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Background: The ideal graft for anterior cruciate ligament (ACL) reconstruction (ACLR) in young athletes has a high return-to-sport (RTS) rate and a low reinjury rate. Quadriceps tendon autografts are being used with increasing frequency for ACLR in this population, despite a paucity of evidence to support their use. Purpose: To report the RTS rate, ipsilateral reinjury rate, and contralateral ACL injury rate in a young athletic population undergoing primary ACLR using an all–soft tissue quadriceps tendon (ASTQT) autograft. Study Design: Cases series; Level of evidence, 4. Methods: Patients aged 14 to 22 years who underwent primary ACLR using an ASTQT autograft by a single surgeon between January 1, 2005, and April 30, 2020, were identified via electronic medical records and contacted ≥24 months after ACLR to complete a survey regarding subsequent ipsilateral or contralateral ACL injuries and RTS. Patients who had undergone previous ACLR (ipsilateral or contralateral) were excluded. Results: A total of 656 patients (330 male, 326 female; mean age, 17.9 years) were identified, and 395 patients completed the survey (60.2%; 174 male, 221 female; mean age, 17.8 years) with a mean follow-up of 73 ± 29 months (range, 24-139 months). The RTS rate was high (male: 87.7%; female: 82.8%; P =.19). Male and female patients had similar rates of revision ACLR (male: 12.6%; female: 10.0%; P =.40) and contralateral ACL injuries (male: 13.8%; female: 11.3%; P =.46). Conclusion: A high RTS rate and similar rates of ipsilateral and contralateral ACL injuries were found for male and female patients in a young athletic population undergoing primary ACLR using an ASTQT autograft. These results help one to better understand the utility of ASTQT grafts to support successful ACLR in young athletic populations, for which ASTQT grafts appear to yield favorable outcomes. [ABSTRACT FROM AUTHOR]

Context: Understanding how neuromuscular and biomechanical deficits that are associated with knee injuries change as youth mature may improve injury prevention strategies in this population. Objective: To investigate sex and maturation differences in jump-landing technique performance in youths using a practical clinical tool. Design: Cross-sectional study. Setting: High Performance Center Laboratory. Participants: A total of 165 youth athletes were included in this study. Main Outcome Measures: The main outcome measures were each of the 10 items of the modified tuck jump assessment and the total score. These measures include (1) knee valgus at landing, (2) thighs do not reach parallel, (3) thighs not equal side to side, (4) loot placement not shoulder width apart, (5) foot placement not parallel, (6) foot contact timing not equal, (7) excessive landing contact noise, (8) pause between jumps, (9) technique declines prior to 10 seconds, and (10) does not land in same footprint. Results: Only knee valgus at landing had a significant sex x maturation interaction. The main effect of maturation was significant for items 2, 3, 6, 7, 9, and total score. Plyometric technique performance improved with increasing maturation. The main effect of sex was significant for items 1 and 9, with males performing better than females. Conclusions: Female athletes demonstrate increased knee valgus at landing and fatigue relative to males improved jump-landing performance with maturation. [ABSTRACT FROM AUTHOR]

Context: Youth athletes may be at elevated risk for adverse health due to sport specialization. Sport organizations have developed guidelines for participation during growth and development. Objective: To assess youth sport development guidelines using a 15-item framework across sport organizations and governing bodies in soccer, basketball, ice hockey, and swimming. Data Sources: English-language results from January 1, 2000, to December 31, 2018, from published sport organization guidelines and athlete development plans. Study Selection: Two investigators independently reviewed publications identified from sport organizations. A total of 23 guidelines were incorporated, including 5 general sport organizations and 18 sport-specific guidelines. Study Design: Systematic review. Level of Evidence: Level 4. Data Extraction: Two investigators independently identified all recommendations that fit within a predetermined rubric of recommendations encompassing 4 domains: Psychological Development/Approach, Physical Development/Load, Facilities and Resources, and Timing and Monitoring of Specialization. Sport-specific guidelines on volume were summarized. Results: Sport organizations and sport-specific guidelines had consensus on 2 items out of the 15-item: emphasis on early skill development and access to well-trained coaches. While recommended by all sports organization, multisport participation was emphasized by 3 of 4 sports, excluding soccer. Volume recommendations were inconsistent between and within sports. No group proposed methods to monitor athlete well-being. Conclusion: This review highlights areas of agreement within sport organizations and governing bodies. Creating a framework to guide youth sport specialization may lead to specific and consistent guidelines. [ABSTRACT FROM AUTHOR]

