Quantification of Achilles and patellar tendon structure on imaging does not enhance ability to predict self-reported symptoms beyond grey-scale ultrasound and previous history
- Authors: Docking, Sean , Rio, Ebonie , Cook, Jill , Carey, David , Fortington, Lauren
- Date: 2019
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 22, no. 2 (2019), p. 145-150
- Full Text: false
- Reviewed:
- Description: Background: Tendon pathology on imaging has been associated with an increased risk of developing symptoms. This evidence is based on classifying the tendon as normal or pathological. It is unclear whether the extent of tendon pathology is associated with the development or severity of symptoms. Objectives: To investigate whether the presence and extent of tendon pathology on ultrasound tissue characterisation (UTC), or a previous history of symptoms, were associated with the development of symptoms over a football season. Methods: 179 male Australian football players underwent UTC imaging of their Achilles and/or patellar tendon at the start of the pre-season. Players completed monthly OSTRC overuse questionnaires to quantify the presence and severity of Achilles and/or patellar tendon symptoms. Risk factor analysis was performed to identify associations between imaging and the development of symptoms. Results: A pathological Achilles tendon increased the risk of developing symptoms (RR = 3.2, 95%CI 1.7–5.9). Conversely, a pathological patellar tendon was not significantly associated with the development of symptoms (RR = 1.8, 95%CI 0.9–3.7). Quantification of tendon structure using UTC did not enhance the ability to identify athletes who developed symptoms. Previous history of symptoms was the strongest predictor for the development of symptoms (Achilles RR = 3.0 95%CI 1.8–4.8; patellar RR = 3.7 95%CI 2.2–6.1). Conclusion: Tendon pathology was associated with the development of self-reported symptoms; however previous history of symptoms was a stronger risk factor. The extent of disorganisation quantified by UTC should not be used as a marker for the presence or severity of current and future symptoms.
Identifying high risk loading conditions for in-season injury in elite Australian football players
- Authors: Stares, Jordan , Dawson, Brian , Peeling, Peter , Heasman, Jarryd , Rogalski, Brent , Drew, Michael , Colby, Marcus , Dupont, Gregory , Lester, Leanne
- Date: 2018
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 21, no. 1 (2018), p. 46-51
- Full Text: false
- Reviewed:
- Description: Objectives To examine different timeframes for calculating acute to chronic workload ratio (ACWR) and whether this variable is associated with intrinsic injury risk in elite Australian football players. Design Prospective cohort study. Methods Internal (session rating of perceived exertion: sRPE) and external (GPS distance and sprint distance) workload and injury data were collected from 70 players from one AFL club over 4 seasons. Various acute (1–2 weeks) and chronic (3–8 weeks) timeframes were used to calculate ACWRs: these and chronic load categories were then analysed to determine the injury risk in the subsequent month. Poisson regression with robust errors within a generalised estimating equation were utilised to determine incidence rate ratios (IRR). Results Altering acute and/or chronic timeframes did not improve the ability to detect high injury risk conditions above the commonly used 1:4 week ACWR. Twenty-seven ACWR/chronic load combinations were found to be “high risk conditions” (IRR > 1, p < 0.05) for injury within 7 days. Most (93%) of these conditions occurred when chronic load was low or very low and ACWR was either low (<0.6) or high (>1.5). Once a high injury risk condition was entered, the elevated risk persisted for up to 28 days. Conclusions Injury risk was greatest when chronic load was low and ACWR was either low or high. This heightened risk remained for up to 4 weeks. There was no improvement in the ability to identify high injury risk situations by altering acute or chronic time periods from 1:4 weeks.