Sports Health [JOURNAL]
Sun
200 papers
Metabolic Optimization Before Orthobiologic Therapies (MOBOT): A Narrative Review.
C A M Fernandes G, Rodeo SA
Sports Health · 2026 · PMID 41549467 · Full text
CONTEXT: The efficacy of orthobiologic therapies, such as platelet-rich plasma (PRP) and concentrated bone marrow aspirate (cBMA), is influenced by not only the biologic product but also the patient's systemic biological...
CONTEXT: The efficacy of orthobiologic therapies, such as platelet-rich plasma (PRP) and concentrated bone marrow aspirate (cBMA), is influenced by not only the biologic product but also the patient's systemic biological milieu. Emerging preclinical and clinical evidence suggests that modifiable metabolic factors, including obesity, insulin resistance, chronic low-grade inflammation, inflammaging, sarcopenia, dysbiosis, poor sleep, and lifestyle behaviors such as smoking and alcohol use, can impair tissue regeneration and reduce the effectiveness of orthobiologics. EVIDENCE ACQUISITION: A structured approach guided article selection. Searches in PubMed, Embase, and Scopus through July 2025 were supplemented by reference checking. Terms included "metabolic optimization," "obesity," "insulin resistance," "inflammation," "sarcopenia," "dysbiosis," "sleep," "orthobiologics," "PRP," and "bone marrow aspirate." Preclinical and clinical studies, mechanistic reviews, and meta-analyses assessing the impact of metabolic factors on musculoskeletal regeneration and orthobiologic outcomes were included. Only English-language articles relevant to mechanisms, clinical implications, or patient optimization were considered. STUDY DESIGN: Narrative review. LEVEL OF EVIDENCE: Level 5. RESULTS: Evidence-based strategies to optimize metabolic health include targeted exercise, nutritional optimization, pharmacologic interventions, sleep regulation, microbiome support, and behavioral counseling for tobacco and alcohol cessation. While clinical evidence remains limited and of low methodological rigor, preclinical and available clinical studies support the plausibility, safety, and potential efficacy of these interventions. Optimizing metabolic factors can enhance tissue responsiveness, reduce interpatient variability, and improve orthobiologic therapy outcomes. CONCLUSION: Optimizing metabolic health before orthobiologic therapy improves the biological environment and regenerative outcomes. Screening and managing factors such as insulin resistance, chronic inflammation, and poor sleep are essential. Further randomized controlled trials and biomarker-guided studies are needed to validate strategies and personalize interventions.Strength-of-Recommendation Taxonomy (SORT):C: Supported mostly by preclinical and indirect clinical evidence.
Navigating the New Frontier: Recommendations for Sports Medicine Physicians in the Era of NIL and Direct Athlete Compensation.
Nocek M, Hawryluk CJ, Villegas Meza AD … +4 more , Herrmann CB, Uppstrom TJ, McCarty EC, Millett PJ
Sports Health · 2026 · PMID 41486876 · Full text
Abstract loading — click title to view on PubMed.
From Court to Laboratory: Tennis-Specific Research 2025.
Johansson F, Ellenbecker TS
Sports Health · 2026 · PMID 41486875 · Full text
Abstract loading — click title to view on PubMed.
Ultrasonographic Assessment of Posterior Shoulder Capsule Thickness in Baseball Pitchers: A Validation Study.
Paul RW, Long SS, Coladonato C … +8 more , Ahrens J, Hoback A, Buchheit P, Rauch J, Ciccotti MG, Cohen SB, Erickson BJ, Thomas SJ
Sports Health · 2026 · PMID 41408701 · Full text
BACKGROUND: A thickened posterior shoulder capsule may increase injury risk in baseball pitchers due to maladaptive shoulder biomechanics such as altered arthrokinematics, decreased internal rotation range of motion (ROM...
BACKGROUND: A thickened posterior shoulder capsule may increase injury risk in baseball pitchers due to maladaptive shoulder biomechanics such as altered arthrokinematics, decreased internal rotation range of motion (ROM) and increased scapular upward rotation. While diagnostic ultrasound offers a reliable method of measuring posterior capsule thickness (PCT), it is currently unclear whether PCT thus measured is valid. HYPOTHESIS: Diagnostic ultrasound is a valid method for measuring PCT compared with magnetic resonance imaging (MRI). STUDY DESIGN: Cross-sectional. LEVEL OF EVIDENCE: Level 4. METHODS: Asymptomatic baseball pitchers recently drafted into professional baseball from a single organization were enrolled during the 2021 to 2024 seasons. Pitchers underwent both diagnostic ultrasound and shoulder MRI on the same day to minimize any acute changes in PCT. All shoulder ultrasounds were performed with a 15-MHz linear transducer. Posterior capsule was identified as the tissue immediately lateral to the tip of the labrum between the humeral head and rotator cuff. PCT was measured on axial MRI scans by a musculoskeletal radiologist blinded to the ultrasound measurements. Agreement between modalities was evaluated through Pearson correlations and Bland-Altman analysis. RESULTS: Overall, 25 drafted pitchers were included. PCT obtained via diagnostic ultrasound had a mean of 2.4 ± 0.6 mm while PCT obtained via MRI scan had a mean of 2.4 ± 0.8 mm. Ultrasound PCT and MRI PCT were strongly positively correlated ( = 0.945, = 0.892, < 0.001). The Bland-Altman plot demonstrated 95% limits of agreement of 0.55 mm between diagnostic ultrasound and MRI measurements of PCT. CONCLUSION: Measuring PCT with diagnostic ultrasound is a valid technique compared with the gold standard of MRI. CLINICAL RELEVANCE: Clinicians who wish to evaluate PCT in baseball pitchers may use this validated technique to quantify PCT and evaluate for potential contributors to glenohumeral internal rotation deficit.
