ORCID Profile
0000-0002-3783-0505
Current Organisation
English Institute of Sport
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Publisher: Springer Science and Business Media LLC
Date: 29-01-2016
Publisher: Elsevier BV
Date: 05-2007
Publisher: AMPCo
Date: 04-2018
DOI: 10.5694/MJA18.00132
Publisher: RCN Publishing Ltd.
Date: 06-01-2016
Publisher: Elsevier BV
Date: 07-2019
DOI: 10.1016/J.JSAMS.2019.01.018
Abstract: To Describe the injury incidence and prevalence during two years of a professional women's T20 cricket tournament. Prospective cohort study. Injuries were recorded prospectively for 68 matches during a professional women's T20 tournament in 2016 and 2017. There were six teams of 15 players. Participants were female, aged between 16-38 years (mean 23.4±4.8). Time-loss and non time-loss incidence and prevalence were calculated for match days, region, skill group, mode and activity at time of injury. The greatest incidence occurred in the shoulder (1.8 injuries per 100 match days), lower back (1.7 injuries per 100 match days) and knee (1.7 injuries per 100 match days). The highest time-loss prevalence occurred in hand (1.7%), head/face (0.8%) and thigh (0.6%). All head injuries were concussion. Catching related injuries caused the most time-loss (2.5% prevalence) and throwing related shoulder injury had the highest incidence (2.3 injuries per 100 match days). Gradual onset injuries had the highest overall incidence (7.9 injuries per 100 match days). In elite female T20 cricket, time-loss injuries, particularly impact/traumatic injuries are most likely to occur during fielding, suggesting pitch side support and trauma training is a priority. The high incidence of gradual onset injuries, particularly throwing related shoulder pain, indicates that managing workload and ensuring physical preparedness is vital.
Publisher: British Editorial Society of Bone & Joint Surgery
Date: 12-2010
DOI: 10.1302/0301-620X.92B12.24913
Abstract: In our study, the aims were to describe the changes in the appearance of the lumbar spine on MRI in elite fast bowlers during a follow-up period of one year, and to determine whether these could be used to predict the presence of a stress fracture of the posterior elements. We recruited 28 elite fast bowlers with a mean age of 19 years (16 to 24) who were training and playing competitively at the start of the study. They underwent baseline MRI (season 1) and further scanning (season 2) after one year to assess the appearance of the lumbar intervertebral discs and posterior bony elements. The incidence of low back pain and the amount of playing and training time lost were also recorded. In total, 15 of the 28 participants (53.6%) showed signs of acute bone stress on either the season 1 or season 2 MR scans and there was a strong correlation between these findings and the later development of a stress fracture (p 0.001). The prevalence of intervertebral disc degeneration was relatively low. There was no relationship between disc degeneration on the season 1 MR scans and subsequent stress fracture. Regular lumbar MR scans of asymptomatic elite fast bowlers may be of value in detecting early changes of bone stress and may allow prompt intervention aimed at preventing a stress fracture and avoiding prolonged absence from cricket.
Publisher: BMJ
Date: 30-03-2017
DOI: 10.1136/BJSPORTS-2016-097206
Abstract: There are three major questions about return to play (RTP) after hamstring injuries: How should RTP be defined? Which medical criteria should support the RTP decision? And who should make the RTP decision? The study aimed to provide a clear RTP definition and medical criteria for RTP and to clarify RTP consultation and responsibilities after hamstring injury. The study used the Delphi procedure. The results of a systematic review were used as a starting point for the Delphi procedure. Fifty-eight experts in the field of hamstring injury management selected by 28 FIFA Medical Centres of Excellence worldwide participated. Each Delphi round consisted of a questionnaire, an analysis and an anonymised feedback report. After four Delphi rounds, with more than 83% response for each round, consensus was achieved that RTP should be defined as ‘the moment a player has received criteria-based medical clearance and is mentally ready for full availability for match selection and/or full training’. The experts reached consensus on the following criteria to support the RTP decision: medical staff clearance, absence of pain on palpation, absence of pain during strength and flexibility testing, absence of pain during/after functional testing, similar hamstring flexibility, performance on field testing, and psychological readiness. It was also agreed that RTP decisions should be based on shared decision-making, primarily via consultation with the athlete, sports physician, physiotherapist, fitness trainer and team coach. The consensus regarding aspects of RTP should provide clarity and facilitate the assessment of when RTP is appropriate after hamstring injury, so as to avoid or reduce the risk of injury recurrence because of a premature RTP.
