) for ATs. S-As represented 21 sports (mean age 20.3 years, range 18–24, 54% male). Sports-related concussion knowledge scores were lower in male S-As (median 73%; interquartile range [IQR] 55%-85%) than in female S-As (79%; 55%–88%) (P 
Objective:
To compare soreness location and intensity between male and female soccer athletes across 2 competitive seasons.
Design:
Descriptive Cohort Study.
Setting:
Collegiate Sports Medicine Facility.
Participants:
Forty male and 42 female collegiate soccer athletes.
Intervention:
Season-long soccer trainings and games.
Main Outcome Measures:
Athletes reported perceived soreness location and intensity daily. χ2 analysis and linear mixed effect models were used to compare soreness locations and intensities by sex.
Results:
Male and female soccer athletes reported similar number of soreness instances, but male soccer athletes reported soreness more frequently at the ankle, foot, hip, pelvis, and posterior thigh. Female soccer athletes reported soreness more frequently at the anterior leg, anterior thigh, and knee. There was no significant difference in soreness intensity between sexes at any body location (P = 0.86). When collapsed across sex, the frequency of anterior thigh soreness was higher at preseason (7.49%, CI: 5.46-9.52) than at midseason (4.55%, CI: 2.52–6.57; t = −2.94, P = 0.023) and at postseason (3.00%, CI: 0.76-5.23; t = −3.74, P 
Objective:
To retrospectively analyze publicly available elbow ulnar collateral ligament reconstruction (UCLR) injury data for professional baseball players.
Design:
Descriptive epidemiology study.
Setting:
A retrospective analysis using an open-source database was performed. The database contained all known UCLR surgeries among Major League Baseball (MLB) and Minor League Baseball (MiLB) players.
Participants:
In total, 1801 professional male professional baseball pitchers (age: 24.5 ± 3.9 years) who have undergone UCLR between 1974 and 2024.
Main Outcome Measures:
The number of UCLR procedures each year.
Independent Variables:
Change-point analysis was used to identify changes in the number of UCLR surgeries over time among MLB and MiLB players. For MLB players, number of UCLR surgeries from 1974 to 2023 was analyzed, while for MiLB players, data starting from 1981 to 2024 were analyzed.
Results:
For MLB players, 3 change points were identified, occurring around 1989 (95% confidence interval [CI], 1988–1990), 2000 (95% CI, 2000–2000), and 2012 (95% CI, 2011–2017). For MiLB players, 3 change points were identified occurring around 2001 (95% CI, 2001–2001), 2009 (95% CI, 2008–2010), and 2013 (95% CI, 2013–2015).
Conclusions:
Overall, there has been a rise in the number of UCLR surgeries per year for the past 50 years in professional baseball, with distinct time points identified, representing increases in the number of UCLR surgeries each year. A higher number of UCLR surgeries are performed per year in the MiLB than in the MLB. 
Objective:
To identify strength and flexibility measures that are associated with the risk of running-related overuse injuries.
Design:
Prospective observational study.
Setting:
Secondary analysis of a previously reported cohort of runners.
Participants:
Runners registered for the 2019 New York City Marathon.
Independent Variables:
Participants were asked to complete a baseline strength and flexibility self-assessment 16 weeks before the marathon date.
Main Outcome Measure:
Participants were asked to respond to surveys on running-related injuries occurring within 4-week “training quarters” at 16, 8, 4, and 1 week(s) before the marathon date.
Results:
Of the n = 867 runners included in our final analytic sample, 36.1% sustained a running-related overuse injury while preparing for the marathon. The only significant difference in odds and/or hazard of injury was found in the single-leg glute bridge test. Participants who reported that they could hold a single-leg glute bridge on their weaker side for 20 to 29 seconds had 64% lower risk of running-related overuse injury (aHR: 0.36; 95% CI, 0.18–0.72; P = 0.0036) than those who could only hold for 0 to 9 seconds on their weaker side. In addition, participants who reported that they could hold a single-leg glute bridge on their weaker side for 30 seconds or more had 49% lower risk of running-related overuse injury (aHR: 0.51; 95% CI, 0.29–0.92; P = 0.0245).
Conclusions:
Strength training programs, particularly targeting hip abductors and related muscle groups, may provide benefits for distance runners, though more rigorous research is needed. 
Objective:
The study purpose was to examine epidemiology of golf-related injuries and impact of alcohol consumption.
Design:
Descriptive epidemiologic study.
Setting:
Emergency department injury reports in the United States.
Participants:
Individuals reporting to emergency departments for golf-related injuries.
Methods:
Data (2011–2021) were obtained from National Electronic Injury Surveillance System. Examined trends with pivot tables. Incidence rate ratios and confidence intervals were calculated using χ2. Three hundred seventy-one injuries were removed for not being golf related.
Independent Variables:
Age, gender, alcohol use.
Main Outcome Measures:
Injury type, injury location, injury narrative.
Results:
Mean age 46 years. Men (n = 7605, 71.03%) were injured more frequently. Most common injuries were sprain (n = 1699, 15.87%), laceration (n = 1544, 14.42%), and fracture (n = 1340, 12.52%). Most common locations were trunk (n = 2,417, 22.57%) and head (n = 1866, 17.43%). Most common lower extremity was knee (n = 610, 5.70%), and upper extremity was shoulder (n = 447, 4.17%). With alcohol, the rate of injury being a fracture increased from 12.39% to 18.11% [incidence rate ratio (IRR)], 1.46 [95% CI, 1.05–1.97]; P = 0.018), syncope increased from 2.63% to 9.47% (IRR, 3.51 [95% CI, 2.19–5.38]; P = 0.0001), and internal injury increased from 9.48% to 23.05% (IRR, 2.43 [95% CI, 1.82–3.18]; P = 0.0001). Injury location most common with alcohol was the head, increased from 16.95% to 37.86% (IRR, 2.23 [95% CI, 1.79–2.75]; P = 0.0001).
