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Sample records for hamstring strain injuries

  1. Hamstring injuries

    PubMed Central

    Guanche, Carlos A.

    2015-01-01

    There is a continuum of hamstring injuries that can range from musculotendinous strains to avulsion injuries. Although the proximal hamstring complex has a strong bony attachment on the ischial tuberosity, hamstring injuries are common in athletic population and can affect all levels of athletes. Nonoperative treatment is mostly recommended in the setting of low-grade partial tears and insertional tendinosis. However, failure of nonoperative treatment of partial tears may benefit from surgical debridement and repair. The technique presented on this article allows for the endoscopic management of proximal hamstring tears and chronic ischial bursitis, which until now has been managed exclusively with much larger open approaches. The procedure allows for complete exposure of the posterior aspect of the hip in a safe, minimally invasive fashion. PMID:27011828

  2. Hamstring Strain Injuries: Recommendations for Diagnosis, Rehabilitation and Injury Prevention

    PubMed Central

    Heiderscheit, Bryan C.; Sherry, Marc A.; Silder, Amy; Chumanov, Elizabeth S.; Thelen, Darryl G.

    2010-01-01

    Synopsis Hamstring strain injuries remain a challenge for both athletes and clinicians given the high incidence rate, slow healing, and persistent symptoms. Moreover, nearly one-third of these injuries recur within the first year following a return to sport, with subsequent injuries often being more severe than the original. This high reinjury rate suggests that commonly utilized rehabilitation programs may be inadequate at resolving possible muscular weakness, reduced tissue extensibility, and/or altered movement patterns associated with the injury. Further, the traditional criteria used to determine the readiness of the athlete to return to sport may be insensitive to these persistent deficits, resulting in a premature return. There is mounting evidence that the risk of reinjury can be minimized by utilizing rehabilitation strategies that incorporate neuromuscular control exercises and eccentric strength training, combined with objective measures to assess musculotendon recovery and readiness to return to sport. In this paper, we first describe the diagnostic examination of an acute hamstring strain injury, including discussion of the value of determining injury location in estimating the duration of the convalescent period. Based on the current available evidence, we then propose a clinical guide for the rehabilitation of acute hamstring injuries including specific criteria for treatment progression and return to sport. Finally, we describe directions for future research including injury-specific rehabilitation programs, objective measures to assess reinjury risk, and strategies to prevent injury occurrence. Level of evidence: Diagnosis/therapy, level 5. PMID:20118524

  3. An Evidence-Based Approach to Hamstring Strain Injury

    PubMed Central

    Prior, Mathew; Guerin, Michelle; Grimmer, Karen

    2009-01-01

    Background: Hamstring strain injury is a common problem within sport. Despite research interest, knowledge of risks for and management of hamstring strain is limited, as evidenced by high injury rates. Objective: To present the current best evidence for hamstring strain injury risk factors and the management of hamstring strain injury. Methods: MEDLINE, AMED, SportDiscus, and AUSPORT databases were searched (key terms “hamstring” and “strain,” “injury,” “pull,” or “tear”) to identify relevant literature published between 1982 and 2007 in the English language. Studies of adult athlete populations (older than 18 years) pertaining to hamstring strain incidence, prevalence, and/or intervening management of hamstring strain injury were included. Articles were limited to full-text randomized, controlled studies or cohort studies. Twenty-four articles were included. Articles were critically appraised using the McMaster Quantitative Review Guidelines instrument. Data pertaining to injury rates and return to sport outcomes were extracted. Each author undertook independent appraisal of a random selection of articles after establishing inter-rater agreement of appraisal. Results: Previous strain, older age, and ethnicity were consistently reported as significant risks for injury, as was competing in higher levels of competition. Associations with strength and flexibility were conflicting. Functional rehabilitation interventions had preventive effects and resulted in significantly earlier return to sport. Additionally, weak evidence existed for other interventions. Conclusion: Current evidence is inconclusive regarding most interventions for hamstring strain injury, while the effect of potentially modifiable risks is unclear. Further high-quality prospective studies into potential risks and management are required to provide a better framework within which to target interventions. PMID:23015867