Early Effects of Kinesio Taping on Clinical Outcomes in Patients With Arthroscopic Rotator Cuff Repair: A Double-Blind, Randomized Controlled Trial.
Kodak MIH, Özüdoğru A, Basat HÇ … +1 more , Tuncay F
Sports Health · 2025 Dec · PMID 41392499 · Full text
BACKGROUND: Kinesio tape (KT) is being applied increasingly in physical therapy and rehabilitation. This trial aimed to examine the effect of KT in terms of functional outcomes in people undergoing arthroscopic rotator c...
BACKGROUND: Kinesio tape (KT) is being applied increasingly in physical therapy and rehabilitation. This trial aimed to examine the effect of KT in terms of functional outcomes in people undergoing arthroscopic rotator cuff repair (ARCR). HYPOTHESIS: KT after ARCR will reduce pain and edema. STUDY DESIGN: A double-blind, randomized controlled trial. LEVEL OF EVIDENCE: Level 1b. METHODS: A total of 45 patients who underwent ARCR were assigned randomly to 1 of 3 groups: KT (n = 15), sham taping (ST, n = 15), and control (n = 15). Participants received a conservative physiotherapy program. The physiotherapy program, which was conservative in nature, covered the first 7 weeks after surgery. In addition to the program, patients in the KT group were also treated with KT, while those in the ST group received ST. Pain levels (visual analog scale), edema, and functional scores (Western-Ontario Rotator Cuff Index, Modified Constant-Murley Shoulder Score, Revised Oxford Shoulder Score, and Shoulder Pain and Disability Index) were evaluated at regular intervals throughout the treatment. RESULTS: Baseline characteristics of the groups were similar ( > 0.05). All evaluation parameters showed significant improvement over time in all 3 groups ( < 0.05). There were no differences between the groups in any of the parameters when analyzed for group × time interactions ( > 0.05). CONCLUSION: This study found no efficacy of KT after ARCR in reducing pain and edema and improving shoulder function in the short- or medium-term. CLINICAL RELEVANCE: Clinicians should not expect additional short- or medium-term benefits from KT in reducing pain and edema or improving shoulder function after ARCR.
Psychological Profile of Trail Runners Associated With Running-Related Injuries: A Prospective Study.
Gajardo-Burgos R, Sánchez R, Besomi M … +3 more , Viljoen C, Janse van Rensburg DC, Bascour-Sandoval C
Sports Health · 2025 Dec · PMID 41388586 · Full text
BACKGROUND: Trail running has increased in popularity due to the benefits of physical activity in nature. However, trail running has an inherent risk of running-related injuries (RRI). It is known that athletes with cert...
BACKGROUND: Trail running has increased in popularity due to the benefits of physical activity in nature. However, trail running has an inherent risk of running-related injuries (RRI). It is known that athletes with certain psychological traits have a greater tendency to suffer injuries; however, this is unknown in trail runners. The main objective of this study was to identify trail runners' psychological profiles and to compare the proportion of RRI across these profiles. HYPOTHESIS: Trail runners with psychological profiles of high stress, precompetitive anxiety, mental fatigue, competitiveness, and poor sleep quality are at increased risk of RRI. STUDY DESIGN: Prospective cohort study. LEVEL OF EVIDENCE: Level 2. METHODS: A Gaussian mixture model cluster analysis was performed on 202 trail runners (55.5% male; aged 38.7 [33.4-46.2] years) with psychological stress, cognitive and somatic anxiety, self-confidence, mental fatigue, sleep quality, and competitiveness measured 4 weeks before participating in a race. The proportion of RRI during the race was recorded and compared across clusters. RESULTS: Overall RRI proportion during competition was 11.3% (n = 24). The most common RRI were muscle (41.7%) and tendon/bursa (16.7%) injuries, affecting primarily the knee (33.3%) and lower leg (20.8%). Five psychological profiles were identified. Cluster 1 (competitive runners with moderate psychological stress and mental fatigue, low sleep quality and anxiety, and high self-confidence) had a higher RRI proportion than Cluster 3 (similar traits but lower psychological stress, mental fatigue, and higher self-confidence; 21.2% vs 3.2%; = 0.02). CONCLUSION: Certain psychological profiles in trail runners were associated with higher RRI risk. CLINICAL RELEVANCE: The medical team or trail running coaches should monitor runners with psychological profiles with higher psychological stress, mental fatigue, and cognitive anxiety, as well as lower self-confidence and sleep quality, to design strategies to reduce their risk of RRI.
Real-Time Concurrent Neurophysiological Responses to Dynamic In-Motion Physical and Cognitive Functional Tasks in Division I Athletes.
Palmer T, Mangine B, Hill-Lindsay A … +6 more , Clark J, Jacobs B, Eifert-Mangine M, Mark M, Tersak J, Colosimo A
Sports Health · 2025 Dec · PMID 41388254 · Full text
BACKGROUND: Quantitative electroencephalography (qEEG) offers sports medicine clinicians insight into the neurophysiological connection between the brain and musculoskeletal system. Dysregulation in the brain's neural st...
