Sammanfattning Syfte: Syftet med den här studien var att undersöka den upplevda effekten av upprepad behandling med kinesiotejp under 2 veckor, sett till smärta och besvär hos idrottare med medialt tibiasyndrom (MTS). Frågeställningarna som ställdes var: vilken effekt har behandling med kinesiotejp på smärta vid MTS samt vilken effekt har behandling med kinesiotejp på besvär och symtom vid medialt MTS? Metod: Femton personer med diagnosen MTS deltog i studien (10 kvinnor och 5 män). Samtliga deltagare var aktiva inom friidrott alternativt löpning. Deltagarna skattade sin smärta i båda benen, men endast ett ben tejpades. En lottning utfördes för att fastställa vilket ben som skulle behandlas med kinesiotejp. De med smärta i enbart ett ben tejpades på det benet som var symtomgivande. Deltagarna tejpades vid 2 tillfällen, de tejpades vid det första mötet och tejpen fick sedan sitta kvar i 6 dagar. Den sjätte dagen tog deltagarna själva bort tejpen och dagen efter utfördes samma tejpning igen. Sex dagar senare togs tejpen bort och efter 2 veckor utan tejp skickades en uppföljningsenkät ut. Deltagarna skattade upplevd smärta och besvär i båda benen på en visuell analog skala (VAS) vid första mötet och en uppföljning av smärta och besvär gjordes efter 1, 2 och 4 veckor. De fick också uppge upplevd symtomförändring efter 1, 2 och 4 veckor. Resultat: Upplevd smärta och besvär mätt på VAS-skalan visade ingen signifikant förändring över tid mellan det tejpade benet och det otejpade benet. Vid första uppföljning upplevde dock 12 av 15 (80 %) en symtomförbättring i sitt tejpade ben, medan 2 av 12 (16,7 %) upplevde en förbättring i sitt otejpade ben (p<0,05). En tendens till upplevd förbättring fanns vid uppföljning vid vecka 2: 9 av 15 (60 %) upplevde en förbättring på sitt tejpade ben medan 3 av 12 (25 %) upplevde en förbättring på sitt otejpade ben (p=0,57). Slutsats: Resultatet i denna studie visade att behandling med kinesiotejp kunde minska upplevda symtom hos idrottare med MTS den första veckan efter applicering. En tendens till minskning av upplevda symtom kunde även ses vid uppföljning efter 2 veckor med behandling av kinesiotejp. Ingen ytterligare effekt kunde ses efter borttagning av tejpen. Denna omedelbara effekt visar att kinesiotejp kan vara en möjlig behandlingsmetod för idrottare med MTS. Nyckelord: medialt tibiasyndrom, MTS, kinesiotejp, idrottare, överbelastningsskada / Abstract Aim: The purpose of this study was to examine the perceived effect of repeated treatment with kinesiotape during 2 weeks, in terms of pain and symptoms in athletes with medial tibial stress syndrome (MTSS). The research questions were: what effect does treatment with kinesiotape has in pain of MTSS and what effect does treatment with kinesiotape has in pains and symptoms of MTSS? Method: Fifteen people diagnosed with MTSS participated in the study (10 women and 5 men). All participants were track- and-field athletes or runners. The participants estimated their pain in both legs, but only one leg was taped. A lottery was conducted to determine which leg was to be treated with kinesiotape. Those with pain in only one leg were taped to the leg that was symptomatic. Participants were taped on 2 occasions, they were taped in the first meeting and the tape was then left for 6 days. On the sixth day the participants took the tape off and the following day they were taped again. Six days later, the tape was removed and after 2 weeks without tape a follow-up survey was sent. Participants estimated perceived pain and symptoms in both legs on a visual analogue scale (VAS) at the first meeting and follow-ups of pain and symptoms were made after 1, 2 and 4 weeks. They also estimated perceived change in symptoms after 1, 2 and 4 weeks. Results: Perceived pain and symptoms as measured on VAS revealed no significant change over time between the taped leg and the non-taped leg. At the first follow-up however, 12 of 15 (80%) experienced an improvement in symptoms in the taped leg, while 2 of 12 (16.7%) experienced improvement in their non-taped legs (p<0.05). A tendency to perceived improvement was found at follow-up in week 2: 9 of 15 (60%) experienced an improvement in their taped legs while, 3 of 12 (25%) experienced an improvement in their non-taped leg (p=0.57). Conclusions: The result of this study showed that treatment with kinesiotape decreased perceived symptoms in athletes with MTSS in the first week after application. A trend for reduction of perceived symptoms could also be seen at follow-up after 2 weeks of treatment with kinesiotape. No further effect was seen after removal of the tape. This immediate effect showed that kinesiotape may be a possible treatment for athletes with MTSS. Key words: medial tibial syndrome, MTSS, athletes, overuse injury.

