A comprehensive guide to sports physiology and injury management : an interdisciplinary approach

Divided into two parts, physiology and sports injury management, this is an innovative clinical- and evidence-based guide, which engages with the latest developments in athletic performance both long and short term. It also considers lower level exercise combined with the pertinent physiological processes. It focuses on the rationale behind diagnostic work up, treatment bias and rehabilitation philosophy, challenging convention within the literature to what really makes sense when applied to sports settings. Drawing upon experts in the field from across the world and various sports settings, it implements critical appraisal throughout with an emphasis on providing practical solutions within sports medicine pedagogy. Dovetails foundational sports physiology with clinical skills and procedures to effectively manage sports injuries across a variety of settings Takes an interdisciplinary approach and draws upon both clinical- and evidence-based practice Contributed by leading international experts including academics, researchers and in-the-field clinicians from a range of sports teams including the Royal Ballet and Chelsea FC Pedagogical features include learning objectives, clinical tip boxes, summaries, case studies and Editor’s commentary to/critique of concepts and techniques across chapters Front-Matter_2020_A-Comprehensive-Guide-to-Sports-Physiology-and-Injury-Mana A Comprehensive Guideto Sports Physiology and Injury Management: An Interdisciplinary Approach Copyright_2020_A-Comprehensive-Guide-to-Sports-Physiology-and-Injury-Managem Copyright Preface_2020_A-Comprehensive-Guide-to-Sports-Physiology-and-Injury-Managemen Preface List-of-Contribut_2020_A-Comprehensive-Guide-to-Sports-Physiology-and-Injury List of Contributors Dedication_2020_A-Comprehensive-Guide-to-Sports-Physiology-and-Injury-Manage Dedication Chapter-1---Muscle-form-an_2020_A-Comprehensive-Guide-to-Sports-Physiology-a | 1 | - Muscle form and function Neuromuscular control of movement Skeletal muscle structure Whole muscles Muscle arrangements Microstructure and contractile proteins The sliding filament theory of muscle contraction Energy for movement Contractile properties of muscle Excitation–contraction coupling Stretch–shortening cycle Length–tension and force–velocity relationships The moment arm influences joint biomechanics Twitches, summation and tetanus Chapter-2---Muscle-adaptatio_2020_A-Comprehensive-Guide-to-Sports-Physiology | 2 | - Muscle adaptations and fatigue Introduction Important concepts related to endurance exercise The endurance training stimulus The adaptation responses Mitochondrial biogenesis Angiogenesis Muscle adaptations to resistance training Neural adaptations Muscle hypertrophy Other morphological adaptations Regulation of muscle protein turnover Mechanotransduction Transcriptional regulation Intracellular signalling responses Satellite cells and myonuclei addition Muscle fatigue Fatigue during very intense exercise Fatigue during prolonged endurance exercise Chapter-3---The-physiology-of-disuse--i_2020_A-Comprehensive-Guide-to-Sports | 3 | - The physiology of disuse, immobilization and low-load environments Introduction Bone Articular cartilage Ligament Joint capsule Skeletal muscle Cardiorespiratory system Summary Chapter-4---Strength-and-conditioning--sci_2020_A-Comprehensive-Guide-to-Spo | 4 | - Strength and conditioning: scientific aspects including principles of rehabilitation Introduction The importance of muscle strength Factors affecting muscle force Motor unit recruitment Firing frequency Modification by muscle and tendon receptors Cross-sectional area Muscle architecture Muscle length and the mechanical model of muscle Contraction velocity Basic principles for increasing muscle strength and power Overload Specificity Individuality Diminishing returns Reversibility Development of specific qualities Designing a ‘strength’ workout Needs analysis Training frequency Exercise selection Training load and repetitions Maximum strength Hypertrophy Muscular endurance Power Recovery Periodization of training Summary Chapter-5---Biomechanics-of-sports-injuri_2020_A-Comprehensive-Guide-to-Spor | 5 | - Biomechanics of sports injuries, their management and clinical considerations Introduction Ankle injuries Mechanism and clinical presentation Ankle rehabilitation protocols Strength training protocols Effects on measures of impairment Effect on measures of self-reported function Multiple treatments and training mode protocols Effects on measures of impairment Effects on measures of functional