BACKGROUND: Quantitative electroencephalography (qEEG) offers sports medicine clinicians insight into the neurophysiological connection between the brain and musculoskeletal system. Dysregulation in the brain's neural state has been linked with altered biomechanical and/or musculoskeletal performance associated injury; however, comparative benchmark data among uninjured athletes without brain and/or musculoskeletal injury remain limited. HYPOTHESIS: Evaluating real-time qEEG neurophysiological and physiometric neurological brain responses while performing physical and cognitive functional tasks will offer clinicians performance insight to the neuromuscular preparedness in healthy Division I athletes. STUDY DESIGN: Descriptive prospective case series. LEVEL OF EVIDENCE: Level IV. METHODS: A total of 24 healthy female (n = 11) and male (n = 13) National Collegiate Athletic Association (NCAA) Division I athletes from multiple sports volunteered to participate in a qEEG neurophysiological and functional task assessment. A 21-channel Dry headset collected neurophysiological brain wave activity representing participants' level of attention, workload and sensorimotor rhythm (SMR) pre- and post-physical and cognitive tasks. Physiometric dependent variables included heartrate, respiration rate, heartrate variability, galvanic skin response, trapezius electromyography and peripheral temperature. Participants had no diagnosed attention deficits, learning impairments, and/or orthopaedic injuries. RESULTS: Healthy Division I athletes had balanced/regulated neurophysiological levels of change in neurophysiological activity. Brain connectivity, attention, and workload metrics were significantly higher in men ( ≤ 0.05). There were no sex or hemisphere differences at baseline for SMR; however, there were significant SMR differences pre- to post- for motor imagery tasks ( ≤ 0.05). There were relatively strong positive correlations between brain activity and physiometric performance (0.81-0.85), as well as, brain symmetry, workload, and attention (0.65-0.85). CONCLUSION: Real-time qEEG brain mapping of neurophysiological and physiometric responses during functional and cognitive tasks provide standard performance benchmarks for healthy, Division I athletes. CLINICAL RELEVANCE: Monitoring qEEG neurophysiological and physiometric benchmarks of healthy athletes can offer clinicians performance insight into neuromuscular preparedness.
Identifying Prevention Strategies for Ice Hockey Laceration Injuries.
DeLong RN, Brookhart B, Martin C … +3 more , Shore E, Kucera KL, Register-Mihalik JK
Sports Health · 2026 · PMID 41388241 · Full text
RATIONALE: The International Ice Hockey Federation and USA Hockey are ice hockey governing bodies that have made neck guards mandatory beginning August 2024. These mandates do not include National Hockey league (NHL) or...
RATIONALE: The International Ice Hockey Federation and USA Hockey are ice hockey governing bodies that have made neck guards mandatory beginning August 2024. These mandates do not include National Hockey league (NHL) or National Collegiate Athletic Association (NCAA) level players. PURPOSE: To describe life-threatening laceration injuries in ice hockey and identify prevention strategies. METHODS: Case summaries for catastrophic ice hockey laceration injuries from the National Center for Catastrophic Sport Injury Research (NCCSIR) were reviewed to describe the mechanism of injury, use of neck protection, and outcome. A Haddon Matrix informed preventative strategies across pre-event, event, and post-event phases as they relate to the athlete, source (skate, puck, stick), and environment.Results:NCCSIR captured 26 catastrophic ice hockey laceration injuries from 1982 to 2025 (13 professional/semi-professional, 6 high school, 2 select/junior/adult league, 1 college; ages 13-34). Of these 26 injuries, 24 (92%) were caused by skates, and 1 each by puck and stick. The neck was the body part lacerated most commonly (15, 58%), followed by the arm (6), wrist (2,) leg (1), and eye (1). Of 15 athletes with neck lacerations, 7 were reportedly not wearing neck protection; 8 were unknown/unreported. A total of 5 (19%) injuries resulted in death (ages 13-29 years), and 3 of those 5 athletes were reportedly not wearing neck protection. A Haddon Matrix identified prevention strategies by phase and included pre-event: cardiopulmonary resuscitation (CPR) and first-aid training, stop-the-bleed kits, mandated neck protection; during event: equipment inspection, player training; and post-event: secure a safe space for medical personnel to enter/exit ice and provide quick emergency response. DISCUSSION: Ice hockey is an inherently dangerous sport, and lacerations are a common injury type that can result in serious injury or death. This study highlights the Haddon Matrix as a valuable tool for identifying preventive measures for life-threatening lacerations in ice hockey. Further research should investigate the effectiveness of the strategies proposed.
Quadriceps Rate of Torque Development Is More Impaired Than Strength 4 to 12 Months Post-ACLR in Collegiate Athletes.
Cobian DG, Joachim MR, Cornelius JR … +2 more , Knurr KA, Heiderscheit BC
Sports Health · 2025 Dec · PMID 41388095 · Full text
BACKGROUND: Quadriceps neuromuscular impairments are common after anterior cruciate ligament reconstruction (ACLR). Quadriceps function is typically characterized by peak torque (PT) assessment, and reported as limb symm...
