This study sought to evaluate the effectiveness of the Advanced Throwers Ten Exercise Program (ATTEP) as an injury-prevention exercise program and to assess how ATTEP may serve as a viable aid to the long-term health and performance of badminton players, with the aim of filling a gap in the current literature. Our search identified 100 records; 13 were removed, leaving 87 for screening. After title and abstract screening, 35 studies met the eligibility criteria. Of these, 25 underwent detailed quality appraisal, with 6 subsequently excluded for not fully meeting the predefined age, injury-site, or intervention criteria. Ultimately, 19 studies were included in the qualitative synthesis. The musculoskeletal characteristics of overhead-throwing athletes are unique and are based on instability of the glenohumeral complex. This program is designed to promote muscular coordination and balance and may support the transition from rehabilitation to competitive activity by incorporating dynamic stabilization principles. Incorporated as a warm-up, the program could help athletes reduce the risk of injury to the shoulder joint and improve performance in overhead athletes. Thus, introducing the ATTEP into pre-game exercises might aid in badminton performance enhancement and injury prevention and rehabilitation relating to overuse shoulder injuries.
This scoping review mapped direct evidence on injury prevention and health-risk management in freestyle and other Olympic-style wrestling and distinguished it from cautiously transferable evidence. Following PRISMA-ScR, PubMed, Web of Science Core Collection and Scopus were searched for records published from 1 January 2021 to 14 May 2026. A post hoc source-role audit separated wrestling-specific from contextual sources, and findings were narratively synthesised. Eighteen direct and 41 contextual sources were included: five surveillance studies, seven studies of screening, monitoring or performance proxies, one preventive-intervention trial and five health-risk studies. Surveillance definitions and denominators varied, and most screening studies did not prospectively assess injury prediction. In male cadet freestyle wrestlers, Wrestling+ recorded 20 injuries versus 30 in controls, although inconsistent effect estimates limit interpretation. Standardised surveillance is needed, and Wrestling+ may merit consideration in comparable populations; evidence for screening, health-risk management and implementation remains insufficient.
This case report describes the management of a distal biceps femoris (type 2 T-junction) injury in a footballer, guided solely by clinical examination findings. An ultrasound examination was performed 76 hours post-injury; however, the imaging outcomes were not disclosed to either the physiotherapist managing the injury or the player prior to return to play (RTP). A 25-year-old midfielder sustained the injury during a competitive match and was substituted. Pain length and intensity during contraction and mobility tests progressively improved over the first month and return to full training was permitted at 39 days post-injury. Rehabilitation consisted of a gym-based programme followed by on-field progression, with return to play achieved at 70 days. Post-RTP maximal strength testing showed 252 N in the Nordic Exercise and 352 N in the 90º-90º isometric posterior chain test. The athlete remained free from injury and maintained full participation with the team for the remainder of the season.
Despite the growth of women's football, limited research has examined injury profiles and at a non-elite level. This study aimed to evaluate coaches' perceptions of injuries and risk factors in senior non-elite women's football within the United Kingdom. A quantitative, cross-sectional, online survey was completed by 21 qualified coaches which examined perceived injury types, locations, mechanisms, risk factors, and the influence of the menstrual cycle. Data were analysed using frequency and descriptive statistics. Coaches perceived muscle strains/tears (81%) and ligament sprains/tears (67%) as the most common injuries, with the knee (86%), ankle (62%), and hamstrings (48%) identified as the most frequently injured sites. Injuries were believed to occur predominantly during match play (95%) and in-season (86%), with change of direction (67%) the most commonly reported mechanism. Previous injury (81%) was perceived as the primary internal risk factor, while playing surface (95%) was the leading external factor. Notably, 43% of coaches either considered the menstrual cycle insignificant to injury risk or were unsure of the different phases. Findings align with literature but reveal a substantial knowledge gap regarding female-specific factors, particularly the menstrual cycle. Coach education and targeted professional development are warranted to improve injury prevention strategies and support athlete health.
