Scielo RSS <![CDATA[South African Journal of Sports Medicine]]> http://www.scielo.org.za/rss.php?pid=1015-516320220001&lang=en vol. 34 num. 1 lang. en <![CDATA[SciELO Logo]]> http://www.scielo.org.za/img/en/fbpelogp.gif http://www.scielo.org.za <![CDATA[<b>Major steps in 2021</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1015-51632022000100001&lng=en&nrm=iso&tlng=en <![CDATA[<b>Pain and physical activity levels among Rheumatoid Arthritis patients between the ages of 18 to 50 years in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1015-51632022000100002&lng=en&nrm=iso&tlng=en BACKGROUND: Little epidemiological research on rheumatoid arthritis (RA) has been done in Africa, suggesting that it is an uncommon illness. In rural South Africa, RA has an overall prevalence of 0.07% and a prevalence of 2.5% in urban areas; therefore, it is not as uncommon as perceived by the lack of research. Patient-centred programmes to improve physical function have been lacking and, as a result, the prior assumption was that physical activity should be avoided. OBJECTIVES: To determine pain and physical activity levels among RA patients between the ages of 18 to 50 years in South Africa. METHODS: A combination of two questionnaires were used, namely, the Global Physical Activity Questionnaire (2002) and the Pain Outcomes Questionnaire (2003). The collated questionnaires were distributed by rheumatologists and on social media platforms to RA patients between the ages of 18 to 50 years old living in South Africa. This study had a sample size of 105 participants, with participation occurring through the online Google forms platform. RESULTS: One hundred and five participants with RA were recruited with an average age of 38±9 years. Most of the participants were females (93.3%). Seventy-two percent of the sample was classified as physically active, where work, leisure and travel activities were considered. No significant correlation between pain and physical activity was evident (r=0.10; p=0.311). Results showed significant correlations between pain and personal grooming (r=0.30; p=0.002), pain and ambulation (r=0.60; p=0.000), and pain and stair climbing (r=0.60; p=0.000. CONCLUSION: Physical activity has proven to have multiple benefits for those suffering with RA. In this South African sample of RA patients, the majority were classified as physically active, and pain did not affect the activity levels of the involved participants. This study opens further research questions regarding RA prevalence in South Africa, and the type and intensity of physical activity that would be beneficial for RA. <![CDATA[<b>Sport during the COVID-19 bio-bubble: Wellness and opinions in South African elite football</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1015-51632022000100003&lng=en&nrm=iso&tlng=en BACKGROUND: COVID-19 imposed challenges on professional sport, with restrictions leading to the delay in the completion of the South African Premier Soccer League (PSL). Creating a biologically safe environment (BSE) provided a solution enabling the 2019/2020 season to be completed. OBJECTIVES: Evaluating the impact that the BSE had on player wellness and what coping mechanisms were used in the BSE. METHODS: A questionnaire was distributed to PSL teams on the final weekend in the BSE. It consisted of three validated psychology questionnaires. An additional section focused on the impact and coping strategies during the PSL's BSE. RESULTS: A total of 37 completed questionnaires were analysed. General anxiety (4.7±4.2) and depression levels (4.8±3.9) were at an overall low. The health of the players, as well as separation from and concerns about family, were the greatest contributors to anxiety. Electronic communication with family and friends, social interactions with others in the BSE and time spent on self-reflection were important coping mechanisms for players. As time progressed, they adapted to the BSE. CONCLUSION: The BSE did not have a negative impact on the anxiety and depression levels of the respondents, with a variety of coping mechanisms key helping them adapt in the BSE. <![CDATA[<b>Dr Clive Noble - A Tribute</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1015-51632022000100004&lng=en&nrm=iso&tlng=en BACKGROUND: COVID-19 imposed challenges on professional sport, with restrictions leading to the delay in the completion of the South African Premier Soccer League (PSL). Creating a biologically safe environment (BSE) provided a solution enabling the 2019/2020 season to be completed. OBJECTIVES: Evaluating the impact that the BSE had on player wellness and what coping mechanisms were used in the BSE. METHODS: A questionnaire was distributed to PSL teams on the final weekend in the BSE. It consisted of three validated psychology questionnaires. An additional section focused on the impact and coping strategies during the PSL's BSE. RESULTS: A total of 37 completed questionnaires were analysed. General anxiety (4.7±4.2) and depression levels (4.8±3.9) were at an overall low. The health of the players, as