Publisher: BMJ
Date: 02-2018
DOI: 10.1136/BMJSEM-2017-000298
Abstract: Several lower limb tendinopathy treatment modalities involve identification of pathological paratendinous or intratendinous neovascularisation to target proposed co-location of painful neoneuralisation. The ability to reliably locate and assess the degree of neovascularity is therefore clinically important. The Modified Ohberg Score (MOS) is frequently used to determine degree of neovascularity, but reliability has yet to be established among Sport and Exercise Medicine (SEM) consultants. This study aims to determine inter-rater and intra-rater reliability of an SEM consultant cohort when assessing neovascularity using the 5-point MOS. Eleven participants (7 male and 4 female) provided 16 symptomatic Achilles and patella tendons. These were sequentially examined using power Doppler (PD) enabled ultrasound (US) imaging by 6 SEM consultants who rated neovascular changes seen using the MOS. Representative digital scan images were saved for rescoring 3 weeks later. Inter-rater and intra-rater reliability of the MOS was examined using intraclass correlation coefficient (ICC) and Kappa Agreement scores. Neovascular changes were reported in 65.6% of 96 scans undertaken. ICC for inter-rater reliability was 0.86 and Fleiss Kappa 0.52. ICC for intra-rater reliability was 0.95 and Weighted Kappa 0.91. Neovascular changes were present in two-thirds of symptomatic tendons. Excellent SEM consultant inter-rater and intra-rater reliability was demonstrated. These findings support the use of PD-enabled US to assess neovascularity by appropriately experienced SEM consultants. Furthermore, future interventional research using a similarly experienced SEM consultant cohort can be undertaken with assurance that assessment of neovascularity will be reliable.
Publisher: SAGE Publications
Date: 05-05-2017
Publisher: Elsevier BV
Date: 06-2018
DOI: 10.1016/J.JSAMS.2017.10.038
Abstract: To determine, in conjunction with a wider investigation, whether 11 genetic variants in the vicinity of vitamin D, collagen and Wnt signalling pathways were associated with stress fracture injury in the Stress Fracture Elite Athlete (SFEA) cohort. Genotype-phenotype association study. Self-reported stress fracture history and demographic data were recorded in 518 elite athletes, 449 male and 69 female (mean age 24.2±5.5 years) from the SFEA cohort. Elite athletes were assigned to two groups based on history of stress fracture injury. Data were analysed for the whole cohort and sub-stratified in to male only and multiple stress fracture cases. Genotype was determined using a proprietary fluorescence-based competitive allele-specific polymerase chain reaction assay. SOST SNP rs1877632 and VDR SNPs rs10735810 and rs731236 were associated with stress fracture (p 0.05). These data suggest an important role for SOST SNP rs1877632 and VDR SNPs rs10735810 and rs731236 in the pathophysiology of stress fracture. This might be due to the role of the SNPs in the regulation of bone remodelling and adaptation to mechanical loading, with potential implications for the prevention and treatment of stress fracture injuries.
Publisher: BMJ
Date: 16-02-2013
DOI: 10.1136/BJSPORTS-2012-091898
Abstract: Batters in cricket are continuing to sustain head and facial injuries despite wearing protective helmets. To gain an understanding of the types and mechanisms of head injuries sustained by batters wearing a helmet. Injury type, location and mechanism were categorised via analysis of 35 videos of National or International cricketers sustaining a head injury while batting. 53% of the injuries occurred following ball impact to either the helmet faceguard and peak, or the faceguard alone. Ten injuries (29%) resulted from the ball penetrating the gap between the helmet peak and faceguard. 29% of the injuries involved the ball contacting the face following penetration of the gap between the helmet peak and faceguard. Fractures, lacerations and contusions were the most common injuries associated with face or faceguard impacts while concussion was more commonly associated with impacts to the side or rear of the helmet shell. Many of the injuries described resulted in prolonged or permanent absence from cricket. Significant head and facial injuries occur in cricket batters despite wearing of helmets. Cricket helmet design and associated National and International Safety Standards should be improved to provide increased protection against head injury related to ball impact to the faceguard and shell of the helmet.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2008
Publisher: BMJ
Date: 09-2017
Publisher: BMJ
Date: 12-03-2018
DOI: 10.1136/BJSPORTS-2017-098417
Abstract: To investigate concussion injury rates, the likelihood of sustaining concussion relative to the number of rugby union matches and the risk of subsequent injury following concussion. A four-season (2012/2013–2015/2016) prospective cohort study of injuries in professional level (club and international) rugby union. Incidence (injuries/1000 player-match-hours), severity (days lost per injury) and number of professional matches conferring a large risk of concussion were determined. The risk of injury following concussion was assessed using a survival model. Concussion incidence increased from 7.9 (95% CI 5.1 to 11.7) to 21.5 injuries/1000 player-match-hours (95% CI 16.4 to 27.6) over the four seasons for combined club and international rugby union. Concussion severity was unchanged over time (median: 9 days). Players were at a greater risk of sustaining a concussion than not after an exposure of 25 matches (95% CI 19 to 32). Injury risk (any injury) was 38% greater (HR 1.38 95% CI 1.21 to 1.56) following concussion than after a non-concussive injury. Injuries to the head and neck (HR 1.34 95% CI 1.06 to 1.70), upper limb (HR 1.59 95% CI 1.19 to 2.12), pelvic region (HR 2.07 95% CI 1.18 to 3.65) and the lower limb (HR 1.60 95% CI 1.21 to 2.10) were more likely following concussion than after a non-concussive injury. Concussion incidence increased, while severity remained unchanged, during the 4 years of this study. Playing more than 25 matches in the 2015/2016 season meant that sustaining concussion was more likely than not sustaining concussion. The 38% greater injury risk after concussive injury (compared with non-concussive injury) suggests return to play protocols warrant investigation.
