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A Literature Review on the Potential Benefits of OMM on the Cervical Region for Race Car Drivers Before and After Motorsports Races

Journal: Journal of Osteopathic Medicine Date: 2023/12, 123(12):Pages: A9-A10. doi: Subito , type of study: review

Full text    (https://www.degruyter.com/document/doi/10.1515/jom-2023-2000/html)

Keywords:

cervical spine [210]
injuries [66]
MET [449]
motorsports [1]
muscle energy technique [157]
narrative review [39]
sports [103]

Abstract:

Statement of Significance: This literature review explored common racecar driver injuries, such as neck sprain and fatigue, secondary to sustained 4-5G forces exposure, vibration, overuse, and lactate accumulation. Muscle energy (ME) techniques analyzed from multiple articles improved cervical range of motion and pain, comparable to ketorolac injection for acute moderate to severe pain relief. This supports our hypothesis that ME could treat racecar driver injuries, an unfilled gap in the existing literature. To identify if Osteopathic Manipulative Treatment is an appropriate or improved alternative to existing medical practices in the motorsports realm. In this literature review, our goals are to identify common methods of treatment inside the motorsports realm (ex: nascar, formula-1). We will also look outside of motorsports in areas such as: aeronautics, and performing arts. Based on this review we can apply these techniques to aid drivers in faster recovery and reduction of muscle strain. Research Methods: A comprehensive literature search was conducted across multiple databases, including PubMed, ResearchGate, and Defense Technical Information Center—the time frame for the literature search extended from the inception of these databases until June 2023. Studies were included based on the following criteria: – If they were available in full text; – If they were peer-reviewed; – If they were written in or translated into English; – If they provided relevant insights regarding one of the following: – the effects of G force exposure to race car drivers’ musculoskeletal pain or injuries – the physiological stress experienced by race car drivers – the effectiveness of osteopathic manipulation medicine on pain level reduction – the common injuries experienced by race car drivers Data Analysis: 16 studies that met the inclusion criteria were included in the review, involving more than 3,550 participants. Race car drivers experienced G forces ranging from 4-6 G in the anterior-posterior and mediolateral directions at speeds between 150-300 km/hour. Lateral G-forces exerted a force of 250N per turn on the head and neck, requiring straining maneuvers for stability. The average number of turns on an F1 track is 17, equal to 4,250N of force generated per lap. Any F1 driver would have a total counterbalancing force of roughly 255,000N, given 60 laps on average in each race. Survey data indicated that 90% of professional race car drivers experienced neck and leg muscle fatigue after races. Open-wheel drivers demonstrated 40-60% greater lateral neck flexion strength than non-race car drivers and aircraft pilots. Musculoskeletal symptoms commonly affected the lumbar, cervical, shoulder, and thoracic spine, with neck sprain accounting for 44.6% of injuries during races. Localized and generalized vibrations during races predisposed drivers to neck and back pain. Race car drivers exhibited elevated blood lactate levels of up to 3.2 mmol/L due to increased glucose metabolism and emotional stress. Lactate accumulation during high-intensity exercise heightened sensitivity to muscle pain by 62% via enhancing acidsensing Na+ channels on ischemia-sensing neurons. Therefore, overuse injuries related-pain were common among race car drivers, primarily in the head, neck, abdominal region, and upper extremities during braking and high-speed turning. Beneficial Effects of Muscle Energy Techniques on Neck PainStudies found that muscle energy techniques (MET) of osteopathic manipulative medicine (OMM) were more effective than stretching in improving pain by 20% and the range of motion by 10% in a group of 58 patients. Another study found that MET was as effective as intramuscular Ketorolac in providing moderate to severe pain relief in 58 patients with acute neck pain. Conclusion: This narrative literature review of 16 studies published between 1983 and 2021 included an estimation of 3,550 participants and identified the common stressors contributing to neck pain experienced by race car drivers, which included G-force exposure, high-magnitude of vibration during operations of race cars, overuse injuries, and lactate accumulation during the race. After carefully reviewing the literature, we feel that Muscle Energy can be a useful technique to incorporate into a driver’s repertoire for rapid recovery and reducing pain and inflammation associated with muscle strain on the head and neck. Further studies to consider may include the actual testing of Muscle Energy on these drivers and follow-up studies to assess the efficacy of treatment post-race. A combination of Ketorolac injection and Muscle Energy OMT may also be an avenue to explore for drivers who sustain moderate to severe neck strain during an intense race.


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