Inledning Triathlon är en uthållighetsidrott där momenten simning, cykel och löpning utförs i en följd. Svensk triathlon har vuxit beträffande antal utövare och tävlingar sedan år 2005. Syfte och frågeställningar Studiens syfte var att undersöka hur de tidigare outforskade svenska triathleter är fördelade beträffande kön, ålder och huvudsaklig tävlingsdistans, samt vilka skador som förekommer Hur ser fördelningen ut mellan män och kvinnor som tränar/tävlar mot viss distans? Hur ser fördelningen ut mellan olika kategorier av erfarenhet (år av idrottsutövande) mellan dem som tränar/tävlar mot viss distans? Hur är prevalensen för olika skador och hur ser skadepanoramat ut? Hur är prevalensen för skadeproblematik i förhållande till huvudsaklig tävlingsdistans? Metod En enkätundersökning baserad på tidigare internationell forskning bestående av tolv flervalsfrågor skapades beträffande den svenske triathletens bakgrund, erfarenheter, tränings- och/eller tävlingsdistans och skadeproblematik. Totalt inkom 614 varav 564 (92 %) kompletta svar. Studiens resultat visar på att triathleter som tränar och/eller tävlar i sprintdistans är de som är mest skadefria (30 %). Ökad distans ger ökad risk för skador och/eller överbelastningsproblematik, nästan 18 % av de som tränar/tävlar i längre distans än sprint har drabbats av akut muskelbristning. Flest andel (49,3 %) triathleter påträffas i olympisk och/eller halv Ironman-distans. Något fler kvinnor (24 %) än män (15 %) är aktiva inom sprint och färre kvinnor (27 %) än män (36 %) i ultradistans. Slutsats Svensk triathlon och triathleter är i denna studie snarlik fördelade likt tidigare internationell forskning. Manliga triathleter tränar och/eller tävlar i längre distans än sprint i större utsträckning (85 %) än kvinnliga (76 %). Det är marginellt fler triathleter som är 40 år eller äldre och flertalet av triathleterna (85 %) tränar och/eller tävlar i olympisk distans eller längre. Överbelastningsproblematik är det som svenska triathleter drabbas av i störst utsträckning (60 %), oavsett tävlingsdistans, och vanligen (64 %) drabbas de nedre extremiteterna. / Introduction Triathlon is the sport in which the athlete compete in the order swimming, cycling and running. Swedish triathlon has since year 2005 grown in numbers of practitioners and events. The aim of this study was to investigate how the previously non-examined Swedish triathlon have developed regarding numbers of events, practitioners, common injuries for the triathletes and at what distances the Swedish triathletes train and compete? The issues to be resolved were: How is the distribution between the sexes and race distance? How is the distribution between different categories of experiences (years as athlete) and different race distances? What is the prevalence for triathlon injuries and what injuries are there? What is the prevalence of injuries among the triathletes in different primary race distances? The method involved previous international research done in the field to serve as a basis for the creation of a questionnaire containing twelve multiple choice questions regarding the Swedish triathletes previous experiences within the sport and previous (if any) injuries sustained during either practice or race. 614 answers were collected of which 562 (92 %) were complete. Results from this study shows that the triathletes which are active at the sprint distance are those who have the highest rate (30 %) of answers with "no injury". Longer race distances means an increased risk for overuse injury, almost 18 % of the triathletes which train and/or compete at the longer distances have suffered from an acute muscle rupture. Most of the triathletes (49,3 %) in this study were active in the Olympic and/or half-Ironman distance. The conclusions of this study are that Swedish triathlon and triathletes are comparable to previous international studies. There is a slight difference between the sexes in race distance; there are slightly more (24 %) women active in sprint than men (15 %) and there are slightly less women (27 %) who are active in the Ironman distance than men (36 %). Among the Swedish triathletes there are marginally more of them who are 40 years of age or more and 85 % of all the triathletes train and/or race in Olympic distance or longer. The Swedish triathletes suffers commonly from overuse injury, regardless of race distance, in the lower extremities. This was the case for 64 % of the triathletes of which who completed the questionnaire.

