Sports Health-A Multidisciplinary Approach最新文献

{"title":"The Effect of Additional Neuromuscular Training on Peri-Ankle Muscle Morphology and Function in Chronic Ankle Instability Subjects: A Randomized Controlled Trial.","authors":"Khadijeh Kazemi, Khodabakhsh Javanshir, Feryal Saadi, Shahin Goharpey, Mohammad Jafar Shaterzadeh Yazdi, César Calvo-Lobo, Daniel López-López, Gholamhossein Nassadj","doi":"10.1177/19417381241258467","DOIUrl":"10.1177/19417381241258467","url":null,"abstract":"<p><strong>Background: </strong>Lateral ankle sprain is one of the most common musculoskeletal issues during sports and activities of daily living. This study investigated the effect of combined neuromuscular training and conventional training (including strengthening, range of motion, and balance exercises) on muscle morphology, dynamic balance, perceived ankle instability, and functional capacity in persons with chronic ankle instability (CAI).</p><p><strong>Hypothesis: </strong>The combination of neuromuscular and conventional training programs might result in additional benefits on the morphology of muscle, dynamic balance, and functional capacity in subjects with CAI.</p><p><strong>Study design: </strong>A single-blind parallel-arm randomized controlled trial.</p><p><strong>Level of evidence: </strong>Level 2.</p><p><strong>Methods: </strong>A total of 34 participants with CAI were divided randomly into experimental (EG) and control groups (CG). The EG received conventional and neuromuscular training, while the CG underwent conventional training. Cross-sectional areas of the peroneus longus and tibialis anterior muscles were measured using ultrasonography. Measurements included reaching direction distance, ankle instability, and the foot and ankle outcome score, all evaluated before and immediately after 12 intervention sessions and 4 weeks later in the follow-up phase.</p><p><strong>Results: </strong>Repeated-measures analysis of variance (ANOVA) revealed significant improvement in the EG, particularly in the cross-sectional area of the tibialis anterior muscle on the injured side and the posteromedial reaching direction displacement of the Y balance test. Moreover, the EG's foot and ankle outcome scores increased significantly compared with the CG (<i>P</i> < 0.05). However, the group effect size ranged from minor to moderate (Hedges <i>g</i>, 0.40-0.73).</p><p><strong>Conclusion: </strong>Combining neuromuscular and conventional training programs yields greater benefits than conventional training alone regarding tibialis anterior muscle morphology, posteromedial dynamic balance, and functional capacity in persons with CAI.</p><p><strong>Clinical relevance: </strong>The combination of neuromuscular and conventional training programs could enhance muscle morphology, dynamic balance, perceived ankle instability, and functional capacity in persons with CAI.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"572-584"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Return to Running for Postpartum Elite and Subelite Athletes.","authors":"Lisa Woodroffe, Tyler Slayman, Amanda Paulson, Natalie Kruse, Abigail Mancuso, Mederic Hall","doi":"10.1177/19417381241256973","DOIUrl":"10.1177/19417381241256973","url":null,"abstract":"<p><strong>Context: </strong>There is little evidence to guide elite athletes who desire returning to competition after giving birth to a child. Ultimately, this can result in decreased performance and increased risk of injury. This paper addresses aspects that must be considered when building and monitoring a return to running program for a postpartum elite or subelite athlete, including pelvic floor and core stability, progressive reloading of the musculoskeletal system, monitoring of nutritional parameters, and considerations for lactation.</p><p><strong>Evidence acquisition: </strong>PubMed and CINAHL (Cumulative Index for Nursing and Allied Health Literature) were searched with the following search strategy: (extreme sports OR elite athletes OR running OR exercise) AND (breastfeeding OR lactation OR bone density OR fetal weight OR gestational weight gain OR postpartum or post-partum OR postnatal OR post-natal OR pregnancy OR childbirth). The following information is based on best available evidence and clinical experience.</p><p><strong>Study design: </strong>Clinical review.</p><p><strong>Level of evidence: </strong>Level 4.</p><p><strong>Results: </strong>Due to the interplay between cardiovascular fitness, postpartum nutrition, lactation, and progressive reloading of the muscular and skeletal system, we propose a multimodal, multidisciplinary approach to safely and successfully allow an athlete to return to an elite level of competition.</p><p><strong>Conclusion: </strong>Return to running in the postpartum period is a highly individualized process that benefits from multidisciplinary, individualized care. This includes monitoring of nutrition, core and pelvic floor function, bone reloading, muscle and tendon reloading, and breastfeeding care when applicable.Strengh of Recommendation Taxonomy (SORT):C.