Publisher: Elsevier BV
Date: 02-2008
DOI: 10.1016/J.PTSP.2007.08.001
Abstract: To describe the impact of shoulder injuries on professional cricketers during the 2005 England and Wales first class cricket season. Professional cricketers in England were asked to complete two questionnaires relating to shoulder injuries. Players who returned both questionnaires were included in this study. The impact of any shoulder pain whilst playing cricket, impaired cricketing performance and shoulder injury related problems during training and activities of daily living. One hundred and fifty eight of a total of 378 players (42%) returned both questionnaires. Twenty-three per cent of the participants described shoulder injury during the 2005 season. Injury prevalence (the percentage of players not available for selection in a match due to shoulder injury) was 1.7%. Sixty-four per cent of shoulder injured players often or always had associated problems when fielding, and 58% of shoulder injured players fielded in a specific position to avoid shoulder injury related problems. Eighteen per cent of all study participants felt pain on throwing at some stage during the survey period. Professional cricketers generally play on with shoulder injuries without missing matches, though their performance, especially during fielding, is often compromised. Research into the diagnoses, aetiology, appropriate treatment and prevention of shoulder injuries in cricket is required.
Publisher: British Editorial Society of Bone & Joint Surgery
Date: 08-2005
DOI: 10.1302/0301-620X.87B8.16405
Abstract: Low back injuries account for the greatest loss of playing time for professional fast bowlers in cricket. Previous radiological studies have shown a high prevalence of degeneration of the lumbar discs and stress injuries of the pars interarticularis in elite junior fast bowlers. We have examined MRI appearance of the lumbar spines of 36 asymptomatic professional fast bowlers and 17 active control subjects. The fast bowlers had a relatively high prevalence of multi-level degeneration of the lumbar discs and a unique pattern of stress lesions of the pars interarticularis on the non-dominant side. The systems which have been used to classify the MR appearance of the lumbar discs and pars were found to be reliable. However, the relationship between the radiological findings, pain and dysfunction remains unclear.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-09-2021
Publisher: BMJ
Date: 29-06-2022
Publisher: Springer Science and Business Media LLC
Date: 14-05-2005
Publisher: RCN Publishing Ltd.
Date: 06-11-2015
Publisher: Informa UK Limited
Date: 11-2009
DOI: 10.1080/14763140903469908
Abstract: Fast bowling in cricket is an activity that is well recognised as having high injury prevalence and there has been debate regarding the most effective fast bowling technique. The aim of this study was to determine whether two-year coaching interventions conducted in a group of elite young fast bowlers resulted in fast bowling technique alteration. Selected kinematics of the bowling action of 14 elite young fast bowlers were measured using an 18 camera Vicon Motion Analysis system before and after two-year coaching interventions that addressed specific elements of fast bowling technique. Mann-Whitney tests were used to determine whether any changes in kinematic variables occurred pre- and post-intervention between those who had the coaching interventions and those who didn't. The coaching interventions, when applied, resulted in a more side-on shoulder alignment at back foot contact (BFC) (p = 0.002) and decreased shoulder counter-rotation (p = 0.001) however, there was no difference in the degree of change in back and front knee flexion angles or lower trunk side-flexion. This study has clearly shown that specific aspects of fast bowling technique are changeable over a two-year period in elite level fast bowlers and this may be attributed to coaching intervention.
Publisher: Informa UK Limited
Date: 02-2008
DOI: 10.1080/02640410701501671
Abstract: Lower back injuries, specifically lumbar stress fractures, account for the most lost playing time in professional cricket. The aims of this study were to quantify the proportion of lower trunk motion used during the delivery stride of fast bowling and to examine the relationship between the current fast bowling action classification system and potentially injurious kinematics of the lower trunk. Three-dimensional kinematic data were collected from 50 male professional fast bowlers during a standing active range of motion trial and three fast bowling trials. A high percentage of the fast bowlers used a mixed bowling action attributable to having shoulder counter-rotation greater than 30 degrees. The greatest proportion of lower trunk extension (26%), contralateral side-flexion (129%), and ipsilateral rotation (79%) was used during the front foot contact phase of the fast bowling delivery stride. There was no significant difference in the proportions of available lower trunk extension, contralateral side-flexion, and ipsilateral rotation range of motion used during fast bowling by mixed and non-mixed action bowlers. Motion of the lower trunk, particularly side-flexion, during front foot contact, in addition to variables previously known to be related to back injury (e.g. shoulder counter-rotation), should be examined in future cross-sectional and prospective studies examining the fast bowling action and low back injury.
