Scielo RSS <![CDATA[South African Journal of Sports Medicine]]> vol. 30 num. 1 lang. en <![CDATA[SciELO Logo]]> <![CDATA[<b>The transition of the South African Journal of Sports Medicine</b>]]> <![CDATA[<b>Concussion knowledge and attitudes amongst Stellenbosch University hostel rugby players</b>]]> BACKGROUND: Concussion occurs more frequently in contact sports, such as rugby, and is furthermore not fully recognised during play. It is also underreported in the literature, to medical personnel, or to coaches. OBJECTIVES: The objective of this study was to describe the knowledge about and attitudes towards concussion by Stellenbosch University hostel rugby players. METHODS: The study focussed on gathering quantitative information through implementing a cross-sectional study design. One hundred and eighty Stellenbosch University hostel rugby players completed the modified Rosenbaum Concussion Knowledge and Attitudes Survey - Student Version (RoCKAS-ST). The RoCKAS-ST questionnaire is divided into three parts, namely, the evaluation of the Concussion Knowledge Index (CKI) and Concussion Attitudes Index (CAI), and a 16-symptom checklist. RESULTS: The participants scored on average 75% in the CKI and 81% in the CAI. The correlation between CKI and CAI was r=0.14 which is considered a weak positive correlation. DISCUSSION: The participants demonstrated sufficient knowledge of concussion and thus a safer attitude towards concussion. There were some concerning factors from the knowledge of the concussion questions and the symptoms that may have an effect on attitudes towards concussion. CONCLUSION: The study revealed that Stellenbosch University hostel rugby players have sufficient knowledge of what constitutes concussion, as well as the necessity of having safe attitude towards it. However, a small number of participants showed that they still may lack knowledge in certain areas concerning concussion. <![CDATA[<b>Injury and illness profiles during the 2014 South African Ironman triathlon</b>]]> BACKGROUND: There is a need for ongoing scrutiny of injury and illness profiles of ultra-distance athletes. This study aimed to record the medical history, illness and injuries of athletes receiving medical attention during the 2014 Ironman South Africa (IMSA) triathlon, and to investigate the temporal presentation of medical encounters. METHODS: This was a retrospective, cross-sectional study. All athletes who required medical attention at the main medical tent and all of the medical posts or mobile units along the route were included in this study A total of 2 331 athletes started the race. Data included age, gender, time and stage of the race when medical attention was required, pre-race medical history and medication use, illness and injuries treated, special investigations performed, and weather conditions. RESULTS: Overall, 179 athletes (7.7%) required medical attention. The incidence of medical encounters was 7.8%. A significantly higher percentage of younger participants encountered medical problems (P = 0.04). Most patient encounters (80.1%) occurred after the race. The median duration of treatment was 26 minutes. Medication was used by 35.1% of patients during the race. The most common medical encounters were exertion-related (71.2%), gastrointestinal (16.4%), dermatological (11.9%), musculoskeletal (9.6%) and cardiorespiratory conditions (2.4%). CONCLUSION: Medical encounters occurred more frequently in later stages of the race. Most medical conditions were exertion-related. Potential higher risk may be associated with medication use, recent illness, and in younger participants. Temporal stacking of medical personnel, planning of resources according to expected conditions, preventative measures for high-risk behaviour, and on-going data collection with comparable methodology are recommended. <![CDATA[<b>A cross-sectional study of 2550 amateur cyclists shows lack of knowledge regarding relevant sports nutrition guidelines</b>]]> BACKGROUND: Amateur cyclists use a wide variety of supplements and nutritional substances to increase performance in addition to their training. OBJECTIVES: The intended nutritional supplement use, carbohydrate (CHO) use and hydration practices of amateur cyclists before, during and after endurance cycling were analysed. Evidence of ignorance regarding the use of sports supplements and CHO, as well as the disregard of hydration strategy was hypothesised. METHODS: Amateur cyclists, of all age and sex groups, were requested to complete an online survey anonymously on the 2013 Momentum 94.7 Cycle Challenge website, a few days before the event. RESULTS: Responses were received from 2 550 out of 30 640 race entrants (8%); representing a distribution of 75% males, 25% females, with the majority between 25 to 45 years old. Nutritional supplements were used by 59% of respondents, with 77% dose adherence, and 29% with supplement ingredient knowledge. Half of the respondents (48%) planned to carbo-load two-three days before the event, while only five percent used professional advice to scientifically calculate their carbo-loading requirements. CHO were consumed by 81% during the event. Hydration preferences during the race were sports drinks (59%) and water (22%); and after the race 45% preferred a sports drink and 40% water. Ingredients, taste, colour, and temperature were criteria used to choose a sports drink. Only 18% of respondents knew to use both colour of urine and thirstiness to determine post-race fluid requirements. CONCLUSION: The authors concluded that amateur cyclists had insufficient knowledge regarding nutritional supplement ingredients and usage, CHO requirements and carbo-loading