Bakgrund: Axelskador är vanligt förekommande inom idrott. Det finns ett tydligt samband mellan axelskador och idrotter som innefattar hand- och armrörelser ovanför huvudhöjd, som till exempel handboll. Axellederna utsätts för såväl hård fysisk kontakt som hög belastning vid repetitiva kaströrelser vilket ställer stora krav på axelledens strukturer. Prevalensen av aktuell eller tidigare axelskada rapporteras vara mellan 58 till 75 % hos spelarna. Syfte: Syftet med studien var att undersöka hur ett preventivt träningsprogram riktat mot riskfaktorer för skada i axelleden, utfört under åtta veckor i slutskedet av tävlingssäsong, påverkade prevalensen av överbelastningsskador i axelleden hos elithandbollsspelare i Sverige. Hur påverkas prevalensen av överbelastningskador och av allvarliga överbelastningsskador i axelleden under åtta veckor med samtidigt genomförande av ett preventivt träningsprogram för axelleden på elithandbollsspelare i Sverige? Metod: Studien var av kvasi-experimentell design vilken bestod av sex mättillfällen under åtta veckor. Nio elithandbollslag aktiva i Mellansverige rekryterades, varav 110 av 162 tillgängliga spelare inkluderades vid studiestart. Exkludering under och efter studieperioden gjorde att analysen utfördes på ett färre antal spelare. Lagen delades in i interventions- (n = 48) eller kontrollgrupp (n = 32) genom stratifierat urval, medelålder (± SD) 22.0 (3.3) respektive 21.9 (4.0). Interventionsgruppen tilldelades ett preventivt träningsprogram bestående av tre övningar i syfte att förbättra riskfaktorer för axelskador hos ”overhead athletes”. Kontrollgruppen tilldelades ingen intervention. Träningsprogrammet utvärderades genom att analysera prevalensen av överbelastningsskada och allvarlig överbelastningsskada i axelleden mätt med en modifierad version av The Oslo Sports Trauma Research Centre Overuse Injury Questionnaire. Resultat: Totalt 455 överbelastningssymtom rapporterades hos 42 spelare (53 %) varav 95 symtom var allvarliga hos 18 spelare (23 %). Prevalensen av överbelastningsskada minskade för både interventions- och kontrollgruppen från 42 % (95 % CI 28-56 %) till 25 % (95 % CI 13-37 %) respektive 53 % (95 % CI 36-70 %) till 31 % (95 % CI 15-47 %). Prevalensen av allvarliga överbelastningsskador minskade för både interventions- och kontrollgruppen från 15 % (95 % CI 5-25 %) till 6 % (95 % CI -1-13 %) respektive 19 % (95 % CI 5-32 %) till 13 % (95 % CI 1-24 %). Det fanns ingen signifikant skillnad mellan grupperna gällande prevalensen efter åtta veckors intervention. Allvarlighetspoängen minskade genomgående med en signifikant skillnad (p = 0.001) över tid för båda grupperna där kontrollgruppen förbättrades något mer. Det fanns en tendens till skillnad mellan grupperna (p = 0.064) gällande allvarlighetspoäng. Slutsats: Resultaten av denna studie visar på att prevalensen av allvarlig överbelastningsskada i axelleden hos elithandbollsspelare i Sverige möjligtvis kan reduceras till viss del genom utförande av ett preventivt träningsprogram två eller fler gånger per vecka under åtta veckor. Prevalensen av allvarliga symtom för överbelastningsskada minskade till ett något lägre värde för interventionsgruppen. Skillnaden för prevalens av överbelastningsskada inom interventionsgruppen, undergrupperade på antal utförda förebyggande träningspass, var signifikant (p = 0.044). Allvarlighetspoängen minskade i båda grupperna under studien. Det fanns en tendens till signifikant skillnad mellan grupperna (p = 0,.064), där kontrollgruppen förbättrades något mer trots ett högre värde vid mätning vecka 8. Axelskada och dysfunktioner hos ”overhead athletes” kan orsakas av olika faktorer vilket innebär att även riskfaktorerna bakom var och en av dessa tillstånd kan variera. Det är därför viktigt att upplysa om att träningsprogrammets påverkan på individnivå kan se annorlunda ut jämfört med resultatet på gruppnivå i den större populationen. / Background: Shoulder injuries are common in sport. In particular there is a clear relationship between shoulder injuries and sports that includes hand- and arm movements over the head, for example handball. In handball, the shoulder joints are exposed to hard physical contact as well as high loads during repetitive throwing which puts high demands on the structures inside and surrounding the shoulder joint. The prevalence of current or previous shoulder injuries is reported to be between 58 to 75 % in studies of handball players. Aim: The purpose of this study was to investigate how a preventive training program aimed at risk factors for shoulder injuries in the shoulder joint, performed during eight weeks in the final stage of competitive season, affected the prevalence of overuse injuries in the shoulder joint for elite handball players in Sweden.  