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At least 703 records · Page 39Linked to original sources
PubMed2003

[Biomechanical investigations for the development of a SLAP-II-lesion].

The superior labral-biceps-tendon-complex forms an anatomical and functional unit and combines static and dynamic elements of shoulder stability. At present, only theoretical hypotheses exist on the etiology of the microtraumatic SLAP-II-lesion. To gain further insight into this, an instrument was developed to simulate throwing motions such as the late-cocking/early acceleration phase as well as deceleration/follow-through. Sixteen freshly frozen shoulder specimens were tested, varying the loads on the biceps tendon (25 N, 50 N, 100 N) and the compression of the humeral head against the glenoid (25 N, 50 N, 80 N). Each shoulder had to run through a certain number of cycles during the particular phase of throwing. The tests were stopped after a SLAP-II-lesion was observed, or after a limit of 15,000 cycles. Every 1,000 cycles the results of the tests were checked arthroscopically. A SLAP-II-lesion developed in only 10% of the specimens during the acceleration/ late cocking phase whereas in the deceleration/ follow-through phase 83% developed such a lesion. According to our results, the deceleration/follow-through of the throwing motion seems to be responsible for creating microtraumatic SLAP-II-lesions. One reason is the loss of the centering function of the long head of the biceps tendon during total internal rotation, another is the increased posterosuperior translation of the humeral head in this position, which leads to a non-physiological contact, creating lesions in this area due to the large sheering forces.

Acceleration↗
PubMed2003

[Superior labrum-biceps anchor complex].

The focus in overhead sport injuries of the shoulder has been directed on lesions of the superior labrum-biceps complex during the last few years. This is due to improved imaging modalities as well as a better understanding of the anatomy and biomechanics. Arthroscopy is capable of diagnosing and treating these lesions. The anatomy, biomechanics, and operative treatment strategies and techniques are described in detail. The superior labrum anterior-posterior (SLAP) lesion is found in young active overhead athletes. Based on their classification and concomitant lesions, the unstable SLAP lesions (types II and IV) have to be repaired in order to restore stability to the superior labrum-biceps complex for stabilizing the glenohumeral joint. According to our own results and after review of the current literature, SLAP repair yields good results in overhead athletes enabling them to return to pain-free participation in their sport.

Adult↗
PubMed2005

[Injuries and response to overload stress in running as a sport].

Running is rarely associated with acute injuries (muscle injuries, ankle sprain, ruptures of the Achilles tendon). More than 80% of the complaints are due to overuse injuries, mainly concerning knee, foot and Achilles tendon. Risk factors are high-performance sports, high training quantity, rapid increase of training intensity, previous injuries, and skeletal axis malalignment. Running is not suitable for severely overweight people and those with significant skeletal malalignment, dysplastic hips, spondylolisthesis, or cartilage damage.

Ankle Injuries↗
PubMed2005

[Trendy sport: golf].

Golf is currently the most frequently played sport in the world and it will continue to grow in importance. Nevertheless, there is a striking deficit in our knowledge of the physical and psychological profile of golfers. In the foreground are not the acute but the chronic sport specific injuries, predominantly of the lumbar spine, the upper extremities (golfer's elbow and golfer's shoulder), and less commonly of the lower limbs (minor injuries to the ligaments). In addition to therapy, prophylaxis should also be used in order to better recognise and influence the sport specific burdens.

Arm Injuries↗
PubMed2005

[Extracorporeal shockwave therapy in the treatment of chronic insertional Achilles tendinopathy].

PURPOSE: The purpose of this study was to determine the efficacy of extracorporeal shock wave therapy (ESWT) for the treatment of adults with chronic insertional Achilles tendinopathy. METHODS: 68 patients with chronic insertional Achilles tendinopathy were enrolled in this study. A total of 35 patients were treated with a single dose of ESWT (3000 shocks of 0.20 mJ/mm(2), ESWT group), while 33 patients were treated with traditional non-operative measures (control group). RESULTS: At 3 months post treatment, the mean VAS for the control and ESWT groups were 2.9 and 7.2 respectively. Using the Roles and Maudsley scale, 39% of the control patients and 51% of the ESWT patients were assigned an excellent or good result. CONCLUSIONS: ESWT as applied is a safe and effective treatment for chronic insertional Achilles tendinopathy.

