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At least 1,243 records · Page 69Linked to original sources
PubMed2000

Use of growth factors to improve muscle healing after strain injury.

Muscle injuries represent a large number of professional and recreational sports injuries. Muscle strains habitually occur after an eccentric contraction, which often leads to an injury located in the myotendinous junction. Treatment varies widely, depending on the severity of the trauma, but has remained limited mostly to rest, ice, compression, elevation, antiinflammatory drugs, and mobilization. The authors' research group aims to develop new biologic approaches to improve muscle healing after injuries, including muscle strains. To achieve this goal, the authors investigated several parameters that will lead to the development of new strategies to enhance muscle healing. The authors first evaluated natural muscle healing after strain injuries and showed that muscle regeneration occurs in the early phase of healing but becomes impaired with time by the development of tissue fibrosis. Several growth factors capable of improving muscle regeneration were investigated; basic fibroblast growth factor, insulin-like growth factor, and nerve growth factors were identified as substances capable of enhancing muscle regeneration and improving muscle force in the strained injured muscle. The current study should aid in the development of strategies to promote efficient muscle healing and complete recovery after strain injury.

Animals↗
PubMed2000

Idiopathic scoliosis and spondylolysis in the female athlete. Tips for treatment.

Idiopathic scoliosis and spondylolysis can be common back problems in female athletes. Diagnosis and treatment can be difficult. With the notable trend toward increasing participation of women and girls in organized sports, it is necessary to know which sports carry additional risks for participants to have these two conditions develop and to determine treatment modalities. In general, idiopathic scoliosis is more prevalent in females and even may be higher in the athletes. Treatment options may include observation, the use of a brace, and surgery. In determining treatment, the type of sport and caliber of athlete must be considered in conjunction with the severity of the curve. Spondylolysis or a stress fracture of the posterior vertebral elements can be a common cause of back pain in an athlete. In many sports that are dominated by females (gymnastics, dancing, figure skating), the athletes carry a high risk of having spondylolysis or a stress fracture. Knowing the risk factors permits precise diagnosis and appropriate treatment. Treatment options include the use of a brace and surgery. In the current study, an extensive review of the literature in conjunction with the extensive experience of a well-established sports medicine clinic at the authors' institution is presented.

Athletic Injuries↗
PubMed2001

Health tips for computer users.

Computers have changed everything about our world. Any change of this magnitude brings new challenges and new concerns for the long-term effects of exposure to the product. Computers especially pose specific risks to home care workers. This article reviews health and safety practices related to desktop and hand-held computers.

Anxiety↗
PubMedDate not supplied

Atraumatic osteolysis of the distal clavicle: MR findings.

OBJECTIVE: The purpose of this study was to describe the MRI appearance in atraumatic osteolysis of the distal clavicle (AODC). MATERIALS AND METHODS: We retrospectively evaluated MRI, medical records, ancillary diagnostic imaging studies and clinical course in five men and two women (mean age, 39 years) in whom the final clinical diagnosis of AODC was established. None of the patients had significant shoulder injury, but all participated in activities involving repetitive strain of the acromioclavicular (AC) joint. In three of these patients, we performed follow-up MRI (ranging from 5 1/2 to 15 months after the initial MRI). RESULTS: In all seven patients, signal intensity changes within the intramedullary portion of the distal clavicle on MRI were consistent with diffuse bone marrow edema. Marrow edema was most conspicuous on STIR imaging and occasionally could be misinterpreted as normal marrow signal patterns on spin-echo imaging. Cortical thinning or irregularity of the distal clavicle was seen in six cases and tiny subchondral cysts were seen in three, corresponding to subtle cystic changes on shoulder radiography. Limited bone scans obtained in two patients showed markedly increased uptake of radiotracer at the distal clavicle and AC joint. Histologic examination in one case showed disruption of articular cartilage, subchondral cysts, and metaplastic bone formation with increased osteoclastic activity. Follow-up MRI in three patients who were asymptomatic following conservative therapy showed normalization of marrow signal intensity. CONCLUSION: Atraumatic osteolysis of the distal clavicle is a relatively uncommon but important cause of shoulder pain. Particularly when the clinical history is suggestive of repetitive AC joint stress, MRI of the distal clavicle should be examined closely for marrow edema, cortical irregularity, and cystic changes. Such abnormalities may be especially conspicuous when STIR imaging techniques are used.