How is the prevalence of overuse injuries and severe overuse injuries in the shoulder joints of elite Swedish handball players affected by the implementation of an eight-week preventive training program? Method: The study was of a quasi-experimental design which consisted of six measurements taken during eight weeks. Nine elite handball teams active in the middle regions of Sweden were recruited, from which 110 of the 162 available players were included. Exclusions during and after the study period reduced the number of players. The teams were divided into an intervention (n = 48) or control group (n = 32) through stratified sampling, with mean age (± SD) 22.0 (3.3) and 21.9 (4.0), respectively. The intervention group was assigned a preventive exercise program consisting of three exercises with the purpose of improving riskfactors for shoulder injuries for overhead athletes. The control group was not assigned any intervention. The training program was evaluated by analyzing the prevalence of overuse and severe overuse symptoms in the shoulder measured with a modified version of The Oslo Sports Trauma Research Centre Overuse Injury Questionnaire. Results: A total of 455 overuse symptoms were reported by 42 players (53 %) of which 95 symptoms in 18 players (23 %) were severe. The prevalence of overuse injuries decreased in both the intervention and the control group from 42 % (95 % CI 28-56 %) to 25 % (95 % CI 13-37 %) and 53 % (95 % CI 36-70 %) to 31 % (95 % CI 15-47 %), respectively. The prevalence of severe overuse injuries decreased in both the intervention and the control group from 15 % (95 % CI 5-25 %) to 6 % (95 % CI -1-13 %) and 19 % (95 % CI 5-32 %) to 13 % (95 % CI 1-24 %), respectively. There was no significant difference between the groups regarding prevalence after the intervention of eight weeks. Severity score consistently decreased with a significant difference over time (p = 0.001) for both groups, with a slightly greater improvement in the control group. There was a tendency towarda difference between the groups (p = 0.064) regarding the severity score. Conclusions: The results of this study show that the prevalence of severe overuse injuries in the shoulder joint of elite handball players in Sweden might be reduced to some extent by performing a preventive exercise program two or more times per week for eight weeks. The prevalence of severe symptoms of overload injury decreased to a slightly lower value for the intervention group. The difference of prevalence of overuse injuries within the intervention group, stratified by the number of executed preventive exercise programs (<2 and ≥2), was significant (p = 0.044). Severity score decreased in both groups during the study. However, there was a tendency to a significant difference between the groups (p = 0.064), where the control group improved slightly more in spite of a higher value when measured at week 8. Shoulder injury and dysfunctions of overhead athletes can be caused by various factors, which means that the riskfactors for each of these conditions may vary. It is therefore important to highlight that the effects of a training program may be different at the individual level compared with the results at group level.

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic at the Durban Institute of Technology, 2008. / Purpose Cricket fast bowlers are prone to the development of Myofascial pain syndrome and in particular active myofascial trigger points in their rotator cuff muscles of the shoulder joint (Scott, et al. 2001). This is due to the severe stresses placed upon the muscles, bones and joints of the shoulder as a result of the high velocity throwing action (Bartlett, et al.1996). In muscles containing active myofascial trigger points a decrease in the stretch range of motion as well as the maximal contractile force is noted, these two factors may negatively affect the speed at which a fast bowler deliver the ball (Travell, Simons and Simons, 1999). Dry needling is viewed as the most effective means of deactivating myofascial trigger points leading to in increase in both the contractile force and range of motion of the affected muscle, which could increase the speed at which the bowler delivers the ball (Wilks, 2003). The aim of the study was to determine the immediate effect of dry needling active myofascial trigger points of the rotator cuff on bowling speed in action cricket fast bowlers. Method The study consisted of 40 participants (randomly split into two equal groups of 20) each with shoulder pain of a myofascial origin. Group A (intervention group) received the dry needling intervention in their most tender active myofascial trigger point. While participants in Group B (control group) received no treatment. Bowling speeds were measured both before and after the intervention, to determine its effect on bowling speed. IV Data was entered into MS Exel spreadsheet and imported into SPSS version 15 (SPSS Inc.,Chicago, Iiiinois, USA), which was used for data analysis. Paticipants were evaluated on bowling speed, Algometer readings and Numerical pain rating Scale (NRS) both pre and post intervention. Participants were also asked if they believed the intervention increased, decreased or had no effect on their bowling speeds. Two sample t-test was used to compare baseline values between the groups. A repeated measure ANOVA was used to compare the rate of change of each outcome over time in the two groups. Pearson’s correlation analysis (intra-group) was used to assess the strength and magnitude of correlations of the changes in the outcomes. The McNemar – Bowker test and Weighted Cohen’s kappa statistics were calculated to assess agreement between perceived and actual levels of change. Results A significant treatment effect was observed in the intervention group were an increase in bowling speed, algometer readings as well a decrease in Numerical pain rating scale(NRS) scores was observed. There was also a perceived increase in the speed the participants delivered the ball in the intervention group. No significant changes were observed in the control group. The findings of this study indicate that dry needling as a treatment modality would be beneficial to fast bowlers in not only increasing their speeds but also the pain experienced as a result of active myofascial trigger points.

