Racial/ethnic disparities in total knee arthroplasty (TKA) are well documented.^1-3 Less studied, but equally important, are the racial/ethnic disparities in outcomes after TKA.⁴ Current evidence suggests that racial/ethnic minority groups experience lower satisfaction, higher postoperative pain, more residual joint stiffness, and poorer physical function (PF) after joint arthroplasty.⁴

While cross-country running is a popular interscholastic sport, it also has a high incidence of running-related injuries (RRIs). Recent literature suggests that functional tests may identify athletes at increased risk of injury. The Y-Balance Test (YBT) is an objective measure used to assess functional muscle strength, balance, and expose asymmetries between tested limbs. The purpose of this study was to determine if the YBT could predict RRI in high school cross-country runners. It was hypothesized that an asymmetric right (R)/left (L) YBT reach distance for the lower or upper extremities would be associated with an increased risk of RRI. Prospective observational cohort. One hundred forty-eight athletes (80 girls, 68 boys) who competed in interscholastic cross-country in Southern California during the 2015 season participated in the study. Prior to the cross-country season, the runners completed Lower-Quarter YBT (LQ-YBT) and Upper-Quarter YBT (UQ-YBT) testing to assess lower and upper extremity asymmetry, respectively. The runners were prospectively monitored for RRI occurrence throughout the season using the Daily Injury Report form. Forty-nine runners (33.1%) incurred a RRI during the 2015 season, with the lower leg (shin/calf) and knee the most common RRI sites. Girls had a higher RRI occurrence (38.8%) than boys (26.5%) (p = 0.12). Boys had greater raw scores for LQ-YBT R and L anterior (ANT), posteromedial (PM), posterolateral (PM) and composite reach distances than girls (p<0.05). With the exception of normalized superolateral reach distance, boys had significantly greater scores for raw and normalized R and L UQ-YBT reach distances and raw composite scores than girls (p<0.05). After adjusting for prior RRI, while boy runners with a LQ-YBT PM reach difference ≥4.0 cm were five times more likely to incur a RRI (Adjusted odds ratio [AOR] = 5.05, 95% CI: 1.3-19.8; p = 0.02), girl runners with a UQ-YBT inferolateral (IL) reach difference ≥ 4.0 cm were 75% less likely to incur a RRI (AOR = 0.25, 95% CI: 0.1-0.7; p = 0.005). By lower extremity body region, boy runners with a UQ-YBT superolateral (SL) reach difference ≥ 4.0 cm were seven times more likely to incur a hip/thigh/knee RRI [AOR] = 7.20, 95% CI: 1.1-45.6; p = 0.002). Greater lower extremity (PM) or upper extremity (SL) reach distance asymmetry, as measured by the LQ-YBT or UQ-YBT, respectively, were associated with RRI in boy high school cross-country runners. 2b.

Adolescent athletes are increasingly encouraged to specialize in a single sport year-round in an effort to receive a college scholarship. For collegiate baseball, only 11.7 scholarships are available for a 35-player team. The beliefs of the parents of baseball athletes towards sport specialization are unknown, along with whether they have an accurate understanding of college baseball scholarship availability. The parents of high school baseball athletes were recruited to complete an anonymous questionnaire that consisted of (1) parent and child demographics, (2) child baseball participation information, and (3) parent attitudes and beliefs regarding sport specialization and college baseball scholarships. One hundred and fifty-five parents participated in the questionnaire (female: 52.9%, age: 49.4 ± 5.5 years old). The parents spent a median of 3000 USD [Interquartile Range (IQR): 1500–6000] on their child’s baseball participation. Most parents believed that specialization increased their child’s chances of getting better at baseball (N = 121, 79.6%). The parents underestimated the number of college baseball scholarships available per team (median [IQR]: 5 [0–5]), but 55 parents (35.9%) believed it was likely that their child would receive a college baseball scholarship. Despite having a realistic understanding of the limited college scholarships available, the parents were optimistic that their child would receive a baseball scholarship.

Despite its positive influence on physical and mental wellbeing, running is associated with a high incidence of musculoskeletal injury. Potential modifiable risk factors for running-related injury have been identified, including running biomechanics. Gait retraining is used to address these biomechanical risk factors in injured runners. While recent systematic reviews of biomechanical risk factors for running-related injury and gait retraining have been conducted, there is a lack of information surrounding the translation of gait retraining for injured runners into clinical settings. Gait retraining studies in patients with patellofemoral pain syndrome have shown a decrease in pain and increase in functionality through increasing cadence, decreasing hip adduction, transitioning to a non-rearfoot strike pattern, increasing forward trunk lean, or a combination of some of these techniques. This literature suggests that gait retraining could be applied to the treatment of other injuries in runners, although there is limited evidence to support this specific to other running-related injuries. Components of successful gait retraining to treat injured runners with running-related injuries are presented.

Collegiate American football has a high rate of injury. The Lower Quarter Y-Balance Test (YBT-LQ), a dynamic assessment of lower extremity strength, mobility, and balance, has been purported to identify athletes at risk for injury in different sports including football. Previous studies examining the association between YBT-LQ and injury have reported varied findings; therefore, the purpose of this study was to assess if preseason YBT-LQ performance predicted whether football players would sustain a non-contact lower extremity or low back (lower quarter (LQ)) injury during the season. Fifty-nine male collegiate American football players (age 20.8 ± 1.3 y, height 1.8 ± 0.1 m, body mass 94.6 ± 14.2 kg) completed a survey of training and injury history and had their YBT-LQ performance assessed at the start of the season. Athletic training staff tracked the occurrence of non-contact LQ injuries during the season. There were no significant relationships found between preseason YBT-LQ values and incidence of non-contact LQ injury in this population of collegiate American football players. This study is consistent with recent reports that have not found a significant association between preseason YBT-LQ values and LQ injury. These results suggest that, in isolation, the YBT-LQ may have limited utility as a screening test for non-contact injury in collegiate football players.