Side strain in sport: a narrative review of pathomechanics, diagnosis, imaging and management for the clinician.
OBJECTIVE
To provide an overview of the published literature on epidemiology, pathomechanics and risk factors for side strain injury in sport, complemented by clinical perspectives of diagnosis and management strategies that are not covered in the literature.


METHODS
Narrative review METHODS: A review of the literature was completed with all studies on side strain up until October 2015 included. As the studies were unable to be synthesised the findings were placed in a clinical context. As there were no papers on the management of side strain a clinical perspective from cricket was included.


RESULTS
Literature on side strain in sport is sparse with only nine papers dedicated to the injury. These comprise epidemiology, case studies, small case series and clinical reviews on imaging, injection and surgery. The epidemiology demonstrates that side strain is most commonly associated with cricket and baseball. Side strain typically occurs acutely mostly on the side contralateral to the dominant arm in athletes. Diagnosis is clinical with consistent imaging features that typically demonstrate a tear of the internal oblique from the lower ribs. Recovery periods can be prolonged and recurrence may occur. There has been no research on the management of side strain and the relationship between clinical assessment and imaging findings and time to return to play or risk of recurrence.


CONCLUSIONS
Side strain injury is prevalent in cricket and baseball. Recovery is extended and recurrence may occur. Incidence appears to be increasing. Knowledge on side strain is limited.
Aspire Physiotherapy Centre, Australia. Electronic address: bowlersidepain@gmail.com.
Andrew R
AR
Nealon
Department of Sports Medicine, Cricket Australia, Australia.
Alex
A
Kountouris
La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Australia.
Jill L
JL
Cook
D001265:Athletic Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D006801:Humans; D000068958:Return to Sport; D012307:Risk Factors; D013180:Sprains and Strains / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D060726:Torso / Q000000981:diagnostic imaging / Q000293:injuries*
Abdominal muscle; Athletes; Costoiliac impingement; Muscle strain; Ribs; Thoracic wall