Globally, over three million women participate in rugby union, yet injury prevention and training strategies are predominantly based on androcentric data. These strategies may have limited generalisability to females, given the cervical spine is more susceptible to whiplash and less adept at resisting inertial loading. A total of 53 university rugby union players (25 female, 28 male, 20.7 ± 1.8 years) had their isometric neck strength measured. Bespoke instrumented mouthguards were used to record the magnitude of head impact events in six female and seven male competitive matches. Mean female maximal isometric neck strength was 47% lower than male. Independent samples Mann-Whitney U tests showed no significant differences for peak linear head acceleration (female: median 11.7 g, IQR 7.9 g; male: median 12.5 g, IQR 7.0 g p=0.23) or peak rotational head acceleration (female: median 800.2 rad·s-2, IQR 677.7 rad·s-2; male: median 849.4 rad·s-2, IQR 479.8 rad·s-2; p=0.76), despite the mean male body mass being 24% greater than female. Coded video analysis revealed substantial differences in head-impact mechanisms; uncontrolled whiplash dominated >50% of all recorded female impact events and <0.5% in males. Direct head-to-ground impacts comprised 26.1% of female and 9.7% of male impacts, with whiplash occurring in 78.0% and 0.5%, respectively. Overall, the data provided in this study do not support the generalisation of male-derived training and injury-prevention data to female rugby athletes. These results suggest a considerable research effort is required to identify specific weakness of female rugby players and derive appropriate training, injury prevention and return to play protocols.

Sex differences in neck strength and head impact kinematics in university rugby union players.

*Department of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, UT, USA; Department of Orthopaedics, Stanford University, Redwood City, CA, USA; The University of Texas Dell Medical School, Ascension Texas Spine and Scoliosis, Austin, TX, USA; Department of Orthopaedics, University of California San Francisco, San Francisco, CA, USA; Virginia iSpine Physicians, PC, Richmond, VA, USA

Vertebrogenic Pain: A Paradigm Shift in Diagnosis and Treatment of Axial Low Back Pain

The purpose of this study was to assess the effects of stroke rate and sex on trunk and shoulder kinematics of Olympic athletes during rowing on an ergometer. Fifty-eight participants (31 females and 27 males) from the Chinese National Rowing Team were recruited. Trunk (i.e., the pelvis, lumbar and thoracic spine) and shoulder kinematics were measured using an inertial measurement unit system for three stroke rates (18, 26, and 32 strokes/min). Range of motion and angles at the catch and finish were assessed using mixed model ANOVA and correlation analyses with rowing power. Range of motion increased significantly at higher rates for both female and male athletes. This may be a strategy used by athletes when dealing with higher demand for power during training, because a greater range of motion with a longer stroke length could reduce the demand for force generation and possibly delay fatigue. Female rowers exhibited greater range of motion in the lumbar spine, thorax and shoulders than males due to more extended positions at the finish. The sex-related kinematic differences may be attributed to differences in body size, muscle strength and endurance. Practitioners are recommended to consider these factors when developing rowing techniques and providing training suggestions.

Trunk and shoulder kinematics of rowing displayed by Olympic athletes

Modern technologies enable to capture multiple biomechanical parameters often resulting in relational data. The current work proposes a generally applicable method comprising automated feature extraction, ensemble feature selection and classification to best capture the potentials of the data also for generating new biomechanical knowledge. Its benefits are demonstrated in the concrete biomechanically and medically relevant use case of gender classification based on spinal data for stance and gait. Very good results for accuracy were obtained using gait data. Dynamic movements of the lumbar spine in sagittal and frontal plane and of the pelvis in frontal plane best map gender differences.

General method for automated feature extraction and selection and its application for gender classification and biomechanical knowledge discovery of sex differences in spinal posture during stance and gait.