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"614-620"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"UCL Throwing Injuries in Nonprofessional Baseball Players: A 14-Year Retrospective Study.","authors":"Jason L Zaremski, Marissa Pazik, Harold Hunt, William S Dodd, Binh K Nguyen, Kevin W Farmer, MaryBeth Horodyski","doi":"10.1177/19417381241238966","DOIUrl":"10.1177/19417381241238966","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated treatment modality (surgical vs nonoperative) of medial ulnar collateral ligament (UCL) injuries in nonprofessional throwing baseball athletes by comparing type, severity, and location of UCL injury.</p><p><strong>Hypothesis: </strong>Baseball players with closed medial epicondyle physes and concomitant throwing-related UCL injury will be more likely to undergo surgical intervention than players with open medial epicondyle physes.</p><p><strong>Study design: </strong>Retrospective.</p><p><strong>Level of evidence: </strong>Level 5.</p><p><strong>Methods: </strong>A total of 119 baseball players with a mean age of 16.9 ± 2.5 years (range, 11-25 years) were included in the study. Datapoints included sex, age at time of injury, severity, and location of UCL injury, growth plate status, operative versus conservative management, and concomitant flexor forearm injury.</p><p><strong>Results: </strong>A total of 75 players were treated conservatively; 43 underwent UCL reconstruction (UCL-R), and 1 had an unknown treatment outcome. No significant difference was found for age related to treatment type, UCL-R (17.2 ± 2.2) versus conservative treatment (16.8 ± 2.6). Athletes with closed medial epicondylar growth plates were more likely to undergo UCL-R than athletes with open medial epicondylar growth plates (<i>P</i> = 0.02). There were no significant differences between UCL injury location (42 distal, 37 proximal, 18 combined tear locations, 11 complete tears, and 11 intact UCLs with inflammation) by treatment type (<i>P</i> = 0.09). There was a significant difference for UCL severity (11 complete tears, 96 partial tears) by treatment type (<i>P</i> = 0.03).</p><p><strong>Conclusion: </strong>Nonprofessional athletes with closed medial epicondylar growth plates and throwing-related UCL injuries were more likely to be treated surgically. Baseball athletes with partial tears, if skeletally immature, require further long-term evaluation.</p><p><strong>Clinical relevance: </strong>Continued knowledge gains in this area of throwing medicine will further improve our treatment algorithms in nonprofessional baseball players.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"445-450"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140327414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal Relationships of Ligamentous Injuries in the Knee on Corticospinal Tract Structure: A Mendelian Randomization Analysis.","authors":"Le Yu, Weichu Tao, Zhengbiao Jin, Yi Li, Xiao'ao Xue, Ru Wang, Yinghui Hua","doi":"10.1177/19417381241255342","DOIUrl":"10.1177/19417381241255342","url":null,"abstract":"<p><strong>Background: </strong>The association between ligamentous knee injuries and corticospinal tract (CST) structure has attracted attention; however, any causal relationship remains uncertain. We performed Mendelian randomization (MR) analysis to identify the causal effects of ligamentous knee injuries on the CST.</p><p><strong>Hypothesis: </strong>Ligamentous knee injuries impair CST microstructure (ie, by reducing fractional anisotropy [FA] and increasing mean diffusivity [MD]).</p><p><strong>Study design: </strong>MR analysis.</p><p><strong>Level of evidence: </strong>Level 2.</p><p><strong>Methods: </strong>MR uses genetic variants as instrumental variables to infer causal relationships between exposures and outcomes. Summary data for ligamentous injuries in knee and CST structure were obtained from genome-wide association study datasets. Significant and independent (5 × 10^-6; <i>r</i>² < 0.001; 10,000 kb) single-nucleotide polymorphisms were extracted for MR analysis. Three methods for MR analysis were used (hypothesis-driven 1-tailed inverse variance weighted, MR-Egger, and weighted median), and sensitivity analyses were conducted to test reliability and stability.</p><p><strong>Results: </strong>Results from 3 MR methods consistently demonstrated that ligamentous knee injuries increased MD of the right CST (β, 0.063; 90% CI, 0.003-0.123; <i>P</i> = 0.04), and weak statistical significance suggested increased MD of the left CST (β, 0.060; 90% CI, -0.002 to -0.121; <i>P</i> = 0.05). However, no significant causal relationships were observed in CST FA, and no significant pleiotropy or heterogeneity was observed. Sensitivity analysis utilizing 2-tailed tests had no significant associations between ligamentous knee injuries and changes in CST structure.