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Study finds athletes fear being judged as weak when they experience pain or injury

Press release:

Trinity researchers have undertaken the first multi-centred, international, qualitative study exploring the athlete experience (in their own words) of sporting low back pain (LBP).

LBP is common in rowers and can cause extended time out from the sport and even retirement for some athletes. Rowers from diverse settings (club and university to international standard) in two continents were included in the study.

The findings have been published in the British Journal of Sports Medicine.

In an Irish context, rowing is currently one of our most successful sports and Rowing Ireland has 4000 registered racing members. About 50% of elite rowers in Ireland will have an episode of rowing related low back pain in a year. Australia is one of the biggest rowing nations in the world. Researchers at Curtin University in Perth, who partnered on this study are globally respected for their back-pain research.

With the evolution of professional sport, the mantra of ‘win at all costs’ pervades. This attitude is present even in grassroot sports.  Focus has shifted from enjoyable participation to prioritising performance outcomes, leading to athletes being regarded as an asset, commodity or an investment.

A culture of toughness and resilience is encouraged but this can create confusion when it comes to reporting  pain and injury which is common in sport. Athletes commonly internalise a myth that pain equates to weakness and personal failure. There is a rising interest in the influence of sporting culture on athlete’s welfare; athlete abuse through mistreatment following injury is part of this.

For many sports, athletes’ health is not prioritised, and this is now recognised as a form of abuse. Some athletes are not provided with a culture and environment where they can report pain and injury without negative consequences. To understand the extent of this issue and to safeguard athletes, their voice and experiences need to be heard in research.

Qualitative research allows athletes to tell their stories in their own words and is a good method of exploring their lived experience. By understanding what an athlete’s experience of pain and injury is will lead to a better management of injury and better outcomes. It is likely to contribute to prevention of injury.

The key messages from the study are:

  • Rowers in this study felt compromised by their LBP and in many cases felt that the prevailing culture and environment did not allow them to be open and honest about their LBP for fear of exclusion.
  • Many felt that they had to continue competing and training when in pain. This may have increased risk of a poor outcome from their LBP as well as the poor negative emotional/mental experience that they encountered
  • Rowers experience of LBP can lead to isolation and can have a profound effect on their life beyond sport.
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More children suffer head injuries playing recreational sport than team sport

Study finds children who do recreational sports like bike riding are more likely to suffer serious head injuries than children who play contact sport like AFL or rugby.

Media Release:

An Australian/ New Zealand study examining childhood head injuries has found that children who do recreational sports like horse riding, skate boarding and bike riding are more likely to suffer serious head injuries* than children who play contact sport like AFL or rugby.

Research**, conducted by the PREDICT research network, Murdoch Children’s Research Institute (MCRI), published on Wiley and soon to be published in the Australian Medical Journal, examined the data of 8,857 children presenting with head injuries to ten emergency departments in Australian and New Zealand hospitals.

A third of the children, who were aged between five and 18 years, injured themselves playing sport. Of these children four out of five were boys.

Lead research author, MCRI’s Professor Franz Babl, says the team looked at ‘íntracranial’ injuries in children because while there is a lot of interest about sport and concussion, less is understood about the severity of head injuries children suffer while playing sport.

“The study found that in children who presented to the emergency departments after head injury and participated in recreational sports like horse riding, skate boarding and bike riding were more likely to sustain serious head injuries than children who played contact sport like AFL, rugby, soccer or basketball,” he says.

“We found that 45 of the 3,177 sports-related head injuries were serious and classified as clinically important Traumatic Brain Injury (ciTBI), meaning the patient required either neuro-surgery, at least two nights in hospital and/or being placed on a breathing machine. One child died as a result of head injuries.”

Prof Babl says that the sports which resulted in the most frequent reason for presentation to emergency departments included bike riding (16 per cent), rugby (13 per cent), AFL (10 per cent), other football (9 per cent), and soccer (8 per cent).

The most frequent causes of serious injury included bike riding (44 per cent), skateboarding (18 per cent), horse riding (16 per cent), with AFL and rugby resulting in one serious head injury each and soccer resulting none.

A total of 524 patients with sports-related head injuries (16 per cent) needed CT imaging, and 14 children required surgery.