Publisher: Nottingham University Press
Date: 24-01-2012
Abstract: The Authors of this book are an anatomist and a sports physiotherapist with wide experience who both teach sports injury related university courses. Because of its critical location in the body and its many components, diagnosing, managing and rehabilitating sport related back injury is extremely challenging and requires a detailed knowledge of the associated anatomy. In this book the general and specific structures of the back, including the cervical, thoracic and lumbo-sacral spine, are presented and illustrated as a basis for clinical practice. Since clinical signs and symptoms require correct interpretation for an accurate diagnosis and effective management, a special feature of this book is to include detailed case histories showing how knowledge of back anatomy can be used to arrive at a correct diagnosis. This book will therefore be of benefit to a wide range of professionals concerned with sports disorders and injuries.
Publisher: American Physiological Society
Date: 03-2016
DOI: 10.1152/PHYSIOLGENOMICS.00105.2015
Abstract: Despite numerous attempts to discover genetic variants associated with elite athletic performance, injury predisposition, and elite/world-class athletic status, there has been limited progress to date. Past reliance on candidate gene studies predominantly focusing on genotyping a limited number of single nucleotide polymorphisms or the insertion/deletion variants in small, often heterogeneous cohorts (i.e., made up of athletes of quite different sport specialties) have not generated the kind of results that could offer solid opportunities to bridge the gap between basic research in exercise sciences and deliverables in biomedicine. A retrospective view of genetic association studies with complex disease traits indicates that transition to hypothesis-free genome-wide approaches will be more fruitful. In studies of complex disease, it is well recognized that the magnitude of genetic association is often smaller than initially anticipated, and, as such, large s le sizes are required to identify the gene effects robustly. A symposium was held in Athens and on the Greek island of Santorini from 14–17 May 2015 to review the main findings in exercise genetics and genomics and to explore promising trends and possibilities. The symposium also offered a forum for the development of a position stand (the Santorini Declaration). Among the participants, many were involved in ongoing collaborative studies (e.g., ELITE, GAMES, Gene SMART, GENESIS, and POWERGENE). A consensus emerged among participants that it would be advantageous to bring together all current studies and those recently launched into one new large collaborative initiative, which was subsequently named the Athlome Project Consortium.
Publisher: Informa UK Limited
Date: 17-07-2015
DOI: 10.1080/02640414.2015.1069375
Abstract: This study aimed to investigate whether high peak ground reaction forces and high average loading rates are necessary to bowl fast. Kinematic and kinetic bowling data were collected for 20 elite male fast bowlers. A moderate non-significant correlation was found between ball speed and peak vertical ground reaction force with faster bowlers tending to have lower peak vertical ground reaction force (r = -0.364, P = 0.114). Faster ball speeds were correlated with both lower average vertical and lower average horizontal loading rates (r = -0.452, P = 0.046 and r = -0.484, P = 0.031, respectively). A larger horizontal (braking) impulse was associated with a faster ball speed (r = 0.574, P = 0.008) and a larger plant angle of the front leg (measured from the vertical) at front foot contact was associated with a larger horizontal impulse (r = 0.706, P = 0.001). These findings suggest that there does not necessarily need to be a trade-off between maximum ball release speed and the forces exerted on fast bowlers (peak ground reaction forces and average loading rates). Furthermore, it appears that one of the key determinants of ball speed is the horizontal impulse generated at the ground over the period from front foot contact until ball release.
Publisher: Human Kinetics
Date: 02-2013
DOI: 10.1123/JAB.29.1.78
Abstract: The aim of this study was to identify the key aspects of technique that characterize the fastest bowlers. Kinematic data were collected for 20 elite male fast bowlers with 11 kinematic parameters calculated, describing elements of fast bowling technique that have previously been linked to ball release speed. Four technique variables were identified as being the best predictors of ball release speed, explaining 74% of the observed variation in ball release speed. The results indicate that the fastest bowlers have a quicker run-up and maintain a straighter knee throughout the front foot contact phase. The fastest bowlers were also observed to exhibit larger amounts of upper trunk flexion up to ball release and to delay the onset of arm circumduction. This study identifies those technique variables that best explain the differences in release speeds among fast bowlers. These results are likely to be useful in both the coaching and talent identification of fast bowlers.
