Clinical Journal of Sport Medicine最新文献

{"title":"Gait Retraining for Patellofemoral Pain Syndrome: A Biomechanical Approach to Pain Relief and Performance Optimization.","authors":"Roberto Tedeschi, Federica Giorgi","doi":"10.1097/JSM.0000000000001519","DOIUrl":"https://doi.org/10.1097/JSM.0000000000001519","url":null,"abstract":"<p><strong>Objective: </strong>Patellofemoral pain syndrome (PFPS) is common among runners and is linked to biomechanical dysfunctions that increase patellofemoral joint stress. Gait retraining has been proposed to redistribute this loading, but the effectiveness of different retraining strategies and their long-term impact remain unclear. This scoping review synthesizes existing evidence on gait retraining strategies for PFPS, focusing on pain, function, and biomechanics.</p><p><strong>Data sources: </strong>MEDLINE, Cochrane CENTRAL, Scopus, PEDro, and Web of Science were searched, following the methodological framework of the Joanna Briggs Institute for scoping reviews. Studies investigating gait retraining interventions in runners diagnosed with PFPS were included. Key outcomes were pain reduction, functional improvement, biomechanical adaptations, and adverse effects.</p><p><strong>Main results: </strong>Three randomized controlled trials met the inclusion criteria, examining cadence modification, impact reduction, and foot strike adjustments. Intervention groups experienced significant pain reduction, with Visual Analog Scale scores improving by 2 to 4 points, alongside functional gains reflected by increased Kujala and Knee Outcome Survey of the Activities of Daily Living Scale scores. Biomechanical adaptations included decreased patellofemoral joint stress, lower impact forces, and improved load distribution. Some participants reported transient calf discomfort during the adaptation period, which resolved over time.</p><p><strong>Conclusions: </strong>Gait retraining is an effective intervention for runners with PFPS, showing sustained pain relief, functional improvement, and biomechanical benefits. Individualized protocols and gradual implementation are essential to optimize outcomes and minimize discomfort. Future research should address long-term retention of gait modifications, optimal training parameters, and applicability beyond runners.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regulatory Deficits and Gaps in Medical Governance in Emerging Mass-Participation Sports.","authors":"Alexander Smith, Jill Colangelo, Michael Liebrenz","doi":"10.1097/JSM.0000000000001518","DOIUrl":"https://doi.org/10.1097/JSM.0000000000001518","url":null,"abstract":"","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Skeletal Maturity Associated With Anatomical Distribution of Sports-Related Lower Extremity Overuse Pain in Young Athletes?","authors":"Shinsuke Sakoda, Kouichi Kajiwara, Arata Yoshida, Kazuya Matsubara, Kimiaki Kawano","doi":"10.1097/JSM.0000000000001517","DOIUrl":"https://doi.org/10.1097/JSM.0000000000001517","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between skeletal maturity and the anatomical distribution of sports-related lower extremity overuse pain in young athletes.</p><p><strong>Design: </strong>Retrospective observational cohort study.</p><p><strong>Setting: </strong>Single-center sports medicine clinic.</p><p><strong>Patients/participants: </strong>A total of 2565 clinical episodes of sports-related lower extremity overuse pain in athletes aged ≤22 years presenting between January 2017 and November 2025.</p><p><strong>Independent variables: </strong>Skeletal maturity classified according to physeal status (open vs closed).</p><p><strong>Main outcome measures: </strong>Anatomical region of overuse pain at presentation. Anatomical distributions were compared between physeal groups, and multinomial logistic regression adjusted for sex and sport type evaluated associations between physeal status and anatomical presentation.</p><p><strong>Results: </strong>Overall anatomical distribution differed significantly according to skeletal maturity (P < 0.001). Although the knee was the most common anatomical region in both groups, athletes with open physes demonstrated relatively greater knee, pelvic girdle, and foot involvement, whereas athletes with closed physes demonstrated relatively greater ankle and lower-leg involvement. In adjusted multinomial logistic regression analyses, open physeal status was independently associated with a greater relative likelihood of foot (relative risk ratio [RRR], 2.65; 95% confidence interval [CI], 1.95-3.61), knee (RRR, 2.45; 95% CI, 1.84-3.27), and pelvic girdle (RRR, 2.25; 95% CI, 1.59-3.20) presentations compared with ankle presentations. These associations remained consistent after additional adjustment for chronological age.