</p><p><strong>Conclusion: </strong>There is statistically weak genetic evidence that corticospinal pathway abnormalities may evolve after ligamentous knee injuries, which manifests as abnormally organized neurites.</p><p><strong>Clinical relevance: </strong>Ligamentous knee injuries require attention not only to damage to the structure of the knee joint itself but also to the process of maladaptive neuroplasticity that leads to structural and functional changes of the CST; novel interventions that target the corticospinal pathway may provide subsequent treatment of ligamentous knee injuries.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"564-571"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141322009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Incidence of Shoulder and Elbow Injuries in High School and Collegiate Softball Athletes: A Systematic Review.","authors":"Nichelle M Enata, Paul M Inclan, Robert H Brophy, Derrick Knapik, Matthew V Smith","doi":"10.1177/19417381241280643","DOIUrl":"10.1177/19417381241280643","url":null,"abstract":"<p><strong>Context: </strong>Despite increased youth and adolescent participation in fast-pitch softball and the reporting of upper extremity injuries, there remains a relative paucity of research examining shoulder and elbow injuries in high school and collegiate softball athletes.</p><p><strong>Objective: </strong>To evaluate the reported incidence, setting, and positional factors associated with shoulder and elbow injuries in high school and collegiate fast-pitch softball players.</p><p><strong>Data sources: </strong>PubMed, Ovid, Medline, EMBASE, Scopus, Cochrane Central, and Clinicaltrials.gov.</p><p><strong>Study selection: </strong>English-language articles reporting the incidence of shoulder and/or elbow injuries occurring in high school or collegiate fast-pitch softball players were included. Biomechanical studies, review articles, abstract only texts, previous systematic reviews, and meta-analyses were excluded.</p><p><strong>Study design: </strong>Systematic review.</p><p><strong>Level of evidence: </strong>Level 4.</p><p><strong>Data extraction: </strong>Two reviewers independently evaluated studies. Data related to the reported incidence of shoulder and elbow injuries, injury setting, position, and rate of return to play after injury were recorded.</p><p><strong>Results: </strong>A total of 22 studies were identified. In high school athletes, shoulder injury rates ranged from 0.88 to 1.14 per 10,000 athletic exposures (AE), with elbow injury rates ranging from 0.41 to 0.71 per 10,000 AE. In collegiate athletes, reported injury rates ranged from 3.76 to 5.93 per 10,000 AE for shoulder and 1.5 to 3.39 per 10,000 AE for elbow injuries. Shoulder and elbow injuries were reported more commonly during competition in high school athletes, and with greater frequency in the practice setting in collegiate athletes. No association between injury incidence and position was appreciated at either the high school or collegiate level. Most (81%-96%) athletes were able to return to sport within 3 weeks of injury.</p><p><strong>Conclusion: </strong>The incidence of shoulder and elbow injuries was greater in collegiate softball athletes than in high school athletes.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"474-483"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilizing the Pronated Forearm Technique for Measuring Glenohumeral External Rotation in Baseball Players.","authors":"Aaron Sciascia, Michael Smith, Joseph Holstedt, Logan Mattingly, W Ben Kibler","doi":"10.1177/19417381241235225","DOIUrl":"10.1177/19417381241235225","url":null,"abstract":"<p><strong>Background: </strong>Alterations in glenohumeral internal rotation (GIR), glenohumeral external rotation (GER), and total range of motion (TROM) have been linked with increased injury risk. GER capacity has been measured routinely with the forearm in neutral rotation (GERN), but a recent study reported GERN was greater than GER with the forearm in pronation (GERP) in Minor League pitchers. This work has not yet been replicated or extended to other groups.</p><p><strong>Hypothesis: </strong>GERP would be significantly less than GERN in Independent League baseball pitchers, and there would be no difference in GERP or GERN measurements between this new group and the previous group of Minor League pitchers.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Methods: </strong>Goniometric measurements were recorded for bilateral GIR, GERN, and GERP, and resulting TROM for 37 Independent League baseball pitchers. These data were compared with the previous study. All motions were compared individually between groups, between throwing and nonthrowing arm, and both within and between techniques (forearm neutral or pronated).