  4. Hamstring strain injuries: factors that lead to injury and re-injury.

    PubMed

    Opar, David A; Williams, Morgan D; Shield, Anthony J

    2012-03-01

    Hamstring strain injuries (HSIs) are common in a number of sports and incidence rates have not declined in recent times. Additionally, the high rate of recurrent injuries suggests that our current understanding of HSI and re-injury risk is incomplete. Whilst the multifactoral nature of HSIs is agreed upon by many, often individual risk factors and/or causes of injury are examined in isolation. This review aims to bring together the causes, risk factors and interventions associated with HSIs to better understand why HSIs are so prevalent. Running is often identified as the primary activity type for HSIs and given the high eccentric forces and moderate muscle strain placed on the hamstrings during running these factors are considered to be part of the aetiology of HSIs. However, the exact causes of HSIs remain unknown and whilst eccentric contraction and muscle strain purportedly play a role, accumulated muscle damage and/or a single injurious event may also contribute. Potentially, all of these factors interact to varying degrees depending on the injurious activity type (i.e. running, kicking). Furthermore, anatomical factors, such as the biarticular organization, the dual innervations of biceps femoris (BF), fibre type distribution, muscle architecture and the degree of anterior pelvic tilt, have all been implicated. Each of these variables impact upon HSI risk via a number of different mechanisms that include increasing hamstring muscle strain and altering the susceptibility of the hamstrings to muscle damage. Reported risk factors for HSIs include age, previous injury, ethnicity, strength imbalances, flexibility and fatigue. Of these, little is known, definitively, about why previous injury increases the risk of future HSIs. Nevertheless, interventions put in place to reduce the incidence of HSIs by addressing modifiable risk factors have focused primarily on increasing eccentric strength, correcting strength imbalances and improving flexibility. The response to these intervention programmes has been mixed with varied levels of success reported. A conceptual framework is presented suggesting that neuromuscular inhibition following HSIs may impede the rehabilitation process and subsequently lead to maladaptation of hamstring muscle structure and function, including preferentially eccentric weakness, atrophy of the previously injured muscles and alterations in the angle of peak knee flexor torque. This remains an area for future research and practitioners need to remain aware of the multifactoral nature of HSIs if injury rates are to decline. PMID:22239734

  5. Muscle activation patterns in the Nordic hamstring exercise: Impact of prior strain injury.

    PubMed

    Bourne, M N; Opar, D A; Williams, M D; Al Najjar, A; Shield, A J

    2016-06-01

    This study aimed to determine: (a) the spatial patterns of hamstring activation during the Nordic hamstring exercise (NHE); (b) whether previously injured hamstrings display activation deficits during the NHE; and (c) whether previously injured hamstrings exhibit altered cross-sectional area (CSA). Ten healthy, recreationally active men with a history of unilateral hamstring strain injury underwent functional magnetic resonance imaging of their thighs before and after six sets of 10 repetitions of the NHE. Transverse (T2) relaxation times of all hamstring muscles [biceps femoris long head (BFlh); biceps femoris short head (BFsh); semitendinosus (ST); semimembranosus (SM)] were measured at rest and immediately after the NHE and CSA was measured at rest. For the uninjured limb, the ST's percentage increase in T2 with exercise was 16.8%, 15.8%, and 20.2% greater than the increases exhibited by the BFlh, BFsh, and SM, respectively (P < 0.002 for all). Previously injured hamstring muscles (n = 10) displayed significantly smaller increases in T2 post-exercise than the homonymous muscles in the uninjured contralateral limb (mean difference -7.2%, P = 0.001). No muscles displayed significant between-limb differences in CSA. During the NHE, the ST is preferentially activated and previously injured hamstring muscles display chronic activation deficits compared with uninjured contralateral muscles. PMID:26059634

  6. Hamstring Muscle Injuries, a Rehabilitation Protocol Purpose

    PubMed Central

    Valle, Xavier; L.Tol, Johannes; Hamilton, Bruce; Rodas, Gil; Malliaras, Peter; Malliaropoulos, Nikos; Rizo, Vicenc; Moreno, Marcel; Jardi, Jaume