limitation Summary Patient disability resulting from ankle disease Rehabilitation effects on incidence and recurrence Take-home message Anterior cruciate ligament injuries Anatomy Injury mechanisms and risk factors Screening and prevention Treatment Outcome measures Consequences Take-home message Shoulder injuries Internal impingement Rotator cuff tears Injury mechanism Management of internal impingement and rotator cuff tears Instability Injury mechanism Management of instability Take-home message Chapter-6---Electrophysical-agents_2020_A-Comprehensive-Guide-to-Sports-Phys | 6 | - Electrophysical agents: physiology and evidence Introduction Therapeutic ultrasound Clinical uses of ultrasound therapy Ultrasound nonthermal effects and uses Ultrasound application in relation to tissue repair Inflammation Proliferation Remodelling Low-intensity pulsed ultrasound (LIPUS) and fracture healing Pulsed shortwave therapy and other radiofrequency applications Pulsed shortwave therapy: clinical effects Non-shortwave radiofrequency applications (Indiba, Tecar) Laser therapy/Photobiomodulation Light absorption in the tissues Laser–tissue interaction Treatment doses Clinical applications Open wounds Inflammatory arthropathies Soft tissue injury Pain Summary Shockwave therapy Microcurrent therapy Conclusion Chapter-7---Cryotherapy--physiolo_2020_A-Comprehensive-Guide-to-Sports-Physi | 7 | - Cryotherapy: physiology and new approaches Introduction Heat transfer Convection Conduction Radiation Evaporation Conversion Specific heat capacity Latent heat of fusion Evidence base Dose–response Skin surface and deep tissue temperature relationship Effect of cooling on muscle Effect of cooling on joint position sense Hindering or optimizing Cryotherapy modalities and methods Ice (crushed/cubed/wetted) Cold water immersion Cryotherapy and compression Pitch-side applications WBC and physiology WBC and recovery WBC and injury WBC and psychology WBC and systemic pathologies Chapter-8---Physiology-of-sportin_2020_A-Comprehensive-Guide-to-Sports-Physi | 8 | - Physiology of sporting and athletic recovery Introduction Functional foods Compression garments Cold water immersion Contrast bathing Whole-body cryotherapy Sleep Chapter-9---Making-sense-of-pain-in-sports-p_2020_A-Comprehensive-Guide-to-S | 9 | - Making sense of pain in sports physiotherapy: applying the Pain and Movement Reasoning Model Introduction Reframing the relationship between pain and tissue damage Reframing the relationship between pain and movement Central processing to produce pain Pain and Movement Reasoning Model Local stimulation Clinical note Regional influences Kinetic chain Pathoneurodynamics CNS convergence Clinical note Central modulation Predisposing factors Activity-dependent plasticity Cognitive–emotive–social state Clinical note Implications for integrated sports rehabilitation Summary Chapter-10---The-physiology-o_2020_A-Comprehensive-Guide-to-Sports-Physiolog | 10 | - The physiology of manual therapy Introduction Effects on pain Mechanical effects Effects on motor control Conclusion Chapter-11---The-physiology-of-a_2020_A-Comprehensive-Guide-to-Sports-Physio | 11 | - The physiology of acupuncture analgesia Introduction Application and mechanisms Acupuncture analgesia Layering effect Inflammation and healing Summary Chapter-12---Physiological-determinants-of-endura_2020_A-Comprehensive-Guide | 12 | - Physiological determinants of endurance performance: maximal oxygen uptake (): Testing, training and practical application Introduction Central vs. peripheral considerations and its association with optimal sports performance and its association with optimal health Physiological assessment of Laboratory-based approaches Considerations in selection of exercise test modality Considerations in test protocol selection and design Identification of peak physiological exertion during laboratory-based exercise testing Field-based approaches Walking tests Running tests Step tests Submaximal cycling tests Nonexercise prediction equations Exercise training prescription Dose–response relationships and Factors confounding and limiting chronic alterations in Exercise prescription for promoting increases in Summary Chapter-13---Ultrasound-imaging_2020_A-Comprehensive-Guide-to-Sports-Physiol | 13 | - Ultrasound imaging in groin injuries The rule-out tool Optimal time to scan Dynamic review Full- vs. partial-thickness tears Scanning planes Follow up Imaging Plain radiographs: are they still helpful Computerized tomography Magnetic resonance imaging Operator experience Ultrasound Suspected adductor-related groin pain Adductor protocol Suspected inguinal-related