This study aimed to investigate humeral torsion in professional cricketers to observe whether differences between the throwing and non-throwing arm exist. A prospective study of twenty-nine professional cricketers in the United Kingdom was performed to assess humeral torsion of the throwing and non-throwing arm using a validated indirect ultrasound method. Humeral torsion measurements were significantly different between the throwing arm, 11.21° (95% CI 8.29-14.45; p < 0.001; SE 1.58) and the non-throwing arm, 23.65° (95% CI 20.21-27.11; p < 0.001; SE 1.74). A mean difference of 12.44° (CI 9.02-15.45; p < 0.001) was observed between the throwing arm and non-throwing arm. The trend towards increased retrotorsion of the throwing arm has important implications for athlete management. It further, informs the interpretation of biomechanical range of motion parameters, employed by those managing throwing athletes to foster insight of these observations and judge if adaptations identified are normal or abnormal.
This systematic review (CRD42022307586) investigated the acute effects of massage techniques on myotendinous structures' stiffness. We searched PubMed, Embase, Web of Science, PEDro, and Cochrane Library databases (to January 2026). Randomized clinical trials examining the acute effects of massage on myotendinous stiffness were included. Studies involving co-interventions or post-exercise were excluded. Risk of bias was evaluated using Cochrane RoB2. Data were synthesized qualitatively and quantitatively through random-effects meta-analysis. From 3,584 records, 25 studies (617 participants) were included. Studies investigated self-massage (n = 17), manual (n = 4) or instrumental massage (n = 4). Meta-analyses revealed no significant effects on overall muscle (SMD: -0.17; 95%CI: -0.35 ~ 0.02) or gastrocnemius medialis stiffness (SMD: -0.15; CI95%: -0.58 ~ 0.29). Qualitative synthesis confirmed no consistent alterations in muscle (n = 16), tendon (n = 2), or muscle-tendon unit (MTU) (n = 9) stiffness. Therefore, evidence suggests that massage techniques do not acutely change muscle, tendon, or MTU stiffness, challenging mechanical tissue-release theories. However, conclusions are limited by methodological heterogeneity.
National Collegiate Athletic Association (NCAA) women's sport programs feature elite-level athletes operating under high-performance demands. We describe the epidemiology of injuries in NCAA women's sports during 2019/20-2021/22. We characterized injury frequencies and distributions by sport, event type, body part, diagnosis, and mechanism of injury. Using a Bayesian negative binomial modeling framework, we estimated injury incidence rates and evaluated differential incidence across sport, event type, NCAA division, and academic year. A total of 10,417 injuries were reported across the study period; injuries to the lower leg and foot accounted for 29.6% of all injuries. The posterior mean overall injury rate was 5.2 per 1,000 AEs (95% CrI: [4.7, 5.3]), and overall injury incidence was estimated to be highest in gymnastics (posterior mean rate = 7.9; 95% CrI: [3.8, 14.1]). Our results indicate that the nature of injuries sustained by NCAA women athletes remains tethered to sport-specific gameplay dynamics.
Over-the-counter (OTC) medications are commonly used in the United States. However, limited healthcare supervision can cause medical complications due to misuse and/or lack of knowledge about dosing and adverse effects. To understand the knowledge gap, a cross-sectional, anonymous survey was distributed to NCAA Division II athletes in the Great Midwest Athletic Conference. Survey participants (N = 173) were moderately to not confident about the adverse effects (74.0%) and dosing (62%) of OTC medications. The majority of participants (81%) had moderate to no education about OTC medications. OTC medication users for allergy/sinus (51%) and digestive health (48%) were unaware of the adverse effects of these medications. Lastly, a lack of confidence about the adverse effects had a strong correlation with a lack of confidence in dosing OTC medications (p < 0.001). This study revealed a significant use of OTC medications amongst college athletes, along with the lack of adequate knowledge about dosing and adverse effects of OTC medications.
