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Petersburg :: Virginia :: Community Health Systems

Anesthesilogist with Pain Fellowship Training Southside Regional Medical Center (300 beds) is actively seeking an Physiatrist with a Pain Fellowship to be employed by the Hospital. This position will

Eau Claire :: Wisconsin :: Job Job Recruiting

Seeking Orthopaedic Surgeon - Sports Medicine Our Clinic is seeking a Fellowship trained Orthopaedic Surgeon to join an established practices at Eau Claire and Weston, Wisconsin. With 25 Ortho. surgeons

Davenport :: Iowa :: Job Job Recruiting

Our Medical Center is looking for a Board Certified Physiatrist, or one who is soon to complete an ACGME approved Physiatry residency for the development of a new Spine Clinic. Interventional skills are

Pittsburg :: Kansas :: Job Job Recruiting

Desirable Physical Medicine Opportunity Our Medical Center is seeking a Board Certified or Newly Board Eligible Physiatrist. This opportunity will allow the right candidate to practice in both an inpatient

Carlsbad :: New Mexico :: Job Job Recruiting

New Clinic - Carlsbad in Southern New Mexico Carlsbad NM - a sunny community in Southern New Mexico The economy is thriving here and so is industry Plenty of patients and mild winters

Palmer :: Alaska :: Community Health Systems

Palmer is located 42 miles northeast of Anchorage on the Glenn Highway. The primary service area is over 73,000. Mat-Su Regional Medical Center is a 40 bed JCAHO accredited hospital and is the sole

Duncan :: Oklahoma :: Job Job Recruiting

This building is easily accessible and offers a continuum of services based on a patient's rehabilitation needs. Our rehab department boasts of a brand new Aquatic Therapy Facility as well as state of

Exeter :: New Hampshire :: Job Job Recruiting

Physical Medicine and Rehabilitation Currently looking for a well trained interventional PM&R physician to join network of more than 96 physicians in the seacoast area of New Hampshire. Very busy orthopaedic

Exeter :: New Hampshire :: Job Job Recruiting

Physical Medicine and Rehabilitation Currently looking for a well trained PM&R physician to join network of more than 96 physicians in the seacoast area of New Hampshire. Very busy orthopaedic group and

Palmer :: Alaska :: Job Job Recruiting

Outdoor Adventures Galore! Set between two majestic ranges of towering, snowcapped mountains, creates a gateway to Alaska and the Mat-Su Valley. Palmer is located 42 miles northeast of Anchorage on

Duluth :: Minnesota :: Job Job Recruiting

Make a healthy difference for children at the our Clinic Practice Specifics: Our Childrens is the regions largest provider of pediatric care, with over 65 pediatric specialists and subspecialists,

Duluth :: Minnesota :: Job Job Recruiting

Start practicing the life you've imagined....in Minnesota Seeking a BC/BE Physiatrist Practice Specifics Comprehensive, general PM&R practice with management of axial skeletal injury. Practice

The importance of sports medicine for the Vancouver Olympic Games

On the value of team medical staff: can the "Moneyball" approach be applied to injuries in professional football?

No injuries, but plenty of pain? On the methodology for recording overuse symptoms in sports

Overuse injuries may represent as much of a problem as do acute injuries in many sports. This paper reviews key concepts related to the methodology for recording overuse symptoms. Results from the FIVB Volleyball Injury Study were used to compare two different recording methods. The aim of this paper was to provide recommendations on how standardised methodology can be developed to quantify overuse injuries in surveillance studies. Using beach volleyball data, a "traditional" cohort study approach using a time-loss injury definition suggested that injury risk was very low. In contrast, the data from a survey of past and present pain problems in the shoulder, knees and low back demonstrated that these were prevalent. The following recommendations are made: (1) studies should be prospective, with continuous or serial measurements of symptoms; (2) valid and sensitive scoring instruments need to be developed to measure pain and other relevant symptoms; (3) prevalence and not incidence should be used to report injury risk; (4) severity should be measured based on functional level and not time loss from sports. In conclusion, new approaches are needed to develop more appropriate methodology to quantify overuse injuries in studies.