    2015-01-01

    Context: Hamstring acute muscle injuries are prevalent in several sports including AFL football (Australian Football League), sprinting and soccer, and are often associated with prolonged time away from sport. Evidence Acquisition: In response to this, research into prevention and management of hamstring injury has increased, but epidemiological data shows no decline in injury and re-injury rates, suggesting that rehabilitation programs and return to play (RTP) criteria have to be improved. There continues to be a lack of consensus regarding how to assess performance, recovery and readiness to RTP, following hamstring strain injury. Results: The aim of this paper was to propose rehabilitation protocol for hamstring muscle injuries based on current basic science and research knowledge regarding injury demographics and management options. Conclusions: Criteria-based (subjective and objective) progression through the rehabilitation program will be outlined along with exercises for each phase, from initial injury to RTP. PMID:26715969

  7. [Acute hamstring injuries in athletes].

    PubMed

    Reurink, Gustaaf; Tol, Johannes L; de Vos, Robert-Jan

    2014-01-01

    Acute hamstring injuries are the most common injuries in participants in popular sports such as football and track and field athletics. The diagnosis is made if there is a history of acute-onset pain in the posterior thigh, and presence of the triad of pain on contraction, stretching and palpation. Additional investigations and possible referral for surgical intervention are indicated if there is a suspicion of a complete hamstring rupture or avulsion fracture, both of which are rare. The basis of treatment of patients with acute hamstring injuries without complete rupture is a progressive physiotherapeutic exercise programme. Currently there is insufficient scientific evidence to support other treatment methods. The mean recovery time for athletes with acute hamstring injuries is 3-6 weeks. The individual recovery time is however hard to predict. It is difficult to define exactly when the sport can be resumed, particularly because of the high risk of recurrent hamstring injury. The most valuable indications for the risk of recurrent hamstring injury are: a history of previous injuries of the athlete; monitoring hamstring tenderness; flexibility; and strength of the hamstring after resuming sporting activities. PMID:25589279

  8. Examination and Treatment of Hamstring Related Injuries

    PubMed Central

    2012-01-01

    Context: There is a wide spectrum of hamstring-related injuries that can occur in the athlete. Accurate diagnosis is imperative to prevent delayed return to sport, injury recurrence, and accurate clinical decision making regarding the most efficacious treatment. Evidence Acquisition: This review highlights current evidence related to the diagnosis and treatment of hamstring-related injuries in athletes. Data sources were limited to peer-reviewed publications indexed in MEDLINE from 1988 through May 2011. Results: An accurate diagnostic process for athletes with posterior thigh–related complaints should include a detailed and discriminative history, followed by a thorough clinical examination. Diagnostic imaging should be utilized when considering hamstring avulsion or ischial apophyseal avulsion. Diagnostic imaging may also be needed to further define the cause of referred posterior thigh pain. Conclusions: Differentiating acute hamstring strains, hamstring tendon avulsions, ischial apophyseal avulsions, proximal hamstring tendinopathies, and referred posterior thigh pain is critical in determining the most appropriate treatment and expediting safe return to play. PMID:23016076

  9. Clinical and Morphological Changes Following 2 Rehabilitation Programs for Acute Hamstring Strain Injuries: A Randomized Clinical Trial

    PubMed Central

    SILDER, AMY; SHERRY, MARC A.; SANFILIPPO, JENNIFER; TUITE, MICHAEL J.; HETZEL, SCOTT J.; HEIDERSCHEIT, BRYAN C.