This thesis includes four papers based on three different prospective cohort studies on injury characteristics in men’s professional football. The same general methodology was used in all papers. Time-loss injuries and player individual exposure was registered for match and training separately. The general aim was to investigate potential internal and external risk factors for injury, with a focus on age, playing position, time in professional football, playing surface (artificial turf and natural grass), changes between surfaces and climate; and to evaluate the study methodology. Paper I was based on data collected between 2001 and 2010 from 26 top professional clubs in Europe; the UCL injury study. In total, 6140 injuries and 797 389 hours of exposure were registered. A decreased general injury rate was observed for newcomers compared with established players (hazard ratio (HR), 0.77; 95% CI 0.61-0.99). Using goalkeepers as a reference, all outfield playing positions had significantly higher age-adjusted injury rates. Using players aged ≤ 21 years as a reference, the overall adjusted injury rate increased with age, with a peak injury rate among players aged 29 to 30  years (HR, 1.44; 95% CI, 1.24-1.68). Paper II and Paper III are based on data collected during two consecutive seasons, 2010 and 2011, in the Swedish and Norwegian male first leagues. In total, 2186 injuries and 367 490 hours of football exposure were recorded. No statistically significant differences were found in acute injury rates on artificial turf (AT) compared with natural grass (NG) during match play (rate ratio, 0.98, 99% CI 0.79-1.22) or training (rate ratio 1.14, 99% CI 0.86-1.50) when analysing at the individual player level. However, when analysing at the club level, clubs with AT installed at their home arena had a significantly higher acute training injury rate (rate ratio 1.31, 99% CI 1.04-1.63) and overuse injury rate (rate ratio 1.38, 99% CI 1.14-1.65) compared to clubs with NG installed at their home venue. No association was found between frequent surface shifts and subsequent overuse injury risk (risk ratio 1.01, 95% CI 0.91-1.12). Analyses on the total cohort showed no difference in injury rates between clubs in the two climate zones (total rate ratio 1.01, 95% CI 0.92-1.10). Data included in Paper IV were collected during two consecutive seasons 2008 and 2009. During this period, two Norwegian elite football clubs were concurrently included in two research groups’ surveillance systems. The capture rate for match injuries was similar between the two audits, while the capture rate for training injuries was slightly higher with individual-based exposure recording. The inter-rater agreement in injury variable categorisations was in most aspects very high.