groin pain Femoral region Inguinal region Suspected hip-related groin pain Hip region Tendinopathy.This can be frequently seen at the adductor longus and rectus femoris tendon insertions. On ultrasound, the tendon ... Tearing.This appears as a cleft or void within the muscle or tendon structure. In the acute phase, it is usually filled with flu... Strain.There are varying degrees of muscle strain noted on ultrasound. It is usually depicted as an area of hyperechogenicity in... Effusion.This is joint fluid and has a hypoechoic appearance on ultrasound. Debris within the fluid can sometimes also be identi... Calcification.Build up of calcification in tendons can be the result of repeated microtrauma. Echogenic areas are noted within t... Avulsion.This describes where a small area of bone has been pulled away from the main bone as a result of tendon or ligamentous ... Myositis ossificans.This is defined as the ‘formation of bone tissue inside muscle tissue after a traumatic injury to the area’ ... Conclusion Chapter-14---Conservative-management-o_2020_A-Comprehensive-Guide-to-Sports- | 14 | - Conservative management of groin injuries: acute and chronic Introduction Incidence and epidemiology Aetiology Diagnosis Evolution of the PLAC Imaging Muscle function and myokinematics Adductor muscle function Abdominal muscle function Groin function in sport Running Change of direction Kicking Medical intervention/pharmacotherapy Rehabilitation Stages of management in acute setting Stage 1: bleeding phase (0–48 hours) Stage 2: inflammatory phase (days 0–5/6/7) Stage 3: tissue conditioning/remodelling phase Differences in chronic/acute on chronic presentation Principles of loading Adductor loading Abdominal loading Bone loading and noncontractile tissue Stage 4 – sports-specific with return to running phase Stage 5 – integration back into full training Summary Chapter-15---The-surgical-managemen_2020_A-Comprehensive-Guide-to-Sports-Phy | 15 | - The surgical management of sporting groin injuries Introduction Incidence Aetiology Presentation and diagnosis Symptoms Signs Adductor injuries Investigations Plain X-rays Radionuclide bone scan Ultrasound scan Magnetic resonance imaging Differential diagnosis Surgery Indications for surgery Surgical technique Adductor tenotomy The physiology of wound healing Outcome and recurrence Rehabilitation The multidisciplinary team Controversies Summary Chapter-16---The-sport_2020_A-Comprehensive-Guide-to-Sports-Physiology-and-I | 16 | - The sporting hip Introduction Structure Joint shape Labrum Periarticular mechanics and microinstability Function Movement in sport Return to activity/sport Pathology Radiology Rehabilitation Chapter-17---Lumbopelvic-dysfunction-in-the_2020_A-Comprehensive-Guide-to-Sp | 17 | - Lumbopelvic dysfunction in the sporting population: the ‘what’, the ‘why’ and the ‘how’ Introduction Assessment – identifying the ‘what’ Patient history Visual assessment and observation Tests in standing or kinetic tests Trunk flexion assessment Trunk extension assessment Trunk side flexion Gillet test or stork test Hip extension test Palpation Supine Prone Sacral nutation, sacral counternutation or sacral tilt Patient positioning Tests in supine lying Active straight leg raise (SLR) Passive SLR Assessment findings – establishing the ‘why’ Prevention – determining the ‘how’ The role of imaging Conclusion Chapter-18---Performance-rehabilitation-fo_2020_A-Comprehensive-Guide-to-Spo | 18 | - Performance rehabilitation for hamstring injuries - a multimodal systems approach Introduction Sporting anatomical demands Classification of hamstring injuries The importance of adequate rehabilitation Creating a performance-enhancement environment Performance-enhancing rehabilitation philosophy Improving athletic ability Reducing risk of future injury Optimizing athlete engagement Performance rehabilitation: strength Developing a variety of hamstring strength qualities Progressive overload Exercise selection Explosive strength: plyometrics Low-threshold plyometrics High-threshold plyometrics Lumbopelvic–hip complex Neuromuscular control (NMC) and neurodynamics Performance rehabilitation: running exposure Pool running: the battle with time begins ... Resisted runs and how much resistance is enough Assisted runs Change of direction and agility Deceleration and turning Acceleration Agility High-speed running and sprinting Return to play Outcome measures Conclusion Chapter---19-----The-management-of-gastrocn_2020_A-Comprehensive-Guide-to-Sp | 19 | - The management of gastrocnemius and soleus muscle tears in professional footballers Introduction Stress/strain concept Incidence