Achilles Tendon↗
PubMed2005

[Overload damage to the Achilles tendon: the importance of vascularization and angiogenesis].

In the Achilles tendon, degenerative changes mostly occur in regions that are hypo- or avascular. Angiogenesis is mediated by angiogenic factors and recent studies have shown that vascular endothelial growth factor (VEGF) is highly expressed in degenerative Achilles tendons, whereas VEGF expression is nearly completely downregulated in healthy tendons. VEGF expression in tendon fibroblasts is regulated by the transcription factor hypoxia inducible factor 1 (HIF-1). Several factors are able to upregulate VEGF expression in tenocytes: hypoxia, inflammatory cytokines and mechanical load. Angiogenesis plays an important role in the tendinotic process. The neovessels are accompanied by small glutamate positive neural structures. This finding suggests that angiogenesis plays an important role in the pain experienced during the degenerative tendon disease. On the other hand, there is some evidence that HIF-1/VEGF induced angiogenesis has an effect on the material properties of the tendinotic tendon tissue. Since VEGF has the potential to stimulate the expression of matrix metalloproteinases and inhibits the expression of tissue inhibitors of matrix metalloproteinases (TIMP) in various cell types this cytokine might play a significant role in the pathogenetic processes during degenerative tendon disease. These experimental findings are in accordance with clinical results which show that eccentric training leads to a regression of neovessels and decrease of pain. Another strategy is the local administration of a sclerosing agent (Polidocanol) to destroy neovessles. Preliminary results show that both strategies are effective in reducing vascular density and pain.

Achilles Tendon↗
PubMed2005

[Patellofemoral pain syndrome].

The patellofemoral pain syndrome is of high socioeconomic relevance as it most frequently occurs in young working patients. As its etiology is often unknown there is no standard treatment protocol. Several studies analyzed the different causes of patellofemoral pain and their different therapies. Static problems (pes planovalgus, instabilities, leg length differences) or chronic overuse of the knee extensor mechanism have to be identified and treated. After exclusion of intra-articular pathologies, the treatment of patellofemoral pain syndrome begins with conservative management. Stretching of the flexor and extensor muscles and training of the quadriceps muscle are the main approaches. If conservative treatment fails and patellofemoral pain persists, there are several surgical procedures for realignment of the patella in the trochlear groove and reduction of the patellofemoral pressure. Overweight patients exhibit chronic mechanical overuse of the patellofemoral joint. This leads to a higher rate of cartilage degeneration and problems at the inserting tendons and stabilizing tissues.

Arthralgia↗
PubMed2006

[Is competitive running associated with osteoarthritis of the hip or the knee?].

BACKGROUND: The aim of the study was to find what degenerative changes were present in the hip and knee joints of former elite marathon runners and how these subjects' joints differ from those of control persons. METHODS: Twenty former elite German marathon runners (active careers 1972-86) underwent clinical (FFbH-OA [hip joint] and AKSS [knee joint]) and radiographic (hip and knee joints, Kellgren and Lawrence classification) examination. X-Rays of the hip joints were compared with those of controls matched for age, gender and BMI who did not engage in much sport. RESULTS: In the group of former elite marathon runners, 3 of the 38 knee joints for which comparison with control joints was possible were found to be affected by grade 2 osteoarthritis. In the same group, severe osteoarthritis (Kellgren and Lawrence grade 3) was documented in 1 and moderate osteoarthritis (grade 2) in 6 of the 28 hips for which direct comparison against the controls was possible, as against 1 hip affected by grade 2 osteoarthritis in the entire control group. The clinical evaluation showed high scores in all athletes. CONCLUSIONS: Osteoarthritis of the knee joint is rare in former elite marathon runners. The risk of osteoarthritis of the hip joint seems to be higher than in control subjects who do not engage in much sport.

Adult↗
PubMed2001

Painful conditions in the Achilles tendon region: a common problem in middle-aged competitive badminton players.

