Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine
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This study investigated history and physical findings among 74 patients with acute ankle injuries in order to determine factors significantly associated with fractures, excluding avulsion fragments < 3 mm in size, and syndesmosis injuries and to determine factors that necessitate radiography. ⋯ Although additional investigation with larger patient numbers would be beneficial, this study highlights the importance of history of previous fracture, pain on the distal mid-fibula or mid-tibia, and pain with external rotation. Furthermore, if these three variables are prospectively applied as criteria for radiography, a 55% reduction in radiography would result with 100% sensitivity. Finally, experienced sports medicine physicians had a 100% sensitivity, 68% specificity, 100% negative predictive value, and 39% positive predictive value for prediction of clinically significant fractures or syndesmosis injuries.
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Improper handling of an unstable neck injury in the prehospital setting may result in potential iatrogenically induced neurologic injury. On-site management of the neck-injured, helmeted football player differs from that of other traumatic cervical spine injuries. Controversy still exists regarding helmet removal protocols for stabilizing the cervical spine of helmeted football players with a suspected neck injury. This article provides a critical review of the scientific evidence on cervical spine management in helmeted football players with a suspected cervical spine injury. ⋯ Although studies support the notion that iatrogenic neurologic deterioration may occur with improper handling and attempted removal of the helmet in the prehospital setting, there is no literature to support increased morbidity associated with not removing helmet and shoulder pads. Stabilization of the cervical spine in an injured football player does not require routine prehospital removal of the helmet and shoulder pads before transport.
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Randomized Controlled Trial Clinical Trial
A randomized controlled trial of the effect of naproxen on delayed onset muscle soreness and muscle strength.
To determine the effect of naproxen in attenuating the symptoms (muscle soreness level) and signs (plasma creatine kinase [CK] activity and muscular strength decrement) of delayed onset muscle soreness (DOMS) induced by repeated bouts of eccentric exercise. ⋯ The data indicate that therapeutic doses of naproxen do not prevent CK release into the plasma but decrease the perception of muscle soreness and positively influence quadriceps peak torque.
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To compare patellar tendon sonographic findings in active, currently asymptomatic, elite athletes with those in nonathletic controls. ⋯ Patellar tendon sonographic hypoechoic areas were present in asymptomatic patellar tendons of a proportion of elite athletes but rarely present in controls. This has implications for clinicians managing athletes with anterior knee pain.
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To establish the appropriate technique for cervical immobilization of the hockey player with an acute neck injury, we analyzed the alignment of the cervical spine in healthy volunteers with combinations of applied hockey equipment and assessed the amount of cervical spine motion possible in a secured hockey helmet. Our hypothesis was that there is a significant difference among various positions of the cervical spine with and without equipment and with active motion in a secured helmet. ⋯ In an acute cervical spine injury involving an ice hockey player, we recommend immobilization in both the helmet and the shoulder pads, with removal of both pieces of equipment in a controlled hospital setting and only after initial radiographic examination. We also recommend securing the player's chin to prevent as much head and neck motion as possible during transport and transfers.