Publisher: Springer Berlin Heidelberg
Date: 2010
Publisher: Elsevier BV
Date: 06-2020
DOI: 10.1016/J.JSAMS.2020.01.004
Abstract: Methodological concerns relating to acute-to-chronic workload ratios (ACWR) have been raised. This study aimed to assess the relationship between an alternative predictor variable named 'differential load', representing the smoothed week-to-week rate change in load, and injury risk in first class county cricket (FCCC) fast bowlers. Prospective cohort study. Bowling loads and injuries were recorded for 49 professional male fast bowlers from six FCCC teams. A range of differential loads and ACWRs were calculated and subjected to a variable selection procedure. Exponentially-weighted 7-day differential load, 9:21-day ACWR, 42-day chronic load, and 9-day acute load were the best-fitting predictor variables in their respective categories. From these, a generalized linear mixed-effects model combining 7-day differential load, 42-day chronic load, and 9-day acute load provided the best model fit. A two-standard deviation (2SD) increase in 7-day differential load (22 overs) was associated with a substantial increase in injury risk (risk ratio [RR]=2.47, 90% CI: 1.27-4.80, most likely harmful), and a 2SD increase in 42-day chronic load (17.5 overs/week) was associated with a most likely harmful increase in injury risk (RR=6.77, 90% CI: 2.15-21.33). For 9-day acute load, very low values (≤1 over/week) were associated with a most likely higher risk of injury versus moderate (17.5 overs/week RR: 15.50, 90% CI: 6.19-38.79) and very high 9-day acute loads (45.5 overs/week RR: 133.33, 90% CI: 25.26-703.81). Differential loads may be used to identify potentially harmful spikes in load, whilst mitigating methodological issues associated with ACWRs.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2015
Publisher: Elsevier BV
Date: 02-2015
DOI: 10.1016/J.BONE.2014.10.004
Abstract: The RANK/RANKL/OPG signalling pathway is important in the regulation of bone turnover, with single nucleotide polymorphisms (SNPs) in genes within this pathway associated with bone phenotypic adaptations. To determine whether four SNPs associated with genes in the RANK/RANKL/OPG signalling pathway were associated with stress fracture injury in elite athletes. Radiologically confirmed stress fracture history was reported in 518 elite athletes, forming the Stress Fracture Elite Athlete (SFEA) cohort. Data were analysed for the whole group and were sub-stratified into male and cases of multiple stress fracture groups. Genotypes were determined using proprietary fluorescence-based competitive allele-specific PCR assays. SNPs rs3018362 (RANK) and rs1021188 (RANKL) were associated with stress fracture injury (P<0.05). 8.1% of the stress fracture group and 2.8% of the non-stress fracture group were homozygote for the rare allele of rs1021188. Allele frequency, heterozygotes and homozygotes for the rare allele of rs3018362 were associated with stress fracture period prevalence (P<0.05). Analysis of the male only group showed 8.2% of rs1021188 rare allele homozygotes had suffered a stress fracture whilst 2.5% of the non-stress fracture group were homozygous. In cases of multiple stress fractures, homozygotes for the rare allele of rs1021188 and in iduals possessing at least one copy of the rare allele of rs4355801 (OPG) were shown to be associated with stress fracture injury (P<0.05). The data support an association between SNPs in the RANK/RANKL/OPG signalling pathway and the development of stress fracture injury. The association of rs3018362 (RANK) and rs1021188 (RANKL) with stress fracture injury susceptibility supports their role in the maintenance of bone health and offers potential targets for therapeutic interventions.
Publisher: BMJ
Date: 08-06-2016
DOI: 10.1136/BJSPORTS-2016-096125
Abstract: Cricket was the first sport to publish recommended methods for injury surveillance in 2005. Since then, there have been changes to the nature of both cricket and injury surveillance. Researchers representing the major cricket playing nations met to propose changes to the previous recommendations, with an agreed voting block of 14. It was decided that 10 of 14 votes (70%) were required to add a new definition element and 11 of 14 (80%) were required to amend a previous definition. In addition to the previously agreed 'Match time-loss' injury, definitions of 'General time-loss', 'Medical presentation', 'Player-reported' and 'Imaging-abnormality' injuries are now provided. Further, new injury incidence units of match injuries per 1000 player days, and annual injuries per 100 players per year are recommended. There was a shift towards recommending a greater number of possible definitions, due to differing contexts and foci of cricket research (eg, professional vs amateur injury surveillance systems vs specific injury category studies). It is recommended that researchers use and report as many of the definitions as possible to assist both comparisons between studies within cricket and with those from other sports.
Publisher: Elsevier BV
Date: 03-2017
DOI: 10.1016/J.PTSP.2016.09.004
Abstract: Basic military training is physically and psychologically demanding placing recruits at high risk of injury and premature discharge. This study aimed to identify risk factors for lower leg, ankle and foot injury in Maltese military recruits during basic training. This was a prospective cohort study. An armed forces barracks. 127 recruits commencing one basic military training course agreed to participate in the study. The cohort comprised 114 males and 13 females with a mean age of 21.7 ± 2.4 years. All injuries to the lower leg, ankle and foot were recorded using the Orchard Sports Injury Classification System. Injuries were analysed for associations with fitness scores, smoking status, body mass index and foot type. A total of 34 (26.2%) recruits sustained at least one injury, with 10 recruits (7.9%) terminating their training prematurely (three due to musculoskeletal injury). Smoking history, body mass index and foot type were not associated with injury risk. Lower fitness levels at the commencement of basic military training compared with fitness levels measured six months prior, were associated with higher injury risk. Lower fitness at the commencement of basic training was associated with higher injury risk in army recruits. Thus, conditioning programmes aimed at improving recruit fitness should be considered within an injury prevention strategy.
