Andrew Franklyn-Miller

Nuritas Inc.

Objectives: To characterise the incidence, severity and recovery of sport-related concussion (SRC) in schoolboy rugby players and explore whether the Sports Concussion Assessment Tool (SCAT), Cogstate Brief Battery (CBB) and the King-Devick test (K-D test) can be used to monitor concussion status through to full recovery. Design: Prospective coh...

Delayed onset muscle soreness (DOMS) due to intense physical exertion can negatively impact contractility and performance. Previously, NPN_1 (PeptiStrong™), a Vicia faba hydrolysate derived from a protein concentrate discovered through artificial intelligence (AI), was preclinically shown to help maintain muscle health, indicating the potential to...

Background Athletic groin pain (AGP) can lead to altered movement patterns during rapid deceleration and acceleration. However, the effect of AGP on movement variability and loading patterns during such actions remains less clear. Purpose To investigate, using a continuous lateral hurdle hop task, how movement variability and magnitude measures of...

Objective: Hip and groin pain is highly prevalent in sub-elite Gaelic Athletic Association (GAA) athletes, but its prevalence at the elite level is unknown. The aims of this study were to report hip and groin pain prevalence in elite male athletes, to report changes in Copenhagen Hip and Groin Outcome Score (HAGOS) across two seasons and to assess...

Bkground No studies have tested the validity of the Copenhagen Hip and Groin Outcome Score (HAGOS) using modern test theory, across different cultures and languages. Objective To validate the Danish, English and Norwegian versions of HAGOS and its six subscales (Symptoms (S, Item 1–7), Pain (P, Item 1–10), activities of daily living (Item 1–5), Sp...

Background Athletic hip and groin pain is common in the Gaelic Athletic Association (GAA) but its prevalence at elite level is unknown. The changes in Hip and Groin Outcome Score (HAGOS) over a season in and the ability of HAGOS to identify those athletes who will go onto develop hip and groin symptoms has not been reported previously. Objective T...

Background Exercise-based rehabilitation targeting intersegmental control has high success rates and fast recovery times in the management of athletic groin pain (AGP). The influence of this approach on hip strength and lower limb reactive strength and how these measures compare with uninjured athletes (CON) remain unknown. Additionally, the effica...

Background Achilles tendinopathy (AT) is a common overuse injury in running-related sports where patients experience pain and impaired function which can persist. A graded rehabilitation program has been successful in reducing pain and improving function to enable a return to sport. The aim of this study is to compare the effectiveness of a criteri...

Classification algorithms determine the similarity of an observation to defined classes, e.g., injured or healthy athletes, and can highlight treatment targets or assess progress of a treatment. The primary aim was to cross-validate a previously developed classification algorithm using a different sample, while a secondary aim was to examine its ab...

Background There is scant literature on outcomes after anterior cruciate ligament (ACL) reconstruction in rugby players, and no prior study has evaluated the outcomes of bone–patellar tendon–bone (BTB) autograft ACL reconstruction. Purpose To assess the rate of return to play, the timing of that return, and the subsequent graft reinjury rate among...

Athletic groin pain (AGP) is a chronic, painful condition which is prevalent in players of field sports that require rapid changes of direction. Following successful rehabilitation, systematic changes have been observed in the kinetics and kinematics of pre-planned change of direction manoeuvres, providing insight into potential foci for rehabilita...

Background Performance measures such as strength, jump height/length, and change of direction (CoD) time during anterior cruciate ligament (ACL) rehabilitation have been used to determine readiness to return to play and identify those who may be at risk of rerupture. However, athletes may reach these criteria despite ongoing biomechanical deficits...

Background: Athletes are twice as likely to rupture the anterior cruciate ligament (ACL) on their healthy contralateral knee than the reconstructed graft after ACL reconstruction (ACLR). Although physical testing is commonly used after ACLR to assess injury risk to the operated knee, strength, jump, and change-of-direction performance and biomecha...

Objectives: The main aim in the current study was to use a single-subject analysis to profile the physical performance characteristics of individuals within an injured group and a between-group approach to profile the group as a whole. These profiles were then used to inform single-subject and between-group rehabilitation interventions. Methods:...