of tears and the football calendar Assessment and use of radiological imaging Commonly considered causes Flexibility Strength inadequacies Foot mechanics and orthotic use Less commonly considered causes Hydration and its effects on muscle elasticity Poor training load management Rehabilitation Treatment room to gym Knee-to-wall test/weight-bearing lunge test Muscle work capacity/calf endurance test Handheld dynamometry (HHD) AlterG protocol What and who are we rehabilitating Gym rehabilitation to return to play How to load Red flags Deep vein thrombosis Tumour Stress fractures Popliteal artery entrapment syndrome (PAES) Summary Chapter---20-----Knee-injuries-in_2020_A-Comprehensive-Guide-to-Sports-Physi | 20 | - Knee injuries in professional football Introduction Epidemiology The Chelsea FC Medical Department philosophy Treatment structure Methods of functional progression ‘Knee-specific’ targeted interventions Common knee injuries Medial collateral ligament injuries Anterior cruciate ligament injuries Meniscus injuries Posterolateral corner injuries On-field rehabilitation The Injury-Prevention Unit at Chelsea FC Conclusion Chapter---21-----The-sporting-ankle--lateral-a_2020_A-Comprehensive-Guide-to | 21 | - The sporting ankle: lateral ankle sprain, the most commonly incurred lower limb musculoskeletal injury Introduction Case description Injury epidemiology Mechanism of injury Clinical assessment: the essentials Fracture Ligaments Physical component of the clinical assessment: the summary Rehabilitation of the footballer’s ankle Sensorimotor insufficiencies: the theory Clinical assessment of sensorimotor insufficiencies Pain Swelling Range of motion: osteokinematics and arthrokinematics Muscle strength Static and dynamic postural balance Range of motion: osteokinematics and arthrokinematics Muscle strength Static and dynamic postural balance Athlete profile Other ankle joint injuries: a brief commentary Conclusion and summary Chapter---22-----The-rehabilitation-of-the_2020_A-Comprehensive-Guide-to-Spo | 22 | - The rehabilitation of the rugby shoulder: a proposed approach to management Introduction Task-based/criterion-based model Rugby union and its demands on the shoulder Healthy shoulders The rotator cuff Assessment The role of imaging in the sporting shoulder The adolescent shoulder Rehabilitation of the injured shoulder Rehabilitation pillars Category 3 and 4 injuries Category 1 and 2 injuries Isometric rotator cuff activation Rotator cuff endurance exercises Joint position sense (proprioception) Closed kinetic chain exercises Eccentric rotator cuff strength Open kinetic chain exercises Upper body strength Horizontal push Horizontal pull Vertical push Vertical pull Rotator cuff reactive strength Return to play Sport- and position-specific skills Return to contact skills Outcome measures Inseason management Conclusion Chapter---23-----Assessment-of-t_2020_A-Comprehensive-Guide-to-Sports-Physio | 23 | - Assessment of the sporting shoulder Principles The diagnostic filter Early identification of serious pathology History Age as a predictor of pathology Mechanism of onset Instability symptoms Occupation (sport) and potential sport-specific risk Pain location Aggravating factors Neurological symptoms Clinical examination On the field assessment Deformity.Does the shoulder contour look rounded like the contralateral shoulder or is there a squared-off appearance to indicat... Bruising.Immediate significant bruising and discolouration after trauma is indicative of bony or vascular injury so should be re... Wasting.Muscle wasting is rarely seen in those aged under 50 years so should be regarded as significant. It may represent the se... Swelling.Swelling in the shoulder is rare, and so when present should be viewed as a significant finding. After trauma this usua... Redness.Redness is a key sign of active inflammation so when present over a joint should raise immediate suspicion of infection ... Bony tenderness.This should be assessed after trauma. Palpate the length of the clavicle, acromion and scapula spine whilst prom... Joints.The sternoclavicular (SC) joint, AC joint and glenohumeral joint should be palpated for tenderness, excessive heat, swell... Range of movement Clinical tests The rotator cuff The belly press test.The patient places the hand on the belly with the elbow at 90 degrees and forward of midline. The tester tr... The bear hug test.The patient places their hand on their opposite shoulder with the elbow unsupported on the chest. The tester t... The lift-off test.The patient places their hand behind their back with the dorsum of the hand against the lumbar spine. The