Acromioclavicular Joint↗
PubMedDate not supplied

Overuse edema in the bone marrow of the hand: demonstration with MRI.

In MRI of the skeleton, marrow edema is a frequent finding that can be caused by avascular necrosis, fracture, bone bruises, transient osteoporosis, osteomyelitis, primary tumors, metastases, and altered biomechanical properties. We examined a 29-year-old woman golfer with mild pain and swelling of the proximal phalanx II of the left hand. No signs of a stress fracture were seen on the MR images or plain radiographs. MRI revealed increased signal intensity on T2-weighted images in the metacarpal and proximal phalanx II in the left hand. We concluded that bone marrow edema may be the result of physiologic bone response to stress and may not necessarily correspond with severe trauma. Our case complements recent observations outlining the influence of altered biomechanics as a reason for marrow edema.

Adult↗
PubMed1996

Lower limb morphology and risk of overuse injury among male infantry trainees.

The effect of anatomic variation on the risk of overuse injuries has not been adequately evaluated. To determine the association of several common anatomic characteristics (genu varum, genu valgum, genu recurvatum, and lower limb length differences) with risk of overuse injury, we made prospective morphologic measurements of young men prior to beginning 12 week of Army infantry training. The training included frequent running, marching, calisthenics, and other vigorous activities. Lower extremity anatomic landmarks were high-lighted, and front- and side-view photographic slides were taken of the 294 study volunteers. The slides were compute digitized, and the following measures calculated: pelvic width to knee width ratio (to assess genu valgum/varum), quadriceps angle (Q-angle), knee angle at full extension, and lower limb length differences. The cumulative incidence of lower limb overuse injury was 30%. Relative risk of (RR) of overuse injury was significantly higher among participants with the most valgus knees (RR = 1.9). Those with Q-angle of more than 15 degrees had significantly increased risk specifically for stress fractures (RR = 5.4). Anatomic characteristics were associated with several other types of injuries, including pain and nonacute muscle strain due to overuse. This pilot study provides evidence that some lower limb morphologic characteristics may place individuals at increased risk of overuse injuries.

Chi-Square Distribution↗
PubMed1997

Lower extremity alignment and risk of overuse injuries in runners.

A group of 304 runners enrolling in a marathon training program had alignment measurements performed and completed a questionnaire on training practices and injuries over the previous 12 months. The alignment measures consisted of arch index (AI), heel valgus (HV), knee tubercle-sulcus angle (TSA), knee varus (KV), and leg-length difference (LLD). Results indicated few consistent statistical associations between these alignment measures and risk of injuries, either bivariately or multivariately: left AI with hamstring injuries; right AI with shin injuries; right HV with back injuries; left TSA with ankle injuries; KV with hip injuries; and LLD with back, ankle, and foot injuries. A few statistically significant relationships were also found between other training and anthropometric factors and injuries: mileage with hamstring injuries; interval training with shin injuries; hard surfaces with back and thigh injuries; shoe use patterns with foot and overall injuries; and body mass index with heel injuries. We conclude that lower-extremity alignment is not a major risk factor for running injuries in our relatively low mileage cohort; however, prospective studies are necessary to confirm or refute these findings.

Adult↗
PubMed1999

Epidemiological patterns of musculoskeletal injuries and physical training.

PURPOSE: The purpose of this study was to identify rates of diagnosis-specific musculoskeletal injuries in U.S. Marine Corps recruits and to examine the association between patterns of physical training and these injuries. METHODS: Subjects were 1,296 randomly selected male Marine recruits, ages 17 to 28 yr, who reported to Marine Corps Recruit Depot San Diego for boot camp training between January 12 and September 14, 1993. Recruits were followed prospectively through 12 wk of training for injury outcomes. Injury patterns were examined in relation to weekly volumes and types of vigorous physical training. RESULTS: The overall injury rate was 39.6% (number of recruits injured/population at risk), with 82% of injuries occurring in the lower extremities. Overuse injuries accounted for 78% of the diagnoses. The most frequent site of injury was the ankle/foot region (34.3% of injuries), followed by the knee (28.1%). Ankle sprains (6.2%, N = 1,143), iliotibial band syndrome (5.3%, N = 1,143), and stress fractures (4.0%, N = 1,296) were the most common diagnoses. Injury rates were highest during the weeks with high total volumes of vigorous physical training and the most hours of running and marching. Weekly injury rates were significantly correlated with hours of vigorous physical training (overuse injuries r = 0.667, P = 0.018; acute injuries r = 0.633, P = 0.027). CONCLUSIONS: The results of this controlled epidemiological investigation indicate that volume of vigorous physical training may be an etiologic factor for exercise-related injuries. The findings also suggest that type of training, particularly running, and abrupt increases in training volume may further contribute to injury risk.

