Scielo RSS <![CDATA[South African Journal of Sports Medicine]]> http://www.scielo.org.za/rss.php?pid=1015-516320190001&lang=en vol. 31 num. 1 lang. en <![CDATA[SciELO Logo]]> http://www.scielo.org.za/img/en/fbpelogp.gif http://www.scielo.org.za <![CDATA[<b>The state of the South African Journal of Sports Medicine, 2019</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1015-51632019000100001&lng=en&nrm=iso&tlng=en <![CDATA[<b>A tale of two sit-bones: The cyclist's ischial hygroma (Perineal nodular induration)</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1015-51632019000100002&lng=en&nrm=iso&tlng=en The ischial hygroma, also known as a perineal nodular induration, is a relatively rare and mostly cycling-specific injury that is often incorrectly diagnosed and managed. Here two cases with divergent managements are described to highlight the spectrum of treatment available to manage this condition. The presentation, assessment and management of two cases of perineal nodular induration are discussed. The management options, namely surgical excision vs conservative management, with saddle pressure mapping highlight that there is no single optimal method and that a multidisciplinary approach should be applied to treat these injuries successfully. Perineal nodular induration should be investigated appropriately to exclude less benign causes of perineal masses. Conservative management and surgical excision can both be successful. Clinicians should be familiar with the assessment and management of this relatively rare but debilitating condition in competitive cyclists. <![CDATA[<b>Negative self-appraisal mediates the relationship between mindfulness and confidence among adolescent female provincial hockey players in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1015-51632019000100003&lng=en&nrm=iso&tlng=en BACKGROUND: Mounting evidence suggests that mindfulness is positively related to athletic performance and athlete wellbeing. However, few attempts have been made to explore the psychological processes by which mindfulness might impact performance. OBJECTIVE: To determine whether negative self-appraisal mediates the relationship between dispositional mindfulness and the confidence component of mental toughness among provincial adolescent female hockey players in South Africa. METHODS: Provincial adolescent female hockey players (n=486) completed measures of dispositional mindfulness, mental toughness-related confidence and negative self-appraisal. Correlation coefficients were calculated between all variables included in the study. An ordinary least-squares regression analysis was performed to test the indirect effect of negative self-appraisal on the relationship between dispositional mindfulness and confidence. RESULTS: Negative self-appraisal exhibited an indirect effect on the relationship between dispositional mindfulness and the confidence component of mental toughness (β = .06, SE = .0, CI95 = .04, .09). A subsequent Soble test confirmed that negative self-appraisal served as a statistically significant mediator (β= .06, SE = .01, Z = 5.76, p = .001) in the model. Furthermore, 78.3% of the variance in the effect of dispositional mindfulness on the confidence component of mental toughness was accounted for by negative self-appraisal. CONCLUSION: The effect of dispositional mindfulness on the confidence component of mental toughness among adolescent athletes is mediated by negative self-appraisal. Based on the current findings, dispositional mindfulness may foster confidence by lessening the impact of rigid negative appraisals of one's performance and worth as an athlete. <![CDATA[<b>The lateral batting backlift technique: is it a contributing factor to success for professional cricket players at the highest level?</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1015-51632019000100004&lng=en&nrm=iso&tlng=en BACKGROUND: This study aimed primarily to investigate the lateral batting backlift technique (LBBT) among semi-professional, professional and current international cricket players. A key question was to investigate whether this technique is a factor that contributes to success for cricket players at the highest levels of the gameMETHODS: The participants in this study's sample (n = 130) were South African semi-professional players (SP) (n = 69), professional players (PP) (n = 49) and South African international professional players (SAI) (n = 12). Biomechanical and video analyses were performed on all the participating groups. Classifiers were utilised to identify the batting backlift technique type (BBTT) employed by all batsmen. All statistics and wagon wheels (scoring areas of the batsmen on a cricket field) were sourced online. A Pearson's Chi-squared test, Student T-test, one-way analysis of variance and T-test were performed in this study. All analyses were performed using R (R Core Team) at