</p><p><strong>Conclusions: </strong>Skeletal maturity was associated with differences in anatomical distribution of sports-related lower extremity overuse pain. These findings suggest that skeletal maturity may influence where repetitive sport-related loading becomes clinically expressed and may improve the clinical interpretation of regional overuse pain in young athletes.</p><p><strong>Clinical relevance: </strong>Considering skeletal maturity when evaluating regional overuse pain may improve the clinical interpretation of sports-related lower extremity pain in young athletes.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hamstring Strain Grade on MRI and Return to Play in Elite Australian Cricket Players.","authors":"Thomas Cooney, Ashton Reeve, Anna E Saw, Alex Kountouris, John W Orchard, James Linklater","doi":"10.1097/JSM.0000000000001511","DOIUrl":"https://doi.org/10.1097/JSM.0000000000001511","url":null,"abstract":"<p><strong>Objective: </strong>The aims of this study were to (1) examine the relationship between magnetic resonance imaging (MRI)-confirmed hamstring strain grade and time to return to play; (2) examine this relationship specifically in pace bowlers; and (3) describe the incidence, prevalence, and grade of MRI-confirmed hamstring strains in elite Australian cricket players.</p><p><strong>Design: </strong>This is a retrospective cohort study.</p><p><strong>Setting: </strong>Elite Australian cricket teams over 13.5 seasons were analyzed.</p><p><strong>Participants: </strong>Four hundred seventy-eight male and 365 female contracted Australian cricketers participated in this study.</p><p><strong>Independent variable: </strong>British Athletics Muscle Injury Classification system grading of hamstring strains, which had received MRI scan, was the independent variable.</p><p><strong>Main outcome measure: </strong>The main outcome was time to return to play (days).</p><p><strong>Results: </strong>One hundred forty-one hamstring strain injuries with available MRI imaging scans were recorded during the study period (average 3.2 per 100 players per season: male 4.5, female 1.2). The most commonly injured muscle was biceps femoris (63%, 95% confidence interval: 56%-71%) and the most frequent category of injury was grade 2C (27%, 20%-35%). Across all injury grades, players were unavailable for full participation for a median of 22 (interquartile range: 15-38) days and missed 3 (1-6) matches. The number of days unavailable were higher for injuries that were graded 2 or 3, compared with grade 1 injuries (P = 0.004 and P = 0.007, respectively), and injuries that included the tendon compared with those which did not (P = 0.002). Pace bowlers has a higher number of days unavailable compared with players with other dominant skills for grade B and C injuries combined (P = 0.046).</p><p><strong>Conclusions: </strong>This study provides evidence that higher grade injuries and those involving the intramuscular tendon are associated with a more prolonged return to play. This finding should be viewed in context of the study limitation that MRI findings may have informed management.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Factors Are Associated With Shoulder Joint Pain in Male Swimmers? Including Thoracic Kyphosis Angle.","authors":"Hiroki Takayama, Ryosuke Takane, Koji Azuma, Tateru Shima, Katsufumi Oketa, Koji Miyawaki, Tadanari Umeda, Masatoshi Nakamura","doi":"10.1097/JSM.0000000000001483","DOIUrl":"https://doi.org/10.1097/JSM.0000000000001483","url":null,"abstract":"<p><strong>Objective: </strong>A common cause of shoulder joint pain in this population is subacromial impingement, often associated with increased thoracic kyphosis. However, the association between thoracic kyphosis angle and shoulder joint pain in competitive swimmers remains uncertain. The aim of this study was to investigate factors associated with shoulder joint pain in male competitive swimmers, considering both previously reported variables and the thoracic kyphosis angle.</p><p><strong>Design: </strong>Cross-sectional observational study.</p><p><strong>Setting: </strong>Poolside at the participants' school.</p><p><strong>Participants: </strong>A total of 64 male university and adult swimmers participated.