BACKGROUND: Quadriceps neuromuscular impairments are common after anterior cruciate ligament reconstruction (ACLR). Quadriceps function is typically characterized by peak torque (PT) assessment, and reported as limb symmetry index (LSI). Even when PT LSI is restored, high reinjury rates and abnormal biomechanics persist. Quadriceps rate of torque development (RTD) may have significant functional relevance, but direct comparisons of PT and RTD recovery post-ACLR are lacking. HYPOTHESIS: Quadriceps RTD LSI will recover more slowly than PT LSI post-ACLR. STUDY DESIGN: Longitudinal cohort study. LEVEL OF EVIDENCE: Level 3. METHODS: 42 athletes 4, 8, and 12 months post-ACLR completed maximal and rapid voluntary isometric knee extension contractions with both limbs. RTD was calculated as torque-time curve slopes from onset to 100 ms (RTD), 100 ms to 200 ms (RTD), onset to 200 ms (RTD, and 20% to 80% of PT (RTD). Between-limb differences were assessed with paired tests (Bonferroni adjusted < 0.003). Linear mixed models assessed the effect of time and variable on differences in PT and RTD LSIs and variable-by-time interactions. Least square mean differences and 95% CIs between PT and RTD LSIs are reported. RESULTS: Significant between-limb asymmetries were observed at all timepoints ( < 0.001) for all PT and RTD variables. No variable-by-time interactions were detected. There was a main effect of both time ( < 0.001) and variable ( < 0.001). RTD LSI was not significantly different than PT LSI ( = 0.36). RTD, RTD, and RTD LSIs were less than PT LSI by 10.4% (6.0, 14.9), 7.3% (2.8, 11.7), and 15.7% (11.2, 20.1), respectively ( < 0.002). CONCLUSION: In collegiate athletes, RTD impairments are greater than PT impairments from 4 to 12 months post-ACLR, but the specific RTD metric is important. CLINICAL RELEVANCE: Increased focus on the development and implementation of interventions to improve quadriceps RTD, beginning earlier post-ACLR, is warranted.
The Burden of Shoulder and Elbow Injuries in Wrestling: A Systematic Review of Incidence, Injury Types, and Competition-Level Comparisons.
Maunder DJ, Nelson BC, Murthi AM … +1 more , Hoffman RA
Sports Health · 2025 Dec · PMID 41387769 · Full text
CONTEXT: Wrestling is a physically demanding sport that places athletes at a high risk of musculoskeletal injuries, particularly to shoulder and elbow joints. OBJECTIVE: This study summarizes published data on shoulder a...
CONTEXT: Wrestling is a physically demanding sport that places athletes at a high risk of musculoskeletal injuries, particularly to shoulder and elbow joints. OBJECTIVE: This study summarizes published data on shoulder and elbow injuries in wrestling, determines their burden, and reports weighted average injury rates (wIRs). DATA SOURCES: Databases searched included PubMed, Embase, Medline, Cochrane Library, and SPORTDiscus. STUDY SELECTION: Full-text studies in English evaluating shoulder or elbow injuries in competitive wrestlers with reported injury data specific to wrestlers, as well as to the shoulder or elbow were included. Exclusions were case reports, reviews, and studies not reporting orthopaedic injury data. STUDY DESIGN: Systematic review. LEVEL OF EVIDENCE: Level 4. DATA EXTRACTION: Extracted data included the first author, publication year, journal, country of the corresponding author, level of competition, method of data collection, duration of data collection, incidence of injury (injury rate [IR]) per athlete-exposure (AE), number of shoulder or elbow injuries, total number of injuries, total AEs, specific injury types, mechanism of injury, and time lost due to injury. RESULTS: Shoulder and elbow injuries together accounted for 21.2% of all wrestling injuries, with a wIR of 14.1 per 10,000 AEs. Shoulder injuries accounted for 14.1% of all injuries (wIR = 6.2 per 10,000 AEs), while elbow injuries accounted for 7.2% (wIR = 4.1 per 10,000 AEs). The most frequent injuries were shoulder strains/sprains (wIR = 4.2), including rotator cuff (wIR = 3.4) and acromioclavicular joint injuries (wIR = 1.5), shoulder instability (wIR = 2.5), and elbow instability, including ulnar collateral ligament injury (wIR = 1.8). CONCLUSION: Shoulder and elbow injuries are common in wrestling, with shoulder injuries being more prevalent due to the joint's mobility and relative instability. This review identifies the most common injuries and serves as a valuable resource for physicians managing the care of wrestlers.
Prevalence of Ulnar Nerve Dislocation Among Division I Collegiate Baseball Players.
Vega TF, Ithurburn MP, Yates AF … +3 more , Westbrooks B, Carlson S, Colberg RE
Sports Health · 2026 · PMID 41387714 · Full text
BACKGROUND: Ulnar nerve dislocation is an under-reported cause of medial elbow mechanical symptoms in baseball players. It is often accompanied by a "pop" during the throwing motion. This mechanical symptom is often conf...
BACKGROUND: Ulnar nerve dislocation is an under-reported cause of medial elbow mechanical symptoms in baseball players. It is often accompanied by a "pop" during the throwing motion. This mechanical symptom is often confused with ulnar collateral ligament (UCL) injury. This study evaluated associations of asymptomatic ulnar nerve subluxation with UCL laxity in collegiate baseball players. HYPOTHESIS: Asymptomatic ulnar nerve dislocation is prevalent among collegiate baseball players, and associated with years of playing baseball, playing as a pitcher, and having medial UCL laxity. STUDY DESIGN: Cross-sectional study. LEVEL OF EVIDENCE: Level 4. METHODS: Healthy, asymptomatic, National Collegiate Athletic Association Division I, male, collegiate baseball athletes were evaluated with dynamic stress ultrasound imaging for ulnar nerve dislocation and UCL laxity, and associations with demographic and athletic variables were evaluated. RESULTS: A total of 50 male athletes were evaluated (mean age, 20.5 years; 40% pitchers; mean playing experience, 15.7 years). Ulnar nerve dislocation was found in 16% of players (8 of 50 players) and in 11% of elbows evaluated (11 of 100 elbows; bilateral dislocations were identified in 3 players). None of the players reported ulnar nerve symptoms. No demographic or athletic variables, including years of playing or position, were associated with dislocation ( > 0.05). Players with ulnar nerve dislocation demonstrated higher values for all sonographic UCL laxity measurements than those who did not dislocate, including 0.6 mm greater valgus stress ulnohumeral joint space and 0.4 mm greater joint space gap. However, these group differences did not reach statistical significance ( > 0.05). CONCLUSION: Ulnar nerve dislocation can be an asymptomatic finding in baseball athletes. Ulnar nerves may be more prone to dislocate in the presence of medial elbow valgus laxity. CLINICAL RELEVANCE: Ulnar nerve dislocation should be considered a cause of medial elbow mechanical symptoms, even if the athlete is asymptomatic.