Background: Patient-reported outcomes and return-to-play (RTP) rates are inferior after revision anterior cruciate ligament reconstruction (ACLR) compared with primary ACLR. Physical properties such as maximal, explosive, and reactive strength influence reinjury and RTP rates after ACLR. No study has compared these outcomes between revision and pr...

Background Despite the importance of return-to-play (RTP) rates, second anterior cruciate ligament (ACL) injury rates, and patient-reported outcomes of athletes returning to sports after ACL reconstruction (ACLR), these outcomes have not been evaluated together across a single cohort nor the pre- and intraoperative factors influencing outcomes expl...

The validity of an inertial sensor-based motion capture system (IMC) has not been examined within the demands of a sports-specific field movement test. This study examined the validity of an IMC during a field test (VU®) by comparing it to an optical marker-based motion capture system (MMC). Expected accuracy and precision benchmarks were computed...

Background: : Long-standing groin pain (LSGP) is a chronic painful condition resulting in both impaired per- formance and time loss from participation in multidirectional field sport. Research question: : What are the differences in intersegmental coordination strategy and variability of trunk- pelvic and thigh coupling during change of direction in...

This study sought to investigate the kinematic and kinetic variables that change in patients with athletic groin pain (AGP) after a successful exercise intervention. The kinematic and kinetic measures of subjects with AGP (n = 65) that completed a lateral hurdle hop, pre and post an exercise rehabilitation program were compared to a control group o...

Motion analysis systems are widely employed to identify movement deficiencies-e.g. patterns that potentially increase the risk of injury or inhibit performance. However, findings across studies are often conflicting in respect to what a movement deficiency is or the magnitude of association to a specific injury. This study tests the information con...

Background:: After anterior cruciate ligament reconstruction (ACLR), athletes have demonstrated performance asymmetries as compared with healthy cohorts, but little research has investigated if biomechanical asymmetries are also different during jump and change-of-direction (CoD) tasks between groups. Purpose:: To identify if differences in magn...

Abstract Welch, N, Richter, C, Moran, K, and Franklyn-Miller, A. Principal component analysis of the associations between kinetic variables in cutting and jumping, and cutting performance outcome. J Strength Cond Res XX(X): 000–000, 2019—The primary aim of this study was to determine which features within the ground reaction force (GRF) trace durin...

Abstract Welch, N, Richter, C, Franklyn-Miller, A, and Moran, K. Principal component analysis of the biomechanical factors associated with performance during cutting. J Strength Cond Res XX(X): 000–000, 2018—The main aim of the current study was to investigate the relationship between kinematic variables in cutting and performance outcome across di...

Introduction Sports-related concussion (SRC) can be challenging to diagnose, assess and manage. Much of the SRC research is conducted on adults. The assessment of SRC should aim to identify deficits using a detailed multimodal assessment; however, most studies investigating the effects of SRC use diagnostic tools in isolation. It is likely that a c...

This study discusses possible sources of discrepancy between findings of previous human motion studies and presents a framework that seeks to address these issues. Motion analysis systems are widely employed to identify movement deficiencies - e.g. patterns that potentially increase the risk of injury or inhibit performance. However, findings acros...

Whilst anterior cruciate ligament injury commonly occurs during change of direction (CoD) tasks, there is little research on how athletes execute CoD after anterior cruciate ligament reconstruction (ACLR). The aims of this study were to determine between-limb and between-test differences in performance (time) and joint kinematics and kinetics durin...

Context: Despite an increase in the literature, few definitive guidelines are available to determine when an athlete been fully rehabilitated after anterior cruciate ligament reconstruction (ACLR). Objective: To examine countermovement jump and isokinetic dynamometry measures to (1) identify which measures can best distinguish between ACLR and c...

Introduction Previous studies examining jump tasks after anterior cruciate ligament reconstruction (ACLR) have focused on performance measures without examining joint kinematic and kinetic variables. The aim of this study was to identify differences in biomechanical and performance measures between limbs across tests nine months after surgery. Met...

Background Clinical assessments and rehabilitation in athletic groin pain (AGP) have focused on specific anatomical structures and uniplanar impairments rather than whole body movement. Objective To examine the effectiveness of rehabilitation that targeted intersegmental control in patients with AGP and to investigate post rehabilitation changes i...