test... Isometric external rotation test.The patient stands with both elbows flexed to 90 degrees and the shoulders in neutral rotation.... External rotation lag sign.If there is considerable weakness of isometric external rotation then passively rotate the shoulder t... The full can test.The arm is abducted to 90 degrees in the plane of the scapula with the hand orientated so that the thumb point... The empty can (Jobe’s) test.This is similar to the full can test, however the hand is orientated so that the thumb points toward... Palpation. AC joint pain is very localized and the joint will be tender to firm palpation The scarf test.The patient flexes the shoulder to 90 degrees and adducts the hand towards the opposite shoulder. Overpressure is... Instability testing.If there is a dislocation of the AC joint the tester should offload the weight of the arm and assess whether... Bateman method.This method of testing the pectoralis major involves the tester standing face-to-face with the patient. First the... Bicep rupture Hook test (O’Driscoll et al., 2007).This is performed by placing a hooked finger behind the distal tendon and pulling forward. A... SLAP tear and proximal biceps tendinopathy Palpation. The long head of bicep tendon may be tender proximally over the bicipital groove O’Brien’s active compression test (O’Brien et al. 1998).The patient’s arm is flexed to 90 degrees and adducted 30 degrees with t... Glenohumeral joint laxity and instability The sulcus sign (Neer and Foster, 1980).The patient sits with the arm relaxed at their side. The tester applies a downward tract... The apprehension and relocation tests (Farber et al., 2006).With the patient sitting or supine lying the arm is abducted to 90 d... Generalized laxity: Beighton score Differential tests for the neck and neurological screening Functional assessment Imaging Plain film X-ray.Radiography of the shoulder has low radiation exposure and is a cheap, accessible form of imaging. Plain X-ray ... Ultrasound scan.Ultrasound is often preferred to magnetic resonance imaging for suspected rotator cuff pathology as it has simil... Computed tomography (CT).A cross-sectional imaging modality using a high dose of radiation mainly to assess bone. This is rarely... Magnetic resonance imaging (MRI).High-resolution cross-sectional imaging is used to identify rotator cuff/bicep/pectoral tendon ... Magnetic resonance arthrogram (MRA).This is similar to MRI but with the addition of an injection of a liquid contrast agent into... Laboratory tests Bloods and aspiration.If the patient presents with a recent onset of a severely painful, red, hot, swollen joint with systemic f... Conclusion Chapter---24-----The-spor_2020_A-Comprehensive-Guide-to-Sports-Physiology-an | 24 | - The sporting elbow Introduction Elbow anatomy Osteology Ligaments Muscles Biomechanics Phase I (windup). In this preparatory phase the elbow flexes and the forearm is slightly pronated Phase II (cocking).The shoulder abducts and moves into maximal external rotation, the elbow flexes to between 90 degrees and 120... Phase III (acceleration).A large forward-directed force in generated as the extremity moves into rapid elbow extension. Biomecha... Phase IV (deceleration).Eccentric contraction occurs in all muscles to slow the arm. High torque is generated during this phase,... Phase V (follow-through). In this final phase the forces are dissipated, and the body rebalances to stop forward motion Elbow instability Acute instability Valgus instability Lateral epicondylitis Physiotherapy Antiinflammatory agents Bracing Biological treatments Surgical treatment Medial epicondylitis Tendon ruptures/avulsions Distal biceps tendon rupture Triceps tendon rupture Key messages Chapter---25-----Hand-and-wrist-in_2020_A-Comprehensive-Guide-to-Sports-Phys | 25 | - Hand and wrist injuries: a focus on boxing Introduction Main injuries occurring at the hand and wrist in boxing The knuckles: sagittal band injuries Presentation/testing for sagittal band injuries Objective measures Range of motion Strength (hand function) Diagnostic work-up (investigations) Ice and compression Manual therapy (joint mobilizations) Electrotherapy modalities Acupuncture Soft tissue mobilization Rehabilitation (exercise therapy) Antiinflammatories and injection therapy Surgical intervention Carpometacarpal joint injuries Presentation/testing Strength (hand function) Diagnostic work-up (investigations) Ice and compression Manual therapy Electrotherapy Acupuncture Soft tissue mobilization Rehabilitation (exercise therapy) Antiinflammatories and injection therapy Surgical management Ulnar collateral ligament