Publisher: BMJ
Date: 02-08-2021
DOI: 10.1136/BJSPORTS-2021-104392
Abstract: To report COVID-19 illness pattern, symptom duration and time loss in UK elite athletes. Observational, clinical and database review of athletes with symptomatic COVID-19 illness managed within the UK Sports Institutes. Athletes were classified as confirmed (positive SARS-CoV-2 PCR or antibody tests) or probable (consistent clinical features) COVID-19. Clinical presentation was characterised by the predominant symptom focus (eg, upper or lower respiratory illness). Time loss was defined as days unavailable for full sport participation and comparison was made with a 2016–2019 respiratory illness dataset from the same surveillance system. Between 24 February 2020 and 18 January 2021, 147 athletes (25 Paralympic (17%)) with mean (SD) age 24.7 (5.2) years, 37% female, were diagnosed with COVID-19 (76 probable, 71 confirmed). Fatigue was the most prevalent symptom (57%), followed by dry cough (50%) and headache (46%). The median (IQR) symptom duration was 10 (6–17) days but 14% reported symptoms days. Median time loss was 18 (12–30) days, with 27% not fully available days from initial date of infection. This was greater than our historical non-COVID respiratory illness comparator 6 days, 0–7 days (p .001) and 4% unavailable at 28 days. A lower respiratory phenotype (ie, including dyspnoea±chest pain±cough±fever) was present in 18% and associated with a higher relative risk of prolonged symptoms risk ratio 3.0 (95% CI: 1.4 to 6.5) and time loss 2.1 (95% CI: 1.2 to 3.5). In this cohort, COVID-19 largely resulted in a mild, self-limiting illness. The presence of lower respiratory tract features was associated with prolonged illness and a delayed return to sport.
Publisher: Elsevier BV
Date: 09-2020
Publisher: BMJ
Date: 14-12-2012
Publisher: RCN Publishing Ltd.
Date: 07-12-2015
Publisher: BMJ
Date: 11-10-2017
DOI: 10.1136/BJSPORTS-2017-097912
Abstract: Concussion, the most common injury in professional rugby union, occurs most commonly during the tackle. Thus, we investigated the association between tackle characteristics and concussion. 182 video clips of tackles leading to clinically diagnosed concussion and 4619 tackles that did not were coded across three professional rugby union competitions. A variable selection process was undertaken to identify the most important variables for interpretation. A multivariate generalised linear model was used to model the association between retained variables and concussion risk. Magnitude-based inferences provided an interpretation of the real-world relevance of the outcomes. The four retained variables were: accelerating player, tackler speed, head contact type and tackle type. Overall, 70% of concussions occurred to the tackler and 30% to the ball carrier. There was a higher risk of concussion if the tackler accelerated into the tackle (OR: 2.49, 95% CI 1.70 to 3.64) or the tackler was moving at high speed (OR: 2.64, 95% CI 1.92 to 3.63). Head contact with the opposing player’s head (OR: 39.9, 95% CI 22.2 to 71.1) resulted in a substantially greater risk of concussion compared with all other head contact locations. Interventions that reduce the speed and acceleration of the tackler and reduce exposure to head-to-head contact would likely reduce concussion risk in professional rugby union.
Publisher: Informa UK Limited
Date: 29-03-2018
DOI: 10.1080/02640414.2018.1458588
Abstract: Artificial rugby union playing surface installation is increasing. This prospective cohort study aimed to examine the effect of playing surface on match injury types within 157 players of two UK professional rugby union clubs playing 209 matches (96 on artificial surfaces and 113 on grass) over three seasons. There was no difference in overall injury risk between the two playing surfaces with injury incidence on artificial 80.2 (CI 69.9-91.7) and on grass 81.9 per 1000 match-hours (CI 72.2-92.5), with an incidence rate ratio (RR) of 0.98 (CI 0.82-1.17). There was a higher rate of concussion (RR 0.52, CI 0.34 - 0.78) and chest injuries on grass (RR 0.26 CI 0.07, 0.95), and a higher rate of thigh haematoma (RR 2.25, CI 1.05-4.82) foot injuries (RR 4.12, CI 1.10, 15.40) and injury to players being tackled (RR 1.46, CI 1.00, 2.15) on artificial. Whilst there was no higher injury risk for matches played on artificial versus natural grass surfaces, the higher incidence of concussion and chest injury on grass, and the higher rate of foot injuries on artificial surfaces may be related to tackle and footwear-to-surface interface factors.