a significance level of á = 0.05RESULTS: This study found that a LBBT is more common at the highest levels of batsmanship with batsmen at the various levels of cricket having percentages of the LBBT as follows: SP = 37%; PP = 38%; SAI = 75%; p = 0.001. There was also a noticeably higher difference in the highest scores and career averages between all groups of players, as well as batsmen who either use a straight batting backlift technique (SBBT) or a LBBT. This study also found that SAI batsmen who used the LBBT were more proficient at scoring runs in various areas around the cricket field (according to the wagon wheel analysisCONCLUSION: This study found that a LBBT is a contributing factor for success regarding players wanting to play cricket at the highest levels. Cricket coaches should also pay attention to the direction of the backlift with players, especially when correlating it to various scoring areas on the cricket field. Further in-depth research is required to fully investigate the change in batting backlift techniques among cricket players over a long-term period <![CDATA[<b>The impact of a fast bowling spell on physiological, perceptual and performance responses in non-elite cricketers</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1015-51632019000100005&lng=en&nrm=iso&tlng=en BACKGROUND: The demands placed on fast bowlers may elicit unique responses that contribute towards increased injury risk and comprised performance capabilities. Despite this, very few investigations have attempted to quantify these demands and their impact on performance in cricketersOBJECTIVE: This investigation attempted to quantify the effects of a fast bowling protocol on the musculoskeletal, physiological and perceptual responses of fast bowlers; as well as ball speed and accuracyMETHODS: Eight young adult bowlers (20 ± 2 years) participated in a 10-over bowling protocol that had been separated by intermittent fielding drills into three bowling spells respectively (4-, 3- and 3- overs). Selected responses were collected throughout the protocolRESULTS: Functional strength was measured and showed no change. Heart rate responses increased significantly (p<0.05) at the start of the bowling protocol. Local ratings of perceived exertion increased significantly (p<0.05) as a function of exercise duration, while low to moderate intensities of perceived discomfort were noted in the anterior and posterior shoulder areas, upper portion of the lower limb musculature, as well as in the middle and lower back regions. Performance responses experienced no significant changeCONCLUSION: There was no significant change in ball release speed and accuracy across the bowling protocol. Lower limb muscle power remained consistent and heart rates reached a steady state after the first over. In comparison, local ratings of perceived effort and body discomfort increased over time, which could mean that those unchanged measures do not accurately reflect fatigue or that perceptions are a more effective indicator of impending fatigue <![CDATA[<b>The effect of the contract-relax-agonist-contract (CRAC) stretch of hamstrings on range of motion, sprint and agility performance in moderately active males: A randomised control trial</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1015-51632019000100006&lng=en&nrm=iso&tlng=en BACKGROUND: Although stretching is done routinely to prevent injury during explosive sport activities, there is some concern that effective stretching might negatively impact on performanceOBJECTIVE: This study's main objective was to investigate the impact of a specific stretch, the contract-relax-agonist-contract (CRAC) stretch, in which the muscle to be stretched, namely, the hamstrings, is actively contracted and then relaxed. This is followed by the antagonist muscle (the quadriceps) contracting. Secondly, the impact of the stretch on performance was examinedMETHODS: A randomised control trial was used. Forty healthy active males between 21 and 35 years old were assigned to either receive three repetitions of CRAC or rest. Hamstring flexibility and the Illinois Agility Test were the primary outcome measuresRESULTS: The intervention was effective in improving hamstring flexibility by 37% immediately post-application and was maintained for eight minutes thereafter. It had no significant effect on agility or sprint timesCONCLUSION: CRAC, when applied to stretch the hamstring muscles of active males, resulted in a large increase of active knee extension range of motion, without decreasing performance. Therefore, CRAC appears to be a safe and effective method of increasing the length of the hamstrings pre-sport activity and should be utilised by sports physiotherapists if deemed necessary. It was also shown to be beneficial following the initial assessment <![CDATA[<b>Anterior knee pain and its extrinsic risk factors among