First Time Doing Resisted Sprint Training? Effects of Different Loads on the Force-Velocity Profile and Sprint Performance in Professional Male and Female Football Players and Referees: A Pilot Study.
Alonso-Callejo A, Garcia-Unanue J, Gallardo L … +1 more , Felipe JL
Sports Health · 2026 · PMID 41351337 · Full text
BACKGROUND: The force-velocity profile (FVP) is essential for understanding sprint performance, capturing parameters such as maximum theoretical force (F), maximum theoretical velocity (V), and power (P). Effective horiz...
BACKGROUND: The force-velocity profile (FVP) is essential for understanding sprint performance, capturing parameters such as maximum theoretical force (F), maximum theoretical velocity (V), and power (P). Effective horizontal force application, especially during acceleration, enhances sprinting outcomes. Resisted sprint training (RST) using varied loads (light, moderate, heavy) can improve neuromuscular adaptations, sprint mechanics, and sport-specific performance. This study explores the effects of RST with different load magnitudes. HYPOTHESIS: Heavy loads (HL) in athletes with no previous experience in RST are expected to promote better results on sprint performance than light loads (LL) and no loads (CON). STUDY DESIGN: Randomized clinical trial. LEVEL OF EVIDENCE: Level 3. METHODS: Professional male and female football players and referees without experience in sled sprint, allocated into HL (80% of body mass [BM]), LL (20% of BM), and CON (0% of BM) groups, performed RST twice weekly over 6weeks, with pre- and postintervention assessments of sprint performance. RESULTS: RST with HL significantly improves acceleration, maximum velocity, and horizontal force application. The HL group demonstrated reduced sprint times, enhanced force production during the acceleration phase, and improvements in maximum velocity metrics such as V and maximum velocity (V). The LL group showed small benefits in V and decreased times in the 10 meter to 20 meter and 20 meter to 30 meter splits. Intergroup comparisons revealed that the HL group obtained better results compared with the LL and CON groups. CONCLUSION: Both LL and HL improved the right spectrum of the FVP. However, the HL group also improved the acceleration phase variables and force production at low velocity. CLINICAL RELEVANCE: These findings suggest that HL provides superior neuromuscular adaptations and mechanical outputs compared with lighter loads in athletes without previous experience in RST. The inclusion of professional female football players expands the applicability of these results.
Can You Trust Your Strength Assessment? Evaluating the Reliability and Validity of Handheld and Externally Fixated Dynamometers for Measuring Knee and Hip Strength.
Depuydt LR, Vanrenterghem J, Verschueren S … +1 more , Smeets A
Sports Health · 2026 · PMID 41351336 · Full text
BACKGROUND: The gold standard for measuring hip and knee strength is isokinetic dynamometry. This study evaluated the reliability and concurrent validity of a handheld dynamometer (HHD) and a externally fixated dynamomet...
BACKGROUND: The gold standard for measuring hip and knee strength is isokinetic dynamometry. This study evaluated the reliability and concurrent validity of a handheld dynamometer (HHD) and a externally fixated dynamometer (ForceFrame [FF]) against isokinetic dynamometry, considering their practicality, cost-effectiveness, and ease of use in clinical practice. HYPOTHESIS: The FF and HHD are reliable and valid for assessing hip and knee strength. STUDY DESIGN: Controlled laboratory study. LEVEL OF EVIDENCE: Level 4. METHODS: Maximal isometric hip strength (extension, flexion, abduction, adduction, internal and external rotation) and knee strength (extension and flexion) of 14 healthy persons (7 men; age, 24.4 ± 3.1 years; height, 176.3 ± 9.7 cm; weight, 68.5 ± 10.8 kg) was assessed with an isokinetic dynamometer, HHD, and FF. Measurements were repeated on 2 different days for test-retest reliability and by 2 different investigators on 1 day for interrater reliability. Intraclass correlations (ICC) were calculated, and Pearson correlation coefficients assessed concurrent validity. RESULTS: Moderate to good test-retest reliability was found for both the HHD (ICC, 0.62-0.88; MDC, 10-21%) and FF (ICC, 0.61-0.82; MDC, 15-38%). Interrater reliability was poor to good (HHD ICC, 0.15-0.80; FF ICC, 0.14-0.77). Concurrent validity was better for the HHD than FF. CONCLUSION: Both the HHD and FF provide stable measurements of hip and knee strength over a 1-week interval. The calculated MDCs (HHD, 10-21%; FF, 15-38%) suggest that only differences exceeding these thresholds can be interpreted as true changes, rather than measurement errors. Inter-rater reliability was rather low, indicating that repeated evaluations are best performed by the same tester. Poor concurrent validity cautions against substituting the HHD and FF for isokinetic dynamometry. CLINICAL RELEVANCE: HHD and FF offer practical and cost-effective alternatives for a single tester to evaluate strength changes over time.
Regional Activation of the Latissimus Dorsi Muscle by High-Density Surface Electromyography During Isometric Shoulder and Trunk Exercises.