well as separation from and concerns about family, were the greatest contributors to anxiety. Electronic communication with family and friends, social interactions with others in the BSE and time spent on self-reflection were important coping mechanisms for players. As time progressed, they adapted to the BSE. CONCLUSION: The BSE did not have a negative impact on the anxiety and depression levels of the respondents, with a variety of coping mechanisms key helping them adapt in the BSE. <![CDATA[<b>Heat shock protein response during fixed intensity and self-paced exercise in the heat in young, healthy women on oral contraceptives compared with young healthy men</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1015-51632022000100005&lng=en&nrm=iso&tlng=en BACKGROUND: Heat shock proteins respond to a variety of physiological and environmental stresses, including heat stress, ischemia and endotoxic shock. Hormonal changes during the female menstrual cycle can have a thermogenic effect on body temperature. The monophasic oral contraceptive (OC) pill provides low doses of progesterone and oestrogen over the course of the normal menstrual phase. There is little evidence regarding the combined effects of OC on exercise performance and heat stress with respect to heat shock protein response. OBJECTIVES: This study aimed to determine the response of heat shock proteins (Hsp72) during fixed-intensity and self-paced exercise in the heat in young, healthy women on oral contraceptives compared with young healthy men. METHODS: Sixteen physically active men and women performed 30 min fixed-intensity cycling at 50% of maximum workload, followed by 30 min of a self-paced time trial (TT) interspersed by 30 s maximal sprint at 9, 19 and 29 min respectively. Trials were undertaken in cool (20°C; 48±3% relative humidity (RH)) and warm (32°C; 66±2% RH) ambient conditions. Core (Tc) and skin temperature, heart rate (HR) and subjective responses were measured before, during and post exercise. RESULTS: The distance, mean and peak power output, mean and peak speed during the self-paced time trial showed no difference between the ambient temperatures for men and women. Hsp72 in females was higher than males at all sample points at both 20°C and 32°C, except for pre-exercise at 20°C (p< 0.04). Women also attained a higher Tc than men at the end of the TT in the heat (38.5°C v 37.9°C for women and men, respectively; p<0.03), higher mean HR and perceived exertion. CONCLUSION: This study indicates that females who use oral contraceptives (OC) had higher levels of Hsp72 than males when tested under the same environmental conditions. <![CDATA[<b>The unexpected evolution of myocardial injury while infected with the coronavirus: A COVID-19 case report</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1015-51632022000100006&lng=en&nrm=iso&tlng=en BACKGROUND: A novel virus breakout in December 2019, with diverse clinical manifestations, initially identified as infecting the respiratory system, has spread rapidly around the world, with adverse effects which have caused acute myocardial injury and chronic damage to the cardiovascular system in some individuals AIM: To present a clinical case with the manifestation of COVID-19 suspected to be either a mild case of either myocarditis or pericarditis. This case highlights a relatively atypical presentation of COVID-19 and the value of a coordinated approach to the unexpected sequences of patient recovery patterns that may require further specialist referral and intervention FINDINGS: A ribonucleic acid (RNA) viral infection was confirmed by a polymerase chain reaction with reverse transcription (RT-PCR) and the patient was diagnosed with coronavirus disease 2019 (COVID-19). The presenting symptoms failed to resolve and the patient was admitted to the accident and emergency (A) department. Upon the second visit to the A department at 27 days postinfection, an electrocardiograph (ECG) was conducted revealing T wave inversion IMPLICATIONS: A coordinated approach is needed to combat the infection, develop cardiac-protective strategies and direct supportive measures <![CDATA[<b>The core of performance in adolescent cricket pace bowlers: Trunk muscle stability, maybe, but not strength-endurance and thickness</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1015-51632022000100007&lng=en&nrm=iso&tlng=en BACKGROUND: The trunk connects the upper and lower limbs and transfers energy during movement. Exploring the role of the trunk muscles in bowling performance affords us the opportunity to uncover potential mechanisms to improve bowling performance OBJECTIVES: To investigate the association between bowling performance and trunk muscle stability, strength-endurance and thickness in adolescent pace bowlers METHODS: Adolescent pace bowlers participated in this cross-sectional study. Trunk muscle stability was measured using Sahrmann's Stability Scale, strength-endurance using the Bourbon Trunk Muscle Strength Test and thickness of the abdominal wall and lumbar multifidus