Sports Med
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Chronobiology is the science concerned with investigations of time-dependent changes in physiological variables. Circadian rhythms refer to variations that recur every 24 hours. Many physiological circadian rhythms at rest are endogenously controlled, and persist when an individual is isolated from environmental fluctuations. ⋯ Circadian rhythms are larger in amplitude in physically fit individuals than sedentary individuals. Athletes over 50 years of age tend to be higher in 'morningness', habitually scheduling relatively more training in the morning and selecting relatively higher work-rates during exercise compared with young athletes. These differences should be recognised by practitioners concerned with organising the habitual regimens of athletes.
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Cycling accidents are responsible for significant morbidity and mortality, especially in boys under the age of 16. While most cycling injuries result from simple falls from the bicycle, the majority of fatalities are caused by head injuries resulting from accidents involving motor vehicles. It is estimated that up to 85% of all cycling fatalities caused by head injuries could be prevented by the use of an appropriate cycling helmet. ⋯ But it is clear that appropriate legislation making helmet use compulsory for all cyclists is the only effective method for increasing helmet use, especially by young cyclist. Such legislation would reduce a mortality rate among young cyclists that has been equated to the mortality caused by some childhood infections in the pre-vaccination era. Some argue that physicians have a particular responsibility for promoting effective legislation for mandatory helmet use so that young children can be 'vaccinated' against the risk of the modern childhood epidemic; fatal head injury while cycling.
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Complete midsubstance tears of the anterior cruciate ligament (ACL) in skeletally-immature adolescents are being diagnosed and reported with increasing frequency. Conservative treatment of such ACL tears in junior high schools, subsequent meniscal tears, and very early osteoarthritis. ⋯ Athletes are able to return to competitive sports at their preinjury level. Here, the existing literature on the subject of midsubstance ACL tears in young athletes is reviewed, and guidelines for the management of ACL-deficient knee in this population are provided.
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Alpine skiing is an increasingly popular recreational sport worldwide. While the overall injury rate has declined and the pattern of injury changed over the years, the incidence of knee injuries has not changed substantially and accounts for 20 to 30% of all alpine skiing injuries. Medial collateral ligament (MCL) injuries are the most common in skiing, accounting for 15 to 20% of all skiing injuries and 60% of knee injuries in skiers. ⋯ Isolated posterior cruciate ligament (PCL) injury is rare in skiing, constituting less than 1% of all knee injuries in most series. Careful physical examination must be employed to rule out associated arcuate ligament complex injury and more complex patterns of instability. Most isolated PCL injuries are treated nonoperatively with a programme of initial immobilisation in extension, ice, protected weight-bearing, early range-of-motion exercises and progressive isometric strengthening.(ABSTRACT TRUNCATED AT 400 WORDS)
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Chronic muscle and tendon injuries to the groin are common sports injuries. The symptoms of groin injuries are often uncharacteristic which can result in a delay in the correct and specific diagnosis being reached. The most common injury is the overuse strain resulting in chronic tendinitis of the adductor muscle/tendon units, especially the adductor longus. ⋯ The recommended treatment is well planned and gradually increased rehabilitation programme during the first stages. Surgery for acute injuries is rarely indicated. Surgery, for example tenotomy of the adductor longus, has given satisfactory results in many athletes when nonsurgical treatment has failed.