practices, and hydration strategies before, during and after the event. <![CDATA[<b>Preventing the seemingly unpreventable - challenging the return-to-play criteria for recurrent hamstring strain prevention</b>]]> BACKGROUND: Hamstring strains are one of the most common injuries in sport. Previous injury has been found to be one of the greatest risk factors associated with recurrent hamstring strains. Although rehabilitation programmes have been developed and implemented to aid safe and efficient return-to-play, the incidence of hamstring injuries has not decreased. DISCUSSION: As hamstring strains most commonly occur during the eccentric phase of muscle action, rehabilitation should focus on eccentric muscle strengthening. The L-protocol and the Nordic Hamstring Exercise protocol strengthen the hamstring muscles eccentrically. They have been found to be effective in decreasing the incidence of new hamstring strains as well as the rate of recurrence. This commentary therefore aims to suggest changes to the return-to-play criteria following hamstring strains to prevent the seemingly unpreventable. <![CDATA[<b>Sacroiliac tuberculosis masquerading as mechanical lower back pain in a collegiate basketball athlete: A case presentation</b>]]> BACKGROUND: Sacroiliac tuberculosis is a rare condition for which early diagnosis and effective management frequently proves challenging. This report describes a case that was initially overlooked due to its presentation and unreported constitutional symptoms. AIM: To alert clinicians about skeletal tuberculosis, an often neglected diagnostic differential, which requires a high index of clinical suspicion, especially for patients from endemic areas. FINDINGS: This patient's presentation (sports injury) and unreported constitutional symptoms resulted in a delay in the diagnosis and initial institution of treatment. IMPLICATIONS: This report illustrates the importance of specifically asking about constitutional symptoms, even in sports injury settings and being mindful of infectious diseases or other chronic medical conditions, which may masquerade as common sports injuries <![CDATA[<b>Stress fracture of the thoracic spine in a male rugby player: a case report</b>]]> This case report discusses a stress fracture of the thoracic spine in a professional South African rugby union player. This is a rare anatomical location for this type of injury in this population and has not previously been described. Physicians should be aware that performance of rugby specific movements may lead to rare stress fractures in certain anatomic locations. <![CDATA[<b>The association between being overweight/obese and blood pressure in rural South African women living in the Tshino Nesengani (Mukondeleli) village</b>]]> BACKGROUND: The purpose of this cross-sectional study was to investigate whether bio-behavioural factors are associated with blood pressure and body composition in rural black South African women. METHODS: Data were collected on 200 African women living in the Tshino Nesengani (Mukondeleli) village, Limpopo Province, using simple anthropometry, blood pressure, and self-reported questionnaires for sleep, physical activity, and sugar-sweetened beverage (SSB) consumption. RESULTS: Six patterns of SSB consumption were determined by principal component analysis. Regression analysis showed that longer sleep duration patterns (>nine hours/night) was associated with lower systolic and diastolic blood pressure; whilst the principal components (beer, wine, and sweetened tea) were associated with a higher body mass index. CONCLUSION: These findings highlight novel bio-behavioural contributors of blood pressure and body anthropometry in rural African women. <![CDATA[<b>Building a robust athlete in the South African high school sports system</b>]]> BACKGROUND: School sport in South Africa has become more competitive, and competition schedules are often found to be more congested. As a consequence young athletes are in an environment where they are exposed to high training and match demands. However, the school system generally fails to prepare these athletes physically to withstand the training and competition demands placed on them. DISCUSSION: It is important that schools implement a system that will allow their athletes to develop physically through age-appropriate strength and conditioning. It is especially important for schools to develop a plan to manage the multi-sport athlete in order reduce the risk of injury and burnout. By adopting a five year accumulative development model that fits the athlete's environment, schools will contribute to the development of future professional athletes. <![CDATA[<b>Neurologist at ringside - to be or not to be?</b>]]> BACKGROUND: Ringside physicians are entrusted with the task of protecting the health and safety of combat sports (boxing and mixed martial arts (MMA)) athletes. Ringside physicians come from various disciplines of medicine such as, primary care, internal medicine, orthopaedics, sports medicine, and otolaryngology. However, there are few neurologists who work as ringside physicians. DISCUSSION: Boxing and MMA are highly controversial sports for a neurologist' involvement because every punch and kick to the head is thrown with the intention of winning by knocking the opponent out, or resulting in a concussion. Thus many neurologists feel it is unethical to support boxing as a ringside physician. CONCLUSION: Boxing and MMA are universally thought to be harmful to the brain, and nearly all medical associations have made calls to ban boxing and MMA. While medical associations and physicians, including neurologists, may not support boxing or