Injuries among male and female World Cup alpine skiers

Background: Limited knowledge exists on injuries among professional alpine skiers. Objective: To describe the risk of injury and the injury pattern among competitive World Cup alpine skiers during the competitive season. Methods: Retrospective interviews were performed with all World Cup athletes from 10 nations at the end of the 2006–7 and 2007–8 winter seasons, and all acute injuries occurring during the 4.5-month competitive season were recorded. If the athlete was not present, their coaches or medical personnel were interviewed. Results: A total of 191 acute injuries were recorded among 521 World Cup alpine skiers. As many as 86 injuries (45%) occurred during World Cup/World Ski Championship competitions, corresponding to an injury rate of 9.8 injuries per 1000 runs (95% CI 7.8 to 11.9). The injury rate was found to increase with increasing speed (slalom 4.9 injuries per 1000 runs, 95% CI 2.5 to 7.4—giant slalom 9.2, 5.1 to 13.3—super-G 11.0, 5.2 to 16.8—downhill 17.2, 11.6 to 22.7). The most frequently injured body part was the knee, with 68 injuries (36%), and 37 of these were severe. The overall injury rate was higher in males than in females, but not for knee injuries. Conclusions : The risk of injury among World Cup athletes in alpine skiing is even higher than previously reported. The knee is the most commonly injured body part and with many severe injuries. Injury rate increased with a higher speed and was higher among males than in females.

Medical complications of an aquatic innovation

The sport of swimming has been affected by the innovations of technology with the evolution of the swimsuit. The health benefits of swimming are numerous and are well documented in the scientific literature. As swimming is a low-impact sport, injuries are relatively uncommon. As a direct result of the new swimsuits, team physicians have identified the emergence of a new trend in injury in the aquatic athlete. Extensive blistering and ulceration of the finger tips and distal interphalangeal joints in addition to ecchymoses of the lower limb are now common in the aquatic athlete wearing the new swimsuits. Team physicians working with elite swimmers should be aware of this phenomenon and institute preventive measures.

The prevention of catastrophic head and spine injuries in high school and college sports

Injuries about the shoulder in skiing and snowboarding

There has been a decrease in the overall injury rate, particularly the rate of lower-extremity injuries, for alpine skiing, with a resultant increase in the ratio of upper-extremity to lower-extremity injuries. The upper extremity is injured nearly twice as often during snowboarding than alpine skiing, with approximately half of all snowboarding injuries involving the upper extremity. Shoulder injuries are likely under-reported, as many patients seek evaluation for minor shoulder injuries with their local physicians, and not at the ski medical clinic, where most epidemiology studies obtain their data. Shoulder injuries account for 4 to 11% of all alpine skiing injuries and 22 to 41% of upper-extremity injuries. During snowboarding, shoulder injuries account for 8 to 16% of all injuries and 20 to 34% of upper-extremity injuries. Falls are the most common mechanism of shoulder injury, in addition to pole planting during skiing and aerial manoeuvres during snowboarding. Common shoulder injuries during skiing and snowboarding are rotator cuff strains, glenohumeral dislocations, acromioclavicular separations and clavicle fractures. It is still unclear, when comparing snowboarding and skiing injury data, which sport has the higher incidence of shoulder injuries. Stratifying shoulder injuries by type allows better delineation as to which sport has an increased incidence of certain injury patterns. The differing mechanisms of injury combined with distinct equipment for each sport plays a role in the type and frequency of shoulder injuries seen in these two subgroups. With the increased ratio of upper- to lower-extremity injuries during alpine skiing and the boom in popularity of snowboarding, shoulder injuries are seen with increasing frequency by those who care for alpine sport injuries. According to recent epidemiological data, only clavicle and humerus fractures have shown increased rates of incidence among alpine skiers. Over the past 30 years, there has been a general decrease in both upper- and lower-extremity injuries which can be attributed to improved designs of protective equipment, increased awareness of injury patterns and emphasis on prevention. In the future, physicians and therapists who treat this population must be comfortable and confident in their treatment algorithms to help keep skiers and snowboarders conditioned and ready for the slopes and develop strategies for the prevention of upper-extremity injuries associated with these activities.

