Overuse Injuries In Endurance Athletes

Of interest is this paper on overuse injuries in endurance athletes, abstract:

AIM:

The purpose of this study was to clarify training-related risk factors for overuse injuries.

METHODS:

This was twelve-month retrospective study which was done by self-reported postal questionnaire. The study group consisted of 446 men and women top-level Finnish athletes representing three different endurance sports (cross-country skiing, swimming, long-distance running) between the ages of 15-35. Self-reported anthropometric and training-related variables (such as starting age of training, years of active training, hours trained yearly, competition hours and weekly resting days) and occurrence of overuse injuries.

RESULTS:

Athletes with less than 2 rest days per week during the training season had 5.2-fold risk (95% confidence intervals [CI] 1.89-14.06, P=0.001) for an overuse injury, and athletes who trained more than 700 hours during a year had 2.1-fold risk (95% CI 1.21-3.61, P=0.008) for an overuse injury compared to the others. Athletes who reported a tendon injury were on average two years older than athletes without such an injury (P<0.001).

CONCLUSION:

We found that low number of recovery days and a high amount of training are training-related risk factors for overuse injuries in top-level endurance athletes. The higher number of tendon overuse injuries in older than younger athletes may indicate that age-related degeneration plays an important role in the etiology of tendon injuries. These findings should be taken into account when planning exercise programs for endurance athletes.

The conclusions seem to be relevant for the more casual athlete and average person exercising as well, when one considers that insufficient recovery and excessive training are risk factors for overuse injuries in elite athletes.  The age factor is also very likely relevant as well. If we assume relevance for athletes at all levels of ability and experience, one should plan their exercise programs to incorporate sufficient recovery time, avoid excess training - and these recommendations would be especially important for the older athlete.

Bone Structure Variation And Injury Risk

Does anatomical variation from person to person male some individuals more susceptible for particular kinds of injuries? Here is a study that says that glenoid bone structure can contribute to the risk of having anterior shoulder dislocation, abstract:

BACKGROUND:
Although increased retroversion of the glenoid has been shown to be an important factor in posterior instability of the shoulder, there are few studies reporting glenoid bone structure as a risk factor in anterior dislocation of the shoulder. This study aimed to compare glenoid version in patients with anterior dislocation of the shoulder and individuals in a control group with no shoulder problems before undergoing computed tomography and to assess a possible relationship between demographic characteristics and glenoid version angle.
METHODS:
The study group comprised 63 patients (12 women and 51 men; mean age, 35.71 years) with 1 or multiple unilateral anterior dislocations of the shoulder (dislocated group), whereas 63 individuals (11 women and 52 men; mean age, 35.38 years) with no history of shoulder complaints and no signs of instability constituted the control group. The glenoid version angle was measured on an axial cut of the computed tomography scan.
RESULTS:
The glenoid version angles on the dislocated side in the study group were significantly more anteverted than those of the dominant (P < .001) and nondominant (P = .023) shoulders of the control group. The version angles of dislocated shoulders significantly differed from those of nondislocated shoulders of both men (P = .041) and women (P = .049). There was no significant relationship between the glenoid version angle on the dislocated side and dislocation mechanism (P = .883), age group (P = .356), or number of dislocations (P = .971).
CONCLUSIONS:
Glenoid version is an important factor for the development of anterior dislocation of the shoulder.

You cannot change your inherent bone structure, but if you are aware of it – something that may be important particularly in athletes with a higher risk of certain injuries – you may take precautions to try and prevent those injuries for which you are particularly susceptible.

About Iliotibial Band Syndrome

An interesting analysis on a common overuse injury in runners and cyclists. Abstract:

Iliotibial band (ITB) syndrome is regarded as an overuse injury, common in runners and cyclists. It is believed to be associated with excessive friction between the tract and the lateral femoral epicondyle-friction which 'inflames' the tract or a bursa. This article highlights evidence which challenges these views. Basic anatomical principles of the ITB have been overlooked: (a) it is not a discrete structure, but a thickened part of the fascia lata which envelops the thigh, (b) it is connected to the linea aspera by an intermuscular septum and to the supracondylar region of the femur (including the epicondyle) by coarse, fibrous bands (which are not pathological adhesions) that are clearly visible by dissection or MRI and (c) a bursa is rarely present-but may be mistaken for the lateral recess of the knee. We would thus suggest that the ITB cannot create frictional forces by moving forwards and backwards over the epicondyle during flexion and extension of the knee. The perception of movement of the ITB across the epicondyle is an illusion because of changing tension in its anterior and posterior fibres. Nevertheless, slight medial-lateral movement is possible and we propose that ITB syndrome is caused by increased compression of a highly vascularised and innervated layer of fat and loose connective tissue that separates the ITB from the epicondyle. Our view is that ITB syndrome is related to impaired function of the hip musculature and that its resolution can only be properly achieved when the biomechanics of hip muscle function are properly addressed.

Individuals with this disorder should discuss this article with their physician and/or physical therapist to see if something can be done to address the biomechanical deficiencies leading to the problem. Perhaps a change in technique? Strengthening certain muscles?

An Unusual Case With A Positive Ending

By Ildar Sagdejev (Specious) - Own work, GFDL, https://commons.wikimedia.org/w/index.php?curid=4428926

We all need to be thankful that surgeons and emergency medicine doctors exist and can deal with problems such as that described here.  Abstract:

Background  Transorbital intracranial penetrating injury is rare. Damage caused by a huge metallic foreign body is very critical and life-threatening. Method  We report an extremely rare case of transorbital intracranial penetrating metal strip (a car windshield wiper), which has not previously been reported in the literature. Results  Emergency craniotomy was performed; the object was removed successfully, and the patient's life was saved. Conclusion  With the life-threatening penetrating brain injury caused by a huge foreign body, prompt surgical treatment and comprehensive postoperative treatment are important to save patients' lives.