MMA, their presence at the ringside or cageside helps to make these sports safer through protecting the health and safety of a combat sports athlete. <![CDATA[<b>Anterior cruciate ligament injuries of the knee: Patterns of association between the mechanism of injury and pathology visualised on magnetic resonance imaging</b>]]> BACKGROUND: Anterior cruciate ligament (ACL) injuries are common among athletes and the general public. These injuries may lead to significant absence from all activities with associated financial and social burdens for the patient. No definitive association has been described between the mechanism of injury and the pathology to enable the implementation of preventative measures to limit these injuries AIM: To determine whether there is an association between the mechanism of injury and the pathology seen on a magnetic resonance imaging (MRI) scan in ACL injuries METHODS: This was a cross-sectional analytical study. Eighty-seven male patients with an ACL injury and who had an MRI scan of the knee within the last two years participated in this study. Participants were contacted to give their informed consent to participate in this study. The mechanism of injury and the pathology seen on the MRI scan was noted and categorised into different groups of injuries and associated pathologies. Statistical analyses included summaries of the data and a test for the association between the mechanism of injury and the pathology. Since there were multiple pathology responses to each mechanism, a modified version of the chi-square test for independence was used. A five percent level of significance was specified RESULTS: MRI scans of ACL injuries indicated that the mechanism of a solid foot plant with rotation of the knee has a greater tendency to be associated with medial meniscal injuries (77%). There was also a 54% possibility for it to be associated with lateral meniscal injuries. A solid foot plant with a valgus stress on the knee showed a higher incidence of associated medial collateral ligament (MCL) injuries (41%) and femoral bone bruising (62%). These two mechanisms of injury are the most common in ACL injuries and contribute to the clinical significance found in this study. The p-value was, however, not statistically significant (p=0.44, chi-square value=20.27, df=45) for any association between the pathology and the mechanism of injury CONCLUSION: Some injury mechanisms causing an ACL injury were more common than others and had more associated pathologies. The most common mechanism of injury noted in this study was a solid foot plant with either rotation of the knee or valgus stress on the knee. Strengthening the tissue structures involved in those movement patterns causing these mechanisms can possibly limit future ACL injuries in athletes and the general public <![CDATA[<b>The impact of anterior knee pain on the quality of life among runners in under-resourced communities in Ekurhuleni, Gauteng, South Africa</b>]]> BACKGROUND: Anterior knee pain (AKP) is the most common injury among runners and has a negative impact on the quality of life (QOL) of many athletes. OBJECTIVES: To determine the impact of AKP on the QOL among runners in under-resourced communities in Ekurhuleni, Gauteng, South Africa. METHODS: A cross-sectional study design was used. A population of 73 runners with AKP was included. Participants included runners aged 13 to 55 years with no history of knee surgery, traumatic or degenerative knee conditions. The SF-36 questionnaire was used to collect data. Ethical clearance, permission from club managers and consent from participants were obtained. Data were collected over six weeks and analysed using SPSS. Descriptive statistics included frequencies, percentages, means, standard deviations and ranges. Inferential statistics included the comparison of means using the ANOVA test. RESULTS: The lowest SF-36 mean scores were in two health domains: role limitation due to emotional problems (59) and vitality (59). Highest scores were in the general physical functioning domain (72). Females presented with lowest SF-36 scores (48) on role limitation due to emotional problems with noticeable difference (p=0.03). Youth presented with lowest scores (62) on the social functioning domain (p=0.001). Significant differences were noted on SF-36 scores between running experienced groups on the following domains: physical functioning (p=0.03), role limitation due to physical problems (p=0.01), vitality (p=0.001), general mental health (p=0.001) and social functioning (p=0.001). The most affected was the group with three-five years of running experience which presented with scores ranging between 46 and 65. Significant mean differences were also noted between BMI groups in the social functioning domain (p=0.01) where overweight and obese groups were mostly affected by AKP. CONCLUSION: This study highlighted a need to prevent, treat and rehabilitate AKP. Multidimensional community-based rehabilitation programmes are recommended. <![CDATA[<b>Analysis of sports science perceptions and research needs among South African coaches</b>]]> BACKGROUND: There appears to be a gap between coaches' expectations concerning their needs and the focus of research findings published by sports scientists. Given the important role of sports science in enhancing athletic performance, closing the gap between sports scientists and coaches is expedient. OBJECTIVES: To investigate sports science perceptions and research needs among South African coaches. METHODS: Using a cross-sectional survey design, a total of 202 (28 females and 174 males) purposively recruited South African coaches completed a validated questionnaire. RESULTS: Findings indicated that improving the technique/efficiency of athletes (4.3±0.8), reducing the incidence of injury/illness in athletes (4.3±0.8), helping athletes peak for competition (4.3±0.9), and the mental preparation of athletes (4.3±1.0) were reported as the most preferred areas of research by coaches. The coaches also reported that there is a need/role for sports science researchers to translate scientific literature into easily understandable language (3.9±1.0). The coaches also indicated that the knowledge of sports science was important for them in performing their roles as coaches (3.9±1.0). CONCLUSION: These findings have practical implications for sports federations to revise their coach education programmes to include sports science concepts which can be applied by coaches to improve the sports performance of individual athletes and teams. <![CDATA[<b>Male Academy rugby union student-athletes in-season physical anthropometrical and physical performance changes, and comparisons with available data</b>]]> BACKGROUND: Physical performance demands of the rugby union (RU) game have increased over the past two decades. However, there are little data on these variables concentrating on developing RU players (student-athletes) over a competitive season. OBJECTIVES: To investigate the potential enhancement of two physical anthropometrical and nine physical performance variables of male New Zealand RU Academy student-athletes over a competitive season and compare with similar published data. METHODS: Twenty student-athletes were recruited to the Otago Rugby Football Union (ORFU) two-year Academy Programme. Each week the student-athletes engaged in 25 hours of strength and conditioning training and participated in 15 hours of on-field rugby training with their respective ORFU Premier League team. Assessments sessions were scheduled for the start of the season, in-season, and pre-play-offs (week 31). RESULTS: Mean data from 20 student-athletes demonstrated a trivial effect size (ES) increase in body weight and skinfold measurements, while a paired t-test (p<0.05) resulted in concurrent significant improvements in lower-body power (ES = large), acceleration (ES = large), speed (10 m sprint, ES = small, 40 m sprint, ES = small), and upper body strength (bench press, ES = large and bench pull, ES = small). A nonsignificant physical performance improvement, with trivial ES difference, was also noted in anaerobic endurance performance. CONCLUSION: Based on these data significant physical performance enhancements were observed during in-season Premier League competition while limiting fatigue and overtraining. <![CDATA[<b>The short-term effects of a sport stacking intervention on the cognitive and perceptual motor functioning in geriatrics: a pilot study</b>]]> BACKGROUND: Sport stacking has been found to be beneficial in improving reaction time, as well as hand-eye- coordination, in children. AIM: The aim of this study was to determine the effects of a sport stacking physical activity intervention on the motor and cognitive functioning of geriatrics. METHODS: An intact, convenient sample of 58 geriatrics from a retirement home in KwaZulu-Natal, South Africa, was selected to participate in this study. Twenty-eight participants were exposed to an eight-week intervention consisting of 16 physical activity sessions, combined with sport stacking techniques, while the control group (30 participants) continued with activities as usual. All participants performed selected motor and cognitive functioning tests, pre- and postintervention. RESULTS: The intervention group had greater improvements in mean reaction time and plate tapping (hand-eye coordination) times compared to the control group. There were no changes in the balance test, memory and quality of life tests. CONCLUSION: A sport stacking activity intervention may improve reaction times and hand-eye coordination in geriatrics. <![CDATA[<b>Physical demands analysis of soccer players during the extra-time periods of the UEFA Euro 2016</b>]]> BACKGROUND: Despite the importance of extra-time (ET) in determining success in the knockout stages of tournaments, there is scant information on the physical demands of ET on soccer players. METHODS: This study investigated the physical demands of all soccer players (n=59) who completed four matches that went to ET at the 2016 UEFA Euro Championship. Players were categorised as follows: central defenders (CDs), wide defenders (WDs), central midfielders (CMs), wide midfielders (WMs) and attackers (ATs). Match activities were captured using a validated camera tracking system (InStat®). Descriptive statistics and repeated measures one-way analysis of variance (ANOVA) were used to analyse the data. RESULTS: The findings showed that total distances covered by players during matches decreased by 13% from the first half of the game (113±10 m/min) to ET (98±10 m/min). Concerning playing positions, a decline in total distances covered during matches was more apparent among midfielders than players in other field positions. A repeated measures ANOVA, with a Greenhouse-Geisser correction, showed that the mean total distances differed significantly between halves of the game [F(1.54, 83.28) = 121.97, p < 0.001. CONCLUSION: Intervention strategies needed to sustain soccer players' physical performance during ET periods and of postmatch recovery modalities warrant further investigation. <![CDATA[<b>The Currie Cup Premiership Competition Injury Surveillance Report 2014 - 2017</b>]]> The content of the report is based on data collected by the SA Rugby Injury and Illness Surveillance and Prevention Project (SARIISPP) steering group.