    2013-01-01

    STUDY DESIGN Randomized, double-blind, parallel-group clinical trial. OBJECTIVES To assess differences between a progressive agility and trunk stabilization rehabilitation program and a progressive running and eccentric strengthening rehabilitation program in recovery characteristics following an acute hamstring injury, as measured via physical examination and magnetic resonance imaging (MRI). BACKGROUND Determining the type of rehabilitation program that most effectively promotes muscle and functional recovery is essential to minimize reinjury risk and to optimize athlete performance. METHODS Individuals who sustained a recent hamstring strain injury were randomly assigned to 1 of 2 rehabilitation programs: (1) progressive agility and trunk stabilization or (2) progressive running and eccentric strengthening. MRI and physical examinations were conducted before and after completion of rehabilitation. RESULTS Thirty-one subjects were enrolled, 29 began rehabilitation, and 25 completed rehabilitation. There were few differences in clinical or morphological outcome measures between rehabilitation groups across time, and reinjury rates were low for both rehabilitation groups after return to sport (4 of 29 subjects had reinjuries). Greater craniocaudal length of injury, as measured on MRI before the start of rehabilitation, was positively correlated with longer return-to-sport time. At the time of return to sport, although all subjects showed a near-complete resolution of pain and return of muscle strength, no subject showed complete resolution of injury as assessed on MRI. CONCLUSION The 2 rehabilitation programs employed in this study yielded similar results with respect to hamstring muscle recovery and function at the time of return to sport. Evidence of continuing muscular healing is present after completion of rehabilitation, despite the appearance of normal physical strength and function on clinical examination. LEVEL OF EVIDENCE Therapy, level 1b–. J Orthop Sports Phys Ther 2013;43(5):284-299. Epub 13 March 2013. doi:10.2519/jospt.2013.4452 PMID:23485730

  10. Soccer fatigue, sprinting and hamstring injury risk.

    PubMed

    Small, K; McNaughton, L R; Greig, M; Lohkamp, M; Lovell, R

    2009-08-01

    The aim of this study was to investigate the effect of a multi-directional soccer-specific fatigue protocol on sprinting kinematics in relation to hamstring injury risk. Nine semi-professional soccer players (Mean +/- SD: Age: 21.3 +/- 2.9 year; Height 185.0 +/- 8.7 cm; Body Mass 81.6 +/- 6.7 kg) completed the SAFT(90); a multi-directional, intermittent 90 min exercise protocol representative of soccer match-play. The 10m sprint times and three-dimensional kinematic data were recorded using a high-speed motion capture system (Qualisys Track Manager) every 15 min during the SAFT(90). A significant time dependent increase was observed in sprint time during the SAFT(90) (P<0.01) with a corresponding significant decrease in stride length (P<0.01). Analysis of the kinematic sprint data revealed significantly reduced combined maximal hip flexion and knee extension angle, indicating reduced hamstring length, between pre-exercise and half-time (P<0.01) and pre-exercise and full-time (P<0.05). These findings revealed that the SAFT(90) produced time dependent impairments in sprinting performance and kinematics of technique which may result from shorter hamstring muscle length. Alterations in sprinting technique may have implications for the increased predisposition to hamstring strain injury during the latter stages of soccer match-play. PMID:19455478

  11. Acute hamstring strain injury in track-and-field athletes: A 3-year observational study at the Penn Relay Carnival.

    PubMed

    Opar, D A; Drezner, J; Shield, A; Williams, M; Webner, D; Sennett, B; Kapur, R; Cohen, M; Ulager, J; Cafengiu, A; Cronholm, P F

    2014-08-01

    This study aimed to observe the incidence rates of hamstring strain injuries (HSIs) across different competition levels and ages during the Penn Relays Carnival. Over a 3-year period, all injuries treated by the medical staff were recorded. The type of injury, anatomic location, event in which the injury occurred, competition level, and demographic data were documented. Absolute and relative HSI (per 1000 participants) were determined, and odds ratios (ORs) were calculated between sexes, competition levels, and events. Throughout the study period 48,473 athletes registered to participate in the Penn Relays Carnival, with 118 HSIs treated by the medical team. High school girls displayed lesser risk of HSI than high school boys (OR?=?0.55, P?=?0.021), and masters athletes were more likely than high school- (OR?=?4.26, P?