</p><p><strong>Results: </strong>GERP was significantly less than GERN for both arms within each group tested (<i>P</i> < 0.01). Independent League pitchers had greater between arm differences for GIR (-16.9° vs -6.9°), GERN (+15.1° vs -0.6°), and GERP (+13.1° vs -5.9°) compared with Minor League pitchers. TROM for the Independent League pitchers was not statistically different for either measurement technique, while TROM for the throwing arm of the Minor League pitchers was statistically reduced with varying effect sizes (<i>d</i> = 0.35-0.99) compared with the nonthrowing arm (<i>P</i> < 0.01).</p><p><strong>Conclusion: </strong>This study confirmed earlier findings that the pronated forearm resulted in decreased GER capacity, illustrating the adaptive response to throwing and the need to evaluate for this variable.</p><p><strong>Clinical relevance: </strong>GERP should be evaluated in all groups of pitchers, but there may be variations within tested groups.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"438-444"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140159479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radial Tunnel Syndrome in a Collegiate Baseball Pitcher: A Case Report.","authors":"Alex McCourt, Marissa Pazik, Ryan P Roach, Toby Harkins, Giorgio Zeppieri, Robert Matthias, Kevin W Farmer","doi":"10.1177/19417381241258479","DOIUrl":"10.1177/19417381241258479","url":null,"abstract":"<p><p>A Division I baseball pitcher presented with chronic forearm pain in his throwing arm while pitching. Physical examination was remarkable for point tenderness over the radial tunnel. A postexertion magnetic resonance imaging (MRI) scan revealed edema around the posterior interosseous nerve. The patient underwent decompression of the nerve along with radial tunnel release, which resulted in full resolution of symptoms and return to full baseball activities. Radial tunnel syndrome is a rare phenomenon but can occur in throwing athletes. MRI immediately after a pitching session aided in accurate diagnosis and successful surgical management.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"470-473"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity of Rating of Perceived Exertion Scales in Relation to Movement Velocity and Exercise Intensity During Resistance-Exercise: A Systematic Review.","authors":"Jorge L Petro, Guido Ferrari, Luis A Cardozo, Salvador Vargas-Molina, Leandro Carbone, Richard B Kreider, Diego A Bonilla","doi":"10.1177/19417381241260412","DOIUrl":"10.1177/19417381241260412","url":null,"abstract":"<p><strong>Context: </strong>Movement velocity (MV) may be a valid tool to evaluate and control the load in resistance training (RT). The rating of perceived exertion (RPE) also enables practical load management. The relationship between RPE and MV may be used to monitor RT intensity.</p><p><strong>Objective: </strong>To evaluate the validity and practicality of RPE scales related to MV and training intensity in resistance exercise. We hypothesize a positive correlation among RPE, MV, and load intensity in RT. Therefore, RPE may serve as a supplementary indicator in monitoring RT load.</p><p><strong>Data sources: </strong>Boolean algorithms were used to search several databases (SPORTDiscus, EBSCO, PubMed, Scopus, and Google Scholar).</p><p><strong>Study selection: </strong>Studies published from 2009 to 2023 included clinical trials (randomized or not) in healthy female and male subjects that analyzed the relationship between different RPE scales and MV in basic RT exercises.</p><p><strong>Study design: </strong>Systematic review.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Results: </strong>A total of 18 studies were selected using different RPE scales with reported MV training loads. Participants included RT and untrained male and female subjects (15-31 years old). Two RPE scales (OMNI-RES and repetitions in reserve) were used. The selected studies showed moderate positive correlations among these RPE scales, MV, and training load (eg, percentage of 1-repetition maximum [%1-RM]). In addition, equations have been developed to estimate %1-RM and MV loss based on the OMNI-RES scale.</p><p><strong>Conclusion: </strong>Studies show that RPE scales and MV constitute a valid, economic, and practical tool for assessing RT load progression and complementing other training monitoring variables. Exercise professionals should consider familiarizing participants with RPE scales and factors that might influence the perception of exertion (eg, level of training, motivation, and environmental conditions).</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"621-628"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current State of Baseball Interval Throwing Programs: A Systematic Review of Content, Structure, and Variability of Published Throwing Programs.","authors":"Mark T Langhans, Alexander M Boos, Sanathan Iyer, Karissa N Simon, Chad E Cherny, Andrew J Johnson, John M Zajac, Daniel J Christoffer, Aaron R Hellem, Adam N Finck, Christopher L Camp","doi":"10.1177/19417381251333402","DOIUrl":"https://doi.org/10.1177/19417381251333402","url":null,"abstract":"<p><strong>Context: </strong>There is need for an up-to-date comprehensive review of baseball interval throwing programs in the literature.