</p><p><strong>Independent variables: </strong>Participants were divided into Group P (with shoulder joint pain) and Group N (without shoulder joint pain).</p><p><strong>Main outcome measures: </strong>Measurements included external and internal rotation range of motion (ROM) at 90 degrees shoulder abduction (Abd90°ER and Abd90°IR), internal rotation ROM at 90 degrees shoulder flexion (Flex90°IR), scapular dyskinesis (SD) test, shoulder rotation width, lumbar locked rotation, and thoracic kyphosis angle. The significance level was set at <5%.</p><p><strong>Results: </strong>Four variables exhibited significant differences between groups: Abd90°IR (median, 95% confidence interval [CI]): Group P, 66.0 degrees [57.7 degrees-68.5 degrees] versus Group N, 76.0 degrees [69.5 degrees-78.0 degrees]; Flex90°IR (median [95% CI]): Group P, 16.0 degrees [8.4 degrees-17.0 degrees] versus Group N, 25.0 degrees [23.1 degrees-27.1 degrees]; thoracic kyphosis angle (median [95% CI]): Group P, 23.1 degrees [20.4 degrees-25.9 degrees] versus Group N, 19.4 degrees [17.6 degrees-21.1 degrees]; and SD (positive test result in 15 of 27 patients in Group P vs 11 of 37 in Group N).</p><p><strong>Conclusions: </strong>Shoulder joint pain in competitive swimmers may be associated with an increased thoracic kyphosis angle during upper limb elevation, SD, and reduced shoulder ROM.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Velocity Changeups and Sweeper Usage Are Associated With Increased Odds of Undergoing Arthroscopic Shoulder Labral Repair in Professional Baseball Pitchers.","authors":"Clay Rahaman, Maxwell Harrell, Dev Dayal, Caleb Berta, Jared Halstrom, Walter Smith, Thomas Evely, Eugene Brabston, Amit Momaya, Aaron Casp","doi":"10.1097/JSM.0000000000001467","DOIUrl":"https://doi.org/10.1097/JSM.0000000000001467","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to determine whether pitch-specific characteristics, including velocity, spin rate, and pitch type usage, are predictive of arthroscopic shoulder labral repair (ASLR) in major league baseball (MLB) pitchers.</p><p><strong>Design: </strong>A retrospective analysis was conducted using MLB pitchers who underwent ASLR between 2016 and 2024. Pitch metrics were collected from Baseball Savant, a baseball sabermetric database, and compared with healthy league averages. Mann-Whitney U-tests and logistic regression were used to assess differences and predictors of ASLR.</p><p><strong>Setting: </strong>Major league baseball.</p><p><strong>Participants: </strong>Twenty-seven pitchers met the inclusion criteria by having Baseball Savant data from the season before undergoing ASLR.</p><p><strong>Interventions: </strong>None.</p><p><strong>Main outcome measures: </strong>Preinjury pitch metrics, including velocity, spin rate, movement profiles, and pitch usage.</p><p><strong>Results: </strong>Twenty-seven pitchers who underwent ASLR were compared with 6444 healthy league-average pitchers. Pitchers who threw changeups at higher velocities had increased odds of ASLR [P = 0.0028; odds ratio (OR) = 1.263]. Greater use of low-velocity changeups (P = 0.0279; OR = 0.942) and other off-speed pitches (P = 0.0058; OR = 0.929) was associated with lower odds of undergoing ASLR, whereas higher sweeper usage (P = 0.0194; OR = 1.071) was associated with increased odds.</p><p><strong>Conclusions: </strong>Major league baseball pitchers who threw higher-velocity changeups demonstrated increased odds of undergoing ASLR. In contrast, those who threw a higher proportion of lower-velocity changeups and other off-speed pitches, and fewer sweepers, showed decreased odds of labral repair.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: \"Examining the Recovery Course of Adolescent Concussion Patients With Protracted Recovery Referred to a Specialty Concussion Clinic\".","authors":"Ethan Light","doi":"10.1097/JSM.0000000000001459","DOIUrl":"https://doi.org/10.1097/JSM.0000000000001459","url":null,"abstract":"","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timing of Noncontact Anterior Cruciate Ligament Injury According to Developmental Stage in Japanese Female Athletes.","authors":"Hirohisa Magoshi, Misato Yoshida, Chisato Ishii, Masahiro Sato, Hideaki Nagamoto, Yasuyoshi Mase","doi":"10.1097/JSM.0000000000001494","DOIUrl":"https://doi.org/10.1097/JSM.0000000000001494","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to identify the timing of high incidence of noncontact anterior cruciate ligament (ACL) injuries in female athletes by developmental stage.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Orthopedic clinic specializing in sports injuries.