Facial protection and head injuries in ice hockey: a systematic review

Objective: To summarise the best available evidence to determine if facial protection reduces head injury in ice hockey. Data Sources: MEDLINE and Cochrane databases through January 2009. Review Methods: Utilising terms: "head injuries," "craniocerebral trauma [MeSH]", "head injuries, closed [MeSH]", head injuries, penetrating [MeSH]", "face mask", "face shield", "visor" and "hockey", 24 articles were identified through our systematic literature search. Of these, six studies met the inclusion criteria. Three independent reviewers reviewed the articles. The study results and generated conclusions were extracted and agreed upon. Results: Studies reviewed suggest that facial protection reduces overall head injuries in ice hockey. Facial protection showed a statistically significant (p<0.05) reduction in the number and type of facial injuries. In studies evaluating full facial protection (FFP) versus half facial protection (HFP), FFP offered a significantly higher level of protection against facial injuries and lacerations than HFP (relative risk (RR) 2.31, CI 1.53 to 3.48). There was no significant difference in the rate of concussion (RR 0.97, CI 0.61 to 1.54) or neck injury (CI 0.43 to 3.16) between full and partial protection. In those who sustained concussion players with FFP returned to practice or games sooner than players with partial facial protection (PFP) (1.7 sessions, CI 1.32 to 2.18). Conclusions: There is good evidence that FFP reduces the number and risk of overall head and facial injuries in ice hockey compared with PFP and no facial protection. PFP, while not as protective as FFP, appears to offer more risk reduction than no protection.

Division I intercollegiate ice hockey team coverage

Selecting outcome measures in sports medicine: a guide for practitioners using the example of anterior cruciate ligament rehabilitation

Using examples from the field of anterior cruciate ligament rehabilitation, this review provides sports and health practitioners with a comprehensive, user-friendly, guide to selecting outcome measures for use with active populations. A series of questions are presented for consideration when selecting a measure: is the measure appropriate for the intended use? (appropriateness); is the measure acceptable to patients? (acceptability); is it feasible to use the measure? (feasibility); does the measure provide meaningful results? (interpretability); does the measure provide reproducible values? (reliability); does the measure assess what it is supposed to assess? (validity); can the measure detect change? (responsiveness); do substantial proportions of patients achieve the worst or best scores? (floor and ceiling effects); is the measure structured and scored correctly? (dimensionality and internal consistency); has the measure been tested with the types of patients with whom it will be used? (sample characteristics). Evaluation of the measure using these questions will assist practitioners in making their judgements.

Towards research-based approaches for solving body composition problems in sports: ski jumping as a heuristic example

Are there risk factors in alpine skiing? A controlled multicentre survey of 1278 skiers

Objective: To analyse risk factors in alpine skiing. Design: A controlled multicentre survey of injured and non-injured alpine skiers. Setting: One tertiary and two secondary trauma centres in Bern, Switzerland. Patients and methods: All injured skiers admitted from November 2007 to April 2008 were analysed using a completed questionnaire incorporating 15 parameters. The same questionnaire was distributed to non-injured controls. Multiple logistic regression was performed. Patterns of combined risk factors were calculated by inference trees. A total of 782 patients and 496 controls were interviewed. Results: Parameters that were significant for the patients were: high readiness for risk (p = 0.0365, OR 1.84, 95% CI 1.04 to 3.27); low readiness for speed (p = 0.0008, OR 0.29, 95% CI 0.14 to 0.60); no aggressive behaviour on slopes (p<0.0001, OR 0.19, 95% CI 0.09 to 0.37); new skiing equipment (p = 0.0228, OR 59, 95% CI 0.37 to 0.93); warm-up performed (p = 0.0015, OR 1.79, 95% CI 1.25 to 2.57); old snow compared with fresh snow (p = 0.0155, OR 0.31, 95% CI 0.12 to 0.80); old snow compared with artificial snow (p = 0.0037, OR 0.21, 95% CI 0.07 to 0.60); powder snow compared with slushy snow (p = 0.0035, OR 0.25, 95% CI 0.10 to 0.63); drug consumption (p = 0.0044, OR 5.92, 95% CI 1.74 to 20.11); and alcohol abstinence (p<0.0001, OR 0.14, 95% CI 0.05 to 0.34). Three groups at risk were detected: (1) warm-up 3–12 min, visual analogue scale (VAS)speed >4 and bad weather/visibility; (2) VASspeed 4–7, icy slopes and not wearing a helmet; (3) warm-up >12 min and new skiing equipment. Conclusions: Low speed, high readiness for risk, new skiing equipment, old and powder snow, and drug consumption are significant risk factors when skiing. Future work should aim to identify more precisely specific groups at risk and develop recommendations—for example, a snow weather index at valley stations.