Adolescent↗
PubMed1999

Three-dimensional kinetic analysis of running: significance of secondary planes of motion.

PURPOSE: The study of angular kinetic data provides important information regarding muscle function and may lend insight into the etiology of overuse injuries common to runners. These injuries are often due to deviations in the secondary planes of motion. However, little is known about the angular kinetics in these planes leaving no reference for comparison. METHODS: Therefore, three-dimensional kinematic and ground reaction force data were collected on 20 recreational runners with normal rearfoot mechanics. RESULTS: Findings suggest that sagittal plane kinetic data were similar to the two-dimensional studies reported in the literature. Sagittal plane data were least variable (CV: 9.3-11.0%) and comprised the largest percentage of positive or negative work done (80.2-88.8%) at both the rearfoot and knee joints. Transverse plane kinetics were most variable (CV: 68.5-151.9%) and constituted the smallest percentage of work done at both joints (0.7-7.4%). CONCLUSIONS: Although relatively smaller than the sagittal plane component, a substantial amount of positive work was done in the frontal plane at both joints (16.1-18.9%), suggesting that this component should not be ignored.

Ankle Joint↗
PubMed1999

Low back pain in elite rhythmic gymnasts.

BACKGROUND: Rhythmic gymnastics is a sport that blends the athleticism of a gymnast with the grace of a ballerina. The sport demands both the coordination of handling various apparatus and the flexibility to attain positions not seen in any other sport. To attain perfection and reproducibility of their routines, the athletes must practice and repeat the basic elements of their routines thousands of times. In so doing, the athlete places herself at risk of a myriad of overuse injuries, the most common being low back pain. METHODS: To document the presence and severity of low back pain in elite rhythmic gymnasts, a prospective study of seven national team members was undertaken that documented injuries and complaints with daily medical reports over a 7-wk period. These findings were correlated with a retrospective review of 11 elite level gymnasts followed over a 10-month period whose complaints ultimately required evaluation by a physician. RESULTS: Eighty-six percent of the gymnasts in the prospective study complained of back pain at some point over the course of the study. The only injury recorded that required a time loss from sport was a low back injury. The most common complaint requiring a physician's evaluation was low back pain with the diagnoses varying from muscle strains to bony stress reaction or complete fracture of the pars inter-articularis (spondylolysis). No athlete had a spondylolisthesis or ruptured disk. Two had mild scolioses which did not appear to be associated with their low back pain. CONCLUSIONS: It would appear that rhythmic gymnasts are at relative increased risk of suffering low back complaints secondary to their sport.

Adolescent↗
PubMed2000

Shoulder impingement in front-crawl swimming: I. A method to identify impingement.

PURPOSE: The impingement of subacromial structures has been proposed as a major cause of the shoulder problems experienced by athletes who use repetitive overhead actions. The purpose of this study was to develop a noninvasive method to identify instances at which the shoulder was experiencing impingement during front-crawl swimming. METHODS: Shoulder impingement has been reported to occur when an arm is: (a) elevated above shoulder height while being rotated internally; and (b) forcibly elevated at, or beyond, the maximum active elevation angle. In this study shoulder configurations that satisfied the above two conditions were sought throughout the functional range of each shoulder; and a boundary that distinguished configurations that would cause shoulder impingement was defined. The shoulder movements exhibited during performance of the front-crawl stroke were measured using three-dimensional videography and compared with the boundary defined for each shoulder. The shoulder was considered to experience impingement if the shoulder configuration observed exceeded the boundary defined for that shoulder. RESULTS: For a male collegiate swimmer, impingement occurred for 12% of the stroke time for each shoulder. CONCLUSIONS: The analysis permitted the identification of the instances at which the shoulders were experiencing impingement during the front-crawl swimming. In this study, the measurement of the boundary was based entirely upon the mechanism of impingement described in the literature. Further studies are needed to confirm the occurrence of impingement by means of advanced visualization techniques, such as magnetic resonance imaging (MRI) and ultrasonogram.

Acromion↗
PubMed2000

Overuse injuries in the elite rock climber.