  12. Lower eccentric hamstring strength and single leg hop for distance predict hamstring injury in PETE students.

    PubMed

    Goossens, L; Witvrouw, E; Vanden Bossche, L; De Clercq, D

    2015-01-01

    Hamstring injuries have not been under research in physical education teacher education (PETE) students so far. Within the frame of the development of an injury prevention program, for this study we conducted an analysis of modifiable risk factors for hamstring injuries in PETE students. Hamstring injuries of 102 freshmen bachelor PETE students were registered prospectively during one academic year. Eighty-one students completed maximum muscle strength tests of hip extensors, hamstrings, quadriceps (isometric) and hamstrings (eccentric) at the start of the academic year. Sixty-nine of the latter completed a single leg hop for distance (SLHD). Risk factors for hamstring injuries were statistically detected using logistic regression. Sixteen hamstring injuries (0.16 injuries/student/academic year; 0.46 injuries/1000 h) occurred to 10 participants. Eight cases were included in the risk factor analysis. Lower eccentric hamstring strength (odds ratio (ODD) = 0.977; p = 0.043), higher isometric/eccentric hamstring strength ratio (ODD = 970.500; p = 0.019) and lower score on the SLHD (ODD = 0.884; p = 0.005) were significant risk factors for hamstring injury. A combination of eccentric hamstring strength test and SLHD could give a good risk analysis of hamstring injuries in PETE students. This might offer great perspectives for easily applicable screening in a clinical setting. PMID:25189278

  13. Hamstring injuries: prevention and treatment—an update

    PubMed Central

    Brukner, Peter

    2015-01-01

    Despite increased knowledge of hamstring muscle injuries, the incidence has not diminished. We now know that not all hamstring injuries are the same and that certain types of injuries require prolonged rehabilitation and return to play. The slow stretch type of injury and injuries involving the central tendon both require longer times to return to play. A number of factors have been proposed as being indicators of time taken to return to play, but the evidence for these is conflicting. Recurrence rates remain high and it is now thought that strength deficits may be an important factor. Strengthening exercise should be performed with the hamstrings in a lengthened position. There is conflicting evidence regarding the efficacy of platelet-rich plasma injection in the treatment of hamstring injuries so at this stage we cannot advise their use. Various tests have been proposed as predictors of hamstring injury and the use of the Nordboard is an interesting addition to the testing process. Prevention of these injuries is the ultimate aim and there is increasing evidence that Nordic hamstring exercises are effective in reducing the incidence. PMID:26105015

  14. Hamstring Injuries--An Examination of Possible Causes.

    ERIC Educational Resources Information Center

    Liemohn, Wendell

    On the basis of research, the following characteristics appear to be important factors relative to precluding hamstring strains in sprinters: bilaterality relative to hamstring and quadricep strength development, optimum strength ratios between ipsilateral antagonists throughout the range of movement, and above-normal hip-joint flexibility. (JD)

  15. A return-to-sport algorithm for acute hamstring injuries.

    PubMed

    Mendiguchia, Jurdan; Brughelli, Matt

    2011-02-01

    Acute hamstring injuries are the most prevalent muscle injuries reported in sport. Despite a thorough and concentrated effort to prevent and rehabilitate hamstring injuries, injury occurrence and re-injury rates have not improved over the past 28 years. This failure is most likely due to the following: 1) an over-reliance on treating the symptoms of injury, such as subjective measures of "pain", with drugs and interventions; 2) the risk factors investigated for hamstring injuries have not been related to the actual movements that cause hamstring injuries i.e. not functional; and, 3) a multi-factorial approach to assessment and treatment has not been utilized. The purpose of this clinical commentary is to introduce a model for progression through a return-to-sport rehabilitation following an acute hamstring injury. This model is developed from objective and quantifiable tests (i.e. clinical and functional tests) that are structured into a step-by-step algorithm. In addition, each step in the algorithm includes a treatment protocol. These protocols are meant to help the athlete to improve through each phase safely so that they can achieve the desired goals and progress through the algorithm and back to their chosen sport. We hope that this algorithm can serve as a foundation for future evidence based research and aid in the development of new objective and quantifiable testing methods. PMID:21256444