Context: Youth sport specialization may place young athletes at increased risk for negative impacts to their physical and/or psychological health. In response to these health concerns, several health organizations have created guidelines and position statements to guide parents and practitioners toward best practices for management of the young athlete. Objective: To systematically review and synthesize current organizations' recommendations and guidelines regarding youth sport specialization. Data Sources: English-language articles from January 1, 2000, to December 31, 2018, in the NCBI Pubmed, Embase, Cochrane, CINAHL, and SPORTDiscus databases. Study Selection: Articles that reported on recommendations or interventions by health organizations or health representatives of sports organizations. A total of 56 articles were assessed, with 11 meeting inclusion eligibility criteria. Study Design: Systematic review. Level of Evidence: Level 4. Data Extraction: Two investigators independently identified all recommendations within the results that fit within a 15-item framework encompassing 4 domains: Psychological Development/Approach, Physical Development/Load, Facilities and Resources, and Timing and Monitoring of Specialization. Results: Recommendations across organizations were primarily clustered in the Physical Development/Load (43%), Facilities and Resources (48%), and Sport Specialization (55%) domains. In contrast, the Psychological Development/Approach domain had fewer recommendations (20%). The most common recommendations endorsed concepts: "Monitor athlete well-being," "Youth athletes need access to well-trained, quality coaches," "Multi-sport participation," "Limit early organized participation and/or training," and "Parents require awareness of training, coaching, and best practices." The level of evidence provided to support a given recommendation varied significantly. The level of detail and the consistency of terms used throughout the results were typically low. Recommendations were frequently made without reference to potential outcome measures or specific strategies that could be used for practical implementation in the community. Conclusion: There was broad representation of different aspects of specialization but limited consistency between health organization guidelines. Adopting a framework for recommendations as used in this review could assist organizations in structuring future recommendations that are specific, measurable, and framed in a manner that will promote action in the youth sport community. [ABSTRACT FROM AUTHOR]

Suspension training is an adjunct to traditional strength and conditioning. The effect of added instability on muscle activation during traditional exercises is unclear and depends on the exercise and type of instability. The purpose of this review was to compare the activations of different muscles in suspension training exercises and their traditional counterparts. A search of the current literature was performed without language restrictions using the electronic databases PubMed (1969—12 January 2017), SPORTDiscus (1969—12 January 2017) and Scopus (1969—12 January 2017). The inclusion criteria were: (1) descriptive studies; (2) physically active participants; and (3) studies that analysed muscle activation using normalised electromyographic signals during different suspension training exercises. Eighteen studies met the inclusion criteria. For the push-up, inverted row, prone bridge and hamstring curl in suspension, the activation of upper-body and core muscles ranged between moderate (21–40% maximum voluntary isometric contraction (MVIC)) and very high (>60% MVIC). Muscle activation in these same muscle groups was greater with suspension exercises relative to comparable traditional exercises, except for the inverted row. Muscle activation in the upper extremity and core muscles varied greatly amongst studies. [ABSTRACT FROM AUTHOR]