Decreased incidence of knee posterior cruciate ligament injury in Australian Football League after ruck rule change

Objective: To assess whether a rule change introduced in the Australian Football League (AFL) before the start of the 2005 season, to limit the run-up of ruckmen at the centre bounce, has been successful in reducing the incidence of knee posterior cruciate ligament (PCL) injuries Design: Cohort study with historical control. Setting: The AFL competition from 1992 to 2008 inclusive. Assessment of risk factors: The presence of a rule change (four seasons) compared with the previous 13 seasons (divided into two eras of seven and six seasons). Main outcome measure: Occurrence of knee PCL injury during a regular season or finals match, both from all causes and specifically from centre bounce ruck collision mechanisms. Results: From 1992 to 1998 there were 11.0 PCL injuries per 10 000 player-hours, with 0.8 ruck injuries per 10 000 centre bounces. From 1999 to 2004, the rates increased to 12.9 per 10 000 player-hours and 5.6 ruck injuries per 10 000 centre bounces (p<0.01). The rates reduced to 5.9 PCL injuries per 10 000 player-hours and 0.9 ruck injuries per 10 000 centre bounces in the period 2005–2008 following the rule change (p<0.01). There was a lower relative risk in 2005–2008 than in 1999–2004 of incurring a centre bounce ruck PCL injury (0.16 (95% CI 0.04 to 0.69)) or of sustaining any PCL injury (0.45 (95% CI 0.28 to 0.75)). Conclusion: A rule change in the AFL to limit the run-up of ruckmen at the centre bounce has successfully reduced the rate of PCL injuries with this mechanism, with the total incidence of PCL injuries also falling.

A prospective cohort study on physical activity and sports-related injuries in 10-12-year-old children

Objectives: To describe the incidence and severity of injuries resulting from physical education, sports and leisure time physical activity (PA) in 10–12-year-old children. Design: This was a prospective cohort study conducted in primary schools, with 995 children aged 10–12 years old as participants. Individual weekly exposure was estimated from baseline and follow-up questionnaires. Exposure to physical education (PE) classes was equal in all schools. An injury was recorded if it occurred during either PE class, leisure time PA, or sports, and caused the child to at least stop the current activity. Injuries were reported within 1 week of injury onset. The main outcome measure was injury incidence density. Results: During the school year a total of 119 injuries were reported by 104 children, resulting in an overall injury incidence density (ID) of 0.48 per 1000 h of exposure (95% CI 0.38 to 0.57). Injury ID was lowest for leisure time PA, followed by PE and sports, respectively. Of all injuries, 40% required medical treatment and 14% resulted in 1 or more days of absence from regular school activities. In general for girls a higher injury ID was reported than for boys, mainly caused by a twofold higher risk during leisure time PA. Conclusions: Next to specific areas of preventive interest it was found that in this specific age group, girls require special attention as they seem to be at higher injury risk than boys.

UEFA injury study: a prospective study of hip and groin injuries in professional football over seven consecutive seasons

Background: Groin injury is a common injury in football and a complicated area when it comes to diagnosis and therapy. There is a lack of comprehensive epidemiological data on groin injuries in professional football. Objective: To investigate the incidence, pattern and severity of hip and groin injuries in professional footballers over seven consecutive seasons. Study design: Prospective cohort study. Setting: European professional football. Methods: During the 2001/2 to 2007/8 seasons, between nine and 17 clubs per season (23 clubs in total) were investigated, accounting for 88 club seasons in total. Time loss injuries and individual exposure during club and national team training sessions and matches were recorded. Main outcome measure: Injury incidence. Results: A total of 628 hip/groin injuries were recorded, accounting for 12–16% of all injuries per season. The total injury incidence was 1.1/1000 h (3.5/1000 match hours vs 0.6/1000 training hours, p<0.001) and was consistent over the seasons studied. Eighteen different diagnostic entities were registered, adductor (n = 399) and iliopsoas (n = 52) related injuries being the most common. More than half of the injuries (53%) were classified as moderate or severe (absence of more than a week), the mean absence per injury being 15 days. Reinjuries accounted for 15% of all registered injuries. In the 2005/6 to 2007/8 seasons, 41% of all diagnoses relied solely on clinical examination. Conclusions: Hip/groin injuries are common in professional football, and the incidence over consecutive seasons is consistent. Hip/groin injuries are associated with long absences. Many hip/groin diagnoses are based only on clinical examination.