Conclusions:
Common golf injuries include sprains, lacerations, and fractures. Alcohol is a known risk factor, significantly increasing the risk of severe injuries in golfers, such as fractures and internal injuries. In addition, notable increases in head injuries and syncope were identified. 
Objective:
To report injury epidemiology in youth male academy-level athletes in the United States.
Design:
An observational study on injury occurrences and playing time over the 2019 to 2020, 2020 to 2021, and 2021 to 2022 soccer seasons.
Setting:
Data collected from a single midwestern soccer academy in the United States in partnership with a tertiary care level I pediatric heath institution.
Patients:
All male youth athletes to have enrolled and participated in the developmental academy during any of the 3 studied seasons.
Interventions:
None. This was an observational study.
Main Outcome Measures:
Injury rate (incidence per 1000 playing hours), type, location, mechanism (noncontact vs contact), severity, and mode of play (match vs training) in which the injury was sustained.
Results:
Overall rate of injury was 3.64 per 1000 h exposure. Injuries of moderate severity (8-28 days of missed playing time) were most common. When stratified by team, injury rates were highest in the U15 (5.15/1000 h) and lowest in the U12 (0.87/1000 h). Most injuries involved muscles of the lower extremities.
Conclusions:
Among male youth academy-level soccer athletes in the United States, older players tended to sustain injuries at a higher rate than younger. The lower extremity was the most common injury location, and muscle injuries and most common type. Concussions remain common in this population, accounting for nearly a 10th of all athletic injuries.
Clinical Relevance:
Injury epidemiology data from this study add to the growing worldwide pool of data from youth, male, academy-level soccer athletes that will augment development of injury prevention interventions. 
Objective:
To describe the incidence, location, and type of musculoskeletal injuries in ballet dancers at the Opéra de Paris from 2018 to 2023 and to evaluate the effect of COVID-19 on injury incidence.
Design:
Descriptive Retrospective Study.
Setting:
Primary.
Patients:
Professional ballet dancers registered at the Opéra de Paris across 5 seasons (September 1, 2018–June 30, 2023).
Independent variables:
Demographics (age, body mass index, sex, rank).
Main Outcome Measures:
Injury data (duration, mechanism, location, and type).
Results:
The incidence proportion of musculoskeletal injuries ranged from 47.1% to 72.6% per season between 2018 and 2023. Dancers most commonly sustained foot (49.3%) and ankle (45.1%) injuries, with 75.6% of dancers sustaining a lower limb injury. Compared with the 2018 to 2019 season, the risk of a dancer sustaining an injury was significantly lower in the COVID-19 season (2019–2020) (OR, 0.34; 95% CI, 0.21-0.53; P 
Objective:
To evaluate the prevalence and types of injuries incurred during kiteboarding (1), along with treatment approaches (2). In addition, the time to return to kiteboarding following injury (3) and factors associated with the rate and type of injury were analyzed (4).
Setting:
Recreational kiteboarding.
Design:
Retrospective cohort.
Participants:
Three hundred twelve kiteboarders (280 men, 32 women, mean age 42.91 ± 13) were included in the study.
Independent Variables:
Age, sex, experience, and the use of protective gear.
Main Outcome Measures:
Kiteboarding experience, injury location, type, incidence, nonsurgical and surgical treatment modalities, and return-to-kiteboarding data.
Results:
The number of injuries calculated per 1000 sessions was a mean of 7.82 (4.83-10.81). Patients with less than 2 years of kiteboarding experience were at a greater risk of injury than more experienced kiters (P 
Objective:
To identify specific tendon morphologies on ultrasonography of the Achilles tendon (AT) that later develop time-loss injury.
Design:
Blinded post hoc analysis of a 2-year prospective, observational study of 944 AT sonographic videos to identify morphologic characteristics of diagnosed Achilles tendinopathies associated with future time-loss injury. The second year was used to validate the findings from the first year.
Setting:
N/A.
Patients/Participants:
Four hundred seventy-three National Collegiate Athletic Association student-athletes from 3 institutions over 2 years of data collection (57.7% females; 20.1 ± 1.6 years of age; 23.1 ± 2.8 kg/m2 of body mass index; 9.4 ± 3.6 years of sport experience).
Interventions/Assessment of Risk Factors:
Particular tendon morphologies were used to develop 3 ultrasonographic imaging rules that were used to predict AT injury leading to time loss in sport.
Main Outcome Measures:
Positive predictive value (PPV) and negative predictive values of particular tendon morphologies associated with the development of time-loss injury within 1 year.
Results:
One of 3 morphologies, a deep mid-substance focal hypoechogenic area, was validated on 2 separate data sets and found to have a 33.3% PPV in both years for the development of time-loss injury.
Conclusion:
Results suggest a specific phenotype of sonographic abnormality of the AT that suggests a 1-in-3 chance of developing time-loss injury within a year. Detecting abnormality of future AT before symptoms develop may allow for rehabilitation strategies to prevent or reduce time-loss. 
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