Publisher: Informa UK Limited
Date: 02-2013
DOI: 10.1080/02640414.2012.736628
Abstract: High ground reaction forces during the front foot contact phase of the bowling action are believed to be a major contributor to the high prevalence of lumbar stress fractures in fast bowlers. This study aimed to investigate the influence of front leg technique on peak ground reaction forces during the delivery stride. Three-dimensional kinematic data and ground reaction forces during the front foot contact phase were captured for 20 elite male fast bowlers. Eight kinematic parameters were determined for each performance, describing run-up speed and front leg technique, in addition to peak force and time to peak force in the vertical and horizontal directions. There were substantial variations between bowlers in both peak forces (vertical 6.7 ± 1.4 body weights horizontal (braking) 4.5 ± 0.8 body weights) and times to peak force (vertical 0.03 ± 0.01 s horizontal 0.03 ± 0.01 s). These differences were found to be linked to the orientation of the front leg at the instant of front foot contact. In particular, a larger plant angle and a heel strike technique were associated with lower peak forces and longer times to peak force during the front foot contact phase, which may help reduce the likelihood of lower back injuries.
Publisher: Elsevier BV
Date: 2022
Publisher: BMJ
Date: 16-02-2013
DOI: 10.1136/BJSPORTS-2012-091783
Abstract: Injury surveillance is the cornerstone of effective injury management. However, to date no studies using recommended methods and involving multiple nations have been conducted within International Cricket. To conduct injury surveillance across multiple teams during the ICC Cricket World Cup 2011. An electronic system, based on the guidelines for injury surveillance in international cricket, was used to record all new injury episodes was used for data collection. Twenty-three time-loss and 97 non-time-loss injuries were recorded. The injury incidence was 3.7/100 player-days (0.7 time-loss and 3.0 non-time-loss) with time-loss incidence being for match injury 20.1/1000 player-days, bowling injury 3.3/100 bowling days and batting injuries 2.2/10,000 balls faced. Thigh muscle strain and medical illness were the diagnoses with the highest incidence. Fast bowlers, slow bowlers and batters all had a similar injury prevalence of approximately 5%. The bowling delivery stride was the activity that resulted in the greatest lost time. This is the first study to use recommended injury surveillance guidelines to reporting injury rates across multiple teams at a major cricket tournament. Non-time-loss injury incidence appears relatively high and further study of the effect on performance and progression to subsequent time-loss is required. Fast bowler injury prevalence rates are lower than reported elsewhere, however this may be due to the nature of the tournament and match format, which is likely to impose a lower relative workload. In future, data from all competing teams over all formats of the game (Twenty20, ODI and Tests) needs to be analysed to effectively inform injury prevention research and practice.
Publisher: BMJ
Date: 24-01-2023
DOI: 10.1136/BJSPORTS-2022-105992
Abstract: To identify the priority injury and illness types across UK summer Olympic World Class Programme sports to inform development, implementation and evaluation of associated injury risk mitigation and management initiatives. Four years (2016–2019) of electronic medical records of 1247 athletes from 22 sports were analysed and reported using methods based on the 2020 International Olympic Committee consensus statement for epidemiological recording and reporting. 3562 injuries and 1218 illness were recorded, accounting for 146 156 and 27 442 time-loss days. Overall, 814 (65%) athletes reported at least one injury, while 517 (41%) reported at least one illness. There were 1.3 injuries per athlete year resulting in a mean burden of 54.1 days per athlete year. The lumbar elvis, knee, ankle and shoulder body regions had the highest incidence and burden. Athletes reported 0.5 illnesses per athlete year, resulting in a mean burden of 10.4 days per athlete year, with most composed of respiratory illness and gastroenteritis. Injuries within sport groups were representative of the injury risk profile for those sports (eg, knee, hand and head injuries had the highest incidence in combat sports), but respiratory illnesses were consistently the greatest problem for each sport group. To optimise availability for training and performance, systematic risk mitigation and management initiatives should target priority injury problems occurring in the lumbar elvis, knee, ankle and shoulder, and respiratory illness. Follow-up analysis should include identification of sport-specific priority health problems and associated risk factors.
Publisher: Elsevier BV
Date: 05-2016
DOI: 10.1016/J.PTSP.2015.10.001
Abstract: To provide normative values for cervical range of motion (CROM), isometric cervical and shoulder strength for International Senior professional, and International Age-grade Rugby Union front-row forwards. Cross-sectional population study. All international level front-row players within a Rugby Union Tier 1 Nation. Nineteen Senior and 21 Age-grade front-row forwards underwent CROM, cervical and shoulder strength testing. CROM was measured using the CROM device and the Gatherer System was used to measure multi-directional isometric cervical and shoulder strength. The Age-grade players had significantly lower cervical strength (26-57% deficits), cervical flexion to extension strength ratios (0.5 vs. 0.6), and shoulder strength (2-36% deficits) than the Senior players. However, there were no differences between front-row positions within each age group. Additionally, there were no differences between age groups or front-row positions in the CROM measurements. Senior Rugby Union front-row forwards have greater cervical and shoulder strength than Age-grade players, with the biggest differences being in cervical strength, highlighting the need for age specific normative values. Importantly, Age-grade players should be evaluated to ensure they have developed sufficient cervical strength prior to entering professional level Rugby Union.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2016
Publisher: BMJ
Date: 03-2017
DOI: 10.1136/BJSPORTS-2016-097040
Abstract: When an athlete has more than one injury over a time period, it is important to determine if these are related to each other or not. The subsequent injury categorisation (SIC) model is a method designed to consider the relationship between an index injury and subsequent injury(ies). The primary aim was to apply SIC to longitudinal injury data from two team sports: rugby union and cricket. The secondary aim was to determine SIC inter-rater reliability. Rugby union (time-loss TL) and cricket (TL and non-time-loss NTL) injuries sustained between 2011 and 2014 within one international team, respectively, were recorded using international consensus methods. SIC was applied by multiple raters, team clinicians, non-team clinicians, and a sports scientist. Weighted kappa and Cohen’s kappa scores were calculated for inter-rater reliability of the rugby union TL injuries and cricket NTL and TL injuries. 67% and 51% of the subsequent injuries in rugby union and cricket respectively were categorised as injuries to a different body part not related to an index injury (SIC code 10). At least moderate agreement (weighted and Cohen kappa ≥0.60) was observed for team clinicians and the non-team clinician for both sports. Including NTL and TL injuries increased agreement between team clinician and non-team clinician, but not between clinician and sports scientist. The most common subsequent injury in both sports was an injury to a different body part that was not related to an index injury. The SIC model was generally reliable, with the highest agreement between clinicians working within the same team. Recommendations for future use of SIC are provided based on the proximity of the rater to the team and the raters’ level of clinical knowledge.