injury at the base of the thumb (MCP joint) Presentation/testing Objective measures Diagnostic work-up (investigations) Surgical management Conclusion Chapter---26-----The-cervical-spine--_2020_A-Comprehensive-Guide-to-Sports-P | 26 | - The cervical spine: risk assessment and rehabilitation Introduction Risk assessment of the cervical spine in a sporting context Headache and dizziness: danger or direction for treatment How should clinicians proceed Cervical arterial dysfunction Internal carotid artery dissection Clinical presentation Management Vertebral artery dissection Clinical presentation Management Ongoing dizziness Traumatic brain injury Persistent symptoms Management Cervicogenic dizziness Definitions Sensorimotor dysfunction Sensorimotor considerations Mechanoreceptors, reflexes and the sympathetic nervous system Possible mechanisms Clinical examination 1. Smooth pursuit eye movement (in neutral).Examination of oculomotor control includes observation of the eyes following a moving... 2. Saccadic eye movement.The patient is asked to quickly move the eyes to fix his/her gaze between several targets. Targets are p... 3. Smooth pursuit neck torsion test (SPNT).The same as test 1 but with the trunk rotated to achieve 45 degrees of cervical rotati... Further testing 4. Gaze stability.The patient is asked to maintain visual focus on a target as he/she actively moves the head slowly into variati... 5. Eye–head coordination.The patient initiates eye movement to a point to focus and then, while maintaining focus, moves the head... 6. Optokinetic assessment.The patient is positioned 90 cm away from a wall with a laser pointer attached to his/her head; the pat... 7. Head–body disassociation.The patient is asked to maintain a stable head position, using laser as feedback if necessary, whilst... 8. Postural control system.This includes all the sensorimotor and musculoskeletal elements involved in the control of postural or... Motor function Isometric training Global strength training Endurance training Plyometric training Sensorimotor system training Mental health perspectives Summary Chapter---27-----Management-o_2020_A-Comprehensive-Guide-to-Sports-Physiolog | 27 | - Management of head injuries Introduction Symptoms Diagnosis and management Immediate pitch-side recognition of mTBI Red flags Clinical assessment Investigations Acute management Treatment of mTBI Chronic/persistent symptoms Key points and take-home message Chapter---28-----A-high-performance-appro_2020_A-Comprehensive-Guide-to-Spor | 28 | - A high-performance approach to optimizing a major league soccer preseason Introduction The foundation: offseason Strength/power development Running volumes and intensities Soccer-specific conditioning The structure: preseason Testing Offseason-to-preseason transition Preseason: planning the big picture Phase 1: training overload phase Phase 2: game overload phase Phase 3: underload or taper phase Game progression within ‘big picture’ planning Monitoring Strength/power development Summary Chapter---29-----An-introduction-to-wo_2020_A-Comprehensive-Guide-to-Sports- | 29 | - An introduction to working in an elite football academy Introduction The interdisciplinary team and the athlete-centred approach Developing people, not just footballers Custodians of club culture and values Environment Subjective assessment Pain scales Objective, observational and behavioural assessment Rehabilitation planning Avoiding over medicalization Taping Long-term athletic development Growth and maturation What ‘age’ is the player Chronological age Biological or skeletal ‘age’ Assessment of genital/pubic hair development.The Tanner’s Sexual Maturity Scale was devised to assess physical development in ch... Magnetic resonance imaging.The use of MRI offers the possibility of estimating biological/chronological maturity without the nee... Psychological age The relative age effect and bio-banding Safeguarding Creating a safe environment Transport Back to basics Consider environmental factors Multiple roles of IDT members First aid Summary Chapter---30-----Growing-bones--_2020_A-Comprehensive-Guide-to-Sports-Physio | 30 | - Growing bones: anatomy and fractures Introduction Paediatric long bone anatomy Bone growth Salter–Harris classification of physeal fractures Signs and symptoms Diagnosis and treatment Incomplete fractures Greenstick fractures Torus (buckle) fracture Bow fracture Fracture clinical decision tools The Ottawa foot and ankle rules The Ottawa knee rules Fracture treatment Chronic fractures affecting the growth plate Apophyseal avulsion fractures Pelvic apophyseal avulsion fractures Avulsion of the tibial