  16. The effects of multidirectional soccer-specific fatigue on markers of hamstring injury risk.

    PubMed

    Small, K; McNaughton, L; Greig, M; Lovell, R

    2010-01-01

    The purpose of this work was to investigate the effect of multidirectional soccer-specific fatigue on hamstring muscle strength and angle of peak torque. Sixteen male semi-professional soccer players (mean+/-S.D.: age: 21.3+/-2.9 years; height 185.0+/-8.7 cm; body mass 81.6+/-6.7 kg) completed the SAFT(90), a multidirectional, intermittent 90-min exercise protocol based on data from English Championship soccer matches. Prior to exercise (t(0)), at half-time (t(45)) and post-exercise (t(105)), subjects performed three maximal dominant limb isokinetic contractions (Biodex, System 3) at 120 degrees s(-1) through a 90 degrees range for concentric and eccentric knee flexors and concentric knee extensors. Analysis of variance revealed significant time dependant reductions in gravity corrected eccentric hamstring peak torque, and consequently in the functional hamstring:quadriceps ratio (P<0.01). Eccentric hamstring peak torque decreased significantly during each half (t(0): 272.0+/-43.2; t(45): 240.4+/-43.3; t(105): 226.3+/-45.7 Nm). The functional hamstring:quadriceps ratio also decreased significantly during each half (t(0): 116.6+/-21.2; t(45): 107.1+/-17.6; t(105): 98.8+/-20.3%). There were no significant changes in concentric hamstring or quadriceps peak torque observed during SAFT(90) (P>0.05). Data analysis also revealed significant differences for Angle of Peak Torque for eccentric hamstrings (P<0.05) which was significantly higher at the end of each half (t(45): 37+/-15; t(105): 38+/-18 degrees ) than the pre-exercise value (t(0): 28+/-12 degrees ). There was a time dependant decrease in peak eccentric hamstring torque and in the functional strength ratio which may have implications for the increased predisposition to hamstring strain injury during the latter stages of match-play. PMID:18976956

  17. Clinical predictors of time to return to competition following hamstring injuries

    PubMed Central

    Guillodo, Yannick; Here-Dorignac, Caroline; Thoribé, Bertrand; Madouas, Gwénaelle; Dauty, Marc; Tassery, Francois; Saraux, Alain

    2014-01-01

    Summary Objectives: hamstring strain injuries are the most common sports-related muscle injuries and one of the main causes of missed sporting events. Hypothesis: clinical findings reflecting hamstring injury severity at presentation predict time to sports resumption. Design: cohort study (prognosis); Level of evidence, 2. Methods: five sports medicine specialists at four sports medicine centers prospectively evaluated 120 athletes within 5 days of acute hamstring injury. Patients were interviewed and asked to evaluate their worst pain on a visual analog scale (VAS). Four physical criteria were assessed at baseline: bruising, tenderness to palpation, pain upon isometric contraction, and pain upon passive straightening. The same standardized rehabilitation protocol was used in all patients. A standardized telephone interview was conducted 45 days after the injury to determine the time to-full recovery (≤40 days or >40 days). Results: by univariate analysis, clinical criteria associated with a full recovery time >40 days were VAS pain score greater than 6, popping sound injury, pain during everyday activities for more than 3 days, bruising, and greater than 15° motion-range limitation. By multivariate analysis, only VAS pain score and pain during everyday activities were significantly associated with time to recovery >40 days (53% sensitivity, 95% specificity). Conclusion: the initial examination provides valuable information that can be used to predict the time to full recovery after acute hamstring injuries in athletes. PMID:25489558

  18. HAMSTRING INJURY REHABILITATION AND PREVENTION OF REINJURY USING LENGTHENED STATE ECCENTRIC TRAINING: A NEW CONCEPT

    PubMed Central

    Tim, Tyler; McHugh, Malachy

    2012-01-01

    Back ground and Purpose: Hamstring injury is a common occurrence in sport and there has been limited success in reducing this rate of recurrence to date. Description of Topic with Related Evidence: High speed running requires eccentric strength when the hamstring muscles are in a lengthened state. The lengthened state occurs when the hip is in flexion and the lower leg moves into extension, thus lengthening the two joint hamstring muscle over both articulations upon which they act. There is evidence to suggest that athletes who have sustained a hamstring strain lack strength when the muscle is utilized during performance in a lengthened state. Purpose: To examine the risk factors contributing to such a high recurrence rate and propose a unique rehabilitation strategy addressing these factors in order to decrease the rate of reinjury. Discussion/Relation to Clinical Practice: Failing to increase an athlete's eccentric strength in a lengthened position after a hamstring injury may predispose an athlete to subsequent reinjury. Incorporating lengthened state eccentric training may help reduce the rate of reinjury. Level of Evidence: Level 5 PMID:22666648