Background: The negative side of rugby participation is the danger it presents to health in the form of injuries. Most school coaches, advocates of talent development and selectors put a high priority on implementing programmes to develop bigger, stronger, faster and more skilful rugby players who can excel at their sport. These programmes however, do not place enough emphasis on the prevention of injuries. Aims: The primary aim of the study was to determine the effect of an approved injury prevention programme on the incidence (injuries per 1000 player hours) of n~gbyin juries (overall, intrinsic and extrinsic injuries) of 15- and 16 year-old schoolboys, over a two-year period. A further aim was to measure the effect of an approved injury prevention programme on the selected anthropometric, physical and motor and biomechanical and postural variables of all the groups involved in this study over a period of two years. Originating from these aims, a sub-aim of this study was to use information from this study to provide modifications - if necessary - to the current prevention programme in order for it to be effectively applied at high-school rugby level. Design: A non-equivalent experimental-control group design with multiple post-tests was used for the investigation. Subjects: The subjects were 120 schoolboy rugby players. The subjects came from two secondary schools in the North West province of South Africa. Both schools were schools wit11 a tradition of excellence in rugby. Players who participated in the experimental injury prevention programme were the year 2004, 15- and 16-year old elite A teams. The B teams acted as controls. Method: Players were tested over a two-year period. During each of the two years there were three testing occasions where all players were tested: pre-season, during the mid-season break and at the end of the season. The results of these tests were used to monitor changes in anthropometric, physical and motor and biomechanical and postural variables in various stages of the training programme. At the end of every evaluation, deficits were identified in the performance of all players in the experimental group and the prevention programmes were planned accordingly. Players in the experimental group received exercises to address the specific deficits identified. Rugby injuries were screened and injury data collected through the use of weekly sports. medical clinics. Results: Differences and changes in extrinsic injury incidences in this study could not be attributed to the effect of the prevention programme, and as a result injury trends related to overall injury incidences were inconsistent when the experimental groups were compared to the matching control groups. However, the prevention programme did have a positive effect on the intrinsic injury incidence of both experimental groups during the study period. The following moderate or highly practically significant anthropometric changes occurred when inter-group comparisons for the two year period were considered: triceps skinfold (d=0.8 among 16-year olds), subscapular skinfold (d=0.5 among 16-year olds, midaxillary skinfold (d=1.3 among 15-year olds), calf skinfold (d=1.3 among 16-year olds), humerus breadth (d=1.4 among 15-year olds), femur breadth (d=0.5 among 15-year olds), fat percentage (d=0.5 among 16-year olds) and mesomorphy (d=1.3 among 15-year olds). However, these anthropometric changes may be due to other factors, such as the natural growth phase of boys, rather than the effect of the prevention programme. During the inter-group comparisons of physical and motor components, moderately or highly practically significant improvements were recorded in the vertical jump (d=0.8 for 15-year olds and d=1.5 for 16year olds), bleep (d=0.7 for 16-year olds), pull-ups (d=0.6 for 15-year olds) and push-up tests (d=1.5 for 15-year olds and d=1.1 for 16 year-olds) of the experimental groups considering the total two year period. From the results it was clear that in practice, the prevention programme significantly improved only four of the 11 physical and motor components over the two-year period and that these improvements often occurred in only one of the age groups involved. The inter-group comparison of biomechanical and postural variables revealed numerous moderately and highly practically significant improvements in both age groups. over the total two-year period. All in all the prevention p r o v e provided the experimental groups with a more balanced (closer to ideal) dynamic mobility, core stability and postural symmetry. Conclusion: It could be concluded that the present prevention programme did not have a practically significant effect on the incidence of overall rugby injuries and extrinsic rugby injuries of 15- and 16-year old schoolboys over a two-year period. However, in practice, the prevention programme did have a significantly positive effect on the incidence of intrinsic rugby injuries of 15- and 16-year old schoolboys over a period of two years. It could be concluded that the prevention programme did not have a practically significant effect on the anthropometric components of 15- and 16-year old schoolboys over a two-year period. Seeing that the prevention programme had a moderately or highly practically significantly effect on only four of 11 physical-and-motor components over the two-year period, and that these improvements often occurred in only one of the age groups involved, it could be concluded that the prevention programme did not significantly affect the physical and motor variables of 15- and 16-year old schoolboys over a two-year period. Finally the conclusion could be drawn that in practice the prevention programme significantly improved the biomechanical and postural variables over a period of two years. This improvement in biomechanical and postural status may be responsible for the decrease in intrinsic injury incidence. Information from this study was used to provide modifications to the tested prevention programme in order for it to be effectively applied at high school rugby level. / Thesis (Ph.D. (Movement Science Education))--North-West University, Potchefstroom Campus, 2006