Athletic groin pain (AGP) is a common injury prevalent in field sports. One biomechanical measure that may be of importance for injury risk is stiffness. To date however, stiffness has not been examined in AGP. The primary aim was to determine if AGP affects vertical and joint stiffness and if so, whether successful rehabilitation is associated wit...

Movement variability during repetitive performance of a dynamic activity (eg, running, jumping, kicking) is considered an integral characteristic of optimal movement execution; however, its relationship with musculo-skeletal injury is not known. The primary aim of this study was to review published comparison trials to determine whether movement va...

This study examines the ability of commonly used supervised learning techniques to classify the execution of a maximum effort change of direction task into predefined movement pattern as well as the influence of fuzzy executions and the impact of selected features (e.g. peak knee flexion) towards classification accuracy. The experiment utilized kin...

Individuals who suffered an anterior cruciate ligament injury (ACL) also often suffer from long-term consequences [1], and return to play can be as low as 55% [2]. Movement adaptations to avoid pain post injury / surgery can become habitual, well beyond rehabilitation, and might result in non-optimal movement pattern (e.g. asymmetries) that increas...

Advances in the field of groin pain in athletes have long been hampered by the use of inconsistent and confusing nomenclature. This reflects a lack of clarity on whether pathology is clinically relevant and on differentiating between often multiple painful structures. In a systematic review of 72 studies, 33 different diagnostic terms were used1 to...

Background Athletic groin pain (AGP) is prevalent in sports involving repeated accelerations, decelerations, kicking and change-of-direction movements. Clinical and radiological examinations lack the ability to assess pathomechanics of AGP, but three-dimensional biomechanical movement analysis may be an important innovation. Aim The primary aim wa...

Importance Running-related injuries are highly prevalent. Objective Synthesise published evidence with international expert opinion on the use of running retraining when treating lower limb injuries. Design Mixed methods. Methods A systematic review of clinical and biomechanical findings related to running retraining interventions were synthesised...

When reporting a subject's mean movement pattern, it is important to ensure that reported values are representative of the subject's typical movement. Whilst previous studies have utilized the mean of three trials, scientific justification of this number is lacking. One approach is to determine statistically how many trials are required to achieve...

Background Athletic groin pain remains a common field-based team sports time-loss injury. There are few reports of non-surgically managed cohorts with athletic groin pain. Aim To describe clinical presentation/examination, MRI findings and patient-reported outcome (PRO) scores for an athletic groin pain cohort. Methods All patients had a history in...

Background Low back pain is one of the most prevalent musculoskeletal conditions in the world. Many exercise treatment options exist but few interventions have utilised free-weight resistance training. To investigate the effects of a free-weight-based resistance training intervention on pain and lumbar fat infiltration in those with chronic low bac...

In this paper we present an interactive tool that can be used to quantify fat infiltration in lumbar muscles, which is useful in studying fat infiltration and lower back pain (LBP) in adults. Currently, a qualitative assessment by visual grading via a 5-point scale is used to study fat infiltration in lumbar muscles from an axial view of lumbar-spi...

Background: While measures of asymmetry may provide a means of identifying individuals predisposed to injury, normative asymmetry values for challenging sport specific movements in elite athletes are currently lacking in the literature. In addition, previous studies have typically investigated symmetry using discrete point analyses alone. This stu...

Background: Athletic groin pain (AGP) is an encompassing term for the multitude of chronic conditions presenting as pain in the inguinal region. The purpose of this review was to compare the return to play rates (RTPrate) and return to play times (RTPtime) between surgical and rehabilitation interventions in the treatment of AGP. Methods: A syst...

Following anterior cruciate ligament reconstruction (ACLR), strength is a key variable in regaining full function of the knee. Isokinetic strength is commonly used as part of the return to sport (RTS) criteria. We systematically reviewed the isokinetic strength evaluation protocols that are currently being used following ACLR. A secondary aim was t...

Background Chronic low back pain is one of the most prevalent musculoskeletal impairments in Western society with a mean prevalence rate of 18.1% reported in the literature (1). Exercise therapy is suggested as an intervention for those with low back pain by the American College of Physicians and the American Pain Society (2). Hayden et al (3) sugg...

Chronic athletic groin pain (AGP) is common in field sports and has been associated with abnormal movement control and loading of the hip and pelvis during play. A single-legged squat (SLS) is commonly used by clinicians to assess movement control but whether it can provide insight into control during more dynamic sporting movements in AGP patients...