spine (tibial eminence fractures) Signs and symptoms Treatment Tibial tubercle avulsion Signs and symptoms Diagnostics/imaging Treatment Calcaneum avulsion fractures Diagrammatic overview Summary Chapter-31---Growing-bones--Osteochondr_2020_A-Comprehensive-Guide-to-Sports | 31 | - Growing bones: osteochondroses and serious paediatric conditions Introduction Osteochondroses Nonarticular osteochondroses: traction apophysitis Apophysitis treatment and management principles Tibial tubercle traction apophysitis (Osgood–Schlatter disease) Inferior pole of the patella apophysitis (Sinding-Larsen Johansson syndrome) Calcaneal apophysitis (Sever’s disease) Apophysitis of the fifth metatarsal base (Iselin’s disease) Articular osteochondrosis Legg–Calvé–Perthes disease Osteochondritis dissecans (OCD) Köhler’s disease Freiberg’s disease Other ‘not to be missed’ paediatric presentations Slipped upper femoral epiphysis Signs and symptoms Femoroacetabular impingement Cam morphology.This is more prevalent in males than females (23.9% vs. 9.9%) (P < 0.001) (Li et al., 2017). It is also more prev... Symptoms and diagnosis Treatment Lumbar spondylolysis and spondylolisthesis Spondylolysis Spondylolisthesis Spondylolysis symptoms and diagnosis Spondylolysis treatment Spondylolisthesis symptoms and diagnosis Spondylolisthesis treatment Bone and joint infections: septic arthritis and acute osteomyelitis Symptoms Diagnosis and treatment Tumours misdiagnosed as musculoskeletal injuries Bone health, growth, maturation and injuries Summary Chapter-32---Cardiac-event-in-_2020_A-Comprehensive-Guide-to-Sports-Physiolo | 32 | - Cardiac event in the young athlete Introduction Sudden cardiac death in athletes Related cardiac conditions Who to screen Screening programme design Medical history and physical examination The role of the 12-lead resting ECG ESC and AHA consensus for PPS in athletes Ethical perspective Conclusion Chapter-33---Developing-speed-qua_2020_A-Comprehensive-Guide-to-Sports-Physi | 33 | - Developing speed qualities in youth athletes Introduction When is it possible to develop speed qualities in children Does a child have to possess the ‘performance/speed gene’ Accelerated trainability phases Sampling years: 5–11 years of age Fun and learning to train phase What is agility What is not agility Why train agility Agility practice to help reduce injury incidence How do we train agility Stage 1: planned movements Stage 2: reactive movements Stage 3: small-sided games Exercise prescription Measuring heart rate response during the sampling years Measuring active participation during the sampling years Specialization years: 10–16 years of age Training to train phase Developing speed qualities in boys and girls Stride characteristics for developing speed Resistance training High-speed running Exercise prescription Using heart rate to help prescribe practice sessions Challenges Conclusion Chapter-34---Conditioning-for-the-battle-of-m_2020_A-Comprehensive-Guide-to- | 34 | - Conditioning for the battle of momentum: a practical use of GPS technology for conditioning strategies Introduction GPS introduction 1. Data collection stage.The initial introduction of any new technology will naturally allow for an acclimatization period where ... 2. Comparison stage.This stage utilizes the data that has been collected to run comparisons between session types, on sessions « Divided into two parts, physiology and sports injury management, this is an innovative clinical- and evidence-based guide, which engages with the latest developments in athletic performance both long and short term. It also considers lower level exercise combined with the pertinent physiological processes. It focuses on the rationale behind diagnostic work up, treatment bias and rehabilitation philosophy, challenging convention within the literature to what really makes sense when applied to sports settings. Drawing upon experts in the field from across the world and various sports settings, it implements critical appraisal throughout with an emphasis on providing practical solutions within sports medicine pedagogy. •Dovetails foundational sports physiology with clinical skills and procedures to effectively manage sports injuries across a variety of settings •Takes an interdisciplinary approach and draws upon both clinical- and evidence-based practice •Contributed by leading international experts including academics, researchers and in-the-field clinicians from a range of sports teams including the Royal Ballet and Chelsea FC •Pedagogical features include learning objectives, clinical tip boxes, summaries, case studies. »-- Quatrième de couverture