Detection of testosterone administration based on the carbon isotope ratio profiling of endogenous steroids: international reference populations of professional soccer players

Background and objectives: The determination of the carbon isotope ratio in androgen metabolites has been previously shown to be a reliable, direct method to detect testosterone misuse in the context of antidoping testing. Here, the variability in the 13C/12C ratios in urinary steroids in a widely heterogeneous cohort of professional soccer players residing in different countries (Argentina, Italy, Japan, South Africa, Switzerland and Uganda) is examined. Methods: Carbon isotope ratios of selected androgens in urine specimens were determined using gas chromatography/combustion/isotope ratio mass spectrometry (GC-C-IRMS). Results: Urinary steroids in Italian and Swiss populations were found to be enriched in 13C relative to other groups, reflecting higher consumption of C3 plants in these two countries. Importantly, detection criteria based on the difference in the carbon isotope ratio of androsterone and pregnanediol for each population were found to be well below the established threshold value for positive cases. Conclusions: The results obtained with the tested diet groups highlight the importance of adapting the criteria if one wishes to increase the sensitivity of exogenous testosterone detection. In addition, confirmatory tests might be rendered more efficient by combining isotope ratio mass spectrometry with refined interpretation criteria for positivity and subject-based profiling of steroids.

Setting standards for the prevention and management of travellers' diarrhoea in elite athletes: an audit of one team during the Youth Commonwealth Games in India

Objective: Devise and implement evidence-based guidelines for the prevention and management of travellers’ diarrhoea (TD), and establish the incidence of TD during an elite sporting trip to India. Design: Literature review and audit. Setting: Youth Commonwealth Games in India 2008. Participants: All members of the Team England Squad. Main outcome measures: Hygiene guidelines included only drinking bottled water, eating hot food and regular hand washing with alcohol gel. Ciprofloxacin was offered to non-athlete team members as prophylaxis but not to athletes due to its possible association with tendon disease. Following implementation of these guidelines, the incidence of travellers’ diarrhoea (TD) in the whole squad was 24/122 (20%), compared with 7/14 (50%) on the reconnaissance trip (preguidelines). In those taking prophylactic ciprofloxacin, the incidence was 4/33 (12%), compared with 20/89 (23%) in those not taking ciprofloxacin. No athlete missed their event due to TD. Conclusions: The incidence of TD was less during the event than on the reconnaissance trip. The relative contribution to this reduction in strict hygiene guidelines as compared with potentially improved catering hygiene arrangements is unknown. Prophylactic ciprofloxacin also reduced the incidence of TD but it is probably not appropriate for use in elite athletes. Rifaximin may be an alternative for this group.

Sex and limb differences in hip and knee kinematics and kinetics during anticipated and unanticipated jump landings: implications for anterior cruciate ligament injury

Objectives: In this study, the effects of temporal changes in unanticipated (UN) prelanding stimuli on lower limb biomechanics and the impact of sex and limb dominance on these variables during single-leg landings were determined. It was hypothesised that reductions in the time of prelanding UN stimuli, female sex, and the non-dominant limb would significantly increase high-risk landing biomechanics during UN jump landings. Methods: 26 (13 men and 13 women) had initial contact (IC) and peak stance (0–50%) phase (PS) lower limb joint kinematics and kinetics quantified during anticipated (AN) and UN single-leg (left and right) landings. Postlanding jump direction was governed via one of two randomly ordered light stimuli, presented either before initiation of the jump (AN), or 600 ms (UN1), 500 ms (UN2) or 400 ms (UN3) immediately before ground contact. Results: Statistically significant (p<0.05) differences in IC hip posture and PS hip and knee internal rotation moments occurred in UN compared with AN landings. Differences were not observed, however, among UN conditions for any biomechanical comparisons. Significant (p<0.05) differences in specific IC and PS hip and knee postures and loads occurred between sexes and limbs. Neither of these factors, however, influenced movement condition effects. Conclusion: UN landings induce modifications in landing biomechanics that may increase anterior cruciate ligament injury risk in both men and women. These modifications, however, do not appear overly sensitive to the timing of the UN stimulus, at least within a temporal range affording a successful movement response. Expanding UN training to include even shorter stimulus-response times may promote the additional central control adaptations necessary to manoeuvre safely within the random sports setting.