This systematic review evaluated the effectiveness of massage-based rehabilitation interventions in athletes undergoing arthroscopic anterior cruciate ligament reconstruction (ACLR), with particular emphasis on return-to-sport (RTS) outcomes in professional and elite athletes. The review was conducted in accordance with PRISMA guidelines and included studies published between January 2020 and February 2026 from PubMed, Scopus, Web of Science, Embase, and the Cochrane Library. Eligibility criteria were refined to prioritize primary research directly examining massage-based or soft tissue/manual therapy interventions after ACLR. Methodological quality and the risk of bias were assessed using RoB 2 for randomized controlled trials, ROBINS-I for non-randomized studies, and relevant critical appraisal tools according to study design. The findings indicated that massage-based interventions, including sports massage, myofascial release, acupoint stimulation, percussion massage, and related manual therapies, were associated with reduced pain and oedema, improved muscle tone, enhanced proprioception, and faster functional recovery. The most favourable RTS outcomes were reported when these interventions were integrated within structured, individualized, exercise-based rehabilitation programmes. Successful RTS, commonly achieved within 6-12 months, was further supported by phased progression, sport-specific conditioning, objective functional testing, and the assessment of psychological readiness. Massage-based rehabilitation appears to be a valuable adjunct to comprehensive post-ACLR rehabilitation.
We quantified set-by-set acceleration - deceleration exposure during repeated 2v2 small-sided games (SSGs), assessed acute pre - post changes in selected neuromuscular and strength markers, and tested load - response associations. Ninety players completed 8 × 2-min 2v2 bouts with 2-min passive recovery. Total and high-intensity accelerations (Acc)/decelerations (Dec) were derived per set; pre - post testing assessed quadriceps concentric and hamstring eccentric peak torque (60°·s-1), functional H/Q (H_ecc/Q_con), relative leg stiffness (RLS), and reactive strength index (RSI). Total Dec varied across sets (F(7,623)=3.58, p < 0.001) and declined (slope = -0.295 counts·set-1, p < 0.001); high-intensity Dec also varied across sets (F(7,623)=3.67, p < 0.001). Post-SSG, hamstring eccentric torque decreased (Δ = -8.637 N·m; dz = -1.74; p < 0.001), functional H/Q decreased (Δ = -0.028; dz = -1.03; p < 0.001), and RLS decreased (Δ = -2.363 kN·m-1; dz = -2.93; p < 0.001), while RSI increased (Δ = 0.032; dz = 2.37; p < 0.001). In simultaneous multivariable models, accumulated high-intensity Dec independently predicted greater RLS reductions (β = -0.416, p < 0.001; adj R2 = 0.252) . In conclusion, repeated 2v2 SSGs induce acute changes in selected neuromuscular and strength measures, and accumulated high-intensity braking and propulsion loads best explain these acute neuromuscular shifts.
This cross-sectional observational study aimed to characterize the prevalence of musculoskeletal sonographic abnormalities among players (N = 23) in a Major League Rugby team during preseason medical evaluations. Bilateral ultrasound examinations were performed on the acromioclavicular (AC) joints, quadriceps, patellar, and Achilles tendons. Players most commonly reported prior injuries to the ankle/foot, leg, and shoulder. Ultrasound findings revealed a high prevalence of abnormalities across all examined sites: 65.2% in the AC joints, 70.6% in the quadriceps tendons, 100% in the patellar tendons, and 60.9% in the Achilles tendons. The most frequent findings included insertion-site hyperechoic lesions in the quadriceps tendons (58.8%), hypoechoic lesions in the patellar tendons (82.4%), and hypoechoic lesions in the Achilles tendons (34.8%). These results highlight relevant sonographic musculoskeletal abnormalities in professional rugby union players. The study suggests that preseason musculoskeletal ultrasound may serve as a useful screening tool, warranting further investigation into its role in injury prediction and prevention.
This study examined 10-year trends in potential head injury situations across five consecutive FIFA Beach Soccer World Cups (2015-2024). Footage from 160 matches (974 match-hours) was analysed to identify potential head injury situations and associated mechanisms, player actions, outcomes, and visible signs of possible concussion. A total of 463 potential head injury situations were identified, corresponding to an incidence rate (IR) of 475.3 potential head injury situations/1000 match-hours (2.9/match). The overall IR increased significantly by 6.6% biennially, resulting in a 1.95-fold increase over the 10-year period. Increases were most pronounced in incidents involving upper-extremity-to-head contact (9.0%), those occurring during other-duels (17.5%), and those where players were competing for the ball with their feet (14.4%). The IR of medically assessed incidents and those presenting visible signs of possible concussion did not significantly change over time (p>0.05). Findings suggest that increasing potential head injury situations are primarily driven by contested situations involving greater upper-extremity use, warranting targeted prevention strategies.