Publisher: European Respiratory Society (ERS)
Date: 17-12-2020
DOI: 10.1183/13993003.03722-2020
Abstract: Respiratory tract illness is a leading cause of training and in-competition time loss in elite athletes. Asthma is known to be prevalent in athletes, but the coexistence of other respiratory problems in those deemed to be susceptible to respiratory tract illness is unknown. The aim of this study was to apply a comprehensive prospective approach to identify respiratory problems and explore relationships in athletes with heightened respiratory illness susceptibility. UK World Class Performance Programme athletes prospectively completed a systematic review of respiratory health with validated questionnaires and respiratory-focused investigations, including studies of nasal flow, exhaled nitric oxide, spirometry, bronchoprovocation testing and allergy testing. Systematic respiratory health assessment was completed by 122 athletes (55 females, mean± sd age 24±4 years). At least one respiratory health issue, requiring intervention, was identified in 97 (80%) athletes and at least two abnormalities were found in 73 (60%). Sinonasal problems were the most commonly identified problem (49%) and 22% of athletes had a positive indirect bronchoprovocation test. Analysis revealed two respiratory health clusters: 1) asthma, sinus problems and allergy and 2) laryngeal and breathing pattern dysfunction. Respiratory illness susceptible athletes had 3.6±2.5 episodes in the year prior to assessment and were more likely to have allergy (OR 2.6, 95% CI 1.0–6.5), sinonasal problems (2.6, 1.1–6.0) and symptoms of laryngeal (5.4, 1.8–16.8) and breathing pattern dysfunction (3.9, 1.1–14.0) than nonsusceptible athletes (all p .05). A systematic approach to respiratory assessment identifies a high prevalence and coexistence of multiple respiratory problems in illness-susceptible athletes.
Publisher: SAGE Publications
Date: 07-2015
Abstract: Within international Rugby Union, only injury rates during the Rugby World Cup have been reported. Therefore, injury rates and types during other international tournaments are unknown. To assess the 3-year incidence, severity, nature, and causes of match and training injuries sustained during different international tournaments played by the Welsh national Rugby Union team. Descriptive epidemiology study. Injury data for all players (n = 78) selected for 1 national Rugby Union team over a 3-year period were analyzed using the international consensus statement methods. Player height (cm) and mass (kg) were recorded. Tournaments were grouped for comparisons as: autumn tournaments (2012 and 2013), Rugby World Cup (RWC 2011), Six Nations (2012, 2013, and 2014), and summer tournaments (2012, 2013, and 2014). Injury incidence (injuries/1000 hours), prevalence (% of players unavailable), and severity (days lost) were calculated for each tournament. Injury location, type, and cause of match and training injuries were analyzed. Match injury incidence was highest during autumn tournaments (262.5/1000 match-hours) and lowest during the RWC (178.6/1000 match-hours). Summer tournaments had the highest training incidence (5.5 injuries/1000 training-hours). Mild injuries were most likely during the RWC (risk ratio [RR], 2.02 95% CI, 1.26-3.24), while severe injuries were most likely during autumn tournaments (RR, 3.27 95% CI, 1.70-6.29). Quadriceps hematomas (18.8/1000 match-hours 95% CI, 11.3-31.1) and concussions (13.8/1000 match-hours 95% CI, 7.6-24.8) were the most common match injuries, with shoulder dislocations being the most severe (111 mean days lost per injury). Injury rates were considerably higher than those previously reported for multiple teams during RWC tournaments. Further investigation of injury rates and risk factors is recommended to accurately gauge their impact within international Rugby Union, particularly with regard to lower limb hematoma, concussion, and shoulder injuries.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Craig Ranson.