</p><p><strong>Objective: </strong>To (1) understand the origin and basis of interval throwing programs; (2) evaluate the content of programs in the peer-reviewed literature including target audience, initiation criteria, throwing specifics, arm care, and performance evaluation metrics; (3) classify these variables as well defined, ambiguous, or missing; and (4) analyze variability in key aspects including starting criteria, length, progression, and completion criteria.</p><p><strong>Data sources: </strong>Medline, Embase, Cochrane Reviews, Web of Science, and ScopusStudy Selection:The full text of studies, in English, had to be available. Included studies had to contain a complete interval throwing program designed for baseball players.</p><p><strong>Study design: </strong>Systematic review.</p><p><strong>Level of evidence: </strong>Level 4.</p><p><strong>Data extraction: </strong>Initial screening was conducted based on article title and abstract. Full text of the remaining articles was evaluated for fulfillment of inclusion criteria.</p><p><strong>Results: </strong>Nine studies initially met inclusion criteria. The programs' comprehensiveness was poor, with a mean Interval Throwing Program Checklist score of 20 (range 14-23) on a scale of 0 to 30. There were a variety of components, including progressive long toss, weighted ball, and throwing mechanics exercises. The programs identified had significant heterogeneity in duration, intensity, progression, and focus. Overall, there was a significant lack of attempts at validation or formal study of efficacy for published throwing programs.</p><p><strong>Conclusion: </strong>Current published interval throwing programs are mostly variations of an original program published many years ago and were based on principles of progressive loading with pain as sign of injury that should be monitored carefully. However, these programs have minimal clinical validation and objective measures to quantify their effectiveness. This work identifies several limitations in the current literature and can serve as a foundation for future development of evidence-based interval throwing programs.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"19417381251333402"},"PeriodicalIF":2.7,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initiating Testosterone Therapy Without Indication for Treatment of Low Testosterone Is Associated With Higher Risk of Tendon Tear.","authors":"Timothy L Waters, Julianna E Winter, Bela P Delvadia, David S May, Michael J O'Brien, Felix H Savoie, William F Sherman","doi":"10.1177/19417381251334083","DOIUrl":"https://doi.org/10.1177/19417381251334083","url":null,"abstract":"<p><strong>Background: </strong>Studies have demonstrated an increasing rate of testosterone supplementation in patients who do not meet criteria for testosterone deficiency, but the risks associated with testosterone supplementation are unclear.</p><p><strong>Hypothesis: </strong>Patients initiating testosterone therapy would be diagnosed with significantly more tendon tears and undergo significantly more tendon repairs than matched controls never on testosterone therapy.</p><p><strong>Study design: </strong>Cohort study.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Methods: </strong>Male patients who initiated testosterone therapy within 30 days of a primary care visit and who did not meet criteria for treatment of low testosterone were identified (n = 112,242). Propensity score matching generated a control cohort (n = 448,968) with no history of testosterone therapy and based on several comorbidities at the time of said age-matched primary care visit. Rates of tendon tears and tendon repairs within 1 and 2 years after primary care visit were compared using multivariable logistic regression.</p><p><strong>Results: </strong>Within 1 and 2 years, compared with controls, the testosterone supplementation cohort demonstrated significantly higher rates of rotator cuff tear (odds ratio [OR], 1.35; OR, 1.31), patellar tendon tear (OR, 2.06; OR, 2.14), and any tendon tear (OR, 1.33; OR, 1.31). The testosterone supplementation cohort demonstrated significantly higher rates of quadriceps tendon tears within 1 year (OR, 1.59). Within 1 and 2 years, compared with controls, the testosterone supplementation cohort demonstrated significantly higher rates of rotator cuff repair (OR, 1.28; OR, 1.23), distal biceps tendon repair (OR, 1.65; OR, 1.54), patellar tendon repair (OR, 2.28; OR, 2.18), and any tendon repair (OR, 1.27; OR, 1.23).</p><p><strong>Conclusion: </strong>Testosterone supplementation is associated with an increased risk of tendon tears and repairs for at least the first and second year after initiating therapy in patients with no documented laboratory testing. Patients considering testosterone therapy should be counseled on this increased risk of tendon injury.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"19417381251334083"},"PeriodicalIF":2.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}