Badminton is a popular racket sport with a high injury rate. Because most existing studies are cross-sectional or retrospective, this systematic review focused on prospective biomechanical risk factors for injury in healthy players. Six databases were searched from 2010 to October 2025, yielding 435 records; 11 studies met the inclusion criteria. The review found that during lunging, increased knee moments in the sagittal and frontal planes, higher peak loading rate, and posterior tibial displacement are associated with ACL injury risk. During landing, knee valgus, internal rotation, and high vertical ground reaction force also increase ACL injury risk. For shoulder injuries, internal rotation deficit (<55°) and low eccentric-to-concentric strength ratios of shoulder rotators were key risk factors. These findings suggest that injury prevention should emphasize improved lunging and landing mechanics, hamstring and rotator cuff strengthening, and individualized screening.
Dual-task training (DTT) integrates concurrent motor and/or cognitive tasks. This systematic review aimed to synthesize effects of DTT in adults with musculoskeletal injuries. Eight RCTs (n=224) met the inclusion criteria. Methodological quality was assessed via Cochrane Risk-of-Bias-2 tool. Strong evidence indicates that DTT and single-task training (STT) provide comparable improvements in postural control and patient-reported outcome measures (PROMs) following anterior cruciate ligament reconstruction. Moderate evidence shows that DTT is equivalent to STT and superior to no intervention (NI) for improving postural control in individuals with ankle instability DTT's superior to STT for flexor strength and pain in elbow fractures, while remaining equivalent for range of motion, PROMs, and kinesiophobia. DTT equivalent to STT and superior to NI for jump-landing kinetics in chronic ankle instability (CAI). Limited evidence indicates DTT's superiority over NI for biomechanical improvements in knee ligament dominance defects and over STT for peroneus longus activation in CAI. Conflicting evidence persists regarding CAI proprioception.
The study aimed to describe which criteria are used by medical and performance practitioners in elite European football to progress players through different stages of rehabilitation following a hamstring strain injury. Practitioners from European football clubs from five first-division leagues (Bundesliga, La Liga, Ligue 1, Premier League, Serie A) were invited to participate in an online survey developed in English using the online software QuestionPro. The survey was divided into two parts: part one (six questions) aimed to analyse demographic and job roles; part two (six questions) presented two clinical cases. In total, 25 surveys were completed. The participants were asked to rate on a Likert scale from "Not important" to "Very important" the following criteria for the Return-to-high-speed-running, Return-to-training and Return-to-performance phases: Time since injury, Absence of pain, Hamstring flexibility, Askling H-Test, Negative Magnetic Resonance Imaging (MRI) (injury fully healed), Psychological readiness, Isometric strength, Eccentric strength (Nordics test), Isokinetic test, Single leg bridge (maximal number of repetitions), Jump tests, Completion of progressive on-field exposure (internal and external training load), Ability to run at maximal speed, Repeated sprint ability test, Global Position System (GPS) metrics equivalent to match requirements. We found that practitioners used a variety of criteria across the different stages. This heterogeneity highlights the need for a multidisciplinary approach to return-to-play (RTP) decision-making across all the phases, especially when rehabilitating an intramuscular hamstring tendon injury. Overall, the practitioners felt the need for a greater number and higher specificity of tests during the rehabilitation progression for the intramuscular tendon than the myotendinous junction injury.
American football is a high-intensity contact sport associated with substantial mechanical load and risk of musculoskeletal injuries. Despite its growing popularity in Brazil, epidemiological data remain limited. This study aimed to describe the injury profile and explore factors associated with injuries in Brazilian American football players. A cross-sectional study was conducted between August and October 2025 using a questionnaire on demographic, anthropometric, training, competition, sleep, mood, and risk factors. Sixty athletes participated, with 33 reporting injuries and a median of two injuries per athlete. A total of 93 injuries were reported, most occurring during games. The ankle/foot, knee, and thigh were the most affected regions, with muscle strains and sprains predominating. Overall injury incidence was 7.26 injuries per 1,000 exposure hours, higher in games than training. Taller athletes reported more injuries, while non-restorative sleep and irregular routines were common.