  19. Surgical Management of Recurrent Musculotendinous Hamstring Injury in Professional Athletes

    PubMed Central

    Sonnery-Cottet, Bertrand; Daggett, Matt; Gardon, Roland; Pupim, Barbara; Clechet, Julien; Thaunat, Mathieu

    2015-01-01

    Background: Hamstring injury is the most common muscular lesion in athletes. The conservative treatment is well described, and surgical management is often indicated for proximal tendinous avulsions. To our knowledge, no surgical treatment has been proposed for failure of conservative treatment in musculotendinous hamstring lesions. Purpose: To describe the surgical management of proximal and distal hamstring musculotendinous junction lesions in professional athletes after failure of conservative treatment. Study Design: Case series; Level of evidence, 4. Methods: A consecutive series of 10 professional athletes, including 4 soccer players, 4 rugby players, and 2 handball players, underwent surgical intervention between October 2010 and June 2014 for the treatment of recurrent musculotendinous hamstring injuries. All athletes had failed at least 3 months of conservative treatment for a recurrent musculotendinous hamstring injury. Surgical resection of the musculotendinous scar tissue was performed using a longitudinal muscular suture. Lower Extremity Functional Scale (LEFS) and Marx scores were obtained at the 3-month follow-up, and a final phone interview was completed to determine recurrence of hamstring injury and return to previous level of play. Results: The mean age at surgery was 25.2 years (range, 19-35 years). The musculotendinous hamstring lesions involved 8 semitendinosus and 2 biceps femoris, with 6 injuries located proximally and 4 distally. Conservative treatment lasted a mean 5.1 months (range, 3-9 months) after last recurrence, and the patients had an average of 2.7 (range, 2-5) separate incidents of injury recurrence before surgical intervention was decided upon. At the 3-month follow-up, all patients had Marx activity scores of 16 and LEFS scores of 80. All 10 patients returned to the same level of play at a mean 3.4 months (range, 2-5 months). At a mean follow-up of 28.7 months, none of the athletes had suffered a recurrence. No surgical complication was encountered. Conclusion: In cases of failed conservative treatment of musculotendinous hamstring lesions, surgical intervention may be a viable treatment option in professional athletes and allows the patient to return to the same level of play. PMID:26535376

  20. Successful management of hamstring injuries in Australian Rules footballers: two case reports

    PubMed Central

    Hoskins, Wayne T; Pollard, Henry P

    2005-01-01

    Hamstring injuries are the most prevalent injury in Australian Rules football. There is a lack of evidence based literature on the treatment, prevention and management of hamstring injuries, although it is agreed that the etiology is complicated and multi-factorial. We present two cases of hamstring injury that had full resolution after spinal manipulation and correction of lumbar-pelvic biomechanics. There was no recurrence through preventative treatment over a twelve and sixteen week period. The use of spinal manipulation for treatment or prevention of hamstring injury has not been documented in sports medicine literature and should be further investigated in prospective randomized controlled trials. PMID:15967047

  1. The Effectiveness of Injury Prevention Programs to Modify Risk Factors for Non-Contact Anterior Cruciate Ligament and Hamstring Injuries in Uninjured Team Sports Athletes: A Systematic Review

