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"Medicina Sportiva" No.14 - 2008 The 15-th Sports Medicine Balkan Congress


Elena-Taina Avramescu1, Ilona Ilinca1, Cristian Neamtu2
1University of Craiova, Faculty of  Physical Education and Sports, Craiova, 
2University of Medicine and Pharmacy  Craiova, Romania

INTRODUCTION. Different epidemiological researches showed that athlets involved in different sport activities are exposed to different types of injuries, based on unique/specific factors, directly related to each sport and athlete. Sports traumatology is different from general traumatology due to the existence of  cases in which  the  extrinsic  traumatic agent  is missing   ( hyperfunctional pathology group). This pathology  is  located on  locomotory level and represents different  forms of  local
overuse.  The present paper aimes first to individualise the factors that can generate microtrauma and hyperfunctional pathologies in sportives and secondly on decreasing the trauma risk by introducing
trauma prevention strategies within the sport  training  process.  We considered that the key for decreasing the trauma incidence in high top athletes consists in reducing the trauma risk by elaboration of adequate and efficient prevention strategies and of  optimal rehabilitation programmes.
MATERIALS AND METHOD. The subjects were selected from registred top level sportives in the Sport Policlinic Craiova,  that presented different microtrauma. The interested sports were: basketball, volleyball, tennis, long distance running. We studied  a  number of  68 subjects (medium age 26,5 years; 35 man  and 33 women) from which we selected 23 (; 12 man  and  11 women)  with microtraumatic lesions and hyperfunctional pathologies, developed after previous trauma. For all the subjects  we  analysed  the  trauma incidence for a period of  2 years. For identified pathologies we initiated and followed  prophylactical kinetic programmes adressed to main interested joints: the shoulder and knee. We conceived  a  model of kinetic exercises, by which we tryed  to improve the muscular training for the lower and upper limbs,  and in the same time, by keeping the homogenity of the players group, without injuries, to optimise the technical and tactical competitional output.  The proposed model applied for a period of  one year  macrocycle, choosing, grouping and dosing of means and  methods  was realised in direct conexion with  the periodicity of trainings and the mean followed objectives. Goniometric, dynamometric, kinetic and cinematic  tests were carried before and aftet application of the kinetic programmes  in order to re-evaluate the initial recorded parameter
RESULTS. Most of the microtrauma registred were from the overuse and chronic group, developed after previous traumatisms. We found acute ligamentitis;  acute tendinitis, mostly localised at knee ligaments, tendon of brachial biceps, rotator cuff  (volleyball), achilian tendon; chronic and dismetabolic pathologies (11.3%), most frequentely periartritis scapulo-humeralis, spondilosis, effort lombalgies. Application of the preventional programme adressed to the shoulder pathology leaded to an improvement of scapular and palm force index,  final testing showing a progress of  11% and respectively og  16% comparing to initial testing and to an improvement of the amplitude of joint movement of 17% for internal rotation in the dominant limb (scapulohumeral joint). Applications of the preventional programme adressed to patelar tendinitis, leaded to increases of medium forces of the main muscles involved in jumping during the strike  attack, with a percentage betwen  11% and 25%, in the same time with decreases of the compresion forces into the knee joint.
CONCLUSION. Most of registred microtrauma were from the overuse and chronic group, developed after previous  trauma. We appreciate that these pathologie were developed as a result of a local lack of recovery/rehabilitation  and/or external conditions.  The added factors were represented by low vascularisation of these structures and low elasticity compared with other structures in the kinetic
chain.  Changes in biomecanics of movement or stopping the effort can lead to improvement of symptoms. Improvement of joint mobility and increases in muscular forces demonstrate the practical eficiency of the prophylactical proposed programme by equilibration of the muscular and joint imbalance.
KEY WORDS: prophylaxix, trauma risk, overuse, shoulder joint; knee joint.

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