Performance and Return to Sport After Sports Hernia Surgery in NFL Players

“…Groin pain after a sports-related injury can be secondary to CMI, otherwise known as a sports hernia. 6,13,14 Twisting motions, sudden core movements, and rapid changes in direction and speed characteristically result in this type of injury. 7 Despite its prevalence among athletes, CMI remains difficult to diagnose.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of Physical Examination Tests in Core Muscle Injury

et al. 2020

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Background: Core muscle injury (CMI), often referred to as a sports hernia, is a common cause of groin pain in athletes characterized by concomitant injury to the insertion of the adductor longus and the rectus abdominis muscles. Currently, the literature on CMI is sparse with no standardized physical examination tests used in the diagnosis of this type of injury. Purpose: To determine the diagnostic accuracy of various physical examination tests in the diagnosis of CMI. Study Design: Cohort study (Diagnosis); Level of evidence, 3. Methods: A consecutive series of patients evaluated by the senior author with symptoms consistent with CMI were included. Four physical examination tests were routinely performed in these patients by the senior author and were noted in each patient’s chart as positive or negative: (1) pain with resisted cross-body sit-up in figure-of-4 position, (2) pain with straight-leg sit-up, (3) pain with resisted hip flexion in external rotation (external rotation Stinchfield test), and (4) the presence of an adductor contracture. CMI was independently diagnosed by a reference standard (magnetic resonance imaging [MRI]). All MRI scans were read by a musculoskeletal fellowship-trained radiologist. The sensitivity and specificity of each physical examination test alone and in combination were calculated based on this reference standard. Results: A total of 81 patients were included in this study. MRI was positive for a CMI in 39 patients (48%) overall. Both the cross-body sit-up test and the presence of an adductor contracture were found to have a sensitivity of 100% (specificity, 3% for both). The external rotation Stinchfield test was found to have the highest specificity of 60% (sensitivity, 15%). The sensitivity of all 4 physical examination tests in combination was found to be 100% (specificity, 0%). Conclusion: Certain physical examination maneuvers can be used to assist in the diagnosis of a CMI. The cross-body sit-up test and the presence of an adductor contracture are highly sensitive but nonspecific tests for CMI and therefore should be used in conjunction with diagnostic imaging before deciding on an appropriate treatment course.

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“…However, this method of data acquisition has been used in multiple previous studies. 1,4,12,15,19 In this study, career length was not adjusted for "time missed" for players who underwent thumb UCL repair. Their time in the league was in fact longer than reported; however, their seasons spent playing (ie, career length) after surgery are accurate.…”

Section: Discussionmentioning

confidence: 99%

Performance and Return to Sport After Thumb Ulnar Collateral Ligament Repair in Major League Baseball Players

Jack

Sochacki

Gagliano

et al. 2018

Orthopaedic Journal of Sports Medicine

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Background:Acute ruptures of the ulnar collateral ligament (UCL) of the thumb are common injuries in sports. Surgical repair has yielded excellent results and high return-to-sport (RTS) rates in elite athletes.Purpose:To determine (1) the RTS rate in Major League Baseball (MLB) players following thumb UCL repair, (2) postoperative career length and games played per season, (3) pre- and postoperative performance, (4) postoperative performance compared with matched control players, and (5) whether dominant and nondominant hand injuries respond differently.Study Design:Cohort study; Level of evidence, 3.Methods:MLB players who underwent thumb UCL surgery from August 3, 1987, to September 6, 2016, were identified. Demographic and performance data were collected for each player, and matched controls were identified. RTS in the MLB was defined as playing in at least 1 MLB game after surgery. Comparisons were made by use of paired-samples Student t tests.Results:Twenty-one players were identified, with a mean ± SD age of 31.7 ± 3.9 years and mean experience in the MLB of 8.6 ± 3.3 years at time of surgery. Twenty-one players (100%) achieved RTS in the MLB at a mean 120.0 ± 75.9 days. No significant decrease was found in games per season or career length for any position following surgery. Infielders had a significantly lower rate of postoperative wins above replacement (WAR) compared with preoperatively (P = .006), but no significant differences in postoperative performance score were found compared with controls after the index date. No significant difference was found for performance between players undergoing surgery on their dominant hand and those who had surgery on their nondominant (glove) hand compared with controls.Conclusion:In this study, 100% of MLB players achieved RTS after thumb UCL repair, with in-season players returning at a mean of 8 weeks. Players who underwent thumb UCL repair played in a similar number of games per season and had similar career lengths in the MLB as controls. Infielders had a significantly lower postoperative WAR compared with preoperatively, but no significant postoperative performance score differences were noted when infielders were compared with post–index date matched controls. No significant performance differences were noted with regard to surgery on dominant and nondominant hands.

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Performance and Return to Sport After Sports Hernia Surgery in NFL Players

Cited by 29 publications

References 32 publications

Performance and Return to Sport After Tommy John Surgery Among Major League Baseball Position Players

Performance and Return to Sport After Tommy John Surgery Among Major League Baseball Position Players

Diagnostic Accuracy of Physical Examination Tests in Core Muscle Injury

Performance and Return to Sport After Thumb Ulnar Collateral Ligament Repair in Major League Baseball Players

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