The aim of this study was to determine sexual differentiation in the anthropometric and physiological characteristics of Hungarian rowers in different age categories. These characteristics were measured for 15–16-year-old juniors (55 men and 36 women), 17–18-year-old older juniors (52 men and 26 women), and 19–22-year-old seniors (23 men and 8 women). The degree of sexual dimorphism was expressed in units of measurement as percentages and the dimorphism index. In all age categories, females had significantly higher body fat indices. Body fat percentage was determined by electrical impedance and by the Pařízková formula, BMI, and skinfold thicknesses. Males had significantly higher body mass, body height, skeletal muscle mass, sitting height, arm span, lower limb length, and body surface area. Males also scored significantly higher values for the following physiological characteristics: peak power, relative peak power, ErVO2max, jump height, speed max, force max, and relative maximal power. Analysis of anthropometric and physiological characteristics in Hungarian rowers revealed that sexual dimorphism tended to increase with age, regardless of whether it was expressed in units of measurement, percentages, or dimorphism index values. The age-related increase in the sexual dimorphism of Hungarian rowers suggests that training methods should be carefully selected to accommodate the needs of various age and gender groups.

/pdf/sex-differences-in-anthropometric-and-physiological-profiles-6rokccwc.pdf

Sex Differences in Anthropometric and Physiological Profiles of Hungarian Rowers of Different Ages

Objective features of Sedentary Time and Light Activity Differentiate People with Low Back Pain from Healthy Controls, a Pilot Study.

BACKGROUND During a cervical transforaminal epidural injection, injectate flows along the path of least resistance. Given the proximity of the vertebral artery to the intervertebral foramen, injected contrast may flow along the external wall of the artery. The incidence of this contrast flow pattern during cervical transforaminal epidural injections is unknown. PURPOSE To determine the incidence of extravascular perivertebral artery contrast flow patterns during cervical transforaminal epidural injections. STUDY DESIGN/SETTING Retrospective, observational, in vivo study. PATIENT SAMPLE Patients receiving cervical transforaminal epidural injections at a single outpatient spine clinic. OUTCOME MEASURES The presence or absence of extravascular perivertebral artery contrast flow. METHODS The saved images from 100 consecutive patients were reviewed by two independent observers and classified with or without extravascular perivertebral artery contrast flow. The incidence was determined and kappa was used to examine inter-rater reliability. All disagreements were reviewed, and the final classification was determined by consensus. RESULTS The inter-rater reliability was moderate, with a kappa value of 0.69. The incidence of extravascular perivertebral artery contrast flow patterns was 49% by consensus. No statistically significant differences in incidence were present when comparing three different final needle tip positions. CONCLUSIONS During a cervical transforaminal epidural injection, an extravascular perivertebral artery contrast flow pattern is frequently encountered. This includes flow along the exiting nerve and then around the vertebral artery, as suggested by this study. Although this contrast pattern does not represent an intravascular injection into the vertebral artery, practitioners should remain cautious to exclude intravascular needle placement before injecting medication.

Incidence of Extravascular Perivertebral Artery Contrast Flow During Cervical Transforaminal Epidural Injections.

This paper aims to review anatomic and pathology-specific sex differences of the spine. While cadaveric and imaging analyses have shown differences in planar orientation of vertebral anatomy and alignment, the data is less conclusive for clinically correlating these differences. Reports show that predilection to injury in athletes is influenced by both gender and the nature of the sport, which makes it difficult to determine the exact contribution of sex differences to injury rates. Multiple articles report an increased incidence of spondylolysis, disc degeneration, and ankylosing spondylitis in males and an increased incidence of scoliosis in females. There is no clear consensus regarding whether sex influences postoperative outcomes after spinal surgery. Studies pertaining to clinical manifestations of differences in spine anatomy and physiology have been predominantly inconclusive. While multiple reports show gender predilection for certain pathologic conditions and post-surgical outcomes, further studies are needed to determine gender differences in relation to the spine and its clinical relevance.

Sex Differences in the Spine

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Objective features of Sedentary Time and Light Activity Differentiate People with Low Back Pain from Healthy Controls, a Pilot Study.

Incidence of Extravascular Perivertebral Artery Contrast Flow During Cervical Transforaminal Epidural Injections.

Sex Differences in the Spine