Chronic athletic groin pain (AGP) is common in field sports and has been associated with abnormal movement control and loading of the hip and pelvis during play. A single-legged squat (SLS) is commonly used by clinicians to assess movement control but whether it can provide insight into control during more dynamic sporting movements in AGP patients...

Chronic athletic groin pain is commonly experienced in a range of football codes including soccer (Holmich et al. 2014) and gaelic football (Murphy et al. 2012). Much debate surrounds the specific aetiology of AGP but several authors have implicated, at least in part, abnormal movement control and loading in and around the hip and pelvis during pla...

While anterior cruciate ligament (ACL) injuries account for less than 1% of all injuries in football, there is a significant morbidity associated with them (Ekstrand 2014). Professional footballers, for example, can take approximately 6.5 months before a return to team training following ACL repair (ACLR). In addition, the risk of re-injury is rela...

Exercise induced lower leg pain (EILP) is a commonly diagnosed overuse injury in recreational runners and in the military with an incidence of 27-33% of all lower leg pain presentations. This condition has proven difficult to treat conservatively and patients commonly undergo surgical decompression of the compartment by fasciotomy. This case series...

Some studies suggest fat infiltration in the lumbar muscles (LM) is associated with lower back pain (LBP) in adults. Usually fat in MRI-defined lumbar muscles is qualitatively evaluated by visual grading via a 3 point scale, whereas a quantitative continuous (0-100%) approach may provide a greater insight. In this paper, we propose a method to prec...

This study compared levels of inter limb asymmetry between field sports players with athletic groin pain and international rugby union players. Three dimensional kinematics and kinetics were recorded for the single leg hurdle hop and side cut movement. Analysis of characterising phases was utilised to identify significant differences in asymmetry b...

This study compared levels of inter limb asymmetry between field sports players with athletic groin pain (n=15) and international rugby union players (n=15). Three dimensional kinematics and kinetics were recorded for the single leg drop landing and side cut movement. A series of t-tests identified significantly (p<0.05) greater asymmetry in hip ab...

This study examined relationships between three dimensional (3D) pelvis, hip and knee biomechanical measures in a bodyweight single leg squat and those same measures in a drop landing and a pre-planned 75° cutting manoeuvre. 40 field sports players with chronic athletic groin pain were recruited. There were no significant (p > 0.05) correlations be...

Cutting ability is an important aspect of many team sports however the biomechanical determinants of cutting performance are not well understood. This study aimed to address this issue by identifying the kinetic and kinematic factors correlated with the time to complete a cutting maneuver. In addition, an analysis of the test-retest reliability of...

Background Injury in initial military training is common with incidences from 25 to 65% of recruits sustaining musculoskeletal injury. Risk factors for injury include extrinsic factors such as rapid onset of high volume training, but intrinsic factors such as lower limb biomechanics and foot type. Prediction of injury would allow more effective tra...

Case study of upper body biomechanics during 2 common strike types in an elite level hurler Breen, D1, Marshall, B1 , Falvey, E1,2 , Franklyn-Miller A1,2 1Department of Sports Medicine, Sports Surgery Clinic, Santry Demesne, Dublin Ireland 2Centre for Health, Exercise and Sports Medicine, University of Melbourne, Australia Introduction: Little...

Chronic exertional compartment syndrome (CECS) of the lower limb is part of a group of overuse lower limb injuries with common presenting features. It is commonly diagnosed by the measurement of raised intramuscular pressures in the lower limb. The pathophysiology of the condition is poorly understood, and the criteria used to make the diagnosis ar...

To review the efficacy of resistance training (RT) as a therapeutic modality in various musculoskeletal conditions. Systematic review. Data from 1545 rehabilitation patients who had participated in structured RT programmes were included into the review. The total number of patients was composed of separate musculoskeletal conditions-chronic low bac...

Daniel Coyle in The Talent Code 1 talks of hotbeds of talent such as Spartak Tennis Club in Moscow and the ‘footsal’ fields of Sao Paulo producing talent well in excess of expectations. He extends the story to Florence in the Renaissance from which came Michelangelo, Dante, Leonardo da Vinci and Galileo – a remarkable pool of excellence! There are...