Overuse injuries are the most frequent type in badminton, generally localized in the legs. An earlier study found 32% of young Swedish elite badminton players to have experienced disabling pain in the Achilles tendon region during the previous 5 years. The present investigation examined the prevalence and characteristics of painful conditions in the Achilles tendon region in 32 middle-aged competitive badminton players by means of questionnaire and physiotherapist's examination. Pain in the Achilles tendon region was reported by 44%, either presently or during the past 5 years, generally localized in the middle portion of the tendon. Symptoms had lasted 2 weeks-1 year (96 days). On the competition days 22% of the reported pain currently in the region. Age was found to be correlated to Achilles tendon pain, but there was no relationship between symptoms of pain and body mass index, gender, training quantity, or years of playing badminton. In conclusion, Achilles tendon pain seems to be relatively common among Swedish middle-aged competitive badminton players, particularly in the older ones.

Achilles Tendon↗
PubMed2003

Back injuries and pain in adolescents attending a ski high school.

This study compared overuse injuries, small abnormalities, and pain alone in different types of skiing and activity levels. Subjects were 45 ski high school athletes aged 15-19 years. We found the back and knees significantly more prone to activity-related injuries and pain than other body regions. Thirty subjects (67%) had low back pain on the first examination, and 17 had pain caused by overuse of the back. This was more frequent among active, young competitive boys in the cross-country skiing group, with mature height less than 99%, than among noncompetitive boys in the same group or among the alpine skiers. Neck pain was reported only by girls. Eight subjects had low back pain related to small abnormalities. The subjects were given counseling about training and physiotherapy. The 1-year follow-up found a significant reduction in back pain due to overuse injuries (from 17 to 3 subjects) and indistinct neck pain (from 10 to 2) but no reduction in pain in those with small abnormalities in the low back. Low back pain was common in young athletes, particularly in cross-country skiers. Excessively rapid progression of training and faulty technique increased back pain complaints from 36% when entering the school to 67% at the first examination. A proper evaluation and treatment of overuse injuries and accurate counseling of training types, volume, and progression reduced the low back pain problems to 29% of subjects 1 year later in spite of a maintained high activity level. A minimum entrance requirement to conditioning seems mandatory for students attending a ski high school.

Adolescent↗
PubMed2004

Post-traumatic overload or acute syndrome of the os trigonum: a possible cause of posterior ankle impingement.

The purpose of this paper is to discuss the post-traumatic overload syndrome of the os trigonum as a possible cause of posterior ankle impingement and hindfoot pain. We have reviewed 19 athletes who were referred to our foot unit between 1995 and 2001 because of posterior ankle pain, and in whom a post-traumatic overload syndrome of os trigonum was diagnosed. All these patients were followed up over a period of 2 years. In 11 cases a chronic repetitive movements in forced plantar flexion was found. In the other eight cases the pain appeared to persist after a standard treatment of an ankle sprain in inversion plantar flexion. The diagnosis was based on clinical history, physical examination and X-rays that revealed a non-fused os trigonum. The confirmation of diagnosis was carried-out injecting local anaesthetic under fluoroscopic control. In all cases a corticosteroid injection as first line treatment was performed. In 6 cases a second injection was necessary to alleviate pain because incomplete recovery with the first injection. Three cases (16%) were recalcitrant to this treatment and in these three cases a surgical excision of the os trigonum was carried out. Our conclusion is that after some chronic athletic activity or an acute ankle sprain the os trigonum, if present, may undergo mechanical overload, remain undisrupted and become painful. Treatment by corticosteroid injection often resolves the problem.

Adult↗
PubMed2004

Effect of bracing on the prevention of anterior knee pain--a prospective randomized study.

There have been numerous reports about the use of knee braces to prevent traumatic knee injuries. Despite the frequent use of braces, very few prospective studies have been performed to study the effect of knee braces for preventing anterior knee pain syndrome (AKPS). The purpose of this study was to assess the effectiveness of a dynamic patellofemoral brace (On-Track System, dj Orthopedics) in the prevention of AKPS. 167 military recruits without history of knee pain were randomized into two groups prior to the start of their 6-week basic military training (BMT) program. The first group (brace group) consisted of 54 recruits who wore the braces for all physical activities during these 6 weeks. 113 recruits served as a control group, and followed the same 6-week strenuous training program. Chi square statistics (Fisher exact test) were used to compare the number of AKPS patients in the brace group and in the non-brace group. Our results indicated that recruits in the brace group appeared to develop significantly less anterior knee pain compared to the recruits in the control group (p=0.020). Out of the 54 recruits in the brace group, ten (18.5%) developed anterior knee pain during this study. In the control group (n=113), 42 recruits (37%) developed anterior knee pain. We conclude that the result of the present study suggests that the use of a dynamic patellofemoral brace is an effective way to prevent the development of anterior knee pain in persons undergoing a strenuous training program.