Muñoz-Garcés M, Peñailillo L, Mendez-Rebolledo G
Sports Health · 2026 · PMID 41345828 · Full text
BACKGROUND: The latissimus dorsi (LD) comprises 2 neuromuscular regions-the thoracic and lumbar-pelvic-costal (LPC)-that may exhibit distinct activation patterns during shoulder and trunk exercises. A detailed understand...
BACKGROUND: The latissimus dorsi (LD) comprises 2 neuromuscular regions-the thoracic and lumbar-pelvic-costal (LPC)-that may exhibit distinct activation patterns during shoulder and trunk exercises. A detailed understanding of these regional differences is crucial for optimizing therapeutic interventions due to their potential impact on muscle imbalances and rehabilitation outcomes in people with musculoskeletal conditions. HYPOTHESIS: Increasing contraction levels are expected to amplify differences between the thoracic and LPC regions, with the thoracic region demonstrating greater activation, particularly during shoulder extension and internal rotation tasks. STUDY DESIGN: Descriptive laboratory study. LEVEL OF EVIDENCE: Level 5. METHODS: A total of 20 healthy participants (15 men and 5 women) were recruited. High-density surface electromyography (HD-sEMG) electrode grids were positioned over the LD. Participants performed isometric contractions for shoulder extension, adduction, internal rotation, and lateral trunk bending at 10%, 30%, 50%, 70%, and 100% of their maximum voluntary contraction (MVC). The variables assessed included sEMG amplitude for each region and the spatial distribution of muscle activation (- and -axis barycenter). RESULTS: During shoulder extension, the thoracic region showed greater sEMG amplitudes than the LPC region at 50% ( = 0.02), 70% ( = 0.01), and 100% MVC ( < 0.01). Furthermore, shoulder extension generated greater amplitudes than all other exercises across both regions ( < 0.05). Barycenter analysis revealed a significant cephalomedial shift in the -axis during both shoulder extension and internal rotation. CONCLUSION: The thoracic region is preferentially recruited during isometric shoulder extension and internal rotation. This spatial redistribution of muscle activity suggests a functional specialization within the LD, which has important implications for the development of targeted shoulder rehabilitation strategies. CLINICAL RELEVANCE: Exercises emphasizing shoulder extension may preferentially activate the thoracic region of the LD, thereby enhancing scapular stability while reducing strain on the rotator cuff tendons.
Effects of Sport Specialization on Pitching Biomechanics in Adolescent Baseball Pitchers.
Johnson AL, Caballero MR, Fehr S … +2 more , Dziuk CC, Cross JA
Sports Health · 2026 · PMID 41327821 · Full text
BACKGROUND: Adolescent sport culture is moving away from multisport participation, emphasizing sport specialization for improved skill development despite concern of injury. This study examined biomechanical differences...
BACKGROUND: Adolescent sport culture is moving away from multisport participation, emphasizing sport specialization for improved skill development despite concern of injury. This study examined biomechanical differences among low-, moderate-, and high-level specialized pitchers. HYPOTHESIS: Kinetics, kinematics, and peak velocities will vary with specialization level. STUDY DESIGN: Descriptive laboratory study. LEVEL OF EVIDENCE: Level 3. METHODS: Adolescent male baseball pitchers' (N = 46) pain, injury, baseball exposure history, and pitching biomechanics were measured during a single pitching session. Means and standard deviations were calculated for all metrics (significance, ≤ 0.05) and compared among low-, moderate-, and high-level specialization groups. RESULTS: Stride length increased significantly ( = 0.03) from low- (mean, 74% height; SD, 13.6; 95% CI, 64.3-83.8) to high-level (mean, 92.9% height; SD, 6.3; 95% CI, 79.7-86.1) specialization. Hip-shoulder separation at foot contact increased significantly ( = 0.01), with low-, moderate-, and high-level specialization demonstrating means of 21.9° (SD, 12.1; 95% CI, 13.3-30.6), 31.1° (SD, 7.0; 95% CI, 27.7-34.4) and 30.0° (SD, 5.3; 95% CI, 27.3-32.8), respectively. Maximum torso rotation velocity and maximum shoulder internal rotation (IR) velocity increased significantly ( = 0.03) from low- to high-level specialization rising from 930.5 deg/s (SD, 68.4) to 1020.0 deg/s (SD, 75.7), and from 4284.2 deg/s (SD, 311.6) to 4827 deg/s (SD, 512.2), respectively. Peak shoulder distraction force also increased significantly from low- to high-level specialization ( = 0.03), rising from 0.81 N (% bodyweight) (SD, 0.13; 95% CI, 0.72-0.91) to 0.96 N (% bodyweight) (SD, 0.12; 95% CI, 0.89-1.02). There were no significant differences among age, height, weight, or pitch speed across pitching specialization level. CONCLUSION: Differences in pitching biomechanics were observed among low-, moderate-, and high-level specialized high school baseball pitchers. CLINICAL RELEVANCE: Recognizing the impact of sport specialization and negative influences on pitching biomechanics will contribute positively to performance training and injury prevention strategies.
The Protective Effect of Preseason Running Workload Against In-Season Hamstring Strain Injuries in Elite Soccer Players.
Saito H, Kutsuna T, Akiyoshi N … +4 more , Kobayashi Y, Ito S, Ikuno S, Nakayama T
Sports Health · 2026 · PMID 41327818 · Full text
BACKGROUND: Preseason training plays a pivotal role in preparing athletes for the competitive season and reducing the risk of hamstring strain injuries (HSI). This study evaluated the protective effect of preseason runni...