Objective: To estimate the incidence proportion (IP) and incidence rate (IR) of ACL injury in football players.Design: Systematic review with meta-analysis.Data Sources: PubMed, CINAHL and SPORTDiscus electronic databases were searched from inception to 20 January 2017.Eligibility Criteria For Selecting Study: Studies that reported the total number of participants/population by sex, total number of ACL injuries by sex and total person-time by sex were included.Results: Twenty-eight studies were included. The IP and IR of ACL injury in female football players were 2.0% (95% CI 1.2% to 3.1%) and 2.0/10 000 athlete exposures (AEs) (95% CI 1.6 to 2.6; I2=91%) over a period of one season to 4 years. The IP and IR of ACL injury in male players were 3.5% (95% CI 0.7% to 8.2%) and 0.9/10 000 AEs (95% CI 0.7 to 1.1; I2=94%). Studies that evaluated matched cohorts of female and male players showed no difference in IP (relative risk=1.2; 95% CI 0.9 to 1.6; P=0.47) over a period of one season to 4 years. Women were at greater risk than men (incidence rate ratio (IRR)=2.2; 95% CI 1.6 to 3.1; I2=83%; P<0.001). When accounting for participation level, the difference in IR between women and men was greatest for intermediate players (IRR=2.9; 95% CI 2.4 to 3.6) compared with amateur (IRR=2.6; 95% CI 1.4 to 4.8) and elite (IRR=2.0; 95% CI 1.1 to 3.4) players.Summary/conclusion: Overall, more men sustained ACL injury in football. There was no difference in the relative risk of ACL injury between female and male football players in a window that spanned one season to 4 years. The IR of ACL injury among women was 2.2 times higher than the IR of ACL injury among men. The reported sex disparity in ACL injury was independent of participation level. [ABSTRACT FROM AUTHOR]

Objective: To estimate the incidence proportion (IP) and incidence rate (IR) for ACL injury in athletes.Design: Systematic review with meta-analysis DATA SOURCES: The PubMed, CINAHL and SPORTDiscus electronic databases were searched from inception to 20 January 2017.Eligibility Criteria For Selecting Studies: Studies were included if they reported total number of participants/population by sex, total number of ACL injuries by sex and total person-time by sex.Results: Fifty-eight studies were included. The IP and IR of ACL injury in female athletes were 3.5% (1 out of every 29 athletes) and 1.5/10 000 athlete-exposures over a period of 1 season-25 years. The IP and IR of ACL injury in male athletes were 2.0% (1 out of every 50 athletes) and 0.9/10 000 athlete-exposures over a period of 1-25 years. Female athletes had a higher relative risk (RR) for ACL injury compared with males (RR=1.5; 95% CI 1.2 to 1.9; P<0.01) and a higher incidence rate ratio (IRR) of ACL injury compared with males over 1 season-25 years (IRR=1.7; 95% CI 1.4 to 2.2; P<0.010). When accounting for participation level, the disparity in the IR between female and male athletes was highest for amateur athletes compared with intermediate and elite athletes (IRR=2.1; 95% CI 1.3 to 3.4; P<0.01; I²=82%). Amateur female athletes remained at higher risk of ACL injury than did with amateur male athletes. In studies where follow-up length was <1 year, female athletes had a higher IR of ACL injury than did to males (IRR=1.7; 95% CI 1.3 to 2.2; P<0.01). Where follow-up was 1 year and beyond, there was no sex difference in the IR of ACL injury (IRR=2.1; 95% CI 0.9 to 4.8; P=0.06; I²=65%).Summary/conclusions: One in 29 female athletes and 1 in 50 male athletes ruptured their ACL in a window that spanned from 1season to 25 years. The IR of ACL injury among female athletes in a season was 1.7 times higher than the IR of ACL injury among male athletes and the IP of ACL injury among female athletes was 1.5 times higher than the IP of ACL injury among male athletes. The reported sex disparity in ACL injury rates is independent of participation level and length of follow-up. [ABSTRACT FROM AUTHOR]

