online

CLICK ON RESEARCH TITLES TO GO TO ABSTRACT

DECLINING INCIDENCE OF CATASTROPHIC CERVICAL SPINE INJURIES IN FRENCH RUGBY. Bohu Y, Julia M, Bagate C, et al. American Journal of Sports Medicine 2009;37:319–323

This epidemiology study looked at players with cervical spine injuries causing neurological disorder classified from the American Spinal Cord Injury Association (ASIA) scale, grade A to D (Box 1), between the 1996–97 and the 2005–

06 seasons. Circumstances of the injuries and of the clinical outcome were collected by interview. There were 37 cases. The incidence of the cervical spine injuries decreased during this period. The rates of injury were 2.1 per 100,000 players per year during the 1996–97 season and 1.4 per 100,000 players per year during the 2005–06 season. The scrum was a major cause of injury, accounting for 51.3% (19/37) of injuries. The forwards represented 89.2% (33/37) of the injured players. The hookers were involved in 37.8% (14/37) of cases. The measures of prevention with the modification of the rules of scrum and the creation of a medical certificate required for players to play in the front row must have been successful.

sportEX comment The decreased injury rate seems to be linked to the decreasing incidence of injuries in

the scrum. It shows that the preventive measures, particularly rule changes, are working. It is a good model for other sports to follow: identify a cause and do something about it. It has not changed the nature of the game or participation numbers.

BOX 1. The American Spinal Cord Injury Association (ASIA) defined an international classification based on neurological levels, touch and pinprick sensations tested in each dermatome, and strength of ten key muscles on each side of the body, i.e. shoulder shrug (C4), elbow flexion (C5), wrist extension (C6), elbow extension (C7) and hip flexion (L2). Traumatic spinal cord injury is classified into five types: A: “complete” spinal cord injury, where no motor or sensory function is preserved in the sacral segments S4–S5. Since the S4–S5 segment is the lower segment, absence of motor and sensory function indicates “complete” spinal cord injury. B: “incomplete” spinal cord injury, in which sensory but not motor function is preserved below the neurological level and includes the sacral segments S4–S5. This is typically a transient phase. If the patient recovers any motor function below the neurological level, the patient essentially becomes motor-incomplete, ie. ASIA C or D. C: “incomplete” spinal cord injury, in which motor function is preserved below the neurological level and more than half of key muscles below the neurological level have a muscle grade of less than 3. D: “incomplete” spinal cord injury, in which motor function is preserved below the neurological level and at least half of the key muscles below the neurological level have a muscle grade of 3 or more. E: “normal”, ie. motor and sensory scores are normal. Note that it is possible to have spinal cord injury and neurological deficit with completely normal motor and sensory scores.

THE USE AND ABUSE OF PAINKILLERS IN INTERNATIONAL SOCCER. Tscholl P, Feddermann N, Junge A, Dvorak J. American Journal of Sports Medicine 2009;37:260–265

Team physicians reported 10,456 uses of medication 72 hours before each

match in 2,488 soccer players

participating in six international soccer tournaments. Results: The use of a total of 6,577 medical substances was reported, leading to an average intake of 0.63 substances per player per match (under-17s, 0.51; under-20s, 0.51; women, 1.0). Non-steroidal anti-inflammatory drugs were the most commonly prescribed type of medication in

4

all tournaments. Women’s soccer had the highest percentage of players using non-steroidal anti-inflammatory drugs per match (under-17s, 17.3%; under-20s, 21.4%; women, 30.7%). Relatively few players were taking b2

-agonists for the treatment of asthma (under-17s, 1.3%; under- 20s, 1.3%; women, 4.3%).

sportEX comment These findings highlight the apparent excessive medication use in international top-level women’s and men’s youth soccer nearly to the same extent as in men’s soccer. Is it all necessary? Continued abuse of medication may

negatively influence not only the quality of the game but also the health status of the

players. sportEX dynamics 2009;20(Apr):4-6