</p><p><strong>Participants: </strong>The study included 335 female athletes, from elementary school to college, diagnosed with ACL injuries by orthopedic surgeons at our clinic.</p><p><strong>Assessment of risk factors: </strong>The developmental stage at the time of noncontact ACL injury.</p><p><strong>Main outcome measures: </strong>The primary outcome was noncontact ACL injury incidence by developmental stage. Using the Pubertal Development Scale, a multiple-choice self-administered questionnaire, we assessed the developmental stage at the time of ACL injury, and having classified participants into 5 stages-prepubertal, early pubertal, middle pubertal, late pubertal, and postpubertal-we identified the period with highest incidence of ACL injuries.</p><p><strong>Results: </strong>Noncontact ACL injuries by developmental stage were 0 in prepuberty and early puberty, 5 (1.9%) in middle puberty, 221 (84.0%) in late puberty, and 37 (14.1%) in postpuberty. The distribution significantly deviated from an even distribution (χ2(2) = 310.02, P < 0.001), with more than expected in late puberty (adj. residual = 2.6) and fewer in middle puberty (adj. residual = -3.1). Contact injuries also deviated (χ2(2) = 26.34, P < 0.001), with fewer in late puberty (adj. residual = -2.6) and more in middle puberty (adj. residual = 3.1).</p><p><strong>Conclusions: </strong>In female athletes, late puberty seems to be the period of highest incidence of noncontact ACL injuries, suggesting that it could be 1 of risk factors for ACL injury.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exceptional Case Reports of Professional Rugby Players with Diffuse Idiopathic Skeletal Hyperostosis.","authors":"David Brauge, Pierre Bernard","doi":"10.1097/JSM.0000000000001503","DOIUrl":"https://doi.org/10.1097/JSM.0000000000001503","url":null,"abstract":"<p><strong>Abstract: </strong>Diffuse idiopathic skeletal hyperostosis (DISH) is an exceptional finding in athletes but may increase spinal injury risk. We report 2 former elite rugby players who, during amateur play, sustained cervical hyperflexion injuries revealing probable DISH. Case 1: transient paraparesis from cervicothoracic ankylosis and cord compression, treated with posterior decompression. Case 2: transient monoparesis with C1-C2 instability and anterior osteophytes, managed by Magerl fixation. Spinal rigidity from DISH heightens fracture and neural injury risk in collision athletes. Magnetic resonance imaging screening may miss ankylosis; computed tomography should be considered in high-risk individuals, especially after professional retirement.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Lumbar Spine Pathology and Hamstring Injury Diagnosis - A Retrospective Matched Cohort Study.","authors":"Shane R Hudnall, Karl B Fields, Bailey J R Meccariello, Timothy L Lockamy, Xavier Leak, Alex Pow","doi":"10.1097/JSM.0000000000001487","DOIUrl":"https://doi.org/10.1097/JSM.0000000000001487","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether there is an association between hamstring injury diagnosis and clinical lumbar spine pathology.</p><p><strong>Design: </strong>Retrospective analysis of a matched cohort of patients with and without a diagnosis of hamstring injury.</p><p><strong>Setting: </strong>Cone Health System-affiliated clinics, urgent cares, and emergency departments.</p><p><strong>Patients: </strong>In total, 1269 patients identified in EPIC records with a diagnosis of hamstring injury; a control group of 1269 demographically matched patients who did not have a diagnosis of hamstring injury.</p><p><strong>Interventions: </strong>Chart review of patients to assess for lumbar spine pathology in those with and without prior hamstring injury.</p><p><strong>Outcome measures: </strong>Odds ratio (OR) of having lumbar spine pathology in the hamstring injury group and the control group. OR of having lumbar spine pathology based on other demographics.</p><p><strong>Results: </strong>Patients with a diagnosis of hamstring injury had an OR of 1.84 for having lumbar spine pathology. Of other variables, only BMI > 30 had a positive OR of 1.35. Likelihood of lumbar spine pathology does increase steadily in all age groups.</p><p><strong>Conclusions: </strong>Patients with a history of hamstring injury are 84% more likely to have lumbar spine pathology than a matched cohort without a history of injury. Hamstring injury was a stronger predictor of lumbar spine pathology than BMI, age, or other variables.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}