runners in under-resourced communities in Ekurhuleni, Gauteng, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1015-51632019000100007&lng=en&nrm=iso&tlng=en BACKGROUND: Various factors predispose athletes to anterior knee pain (AKP), making a holistic assessment with rehabilitation inevitable. Due to minimal rehabilitation services in under-resourced communities, runners are less likely to report this injury to medical professionals compared to runners in better resourced communities. OBJECTIVE: The purpose of this study was to report on the prevalence of AKP among runners in under-resourced communities and to determine the extrinsic risk factors for this injury. METHODS: This was a cross-sectional study of 347 runners in total. Convenience sampling was used to recruit 183 participants aged between 13 and 55 years with no previous history of knee surgeries, traumatic or degenerative knee conditions. Questionnaires were used to collect data on the prevalence of AKP and extrinsic risk factors. The SPSS (version 25) was used to analyse the data. Data were presented as frequencies and percentages and the results from chi-square and logistic regression tests were provided. RESULTS: Forty percent (40%) of participants presented with AKP, particularly males (n=106, 58%), young runners (n=94, 51%) and those with 3-5 years of running experience (n=57, 31%). Anterior knee pain was associated with age (X²=6.484, p=0.039) and running experience (X²=8.39, p=0.04). The following extrinsic risk factors contributed to AKP significantly: training load (p=0.04, odds ratio [OR]=1.23), warm-up (p=0.04, OR=1.57)' running shoe condition (p=0.04, OR=0.14) and running surface (p=0.05, OR=1.2). CONCLUSION: A substantial presence of AKP and its extrinsic risk factors were found among all participants. These outcomes suggest that extrinsic risk factors should also be considered when managing AKP among runners. <![CDATA[<b>The South African Rugby Union Youth Week Injury Surveillance Report 2018</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1015-51632019000100008&lng=en&nrm=iso&tlng=en BACKGROUND: Various factors predispose athletes to anterior knee pain (AKP), making a holistic assessment with rehabilitation inevitable. Due to minimal rehabilitation services in under-resourced communities, runners are less likely to report this injury to medical professionals compared to runners in better resourced communities. OBJECTIVE: The purpose of this study was to report on the prevalence of AKP among runners in under-resourced communities and to determine the extrinsic risk factors for this injury. METHODS: This was a cross-sectional study of 347 runners in total. Convenience sampling was used to recruit 183 participants aged between 13 and 55 years with no previous history of knee surgeries, traumatic or degenerative knee conditions. Questionnaires were used to collect data on the prevalence of AKP and extrinsic risk factors. The SPSS (version 25) was used to analyse the data. Data were presented as frequencies and percentages and the results from chi-square and logistic regression tests were provided. RESULTS: Forty percent (40%) of participants presented with AKP, particularly males (n=106, 58%), young runners (n=94, 51%) and those with 3-5 years of running experience (n=57, 31%). Anterior knee pain was associated with age (X²=6.484, p=0.039) and running experience (X²=8.39, p=0.04). The following extrinsic risk factors contributed to AKP significantly: training load (p=0.04, odds ratio [OR]=1.23), warm-up (p=0.04, OR=1.57)' running shoe condition (p=0.04, OR=0.14) and running surface (p=0.05, OR=1.2). CONCLUSION: A substantial presence of AKP and its extrinsic risk factors were found among all participants. These outcomes suggest that extrinsic risk factors should also be considered when managing AKP among runners. <![CDATA[<b>The Currie Cup Premiership Competition Injury Surveillance Report 2014 - 2018</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1015-51632019000100009&lng=en&nrm=iso&tlng=en <![CDATA[<b>Musculoskeletal pain in South African wheelchair basketball players of different point classifications</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1015-51632019000100010&lng=en&nrm=iso&tlng=en BACKGROUND: During recent years, wheelchair basketball has gained worldwide popularity. Several studies have demonstrated a high prevalence of injuries amongst wheelchair basketball players. Few studies, however, have investigated the prevalence of musculoskeletal pain in the context of different point classifications - an integral part of wheelchair sportOBJECTIVE: The aim of this study was to determine the prevalence of musculoskeletal pain in wheelchair basketball players of different point classifications in South Africa and to provide information on patterns of pain distribution in relation to point classificationMETHODS: A