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The Enigma of Shin Splints in Athletes

Shin splints is a bad term for a problem that is common in athletes, especially runners. The term just means ‘sore leg’ so it could be due to any one of many different problems, so as a term it should no longer be used. When the term is used, it is probably most often referring to the condition of medial tibial stress syndrome.

This problem is one of a stress reaction along the edge of the shin bone or tibia in the leg. Running is the most common cause of medial tibial stress syndrome. The symptoms can usually be palpated along the edge of the bone. Initially its typically not painful when running, but eventually it progresses to the stage that it i painful when running.

Typically the problem is one of the running technique and the runner can often benefit from a gait analysis and a running retraining program to change the way they run. Typically this will involve running with a wider base of gait.

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Clinical Trial on New Treatment for Plantar Fasciitis

Plantar fasciitis is a common clinical problem of the heel in athlete. This press release is about a new treatment that is undergoing testing:

MiMedx Concludes Enrollment for Phase 3 Plantar Fasciitis Trial

MARIETTA, Ga., Sept. 17, 2020 (GLOBE NEWSWIRE) — MiMedx Group, Inc. (OTC PINK: MDXG) (“MiMedx” or “the Company”), an industry leader in advanced wound care and an emerging therapeutic biologics company, today announced the conclusion of enrollment for a Phase 3 study of plantar fasciitis, an inflammation of the fibrous tissue along the bottom of the foot that results in intense pain. This key clinical trial explores how placental science may address and treat musculoskeletal pain and function disorders. The study has met its timelines.

“Plantar fasciitis is an all-too-common, debilitating and painful foot condition that challenges both patients and clinicians. Several months to years of treatment may be required with conservative therapies before symptoms subside, and I believe plantar fasciitis represents a significant unmet patient need,” said Stuart Miller, M.D., Principal Investigator, Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, and Assistant Professor, Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland. “This is a landmark study that will help us advance the science and elevate the standard of care for millions of patients; I look forward to analyzing and publishing the data regarding treatment efficacy for this musculoskeletal condition. Our progress to date is all the more gratifying given the dampening effect of the pandemic on patient enrollment. This study is designed to provide statistically significant evidence of efficacy for this biologic treatment to reduce pain and improve function.”

More than two million people are treated for plantar fasciitis inflammation in the United States annually. In 10% of patients treated with traditional measures, the condition progresses to chronic plantar fasciitis-related pain – recovery from which is lengthy and recurrence of which is very common, with an estimated $284 million annual national economic burden. The current treatment algorithm aims to maintain arch shape, modify foot loading and/or improve shock absorbency of the heel through night splints and orthotics. While they may assist in reducing pain associated with plantar fasciitis, these treatments do not address the root cause of the condition, which is thought to be both degenerative and inflammatory.

Timothy R. Wright, MiMedx Chief Executive Officer, commented, “Given the variability of efficacy, cost, and potential side effects of available plantar fasciitis treatment options, additional evidence-based alternatives are needed urgently. As a pioneer in the development of placental tissue technology, following through on clinical research is part of our mission to improve patient outcomes. Using our placental science platform to address the unmet need posed by plantar fasciitis is just one of the critical ways that we are exploring its application to improve people’s lives. We look forward to sharing the results of this trial in 2021.”

About the MiMedx Plantar Fasciitis Trial
This study is a Phase 3, prospective, double-blinded, randomized controlled trial of the micronized dehydrated Human Amnion Chorion Membrane (dHACM) injection as compared to saline placebo injection in the treatment of plantar fasciitis. The trial enrolled 276 patients between the ages of 21 and 79 years, with an investigator-confirmed diagnosis of plantar fasciitis for ≥ 1 month (30 days) and ≤ 18 months. Patients were required to have a Visual Analog Scale (VAS) Pain scale of ≥ 45 mm at randomization and be receiving conservative treatment for ≥ 1 month (30 days), including any of the following modalities: Rest, Ice, Compression, Elevation (RICE); stretching exercises; NSAIDs or orthotics. The primary endpoints are change in VAS for Pain at 90 Days and incidence of related adverse events at 180 days, serious adverse events and unanticipated events during the first 12 months post-injection. Secondary endpoints include self-reported responses to the Foot Function Index – Revised (FFI-R) at 90 days.