A prospective study on gait-related intrinsic risk factors for lower leg overuse injuries

Objective: To determine prospectively gait-related risk factors for lower leg overuse injury (LLOI). Design: A prospective cohort study. Setting: Male and female recruits from a start-to-run (STR) programme during a 10-week training period. Participants: 131 healthy subjects (20 men and 111 women), without a history of any lower leg complaint, participated in the study. Interventions: Before the start of the 10-week STR programme, plantar force measurements during running were performed. During STR, lower leg injuries were diagnosed and registered by a sports physician. Main Outcome Measures: Plantar force measurements during running were performed using a footscan pressure plate. Results: During the STR, 27 subjects (five men and 22 women) developed a LLOI. Logistic regression analysis revealed that subjects who developed a LLOI had a significantly more laterally directed force distribution at first metatarsal contact and forefoot flat, a more laterally directed force displacement in the forefoot contact phase, foot flat phase and at heel-off. These subjects also had a delayed change of the centre of force (COF) at forefoot flat, a higher force and loading underneath the lateral border of the foot, and a significantly higher directed force displacement of the COF at forefoot flat. Conclusions: These findings suggest that a less pronated heel strike and a more laterally directed roll-off can be considered as risk factors for LLOI. Clinically, the results of this study can be considered important in identifying individuals at risk of LLOI.

Medication use by athletes during the Athens 2004 Paralympic Games

Objective: To examine the use of food supplements and pharmaceutical preparations by elite Paralympic athletes. Design: Survey study. Setting: Athens 2004 Paralympic Games. Participants: Data obtained from two sources: (i) athletes’ declaration of intake of drugs/supplements recorded on the Doping Control Official Record during sample collection for doping control; (ii) athletes’ application forms for granting of a therapeutic use exemption. Main outcome measures: Classification of declared food supplements according to the active ingredient and medications according to therapeutic actions and active compounds. Results: 64.2% of the athletes tested for doping control declared use of medications or food supplements, and 81.3% of these athletes declared intake of fewer than four preparations. Non-invasive routes of administration dominated. Food supplements (42.1%) were popular, and drugs used to treat several pathological conditions noted. Non-steroidal anti-inflammatory agents and analgesics were commonly used (9.8% and 5.6%, respectively). The prevalence of inhaled β2-agonist use (4.8%) was higher than expected and exceeded that at the Athens Olympic Games. Conclusions: This review, the first to examine elite Paralympic athletes, shows a more rational approach to the use of medication and food supplements, but a similar consumption pattern to that of athletes at the Athens Olympic Games. Because of the dearth of such studies, consumption trends among Paralympic athletes remain unclear. The need to counsel athletes with disabilities on their nutritional needs is confirmed, and close monitoring by healthcare professionals is recommended.

Towards evidence-based classification in Paralympic athletics: evaluating the validity of activity limitation tests for use in classification of Paralympic running events

Objective: To classify Paralympic athletes, classifiers use test batteries to obtain an objective, pre-competition estimate of an athlete’s training level. Five tests were evaluated to determine which combination explained the maximum variance in running performance in a non-disabled population. A non-disabled sample was required to permit psychometric evaluation of the tests without the confounding influence of impairment, and to provide an indication of normative performance. Design: Sixty-seven non-disabled participants (male and female; mean (SD) age 24.78 (6.53) years) completed a six-test battery comprising a 30 m sprint (criterion activity limitation test) and five supplementary activity limitation tests: standing broad jump, four bounds, 10 m skip, running in place and split jumps. Results: Test reliability was high for all tests (intraclass correlations = 0.80–0.99). Pearson correlations with the 30 m sprint were moderate to strong for standing broad jump (–0.82), four bounds (–0.80) and 10 m skip (0.67), but weaker for split jumps (0.35) and running in place (0.19). Multiple regression indicated that standing broad jump, four bounds and 10 m skip explained 75% of the variance in running performance. Conclusions: The test battery is reliable and valid in the non-disabled population and therefore has potential utility in Paralympic classification. Test results were normally distributed, a necessary prerequisite for meaningful interpretation of future studies in athletes with impairments. Further studies evaluating the battery in populations of athletes with impairments of coordination, strength and range of movement are now warranted.