Adolescent↗
PubMed2005

Stress fracture of the olecranon in an adult baseball player.

Stress fractures of the olecranon caused by repetitive stress force have infrequently been reported as a cause of elbow pain in adult athletes, engaged in throwing and pitching sports. We diagnosed as a stress fracture of the olecranon by clinical and radiographic findings and treated surgically. The patient returned to playing baseball at a competitive level and was asymptomatic 4 months after the first operation. However, the patient re-injured the olecranon and a second surgical treatment was performed almost 1 year after the first operation. After the second surgery, the patient returned to playing baseball at a competitive level and was free from elbow symptoms. We presented a stress fracture of the olecranon in a semi-professional adult baseball player and suggested that surgical treatment is necessary.

Adult↗
PubMed2001

Activity-related knee injuries and pain in athletic adolescents.

By collecting data from 45 students at a ski high school, we found that a total of 73% of the students reported activity-related pain/injuries of the knee. Sixty-one percent had overuse injuries, 27% malalignment, and 12% had indistinct knee pain. Females suffered more knee pain/injuries (88%) than males (57%). Significantly higher Q-angle degrees were recorded for females (16) than for males (10). "Jumper's knee" was found in all competitive students with a KT manual maximum difference (MMD) of 3 mm or more (mean 4 mm), with a hard endpoint, whereas this was less common among the other competitive students (P < 0.05). The students were given counselling about training and physiotherapy. In the follow-up study 1 year later, a significant reduction of knee pain/overuse injuries, from 73% to 35%, was recorded. This may be related to better equipment, the development of techniques, and training of the muscles. A high volume of training and knee instability, with MMD of 3 mm or more, seemed to be correlated with an increased risk for "jumper's knee" and, possibly, for skiing injuries. By identifying those at increased risk, preseason recommendations can be made and ski injuries may be prevented.

Adolescent↗
PubMed2001

Strain patterns in the patellar tendon and the implications for patellar tendinopathy.

This study investigated the strain pattern in human patellar tendon in an area of the tendon where changes commonly associated with patellar tendinitis are found. Eight fresh frozen human knees were instrumented with strain gauges on both the anterior and posterior side of the proximal patellar tendon. Both static and dynamic measurements were carried out in a range from 0 degrees to 60 degrees of flexion. We found uniform tensile strain in the tendon with the knee in full extension. However, as the knee was brought into flexion, the tensile strain increased on the anterior side but decreased on the posterior side in the central, proximal location of the tendon. The posterior side of the proximal patellar tendon is most commonly affected in patellar tendinopathy. This study indicates that this area of the tendon may not subjected to the highest tensile loads in the functional flexion range. It is possible that stress shielding is more important etiological factor in insertional tendinopathy as opposed to repetitive tensile loads.

Aged↗
PubMed2001

Risk factors for leg injuries in female soccer players: a prospective investigation during one out-door season.

The following possible risk factors for leg injuries in female soccer players were studied: age, anatomical alignment, generalized joint laxity, thigh muscle torque, muscle flexibility, ligamentous laxity of the knee and ankle joints, recent injuries, and duration of soccer exposure. A total of 146 players from 13 teams in the second and third Swedish divisions underwent clinical examination, isokinetic measurements of quadriceps and hamstring torques, and testing of postural sway of the legs. All soccer-related leg injuries resulting in absence from at least one scheduled practice session or game were recorded during one outdoor season (April-October). In 50 players there were 61 traumatic injuries, and 17 players sustained 19 overuse injuries. The overall injury incidence rate (traumatic and overuse) was 5.49/1000 h of soccer. Variables significantly increasing the risk of traumatic leg injuries included generalized joint laxity, low postural sway of the legs, hyperextension of the knee joint, and a low hamstring-to-quadriceps ratio during concentric action. Multivariate logistic regression showed hyperextension of the knee joint, a low postural sway, reduced H/Q ratio during concentric action, and a higher exposure to soccer to significantly increase the risk of traumatic leg injury. All five players who suffered an anterior cruciate ligament injury during the study period had a lower hamstring-to-quadriceps ratio during concentric action on the injured side than on their noninjured side.

Adult↗