This scoping review aims to map the literature on volleyball injuries based on the Sequence of Prevention model (Step 1-4). Secondary objectives were to describe study characteristics, methodological approaches, and identify literature gaps. PubMed and Embase databases were searched and studies investigating injury epidemiology, risk factors, mechanisms, or prevention programmes in volleyball, recruited players of any age, sex, race, or performance level were included. Only original research articles published in English were included. Database searches yielded 2,675 unique records, with 131 studies included for data extraction. The included studies involved 24,586 players and 29,595 injuries, in total. Studies were mainly concentrated on Step 1 (44.3%) and Step 2 (78.6%) of the sequence of prevention model with risk factor research mainly focused on modifiable (52.6%) and intrinsic (47.3%) risk factors. In comparison, only 7.6% of the studies evaluated effectiveness of various injury prevention programmes (Step 4). About one-third of the studies (34.4%) did not provide a clear injury definition, and staff only registered injuries in 36.6% of the studies. Future research on volleyball injury prevention should focus on preventative measures (Steps 3 and 4) in the sequence of prevention model, using robust methodological approaches.
Female handball players represent an underrepresented yet potentially high-risk population for shoulder injuries. This study investigated shoulder adaptations in elite female handball players by assessing posterior capsule thickness (PCT), supraspinatus tendon thickness (STT), and acromiohumeral distance (AHD) using ultrasound, alongside range of motion (ROM) and isokinetic strength. Twenty athletes (18-32 years) were evaluated bilaterally. No side-to-side differences were observed in PCT or AHD. In contrast, STT and occupation ratio were greater in the throwing shoulder. The throwing shoulder demonstrated reduced internal and greater external rotation ROM, while total rotational ROM remained similar between sides. Internal rotation strength was higher in the throwing shoulder at both angular velocities. No associations were found between PCT and ROM or strength. AHD was positively correlated with external rotation ROM and the external-to-internal rotation strength ratio. These findings suggest sport-specific asymmetrical adaptations in elite female handball players without evidence of posterior capsular thickening.
This study examined the immediate effects of vibration (VFR) and non-vibration foam rolling (FR) on the biomechanical and viscoelastic properties of the knee flexor and extensor muscles. Thirteen young male recreational athletes (mean age: 21.46±1.45 years) completed three conditions: VFR, FR, and control conditions. Assessments were performed pre- and post-test using the MyotonPro. Regarding the knee flexors, no significant effects were observed for muscle tone, stiffness, elasticity, or relaxation time (p>0.05). Creep increased similarly in both VFR and FR groups (p=0.038). Regarding knee extensors, neither intervention affected muscle tone, elasticity, or relaxation time (p>0.05). Stiffness decreased in both groups, with VFR demonstrating greater efficacy compared to FR (p=0.002). Creep increased similarly in both the VFR and FR groups (p=0.016). Both interventions effectively enhanced the creep of knee flexor and extensor muscles and reduced knee extensor muscle stiffness, whereas VFR demonstrated a superior acute benefit in reducing extensor muscle stiffness.
This study evaluated the effects of creatine monohydrate (Cr) supplementation on cognitive and physical performance of young, healthy, omnivorous and physically active individuals, before and after high-intensity exercise. Forty healthy volunteers (20 males [age 23 ± 5 y] and 20 females [age 24 ± 5 y]) completed three visits comprising a familiarization to all test procedures, followed by 2 main trials separated by 1 week of 20 g/day Cr or placebo (maltodextrin) supplementation in a parallel-group design. Participants performed the Stroop Colour and Word Test 1 and 2 and Trail Test A and B pre- and post- a 30-s Wingate cycling test. Cr improved mean (pre-supplementation: 526 W; 95% CI: 510,542; vs. post-supplementation: 570 W; 95% CI: 554,586; p = 0.002; Effect size [ES]=0.94) and peak (pre-supplementation: 738 W; 95% CI: 684,791; vs. post-supplementation: 797 W; 95% CI: 743,850; p = 0.002; ES = 0.91) power output, with no sex differences shown. There were no effects of Cr on any of the cognitive tasks. Cr supplementation improved 30-s Wingate performance but did not affect cognitive performance. These data suggest that Cr may be beneficial for those involved in explosive exercise bouts. There appeared to be a learning effect for several of the cognitive tests, which may have masked any effect with Cr.