BACKGROUND: Preseason training plays a pivotal role in preparing athletes for the competitive season and reducing the risk of hamstring strain injuries (HSI). This study evaluated the protective effect of preseason running workload on the risk of in-season HSI in elite soccer players. HYPOTHESIS: Higher preseason sprint-related metric is associated with reduced risk of in-season HSI in elite soccer players. STUDY DESIGN: Cohort study. LEVEL OF EVIDENCE: Level 3. METHODS: Global positioning system data and HSI records from 67 elite Japanese soccer players between 2021 and 2023 were analyzed. Variables included internal workload, total distance, high-speed distance, sprint distance, sprint count, and acceleration/deceleration count. Multivariable logistic regression analysis determined the association between workload metrics and HSI risk. RESULTS: A total of 17 HSI incidents were recorded during the study period. Increased preseason sprint distance was associated significantly with a reduced risk of in-season HSI (odds ratio [OR], 0.896; 95% CI, 0.822-0.976; = 0.01), even after adjustment (model 1: OR, 0.892; 95% CI, 0.814-0.979; = 0.02, model 2: OR, 0.899; 95% CI, 0.822-0.983; = 0.02). Higher sprint count was associated with decreased HSI risk (OR, 0.761; 95% CI, 0.633-0.916; = 0.004), with consistent findings after adjustments (model 1: OR, 0.755; 95% CI, 0.623-0.916; = 0.004, model 2: OR, 0.763; 95% CI, 0.631-0.923; = 0.005). The area under the curve values for sprint distance and sprint count were 0.721 and 0.739, respectively. CONCLUSION: Preseason training marked by higher sprint distances and counts demonstrates a protective effect against in-season HSI in elite soccer players, supporting comprehensive preseason running workload as an essential strategy for reducing injury risk and enhancing season readiness. CLINICAL RELEVANCE: Incorporating sprint-focused training during the preseason may reduce HSI incidence and minimize injury-related absences in elite soccer players.
Impact of the FIFA World Cup Qatar 2022 on LaLiga Players' Physical Performance: Unveiling Insights Into External Load Patterns.
Pecci J, Reverte-Pagola G, Del Ojo-López JJ … +3 more , López Del Campo R, Resta Serra R, Feria-Madueño A
Sports Health · 2026 · PMID 41327795 · Full text
BACKGROUND: Tracking systems have revolutionized the analysis of physical demands in professional soccer. Monitoring external load parameters through global positioning systems is crucial for monitoring fatigue, technica...
BACKGROUND: Tracking systems have revolutionized the analysis of physical demands in professional soccer. Monitoring external load parameters through global positioning systems is crucial for monitoring fatigue, technical-tactical factors, and preventing injuries, especially during disruptions such as COVID-19 and midseason tournaments. HYPOTHESIS: The FIFA World Cup Qatar 2022 would lead to significant changes in external load parameters among LaLiga players, either positively or negatively, when comparing pre- and post-tournament match performance. STUDY DESIGN: Retrospective observational study. LEVEL OF EVIDENCE: Level 3. METHODS: External load metrics (ie, minutes of game, accelerations, decelerations, sprints, and high-speed running [HSR]) were analyzed to compare performance in 8 pre- versus postleague tournament matches in those soccer players who competed in FIFA World Cup Qatar 2022. The sample consisted of players from the Spanish LaLiga elite soccer league who participated in the Qatar 2022 World Cup. RESULTS: FIFA World Cup Qatar 2022 did not negatively impact external load variables. Post-tournament values showed improvements in (1) number and distance covered at HSR, (2) distance and number of sprints, (3) number of high-intensity actions performed, and (4) number and distance covered at high-intensity deceleration, without significant differences in total distance covered or maximal speed reached during matches. CONCLUSION: FIFA World Cup Qatar 2022 did not negatively affect the performance of Spanish LaLiga players. On the contrary, several external load metrics such as HSR, sprinting, accelerations, and decelerations showed improved performance post-tournament. CLINICAL RELEVANCE: These results may help clarify the effects of future in-season league stoppages due to international competitions.
Evaluation of Exertional Sweat Loss Estimates in Wearable Technology.
Carrier B, Melvin AC, Outwin JR … +5 more , Wasserman MG, Audet AP, Soldes KC, Kozloff KM, Lepley AS
Sports Health · 2026 · PMID 41320899 · Full text
BACKGROUND: Wearable technology shows promise for monitoring exertional sweat loss, yet its accuracy requires evaluation. This study evaluated the accuracy of 2 commercially available smartwatches for estimating sweat lo...
BACKGROUND: Wearable technology shows promise for monitoring exertional sweat loss, yet its accuracy requires evaluation. This study evaluated the accuracy of 2 commercially available smartwatches for estimating sweat loss compared with gold standard methods. HYPOTHESIS: Sweat loss values measured via wearable technology will be determined accurate compared with gold standard methods. STUDY DESIGN: Cross-sectional. LEVEL OF EVIDENCE: Level 2. METHODS: A total of 111 participants (age, 40 ± 14 years; height, 171.0 ± 8.9 cm; body mass, 70.8 ± 14.7 kg; VOmax, 46.8 ± 8.7 ml/kg/min) completed up to 4 running trials under varying conditions (indoor/outdoor, distances from 2.5 km to 20 km, and interval runs). Sweat loss estimates from each smartwatch were compared with criterion measurements based on change in nude body mass pre- and postexercise. Validity statistics included tests for error (mean absolute error [MAE], mean absolute percentage error [MAPE]), linearity (Lin's concordance correlation coefficient [CCC], Pearson's [], and Deming regression), equivalence (CI for difference in means), and Bland-Altman plots for bias assessment. Stratified analyses by sex, weight, and fitness category were also completed, along with a chi-square test of independence. RESULTS: Both devices demonstrated acceptable overall correlation (CCC range, 0.71 to 0.90) but substantial errors in estimating exertional sweat loss (MAPE range, 25.38% to 33.21%). Stratified analyses yielded similar results, with no additional analyses meeting the combined validity thresholds. CONCLUSION: Wearable devices offer a promising and convenient tool for general sweat loss tracking but lack the precision to replace laboratory methods for hydration management. Traditional methods remain essential for the most accurate measurements. CLINICAL RELEVANCE: Wearable devices provide an accessible option for sweat loss monitoring. This study highlights their potential for general tracking while emphasizing the need for laboratory methods when accuracy is critical, ensuring better guidance for hydration strategies in sports performance and health applications.