With the general increase in Rugby union's popularity the past decade, there has been an increase in sport injuries, both from acute and overuse trauma. Approximately half of all sport injuries may be attributed to overuse or repetitive micro trauma rather than a single traumatic event. Although very few overuse injuries have an established aetiology, the fact that over 80% of these injuries occurs at or below the knee suggests that there may be some common mechanisms in the aetiology. It could only be stated with certainty that the aetiology of these injuries is multifactorial and diverse, with both extrinsic and intrinsic factors contributing. Many intrinsic factors (personal) predispose athletes to develop overuse injuries. Intervention of intrinsic injury risk factors is more problematic, as intrinsic risk factors are often difficult to examine and even more difficult to rehabilitate than external factors. Extrinsic risk factors (environmental) that are independent of the injured person can be influenced through the intervention of the extrinsic factors. Main attention should be paid not to the treatment of the site of injury but to the possible cause of the symptoms. It is therefore vital that coaches and medical teams have a complete understanding of the incidence, nature, severity, and causes of injuries in order to review the adequacy of their injury prevention, treatment and rehabilitation. The objectives of this study were to determine the effect of selected anthropometric parameters, biomechanical malalignment and flexibility on the prevalence of Medial tibial stress syndrome (MTSS) in U/19 university rugby players of the 2006 season of the North-West University (NWU) Rugby Institute (RI). A prospective once-off subject availability study was performed that included U/19 rugby union players of the RI of the NWU (n=91). Selected biomechanical and anthropometrical assessments were made. Biomechanical and anthropometrical assessments were preformed on all subjects before the start of the season. All existing injuries were recorded by means of an injury history questionnaire. Descriptive statistics (e.g. mean and standard deviations) and contingency tables were used to analyse the data. Effect sizes were used to decide on the practical significance of the findings. A cut-off point of 0.8 (large effect) was set for practical significance of differences between means. Players with MTSS had a wider Bi-iliocristal width than those without MTSS. There were leg length differences for both players with and without MTSS for Hiospinale, Trochanterion-Tibiale lateral and Tibial lateral length. Iliospinale- and Trochanterion-Tibiale lateral length differences presented with the largest length difference. Iliospinale, Trochanterion-Tibiale lateral and Tibial lateral length difference had a small effect. Only Bi-iliocristal width presented with a medium effect. Hamstrings, Gastrocnemius and Plantaris as well as Soleus and Popliteus flexibility of players without MTSS were tighter than those of players who suffered from MTSS. Only Hamstring tightness had a small effect. Gastrocnemius and Plantaris as well as Soleus and Popliteus presented with a medium effect. Players without MTSS had a more flexible TFL on their right side. All the other flexibility measurements of the Thomas test presented that players without MTSS had a more inflexible profile. Effect size was not analysed because of the small sample sizes in some of the cells. Players without MTSS presented with an overall more inflexible profile than those with MTSS. More players without MTSS supinated at heel contact on both their feet, compared to the players with MTSS. Players without MTSS supinated more on both their feet during mid stance. A small percentage of players with and without MTSS supinated during the propulsion phase. More players without MTSS had a neutral right foot mid stance compared to players with MTSS who had a more neutral mid stance on their right foot. Players with MTSS pronated more with both their feet during propulsion. Players with MTSS pronated mostly during the propulsion phase and mostly had flatter and higher arched feet than players without MTSS. More players with MTSS had a light flat foot, flat foot as well as a high arched foot than players without MTSS. Most of the players with MTSS had normal right arched foot type. None of the players with MTSS had either a light high right foot or a high arched left foot. / Thesis (M.A. (Human Movement Science))--North-West University, Potchefstroom Campus, 2009.

With the general increase in Rugby union's popularity the past decade, there has been an increase in sport injuries, both from acute and overuse trauma. Approximately half of all sport injuries may be attributed to overuse or repetitive micro trauma rather than a single traumatic event. Although very few overuse injuries have an established aetiology, the fact that over 80% of these injuries occurs at or below the knee suggests that there may be some common mechanisms in the aetiology. It could only be stated with certainty that the aetiology of these injuries is multifactorial and diverse, with both extrinsic and intrinsic factors contributing. Many intrinsic factors (personal) predispose athletes to develop overuse injuries. Intervention of intrinsic injury risk factors is more problematic, as intrinsic risk factors are often difficult to examine and even more difficult to rehabilitate than external factors. Extrinsic risk factors (environmental) that are independent of the injured person can be influenced through the intervention of the extrinsic factors. Main attention should be paid not to the treatment of the site of injury but to the possible cause of the symptoms. It is therefore vital that coaches and medical teams have a complete understanding of the incidence, nature, severity, and causes of injuries in order to review the adequacy of their injury prevention, treatment and rehabilitation. The objectives of this study were to determine the effect of selected anthropometric parameters, biomechanical malalignment and flexibility on the prevalence of Medial tibial stress syndrome (MTSS) in U/19 university rugby