Effect of a neuromuscular warm-up programme on muscle power, balance, speed and agility: a randomised controlled study

Objective: To investigate whether a 6-month neuromuscular warm-up programme could improve muscle power, balance, speed and agility. Design: Cluster randomised controlled study. Setting: 27 top level female floorball teams in Finland. Participants: 222 players (mean age 24 years); 119 in the intervention group and 103 in the control group were followed-up for one league season (6 months). Intervention: A neuromuscular warm-up programme included sports-specific running technique, balance, jumping and strengthening exercises. The teams were advised to use the programme 1–3 times per week through the league season. One training session took ~25 min. Main outcome measures: Performance tests were assessed before and after the 6-month intervention and included static jump, countermovement jump, jumping over a bar, standing on a bar and figure-of-eight running. Results: At 6 months, significant between-group differences were found in two outcome measures: jumping over a bar (number of jumps in 15 s) and standing on a bar (number of balance losses in 60 s). These differences were 2.3 jumps (95% CI 0.8 to 3.8, p = 0.003), favouring the intervention group, and –0.4 balance losses (95% CI –0.8 to 0.0, p = 0.050), again in favour of the intervention group. Conclusion: A neuromuscular warm-up programme improved the floorball players’ sideways jumping speed and static balance. The exercises were also safe to perform and can thus be recommended for weekly training of floorball players. Trial registration number: ISRCTN26550281.

Writing a new code of ethics for sports physicians: principles and challenges

A code of ethics for sports physicians needs to be clear, appropriate and practically useful to clinicians in everyday clinical circumstances and for situations that may be difficult or contentious. For a code of ethics to be so apposite requires that it have some basis in the ethical concerns of clinicians. This article reflects on the recent experience of rewriting the code of ethics for the Australasian College of Sports Physicians, describing the findings from the research, the processes and challenges that arose, and providing suggestions for other code writers in this field.

Does cryotherapy aid proprioception and Throwing Accuracy in the Dominant Shoulder?

The use of cold therapy such as ice packs following an acute shoulder injury is common, as well as part of the rehabilitation plan. During athletic events, athletes may return to play following the cold therapy, however while the effects of this treatment on shoulder proprioception has been assessed, the effects on throwing performance is as yet unknown.

Physical activity reduces the risk of work-related repetitive strain injuries (RSI)

A new study has demonstrated that being physically active in leisure time is associated with a lower risk of developing upper limb occupational repetitive strain injuries (RSI). The study considered a cross section of 58,622 Canadian residents between the ages of 15 and 74 who had been employed full time in the previous 12 months.

Can the single leg balance test identify risk of ankle sprains?

Ankle sprains are a common injury which can often be disabling in the athlete. The ability to predict the susceptibility of an athlete to ankle sprain injuries with a simple test could allow a coach to develop preventative strategies such as balance and proprioceptive training alongside taping techniques to support the ankle, hence reducing the risk of injuries occurring.

What are the injury risks to elite windsurfer's?

This study investigated the incidence of injury and considered methods of prevention of injury amongst windsurfer's. 107 windsurfer's from recreational through to international level responded to the questionnaire with regards to their injuries over the previous two year period. They were also asked to note any recurrent injuries, level of ability and any preventative measures they were taking.

Is spine disc replacement the answer for degenerative spine disease in athletes?

Injuries to the vertebral disks are becoming far more common amongst sporting and non sporting injuries, however currently there is no treatment available to "replace" the disk.

Does vibration therapy influence delayed onset of muscle soreness?

This study considered whether the use of Vibration Training improved muscle performance by preventing or controlling Delayed Onset Muscle Soreness (DOMS) – the phenomenon of experiencing muscular pain some time after exercise.

Is early rehabilitation important in the recovery of Anterior Cruciate Ligament (ACL) injury?.

This study, although broadly scientific and lab-based, may have implications in the rehabilitation of injuries to the anterior cruciate ligament (ACL).

Is intermittent application of cryotherapy more effective than standard protocols when treating acute ankle sprains?

The use of cryotherapy (ice packs) in the management of acute injuries is largely anecdotal, however there is some evidence to suggest that intermittent application is more effective at reducing tissue temperature to optimal levels.

Can sport specific balance training can prevent acute injuries in high school basketball players?

In a study by Emery & colleagues, 920 basketball players from Calgary, Canada were studied in two groups. Both groups were taught basic warm up techniques, but the second group were also taught an additional warm up component and given a home based balance training programme involving the use of a wobble board.

Does injury in a previous season predispose a football player to injury the following season?

A study in Sweden looked at the injuries sustained by 12 elite Swedish male football teams during the 2001 and 2002 seasons.

Does fatigue cause women to be at higher risk of ACL injuries?

A small study of 20 NCAA (National Collegiate Athletic Association) athletes suggests that due to biomechanical differences between male and female athletes when landing jumps, females may have higher risks of injuring Anterior Cruciate Ligament (ACL) when fatigued.