muscles using ultrasound imaging RESULTS: Forty-six pace bowlers with a mean age of 15.9 ±1.2 years participated. The average ball release speed was 109.2±11.8 km.h-1. This measurement was higher in level four of stability than in level two (mean difference 22.2 ± SD 6.8 km.h-1; p= .018). No link between ball release speed and strength-endurance could be found. Multiple correlations of moderate strength (r > 0.4) exist between ball release speed and absolute trunk muscle thickness with height and weight as confounding factors. The relationship between accuracy and the trunk muscle variables investigated in this study is weak CONCLUSION: Bowlers with better trunk muscle stability bowled faster than those with a lower level of trunk stability, irrespective of their age, height and weight. Trunk muscle thickness correlated with ball release speed; however, confounding factors such as height and weight play a role and therefore, findings need to be interpreted with caution <![CDATA[<b>Does transversus abdominis function correlate with prone plank and bench bridge holding time in club cricket players?</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1015-51632022000100008&lng=en&nrm=iso&tlng=en BACKGROUND: Bridge and plank holding times are used to evaluate core stability. Transversus abdominis (TA) muscle function is assessed using ultrasound and also provides input on an individual's core stability OBJECTIVES: A correlation study comparing TA muscle function with bridge and plank holding time in club cricketers METHODS: Seventeen male, premier league cricketers (age: 22.1 ± 3.3 years) participated in this study. Ultrasound was used to measure bilateral TA, internal oblique (OI) and external oblique (OE) muscle thickness at rest and during abdominal hollowing. Muscle function was measured by means of a Pearson's correlation as the change in muscle thickness from rest to abdominal hollowing and compared to holding time of the bench bridge and prone plank (seconds RESULTS: TA muscle thickness was preferentially recruited bilaterally (p=0.00001) during abdominal hollowing. No significant correlations were found between TA muscle function and holding time for the bench bridge (dominant (D): r = 0.03 [95% (3:-0.46-0.50]; non-dominant (ND): r = -0.02 [95% CI:-0.50-0.47]) or prone plank (D: r = -0.16 [95% CL-0.60-0.34]; ND: r = -0.13 [95% CL-0.57-0.38 CONCLUSION: Prone plank and bench bridge holding times are not correlated with TA muscle function during abdominal hollowing. (ore stability cannot rely on a single test to evaluate its effectiveness. In particular, the contribution of the local and global muscle system to 'core stability' needs to be evaluated independently. Therefore these tests are not sensitive enough to evaluate the contribution of the local muscle system to the global muscle system in a healthy, pain free, sporting population <![CDATA[<b>1st Conference of the South African Society of Biomechanics</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1015-51632022000100009&lng=en&nrm=iso&tlng=en BACKGROUND: Bridge and plank holding times are used to evaluate core stability. Transversus abdominis (TA) muscle function is assessed using ultrasound and also provides input on an individual's core stability OBJECTIVES: A correlation study comparing TA muscle function with bridge and plank holding time in club cricketers METHODS: Seventeen male, premier league cricketers (age: 22.1 ± 3.3 years) participated in this study. Ultrasound was used to measure bilateral TA, internal oblique (OI) and external oblique (OE) muscle thickness at rest and during abdominal hollowing. Muscle function was measured by means of a Pearson's correlation as the change in muscle thickness from rest to abdominal hollowing and compared to holding time of the bench bridge and prone plank (seconds RESULTS: TA muscle thickness was preferentially recruited bilaterally (p=0.00001) during abdominal hollowing. No significant correlations were found between TA muscle function and holding time for the bench bridge (dominant (D): r = 0.03 [95% (3:-0.46-0.50]; non-dominant (ND): r = -0.02 [95% CI:-0.50-0.47]) or prone plank (D: r = -0.16 [95% CL-0.60-0.34]; ND: r = -0.13 [95% CL-0.57-0.38 CONCLUSION: Prone plank and bench bridge holding times are not correlated with TA muscle function during abdominal hollowing. (ore stability cannot rely on a single test to evaluate its effectiveness. In particular, the contribution of the local and global muscle system to 'core stability' needs to be evaluated independently. Therefore these tests are not sensitive enough to evaluate the contribution of the local muscle system to the global muscle system in a healthy, pain free, sporting population <![CDATA[<b>Gastrocnemius muscle architecture in distance runners with and without Achilles tendinopathy</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1015-51632022000100010&lng=en&nrm=iso&tlng=en BACKGROUND: Achilles tendinopathy is a common condition amongst distance runners due to the cumulative repetitive overload of the