players of the 2006 season of the North-West University (NWU) Rugby Institute (RI). A prospective once-off subject availability study was performed that included U/19 rugby union players of the RI of the NWU (n=91). Selected biomechanical and anthropometrical assessments were made. Biomechanical and anthropometrical assessments were preformed on all subjects before the start of the season. All existing injuries were recorded by means of an injury history questionnaire. Descriptive statistics (e.g. mean and standard deviations) and contingency tables were used to analyse the data. Effect sizes were used to decide on the practical significance of the findings. A cut-off point of 0.8 (large effect) was set for practical significance of differences between means. Players with MTSS had a wider Bi-iliocristal width than those without MTSS. There were leg length differences for both players with and without MTSS for Hiospinale, Trochanterion-Tibiale lateral and Tibial lateral length. Iliospinale- and Trochanterion-Tibiale lateral length differences presented with the largest length difference. Iliospinale, Trochanterion-Tibiale lateral and Tibial lateral length difference had a small effect. Only Bi-iliocristal width presented with a medium effect. Hamstrings, Gastrocnemius and Plantaris as well as Soleus and Popliteus flexibility of players without MTSS were tighter than those of players who suffered from MTSS. Only Hamstring tightness had a small effect. Gastrocnemius and Plantaris as well as Soleus and Popliteus presented with a medium effect. Players without MTSS had a more flexible TFL on their right side. All the other flexibility measurements of the Thomas test presented that players without MTSS had a more inflexible profile. Effect size was not analysed because of the small sample sizes in some of the cells. Players without MTSS presented with an overall more inflexible profile than those with MTSS. More players without MTSS supinated at heel contact on both their feet, compared to the players with MTSS. Players without MTSS supinated more on both their feet during mid stance. A small percentage of players with and without MTSS supinated during the propulsion phase. More players without MTSS had a neutral right foot mid stance compared to players with MTSS who had a more neutral mid stance on their right foot. Players with MTSS pronated more with both their feet during propulsion. Players with MTSS pronated mostly during the propulsion phase and mostly had flatter and higher arched feet than players without MTSS. More players with MTSS had a light flat foot, flat foot as well as a high arched foot than players without MTSS. Most of the players with MTSS had normal right arched foot type. None of the players with MTSS had either a light high right foot or a high arched left foot. / Thesis (M.A. (Human Movement Science))--North-West University, Potchefstroom Campus, 2009.

Thesis (M.App.Sc.) - Carleton University, 2007. / Includes bibliographical references (p. 117-124). Also available in electronic format on the Internet.

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic at the Durban Institute of Technology, 2008. / Purpose Cricket fast bowlers are prone to the development of Myofascial pain syndrome and in particular active myofascial trigger points in their rotator cuff muscles of the shoulder joint (Scott, et al. 2001). This is due to the severe stresses placed upon the muscles, bones and joints of the shoulder as a result of the high velocity throwing action (Bartlett, et al.1996). In muscles containing active myofascial trigger points a decrease in the stretch range of motion as well as the maximal contractile force is noted, these two factors may negatively affect the speed at which a fast bowler deliver the ball (Travell, Simons and Simons, 1999). Dry needling is viewed as the most effective means of deactivating myofascial trigger points leading to in increase in both the contractile force and range of motion of the affected muscle, which could increase the speed at which the bowler delivers the ball (Wilks, 2003). The aim of the study was to determine the immediate effect of dry needling active myofascial trigger points of the rotator cuff on bowling speed in action cricket fast bowlers. Method The study consisted of 40 participants (randomly split into two equal groups of 20) each with shoulder pain of a myofascial origin. Group A (intervention group) received the dry needling intervention in their most tender active myofascial trigger point. While participants in Group B (control group) received no treatment. Bowling speeds were measured both before and after the intervention, to determine its effect on bowling speed. IV Data was entered into MS Exel spreadsheet and imported into SPSS version 15 (SPSS Inc.,Chicago, Iiiinois, USA), which was used for data analysis. Paticipants were evaluated on bowling speed, Algometer readings and Numerical pain rating Scale (NRS) both pre and post intervention. Participants were also asked if they believed the intervention increased, decreased or had no effect on their bowling speeds. Two sample t-test was used to compare baseline values between the groups. A repeated measure ANOVA was used to compare the rate of change of each outcome over time in the two groups. Pearson’s correlation analysis (intra-group) was used to assess the strength and magnitude of correlations of the changes in the outcomes. The McNemar – Bowker test and Weighted Cohen’s kappa statistics were calculated to assess agreement between perceived and actual levels of change. Results A significant treatment effect was observed in the intervention group were an increase in bowling speed, algometer readings as well a decrease in Numerical pain rating scale(NRS) scores was observed. There was also a perceived increase in the speed the participants delivered the ball in the intervention group. No significant changes were observed in the control group. The findings of this study indicate that dry needling as a treatment modality would be beneficial to fast bowlers in not only increasing their speeds but also the pain experienced as a result of active myofascial trigger points.