International SportMed Journal - Volume 6, Issue 1, 2005
Volume 6, Issue 1, 2005
Source: International SportMed Journal 6, pp 1 –6 (2005)More Less
<I>Objective:</I> Most bowlers in cricket attempt to maintain a straight arm during the latter phase of ball delivery. Recently, however, concern has been expressed about several bowlers using a bent arm delivery. This article will compare data from traditional straight arm technique to published analyses of 'bent arm bowling', and examine the potential advantages and disadvantages relative to ball speed, injury potential and elbow joint kinetics. <br><I>Data sources:</I> Refereed journal articles, a web page and conference proceedings. <br><I>Study section:</I> Four articles discussed the kinematics of a bent arm delivery in cricket, and three papers reported data on the kinematics and/or kinetics of the bowling arm. Previously unpublished data for the kinetics of the elbow in bowling are presented and compared to two articles reporting values for varus torques in throwing. <br><I>Data extraction:</I> With the limited number of papers available, no abstraction of data was performed. <br><I>Data synthesis:</I> Varus / valgus torques on the elbow in straight arm bowling are small compared to throwing activities. However, the use of a bent arm introduces the potential to make use of upper arm internal rotation to substantially increase ball release speed. This in turn increases the potential varus stress on the elbow. <br><I>Conclusions:</I> The traditional bowling technique in cricket causes low levels of varus and flexion torques at the elbow to provide joint stabilisation. The use of a legal bent arm action introduces the opportunity to increase ball speed substantially, with a concomitant cost of large increases in varus torques at the elbow. As these torques are generated primarily by ligament and capsular restraints, it increases the potential for elbow injury and it may be necessary to consider additional limitations to bowling frequency to prevent elbow damage.
Author Roland Van den TillaarSource: International SportMed Journal 6, pp 7 –24 (2005)More Less
<I>Objective:</I> This review presents an overview of articles on the kinetics and kinematics of the elbow in overarm throwing sports such as baseball, water polo, team handball, javelin and cricket, and compares the kinematics and kinetics of these sports. <br><I>Data sources:</I> The literature was collected by searching the databases MEDLINE and SportDiscus using the following search terms: overarm throwing, overarm throw, team handball throw, elbow, kinematics, kinetics, baseball, water polo, javelin, and cricket. Together with this search, articles were gathered from references in other relevant articles. <br><I>Study section and extraction:</I> A total of twenty-seven papers were reviewed. The criteria for paper inclusion were kinetics or kinematics of the elbow in overarm throwing sports. <br><I>Data synthesis:</I> A comparison between the throwing sport disciplines showed that the highest values in ball velocity and maximal elbow extension velocity were reported in baseball and the lowest values in water polo. In general, no temporal differences appeared in the occurrence of the maximal elbow angle and the maximal elbow extension velocity among the different throwing sports. No major differences in the kinetics between the different sport disciplines were reported due to the restricted number of studies available. <br><I>Conclusions:</I> The differences in kinematics during the throw are generally caused by the difference of weight or size of the object thrown. More studies on kinetics and muscle activity need to be performed to make a proper comparison between the different throwing sports and to gain more insight about muscle function during overarm throwing.
Source: International SportMed Journal 6, pp 25 –33 (2005)More Less
<I>Objective:</I> To review the existing data available on the epidemiology of elbow injuries in sport. <br><I>Data sources and study selection:</I> A comprehensive, web-based search of existing articles pertaining to elbow injuries in sports was performed. <br><I>Main results:</I> Age, sex, and level of experience in sport influence the incidence of common elbow conditions in tennis players, golfers, snowboarders, baseball players and football players. The cartilaginous composition of the distal humerus and multiple secondary ossification centres in children leads to different injury patterns as compared to adults. Most of the injuries sustained are chronic overuse injuries, and a higher incidence of injuries has been reported with increasing years of play. The amount of time lost from playing sport after sustaining elbow injuries depends on the type and severity of the elbow injury sustained. Return to athletic activity is not usually inhibited after sustaining an elbow injury. The study of epidemiological trends in elbow injury has paved the way for various injury prevention strategies which focus on instructional programmes, flexibility, strengthening, endurance, conditioning of the musculature, warm-up, stretching, and avoidance of fatigue. <br><I>Conclusions:</I> There are few prospective studies on epidemiological trends of elbow injury in sports other than baseball. Extensive sport specific dynamic exercise programmes, are effective in managing and preventing elbow injury in sport. Such programmes should cater for the age, gender, and skill level of the athlete. There is still a vast scope to conduct research and prospective studies in athletes with elbow injuries.
The use of topically applied nitric oxide as a treatment for lateral epicondylosis in athletes : review articleAuthor Justin A. PaoloniSource: International SportMed Journal 6, pp 34 –41 (2005)More Less
<I>Objective:</I> Literature review of topical nitric oxide as treatment for lateral epicondylosis in athletes. <br><I>Data sources:</I> MEDLINE and EMBASE database searches were performed in July, 2004 on all studies from 1966 onwards using the terms: nitric oxide, nitroglycerin, glyceryl trinitrate, elbow, tendon, tendonitis, tendinosis, tendinopathy, tennis elbow, epicondylitis, epicondylosis, sport, athlete. <br><I>Study section:</I> Randomised controlled trials were included in the analysis. Four studies were identified using topical nitric oxide treatment in tendinopathy. <br><I>Data extraction:</I> Relevant literature was identified, sourced, and reviewed. <br><I>Data synthesis:</I> Topical nitric oxide treatment of lateral epicondylosis has not been intensively investigated, and there are no studies on athletes. One randomised controlled trial demonstrates that with continuous dosing of 1.25 mg/ 24 glyceryl trinitrate (a nitric oxide donor) there are significant improvements in: elbow pain with activity at 2 weeks (p = 0.01), epicondylar tenderness at 6 and 12 weeks (p = 0.02), wrist extensor mean peak force and total work at 24 weeks (p = 0.03), and patient outcomes (p = 0.005) when compared to tendon rehabilitation. Mean effect size for all outcome measures was 0.12. <br><I>Conclusions:</I> Topical nitric oxide treatment requires further investigation to: define the mechanism of action of nitric oxide in tendinopathy, confirm the validity of the current literature, and delineate the most effective dosage regime to maximise effect and limit side effects. Topical nitric oxide treatment is a well tested medication with no irreversible side effects and the use of this therapy is warranted, combined with a tendon rehabilitation programme, to improve patient outcomes in lateral epicondylosis.