tendon. Gastrocnemius weakness and inflexibility can predispose to this condition. These predisposing functional deficits could have architectural underpinnings, but the gastrocnemius architecture of distance runners with Achilles tendinopathy has not been previously described or compared to the architecture of healthy distance runners. OBJECTIVES: We aimed to investigate the differences in gastrocnemius architecture between distance runners with Achilles tendinopathy and uninjured counterparts. METHODS: Twenty distance runners (10 with Achilles tendinopathy; 10 uninjured) were recruited to this study. Ultrasound measurement of the gastrocnemius muscle architecture (pennation angle; fascicle length; muscle thickness; muscle belly length; muscle volume; physiological cross-sectional area) was performed. RESULTS: Gastrocnemius Medial Head (GM) fascicle length was significantly greater (p = 0.02), whilst the physiological cross-sectional area (PCSA) was significantly less (p = 0.01) in the case group. Gastrocnemius Lateral Head (GL) pennation angle (p = 0.01) and PCSA (p = 0.01) were significantly lower, whilst fascicle length was significantly greater (p = 0.01) in the case group. There were no significant between-group differences in GM and GL muscle thickness, muscle belly length, or muscle volume. CONCLUSION: Components of gastrocnemius architecture differ significantly between distance runners with Achilles tendinopathy and uninjured controls in our study sample. This study cannot infer whether these results are secondary or predisposing to the condition. Further longitudinal investigation is required to explore these relationships further. <![CDATA[<b>Bilateral patellar tendon rupture in a weightlifter during an acute high-loading resistance exercise bout: A case study</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1015-51632022000100011&lng=en&nrm=iso&tlng=en Bilateral patellar tendon ruptures are exceedingly uncommon, especially when they occur in individuals without predisposing risk factors or systemic disease. Due to its rarity, many cases are missed on initial presentation resulting in poor patient outcomes. Identifying associated risk factors aids in diagnosis and mitigates this oversight. We report a case of a healthy, recreational weightlifter who sustained bilateral patellar tendon ruptures during an acute high-loading resistance exercise bout. We discuss how a spike in acute workload may have predisposed our patient to this injury. Research into training load and athlete injury risk is currently in vogue, however, no studies have analysed whether poor load management increases the risk of tendon ruptures. This case prompts awareness for clinicians who diagnose and manage this injury and helps to stimulate the formation of educational initiatives for athletes and coaches, aimed at injury prevention. <![CDATA[<b>The effectiveness of intratissue percutaneous electrolysis for the treatment of tendinopathy: a systematic review</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1015-51632022000100012&lng=en&nrm=iso&tlng=en BACKGROUND: Tendinopathy is highly prevalent in the general public and common in athletes. It makes up nearly 50% of all sport injuries. A number of treatment techniques with varying evidence of effectiveness are currently available. Intratissue percutaneous electrolysis (EPI) is one such modality, however little consensus exists for EPI's efficacy or the most effective treatment parameters. OBJECTIVE: To review and appraise available evidence for Intratissue Percutaneous Electrolysis (EPI) in the treatment of tendinopathy, examining the effectiveness of EPI in conjunction with other modalities and identifying the strengths and limitations of the evidence base for EPI in order to make evidence-based recommendation for future studies of EPI. METHODS: PubMed, Embase and Scopus were searched with keywords related to EPI and tendinopathy. Grey literature searches were conducted with Embase, OpenGrey, and ProQuest. Extensive citation searching was undertaken. Randomised controlled trials (RCTs), uncontrolled and observational studies of the application of EPI in patients aged 18-65 years with Magnetic Resonance Imaging (MRI) or clinical Ultrasonography (US) confirmed diagnosis of tendinopathy were eligible. RESULTS: Eleven studies met inclusion criteria: six randomised control trials (RCTs) and five uncontrolled studies. Clinical trials of EPI as an adjunct modality with physical therapy reporting greater decreased pain and return to function than treatment with physical therapy alone. The evidence for EPI is limited and influenced by small sample sizes, varying treatment protocols, clinical heterogeneity and high risk of bias. CONCLUSION: It is currently not possible to conclude that EPI is an effective modality for the treatment of tendinopathy. RCTs with clearly described EPI treatment protocols, larger sample sizes and intervention reporting sufficient to support reproducibility are needed to determine the effectiveness of EPI for the treatment of tendinopathy.