Background Traumatic brain injury (TBI) in combat sports is relatively common, and rotational acceleration (RA) is a strong biomechanical predictor of TBI. This review summarizes RA values generated from head impacts in combat sport and puts them in the context of present evidence regarding TBI thresholds. Sources of data PubMed, EMBASE, Web of Science, Cochrane Library and Scopus were searched from inception to 31st December 2021. Twenty-two studies presenting RA data from head impacts across boxing, taekwondo, judo, wrestling and MMA were included. The AXIS tool was used to assess the quality of studies. Areas of agreement RA was greater following direct head strikes compared to being thrown or taken down. RA from throws and takedowns was mostly below reported injury thresholds. Injury thresholds must not be used in the absence of clinical assessment when TBI is suspected. Athletes displaying signs or symptoms of TBI must be removed from play and medically evaluated immediately. Areas of controversy Methodological heterogeneity made it difficult to develop sport-specific conclusions. The role of headgear in certain striking sports remains contentious. Growing points RA can be used to suggest and assess the effect of safety changes in combat sports. Gradual loading of training activities based on RA may be considered when planning sessions. Governing bodies must continue to work to minimize RA generated from head impacts. Areas timely for developing research Prospective research collecting real-time RA data is required to further understanding of TBI in combat sports.

Background: Shoulder injuries in judo are common as the falling player (uke) lands. Two throws implicated in shoulder injury are tai-otoshi and morote-seoi-nage. Kinematic investigation can provide insight into possible shoulder injury mechanisms and allow for appropriate preventative measures to be suggested. We used two-dimensional (2D) video analysis to measure and compare: (a) the peak acceleration and (b) the peak velocity of uke’s shoulder when tai-otoshi and morote-seoi-nage were performed by elite adult judoka. Methods: Eight male participants were recruited from the Budokwai Judo Club in London, UK. The mean age, height, and weight of participants were 25.4 ± 5.2 years (18–34), 1.7 ± 0.0 m (1.7–1.8), and 75.0 ± 5.2 kg (66–80), respectively. Throws were recorded using an iPhone 6S camera and uploaded onto Kinovea for subsequent processing. Results: The peak acceleration (m/s2) was greater in tai-otoshi (71.6 ± 12.4) compared to morote-seoi-nage (67.9 ± 9.9), although this was statistically insignificant. The peak velocity (m/s) was significantly greater (p = 0.030) in tai-otoshi (5.1 ± 0.8) than in morote-seoi-nage (4.5 ± 0.6). Conclusions: A greater peak velocity in tai-otoshi suggests that the shoulder is subjected to increased loads upon impact. This may indicate that tai-otoshi carries a greater risk of shoulder injury. Nage-komi (repetitive throwing) practices in training should follow gradual loading principles—beginning with morote-seoi-nage, before moving to tai-otoshi, for example. We must be aware of any assumptions made in estimations of impact force, and future in vivo research is required to provide more definitive values. Meanwhile, coaches must continue to ensure that correct ukemi (breakfall) technique is displayed by athletes before performing throws.

Background: Coccydynia is defined as pain in the coccyx. We investigated the effect of radial extracorporeal shockwave therapy (rESWT) in the management of coccydynia. Methods: In this prospective study, patients (≥18 y) diagnosed with coccydynia at a sports clinic located in Thessaloniki, Greece were eligible for rESWT treatment, when they reported a visual analogue scale (VAS) pain level ≥6. Treatment sessions were once weekly, and ended when VAS pain levels decreased to ≤3. Recurrence rates were documented at 3-months and 12-months follow-up. Results: Fourteen patients were treated using rESWT. The mean age and symptom duration of our cohort was 33.6±7.9 (range: 20-45) years and 9.4±8.5 (range: 3-36) months respectively. The mean number of treatment sessions per patient was 6.4±1.6 (range: 4-8). The mean device pressure, frequency, and number of pulses was 1.2±0.1 (range: 1-1.4) bar, 5.0±0.1 (range: 5-6) Hz, and 2082±74.8 (range: 2000-2300) pulses respectively. Treatment alleviated pain in all patients, and no recurrence of symptoms was reported during follow-up. There was a positive correlation between symptom duration and the number of treatment sessions (r=0.701, P=0.005). Pairwise comparison highlighted significant reductions in VAS pain levels between each stage of treatment (P < 0.001). Conclusion: Our study affirms the safety and efficacy of rESWT in managing coccydynia.