Ankle braces on Injury rates in Football Players

The Effect of Lace-up Ankle Braces on Injury Rates in High School Football Players

1. Timothy A. McGuine, PhD, ATC (tmcguine@uwhealth.org)

1. University of Wisconsin-Madison, Madison, Wisconsin

1. Scott Hetzel, MS

1. University of Wisconsin-Madison, Madison, Wisconsin

1. John Wilson, MD, MS

1. University of Wisconsin-Madison, Madison, Wisconsin

1. Alison Brooks, MD, MPH

1. University of Wisconsin-Madison, Madison, Wisconsin

Abstract

Background: Although ankle injuries occur frequently in high school football players, no prospective studies have been performed to determine if wearing lace-up ankle braces will reduce the incidence and severity of ankle and other lower extremity injuries in these athletes.

Purpose: This study was conducted to determine if lace-up ankle braces reduce the incidence and severity of lower extremity injuries sustained by high school football players.

Design: Randomized controlled trial; Level of evidence, 1.

Methods: A total of 2081 players from 50 high schools were randomly assigned to a braced or control group. Braced group players wore lace-up ankle braces during the 2010 football season. Athletic trainers recorded brace compliance, athlete-exposures, and injuries. Cox proportional hazards models were utilized to compare injury rates between groups. Injury severity (days lost) was tested with Wilcoxon rank sum.

Results: The rate of acute ankle injury (per 1000 exposures) was 0.48 in the braced group compared with 1.12 in the control group (Cox hazard ratio [HR] = 0.39; 95% confidence interval [CI], 0.24-0.65; P < .001). The severity (median days lost) of acute ankle injuries was the same (5 days) in both groups (P = .985). The rate of acute knee injury was 0.70 in the braced group compared with 0.69 in the control group (HR = 0.92; 95% CI, 0.57-1.47; P = .721). There was no difference (P= .242) in the severity of knee injuries between the groups (controls = 11.5 days, braced = 17 days). The rate of other lower extremity injuries was 0.95 in the braced group and 1.32 in the control group (HR = 0.72; 95% CI, 0.48-1.09; P = .117), while the severity was similar in both groups (6 days vs 7 days; P = .295).

Conclusion: Players who used lace-up ankle braces had a lower incidence of acute ankle injuries but no difference in the incidence of acute knee or other lower extremity injuries. Braces did not reduce the severity of ankle, knee, or other lower extremity injuries.

 

We are always looking for ways to determine the level of inflammation of an athlete as it relates to recovery. If the athlete is suffering from some type of pathology then inflammatory markers will help define the illness. When comes to recovery from various levels of training the jury is still out on that one. Take a look at this study:

 Medicine & Science in Sports & Exercise:

January 2012 - Volume 44 - Issue 1 - p 50–56

doi: 10.1249/MSS.0b013e318229d2e9

Basic Sciences

Effect of Resistance, Endurance, and Concurrent Training on TNF-α, IL-6, and CRP

by LIBARDI, CLEITON AUGUSTO; DE SOUZA, GIOVANA VERGÍNIA; CAVAGLIERI, CLAUDIA REGINA; MADRUGA, VERA APARECIDA; CHACON-MIKAHIL, MARA PATRÍCIA TRAINA

Purpose: The aim of the present study was to evaluate the effects of 16 wk of resistance training (RT), endurance training (ET), and concurrent training (CT) on inflammatory markers, C-reactive protein (CRP), and functional capacity in sedentary middle-age men. 

Methods: Healthy subjects were randomized into RT (n = 11), ET (n = 12), CT (n = 11), and a control group (n = 13). The subjects performed three weekly sessions lasting about 60 min for 16 wk. Maximal strength was tested in bench press and leg press. The peak oxygen uptake (V˙O2peak) was measured in an incremental exercise test. Plasma tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and CRP levels were determined by an enzyme-linked immunosorbent assay.

 Results: Maximal strength was increased after 16 wk, with no differences between RT and CT. V˙O2peak increased in ET and CT comparing before and after training. There were no significant differences in TNF-α, IL-6, and CRP comparing before and after training. 

Conclusions: Sixteen weeks of RT, ET, or CT in middle-age healthy men has not affected low and moderate IL-6, TNF-α, and CRP levels. CT performed in the same weekly frequency and session duration of ET and RT was effective in increasing both maximal strength and V˙O2peak, in addition to improvements in lipid profile.

