Orthopaedic Sport Biomechanics - A new Paradigm

Question 1

What are the 3 main roles in the sport biomechanics paradigm suggested by this paper

Answer 1

1) Injury Prevention
2) Immediate Evaluation of treatment
3) Long term outcome evaluation

Question 2

What approach did orthopaedic and sport physiotherapists rely on 10 years ago to help injuries?

Answer 2

• A trial and error approach
• Providing numerous types of treatments without accurately knowing their effectiveness

Question 3

How does this paper suggest biomechanics specialists can help injury prevention?

Answer 3

• Look at the pathomechanics of sport injury (the mechanism that causes the injury)
• Injuries are caused by an imbalance on internal muscles forces and external environmental forces
• Use this as a foundation for building a preventative model/solution

Question 4

What is the Orthopaedic Sport Paradigm

Answer 4

This is a model in which we have a loop, starting at:
sport participation -> Injury-> Diagnosis+Treatment+Rehab->Return to sport
This paradigm applies sport biomechanics specialist to help reduce incidence and help treatment in 3 ways:
- Injury Prevention
- Improving Treatment
- Monitoring rehab progress to assess whether an athlete is ready to return to sport

Question 5

What are the steps involved in the sequence of injury prevention?

Answer 5

1) What is the problem? (Epidemiology study)
2) Identify the risk factors, aetiology and mechanism (Who are they, why are they injured, how did they get injured)
3) Introduce preventative measures

Question 6

Looking at the sequence of injury prevention, what biomechanic assessments are made to evaluate whether changes have been successful?

Answer 6

1) Are the risk factors suppressed/minimised?
2) is the aetiology eliminated?
3) Is the mechanism prohibited or removed?

Question 7

Give a quick breakdown of the sequence of injury prevention

Answer 7

Question 8

What is epidemiology?

Answer 8

The study of disease in relation to populations

Question 9

What can epidemiology studies tell us?

Answer 9

1) Prevalence for injury in different parts of the body
2) Prevalence of different injuries
3) severity of injuries
4) The sports with the majority of injuries

Question 10

What was the approach labelled as biomechanical epidemiology?

Answer 10

• Asking biomechanic specific questions to an epidemiology study to identify risk factors.
• For example, gathering anthropometric, biomechanic and demographic data

Question 11

What are intrinsic and extrinsic risk factors?

Answer 11

intrinsic: biomechanics, conditioning, maturational stage, somatotype
extrinsic: Weather, field conditions, rules and equipment

Question 12

What does pathomechanism or aetiology refer to?

Answer 12

The causal type risk factor necessarily present for an injury to take place

Question 13

What is a limitation to video analysis methods of injury mechanisms?

Answer 13

• Most injuries happen at low level sport fixtures and videoing all these with multiple angles and good equipment isnt feasable

Question 14

What alternative solutions have been found to explore mechanism of injury and gather data?

Answer 14

• Creation of close to injury situations in labs
• In-vivo ligament sprains on Cadavers

Question 15

Explain a few potential work arounds biomechanists have discovered to explore forces, angles, mechanisms of injury without reproducing the injury itself in a lab with a participant

Answer 15

• Creating and analysisng close to injury situations
• Video analysis on previous injuries
• FEA on ligaments
• sewn Strain gauges in participants and cadavers to record force
• Robotic and cadaveric force tests

Question 16

Give 3 examples of preventative measures employed by biomechanists with the injury it prevents

Answer 16

• High top shoes and taping - Lateral ankle sprain
• Knee braces - ACL rupture
• Sliding bases - Lower extremity injuries caused by sudden stopping at high velocity
• Sprain resistant shoes - Ankle sprain

Question 17

How do the innovative sprain resistant shoes work?

Answer 17

1) Detectors embedded within the sole of the shoes sense plantar pressure and level of supination
2) A threshold of supination is set, if the detectors sense unsafe level of supination they alert a protective device
3) The protective device to activates delaying or stopping the hazardous supination by employing a corrective measure
All this happens before the brain has time to respond and activate the peroneal ankle muscles.

Question 18

Can you give some examples of injury preventative excersises?

Answer 18

• balance board - improve proprioception
• muscle function training - plyometrics
• warm ups and cool downs
• Landing skill practise

Question 19

What does it mean if a preventative measure has been found to be biomechanically effective and clinically effective

Answer 19

• Biomechanically effective: The measure minimises or eliminates the risk factor but has not been proven to reduce the injury risk
• Clinically effective indicates that the preventative measure does reduce injury rate

Question 20

Give an example of an effective preventative measure that has been proven to be clinically effective

Answer 20

• Wobble boards
• improving static and dynamic balance
• reduce sports related injuries and recurrent ankle sprain injuries in controlled trials

Question 21

What are the 5 tools used to measure the outcome of treatment?

Answer 21

1) Muscle activity and function
2) joint loads, torques and kinetics
3) kinematics and motion
4) proprioception and kinaesthesia
5) Sports performance

Question 22

What is the issue when dealing with helping injured athletes return to sport

Answer 22

• There is no standard criteria for this
• We can gather data such as monitoring gait and strength values however its down to the clinicians interpretation of the data