Preoperative High-Intensity Strength Training and Outcomes After Total Knee Arthroplasty: A Systematic Review and Meta-analysis.
Huang ST, Yang SW
Sports Health · 2026 · PMID 41320898 · Full text
CONTEXT: Preoperative and postoperative strength training is beneficial for outcomes of total knee arthroplasty (TKA). However, the effect of high-intensity strength training is not well understood. OBJECTIVE: This syste...
CONTEXT: Preoperative and postoperative strength training is beneficial for outcomes of total knee arthroplasty (TKA). However, the effect of high-intensity strength training is not well understood. OBJECTIVE: This systematic review and meta-analysis aimed to determine the effects of preoperative high-intensity strength training on TKA outcomes. DATA SOURCES: PubMed, EMBASE, and Cochrane CENTRAL were searched up to December 18, 2023. STUDY SELECTION: Randomized controlled trials and cohort studies evaluating the effect of preoperative high-intensity strength training after TKA were eligible. STUDY DESIGN: Systematic review and meta-analysis. LEVEL OF EVIDENCE: Level II, systematic review and meta-analysis of randomized controlled trials and cohort studies. DATA EXTRACTION: Evaluated outcomes consisted of Timed Up and Go (TUG) test, the 6-minute walk test (6MWT), stair test, range of motion (ROM) flexion, Short Form Health Survey (SF-36) scores, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, and the Knee Injury and Osteoarthritis Outcome Score for Activities of Daily Living (KOOS-ADL). These were compared between the intervention and control groups using pooled standardized mean differences. The quality of the studies was appraised using the Risk of Bias in Nonrandomized Studies by Interventions (ROBINS-I) and the Cochrane Collaboration tool. RESULTS: Seven studies, comprising 419 patients in total, were included. The meta-analysis showed that the preoperative high-intensity strength training group (intervention group) exhibited statistically significant improvements compared with the control group in 6MWT (pooled standardized mean difference [pSMD] = 0.73; 95% CI, 0.04 to 1.41), ROM flexion (pSMD = 0.40; 95% CI, 0.08 to 0.72), SF-36 (pSMD = 1.54; 95% CI, 0.32 to 2.75), and WOMAC (pSMD = -0.78, 95% CI, -1.22 to -0.34). CONCLUSION: Preoperative high-intensity strength training as the prehabilitation programs for patients scheduled for TKA lead to better postoperative recovery, enhanced physical function, and improved quality of life.
Pelvic Organ Prolapse Among Female CrossFitters and Non-CrossFitters: A Cross-Sectional Study.
Arbieto ERM, Fukuda FS, Da Roza T … +1 more , da Luz SCT
Sports Health · 2025 Nov · PMID 41320890 · Full text
BACKGROUND: High-intensity exercises, such as CrossFit (CF), may increase risk of pelvic organ prolapse (POP) due to pelvic floor muscle (PFM) overload. HYPOTHESIS: There is no significant difference in the prevalence, s...
BACKGROUND: High-intensity exercises, such as CrossFit (CF), may increase risk of pelvic organ prolapse (POP) due to pelvic floor muscle (PFM) overload. HYPOTHESIS: There is no significant difference in the prevalence, severity, or affected compartment of POP between women who practice CF and those engaged in other sports of similar intensity. STUDY DESIGN: Cross-sectional. LEVEL OF EVIDENCE: Level 3. METHODS: A total of 36 women (age, 32.7 ± 7.7 years) participated in the study-18 CF practitioners and 18 engaging in other forms of high-intensity exercise (non-CF [NCF]). A sample-characterization form and the International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS) assessed vaginal symptoms. The Pelvic Organ Prolapse Quantification (POP-Q) system, and maximum voluntary contraction (MVC) and endurance of PFM assessed POP and PFM variables, respectively. RESULTS: According to POP-Q, 38.9% and 44.4% of women in the CF and NCF groups, respectively, had POP ( = 0.73). Using ICIQ-VS, the prevalence was higher in both groups: 66.7% and 61.1% in CF and NCF, respectively ( = 0.69). First-degree POP was the most common, affecting 27.8% of women in each group. The most affected compartment was the anterior (22.2% [CF], 27.8% [NCF]). Using ICIQ-VS, "dragging pain or heaviness in the lower abdomen" and "very dry vagina" were most reported in both groups. MVC using modified Oxford scale (3 ± 3 vs 3 ± 2), MVC manometer (28.1 ± 25.8 vs 29.9 ± 22.5) and endurance (3.4 ± 1.7 vs 3.4 ± 2.3) were similar between both groups. CONCLUSION: The prevalence, degree, and symptoms of POP and PFM variables in women practicing CF are similar to those in women engaging in other forms of high-intensity exercise. CLINICAL RELEVANCE: Trainers, clinicians, and physiotherapists should understand the impact of high-intensity exercise on PFM and inform women about these dysfunctions to ensure they exercise safely.
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