The objective of the study is to examine injury epidemiology and risk factors for injury in CrossFit athletes. A survey was administered to athletes at four owner-operated facilities in South Florida. Respondents reported number, location of injury, and training exposure from the preceding six months and answered questions regarding potential risk factors for injury. Fifty out of 191 athletes sustained 62 injuries during CrossFit participation in the preceding six months. The most frequently injured locations were the shoulder, knee, and lower back. Injury incidence was 2.3/1000 athlete training hours. Competitors were more likely to be injured (40% v 19%, p = 0.002) and had greater weekly athlete training hours (7.3 ± 7.0 v 4.9 ± 2.9, p < 0.001) than non-competitors. Athletes who reported injury also reported significantly higher values for the following risk factors: years of participation (2.7 ± 1.8 v 1.8 ± 1.5, p = 0.001), weekly athlete training hours (7.3 ± 3.8 v 4.9 ± 2.1, p = 0.020), weekly athlete-exposures (6.4 ± 3.8 v 4.7 ± 2.1, p = 0.003), height (1.72 ± 0.09 m v 1.68 ± 0.01 m, p = 0.011), and body mass (78.24 ± 16.86 kg v 72.91 ± 14.77 kg, p = 0.037). Injury rates during CrossFit and location of injuries were similar to those previously reported. Injury incidence was similar to related sports, including gymnastics and powerlifting. While being a competitor was related to injury, increased exposure and length of participation in CrossFit likely underlied this association. Specifically, increased exposure to training in the form of greater weekly athlete training hours and weekly participations may contribute to injury. Increased height and body mass were also related to injury which is likely reflective of increased load utilized during training. Further research is warranted to determine if biomechanical factors associated with greater height and ability to lift greater loads are modifiable factors that can be adapted to reduce the increase risk of injury during CrossFit. [ABSTRACT FROM AUTHOR]

Context: The labor market suffered a mass exodus of employees, including healthcare workers, due to the COVID-19 pandemic. Previous research highlights the vulnerability of young professional athletic trainers (YPATs) to attrition. Investigating pandemic-related employment changes and their impact is essential for developing strategies to improve the retention of YPATs., Objective: to determine impact of COVID-19 on YPATs' employment and effect of COVID-19 and employment setting migration on outcome measures of personal and financial well-being, job and career satisfaction, and optimism about staying in the profession., Design: Cross-sectional, descriptive study., Setting: Web-based survey., Participants: 1,111 participants responded to survey for an 11.5% response rate (n=1,111/12,810). Partial responses were included; thus, number of respondents varied by question., Data Collection and Analysis: A web-based survey comprised of 34 closed-ended questions was disseminated to NATA members in November 2022. Descriptive statistics including counts and frequencies for each surveyed item in addition to chi-square tests were used to analyze responses., Results: 30.2% (n=335/1,111) of YPATs changed employers and 25.7% (n=286/1,111) reported a change in employment setting. Notably, YPATs migrated from high school, collegiate, and professional athletics to clinic, industrial, or sales settings. Overall, the pandemic decreased job satisfaction, career satisfaction, and optimism about professional longevity. Changes in employment had a positive impact on personal well-being in addition to job and career satisfaction, but not optimism regarding staying in profession. Salary and work-life balance were reported as important predictors of short and long-term retention for YPATs., Conclusions: The pandemic brought changes to employers and employment settings for many YPATs. To reduce turnover and attrition, administrators must begin to prioritize employee well-being and satisfaction. In addition to increasing salary and reducing workload, employers should recognize the importance of administrative support in promoting well-being together with satisfaction and professional optimism in early professional and career-advancing athletic trainers.

The Tuck Jump Assessment (TJA) is a clinician-friendly screening tool that was designed to support practitioners with identification of neuromuscular deficits associated with anterior cruciate ligament injury. This study aimed to evaluate the inter- and intra-rater reliability of the modified scoring (0 to 2) TJA to add an additional range of objectivity for each criterion. A total of 24 elite youth volleyball athletes (12 males and 12 females) were included in this study. Each participant's recorded performance of the TJA was scored independently by two raters across ten criteria using the modified scale. The two raters then scored the same videos one week later. Another investigator who was blind to the identity of the raters analyzed the scores from both raters for each participant. Kappa coefficient ( k ) and percentage of exact agreement (PEA) for both intra- and inter-rater reliability were analyzed for each item. Intraclass correlation coefficients (ICC) were calculated to determine intra- and inter-rater reliability of the modified TJA total score. Intra- and inter-rater k was good to excellent for most items (0.65-0.91). Average PEA between the two raters and two sessions ranged from 83.3 to 100% in all scored items. The ICC for the total score was excellent in both inter- and inter-rater correlations (0.94-0.96). This research demonstrated that the modified version of the TJA predominantly shows good to excellent intra- and inter-rater reliability in all analyzed criteria.