 

Acute Effects of Verbal Feedback on Upper-Body Performance in Elite Athletes

Journal of Strength & Conditioning Research:

December 2011 - Volume 25 - Issue 12 - pp 3282-3287

doi: 10.1519/JSC.0b013e3182133b8c

Original Research

Acute Effects of Verbal Feedback on Upper-Body Performance in Elite Athletes

Argus, Christos K; Gill, Nicholas D; Keogh, Justin WL; Hopkins, Will G

Abstract

Argus, CK, Gill, ND, Keogh, JWL, and Hopkins, WG. Acute effects of verbal feedback on upper-body performance in elite athletes. J Strength Cond Res 25(12): 3282–3287, 2011—Improved training quality has the potential to enhance training adaptations. Previous research suggests that receiving feedback improves single-effort maximal strength and power tasks, but whether quality of a training session with repeated efforts can be improved remains unclear. The purpose of this investigation was to determine the effects of verbal feedback on upper-body performance in a resistance training session consisting of multiple sets and repetitions in well-trained athletes. Nine elite rugby union athletes were assessed using the bench throw exercise on 4 separate occasions each separated by 7 days. Each athlete completed 2 sessions consisting of 3 sets of 4 repetitions of the bench throw with feedback provided after each repetition and 2 identical sessions where no feedback was provided after each repetition. When feedback was received, there was a small increase of 1.8% (90% confidence limits, ±2.7%) and 1.3% (±0.7%) in mean peak power and velocity when averaged over the 3 sets. When individual sets were compared, there was a tendency toward the improvements in mean peak power being greater in the second and third sets. These results indicate that providing verbal feedback produced acute improvements in upper-body power output of well-trained athletes. The benefits of feedback may be greatest in the latter sets of training and could improve training quality and result in greater long-term adaptation. 

Which On-field Signs/Symptoms Predict Protracted Recovery From Sport-Related Concussion Among High School Football Players?

Which On-field Signs/Symptoms Predict Protracted Recovery From Sport-Related Concussion Among High School Football Players?

1. Brian C. Lau, MD*,†, 
2. Anthony P. Kontos, PhD‡, 
3. Michael W. Collins, PhD‡, 
4. Anne Mucha, PT§ and 
5. Mark R. Lovell, PhD‡

+Author Affiliations

1. ^†University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
2. ^‡University of Pittsburgh Medical Center, Department of Orthopaedic Surgery, Sports Medicine Concussion Program, Pittsburgh, Pennsylvania
3. ^§University of Pittsburgh Medical Center, Centers for Rehab Services, Pittsburgh, Pennsylvania
4. Investigation performed at University of Pittsburgh Medical Center, Center for Sports Medicine, Pittsburgh, Pennsylvania

1. ↵* Brian C. Lau, MD, 3200 South Water Street, Pittsburgh, PA 15203 (e-mail:blau10@gmail.com).

Abstract

Background: There has been increasing attention and understanding of sport-related concussions. Recent studies show that neurocognitive testing and symptom clusters may predict protracted recovery in concussed athletes. On-field signs and symptoms have not been examined empirically as possible predictors of protracted recovery.

Purpose: This study was undertaken to determine which on-field signs and symptoms were predictive of a protracted (≥21 days) versus rapid (≤7 days) recovery after a sports-related concussion. On-field signs and symptoms included confusion, loss of consciousness, posttraumatic amnesia, retrograde amnesia, imbalance, dizziness, visual problems, personality changes, fatigue, sensitivity to light/noise, numbness, and vomiting.

Study Design: Cohort study (prognosis); Level of evidence, 2.

Methods: The sample included 107 male high school football athletes who completed computerized neurocognitive testing within an average 2.4 days after injury, and who were followed until returned to play as determined by neuropsychologists using international clinical concussion management guidelines. Athletes were then grouped into rapid (≤7 days, n = 62) or protracted (≥21 days, n = 36) recovery time groups. The presence of on-field signs and symptoms was determined at the time of injury by trained sports medicine professionals (ie, ATC [certified athletic trainer], team physician). A series of odds ratios with χ² analyses and subsequent logistic regression were used to determine which on-field signs and symptoms were associated with an increased risk for a protracted recovery.

Results: Dizziness at the time of injury was associated with a 6.34 odds ratio (95% confidence interval = 1.34-29.91, χ² = 5.44, P = .02) of a protracted recovery from concussion. Surprisingly, the remaining on-field signs and symptoms were not associated with an increased risk of protracted recovery in the current study.

Conclusion: Assessment of on-field dizziness may help identify high school athletes at risk for a protracted recovery. Such information will improve prognostic information and allow clinicians to manage and treat concussion more effectively in these at-risk athletes.

Keywords:

• concussion
 
• mild traumatic brain injury (mTBI)
 
• signs/symptoms
• neurocognitive testing
 
• recovery time
 
• prognosis

Am J Sports Med November 2011 vol. 39 no. 11 2311-2318