UNLABELLED: Closed rupture of the flexor tendon sheath has been known to occur in the elite rock climbing population. However, only one study has investigated the prevalence of this entity. PURPOSE: To examine an elite climbing group in this country for the prevalence of pulley rupture and report on other commonly occurring injuries in the hand and elbow. METHODS: 42 elite rock climbers competing at the U.S. national championships were evaluated by an injury survey and concentrated examination of the hand and elbow. Manual testing for clinical bowstringing was done for each finger, by the same examiner. RESULTS: 11 subjects (26%) had evidence of flexor pulley rupture or attenuation, as manifested by clinical bowstringing. Injury to the PIP collateral ligament had occurred in 17 subjects (40%). Other commonly occurring injury syndromes are described. CONCLUSION: Our results and others suggest that closed traumatic pulley rupture occurs with significant frequency in this population. In addition, all subjects with this injury continued to climb at a high standard and reported no functional disability.

Adolescent↗
PubMed2000

Case report: reduction of low back pain in a professional golfer.

Previous research agrees that the majority of injuries that affect male golfers are located in the lower back and that they are related to improper swing mechanics and/or the repetitive nature of the swing. This study describes the trunk motion and paraspinal muscle activity during the swing of a golfer with related low back pain (LBP) and assesses the effect of a 3-month period of muscle conditioning and coaching on these variables. Motion of the trunk was measured using three-dimensional video analysis and electromyograms (EMGs) were recorded from the same six sites of the erector spinae at the start and end of the 3-month period. At the end of the period, the golfer was able to play and practice without LBP. Coaching resulted in an increase in the range of hip turn and a decrease in the amount of shoulder turn, which occurred during the swing. In addition, a reduction in the amount of trunk flexion/lateral flexion during the downswing occurred in conjunction with less activity in the left erector spinae. These changes may serve to reduce the torsional and compressive loads acting on the thoracic and lumbar spine, which in turn may have contributed to the cessation of the LBP and would reduce the risk of reoccurrence in the future. In conclusion, further research with more subjects would now be warranted in order to test the findings of this program for the prevention of low back in golfers as piloted in this case report.

Adult↗
PubMed2001

Overuse injuries in youth sports: biomechanical considerations.

Many children today participate in highly organized sports programs that involve regimented year-round repetitive training. This type of training has led to an increased incidence of overuse musculoskeletal injuries. Sports physicians have dealt with sports injuries in children for many years and, on the basis of their clinical experience, have developed guidelines to treat and to try and prevent these injuries. The purpose of this article is to provide a biomechanical perspective of sports injuries in young athletes and blend ideas from this perspective with more traditional clinical perspectives that dominate the literature relative to this topic. Basic tissue and gross movement mechanics principles are used to identify growth, morphological, and movement factors that may predispose a child to an overuse injury. Several biomechanical analyses of simple movement tasks are presented to quantify the forces developed in various tissues and to illustrate the effects that growth can have on these forces. Guidelines are given for developing injury prediction models that may be used in the future to establish safe and effective training guidelines for children.

Adolescent↗
PubMed2002

The prevention of shin splints in sports: a systematic review of literature.

PURPOSE: To review the published and unpublished evidence regarding risk factors associated with shin splints, assess the effectiveness of prevention strategies, and offer evidence-based recommendations to coaches, athletes, and researchers. METHODS: We searched electronic data bases without language restriction, identified citations from reference sections of research papers retrieved, contacted experts in the field, and searched the Cochrane Collaboration. Of the 199 citations identified, we emphasized results of the four reports that compared methods to prevent shin splints. We assessed the methodologic quality of these reports by using a standardized instrument. RESULTS: The use of shock-absorbent insoles, foam heel pads, heel cord stretching, alternative footwear, as well as graduated running programs among military recruits have undergone assessment in controlled trials. There is no strong support for any of these interventions, and each of the four controlled trials is limited methodologically. Median quality scores in these four studies ranged from 29 to 47, and serious flaws in study design, control of bias, and statistical methods were identified. CONCLUSION: Our review yielded little objective evidence to support widespread use of any existing interventions to prevent shin splints. The most encouraging evidence for effective prevention of shin splints involves the use of shock-absorbing insoles. However, serious flaws in study design and implementation constrain the work in this field thus far. A rigorously implemented research program is critically needed to address this common sports medicine problem.

Athletic Injuries↗