questionnaire was completed by 48 wheelchair basketball players participating in the SuperSport League Games of South Africa with point classifications ranging from 1.0 to 4.5. The results were used to determine the patterns of musculoskeletal pain distribution in relation to the different point classificationsRESULTS: Forty-three completed questionnaires were analysed. The prevalence of total musculoskeletal pain was 58% (n=25). Shoulder pain presented the highest overall prevalence, regardless of point classification (n=23; 92% since the start of players' wheelchair basketball careers and n=19; 76% over the last 12 months). It was found that lower point classification (1.0-2.5) players commonly experienced arm pain since the start of their wheelchair basketball careers (η=0.358), as well as specifically over the last 12 months (η=0.319), unlike higher point classification (3.0-4.5) playersDISCUSSION: The study contextualises the prevalence of musculoskeletal pain to overall point classification in wheelchair basketball. Such data are important in the formation of injury prevention strategies, as athletes with impairments are predisposed to different types of musculoskeletal pain based on point classification <![CDATA[<b>Exploring the efficacy of low-level laser therapy and exercise for knee osteoarthritis</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1015-51632019000100011&lng=en&nrm=iso&tlng=en BACKGROUND: Knee Osteoarthritis (KOA) is a prevalent, chronic disorder with excessive functional, social and economic burdens. The goal of treatment is to alleviate the symptoms and slow the progression. Documenting the effects of exercise and LLLT as co-modalities in the management of KOA allows practitioners to implement this management tool as part of KOA rehabilitation, resulting in the earlier discharge from a supervised rehabilitation settingOBJECTIVE: The purpose of this study was to determine the effect of low-level laser therapy (LLLT) in the treatment of knee osteoarthritis (KOA). A randomised controlled trial (RCT) was conducted on 111 participants (aged between 40-75 years) diagnosed with KOA. Participants were randomised into an exercise (n=39), LLLT (n=40), or a combined exercise-LLLT (n=32) groupMETHODS: The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale was used to assess pain and functionality. Knee range of motion was assessed using a goniometer, and the one-minute timed sit-to-stand test measured physical functionality at four time points: (T1) baseline, (T2) post 12-session intervention, (T3) one-month post intervention and (T4) three-month's post intervention. Knee circumference was measured using a measuring tapeRESULTS: WOMAC pain and functionality scale and knee circumference scores decreased in all three groups (P<0.05), but the combined exercise-LLLT group demonstrated better outcomes than the LLLT or exercise alone groups respectively. The combined exercise-LLLT group showed better acute and long-term benefits with participants experiencing a 3.5 centimetre decrease in knee circumference, 24 point improvement in the WOMAC pain and functionality scale, and a four repetition increase in physical functionalityCONCLUSION: The findings suggest that LLLT is a viable tool for managing KOA when used in conjunction with physical exercise <![CDATA[<b>Teams with lower injury rates have greater success in the Currie Cup rugby union competition</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1015-51632019000100012&lng=en&nrm=iso&tlng=en BACKGROUND: Professional football teams that rank high on the log at the end of the season generally have fewer injuries than teams that rank lower on the log. This highlights the importance of implementing injury prevention measures, not only to protect player welfare and ensure their longevity in the sport, but also to improve the performance of the team. The association between a low incidence of injury and superior performance during a season may be even more relevant in sports with a higher incidence of injury than football, such as rugby unionDISCUSSION: To examine this association in the South African Currie Cup rugby union competition, time-loss (> 1 day training/match play missed) injury data and final position in the competition was examined over five-seasons. Teams who ranked in 1st position had significantly lower average injury rates than teams who ranked in last position [48 injuries per 1 000 player hours (95% C.I 20 to 76) vs 130 injuries per 1 000 player hours (95% C.I 79 to 180)]. More specifically, the team with the lowest injury rate in each season ranked in 1st or 2nd position. This team performance aspect of injury prevention should be highlighted more. In particular, this should be used to assist with communicating the importance of injury prevention programmes to stakeholders directly involved with budgetary allocations in the team