    PubMed Central

    Monajati, Alireza; Larumbe-Zabala, Eneko; Goss-Sampson, Mark; Naclerio, Fernando

    2016-01-01

    Background Hamstring strain and anterior cruciate ligament injuries are, respectively, the most prevalent and serious non-contact occurring injuries in team sports. Specific biomechanical and neuromuscular variables have been used to estimate the risk of incurring a non-contact injury in athletes. Objective The aim of this study was to systematically review the evidences for the effectiveness of injury prevention protocols to modify biomechanical and neuromuscular anterior cruciate and/or hamstring injuries associated risk factors in uninjured team sport athletes. Data Sources PubMed, Science Direct, Web of Science, Cochrane Libraries, U.S. National Institutes of Health clinicaltrials.gov, Sport Discuss and Google Scholar databases were searched for relevant journal articles published until March 2015. A manual review of relevant articles, authors, and journals, including bibliographies was performed from identified articles. Main Results Nineteen studies were included in this review. Four assessment categories: i) landing, ii) side cutting, iii) stop-jump, and iv) muscle strength outcomes, were used to analyze the effectiveness of the preventive protocols. Eight studies using multifaceted interventions supported by video and/or technical feedback showed improvement in landing and/or stop-jump biomechanics, while no effects were observed on side-cutting maneuver. Additionally, multifaceted programs including hamstring eccentric exercises increased hamstring strength, hamstring to quadriceps functional ratio and/or promoted a shift of optimal knee flexion peak torque toward a more open angle position. Conclusions Multifaceted programs, supported by proper video and/or technical feedback, including eccentric hamstring exercises would positively modify the biomechanical and or neuromuscular anterior cruciate and/or hamstring injury risk factors. PMID:27171282

  2. The biomechanics of running in athletes with previous hamstring injury: A case-control study.

    PubMed

    Daly, C; McCarthy Persson, U; Twycross-Lewis, R; Woledge, R C; Morrissey, D

    2016-04-01

    Hamstring injury is prevalent with persistently high reinjury rates. We aim to inform hamstring rehabilitation by exploring the electromyographic and kinematic characteristics of running in athletes with previous hamstring injury. Nine elite male Gaelic games athletes who had returned to sport after hamstring injury and eight closely matched controls sprinted while lower limb kinematics and muscle activity of the previously injured biceps femoris, bilateral gluteus maximus, lumbar erector spinae, rectus femoris, and external oblique were recorded. Intergroup comparisons of muscle activation ratios and kinematics were performed. Previously injured athletes demonstrated significantly reduced biceps femoris muscle activation ratios with respect to ipsilateral gluteus maximus (maximum difference -12.5%, P = 0.03), ipsilateral erector spinae (maximum difference -12.5%, P = 0.01), ipsilateral external oblique (maximum difference -23%, P = 0.01), and contralateral rectus femoris (maximum difference -22%, P = 0.02) in the late swing phase. We also detected sagittal asymmetry in hip flexion (maximum 8°, P = 0.01), pelvic tilt (maximum 4°, P = 0.02), and medial rotation of the knee (maximum 6°, P = 0.03) effectively putting the hamstrings in a lengthened position just before heel strike. Previous hamstring injury is associated with altered biceps femoris associated muscle activity and potentially injurious kinematics. These deficits should be considered and addressed during rehabilitation. PMID:25913546

  3. Platelet-rich plasma (PRP) treatment of sports-related severe acute hamstring injuries

    PubMed Central

    Guillodo, Yannick; Madouas, Gwénaelle; Simon, Thomas; Le Dauphin, Hermine; Saraux, Alain

    2015-01-01

    Summary Purpose hamstring injury is the most common musculoskeletal disorder and one of the main causes of missed sporting events. Shortening the time to return to play (TTRTP) is a priority for athletes and sports medicine practitioners. Hypothesis platelet-rich plasma (PRP) injection at the site of severe acute hamstring injury increases the healing rate and shortens the TTRTP. Study design Cohort study. Methods all patients with ultrasonography and MRI evidence of severe acute hamstring injury between January 2012 and March 2014 were offered PRP treatment. Those who accepted received a single intramuscular PRP injection within 8 days post-injury; the other patients served as controls. The same standardized rehabilitation program was used in both groups. A physical examination and ultrasonography were performed 10 and 30 days post-injury, then a phone interview 120 days post-injury, to determine the TTRTP at the pre-injury level. Results of 34 patients, 15 received PRP and 19 did not. Mean TTRTP at the pre-injury level was 50.9±10.7 days in the PRP group and 52.8±15.7 days in the control group. The difference was not statistically significant. Conclusion a single intramuscular PRP injection did not shorten the TTRTP in sports people with severe acute hamstring injuries. PMID:26958537

  4. Is There Evidence to Support the Use of the Angle of Peak Torque as a Marker of Hamstring Injury and Re-Injury Risk?

    PubMed

    Timmins, Ryan G; Shield, Anthony J; Williams, Morgan D; Opar, David A

    2016-01-01

    Hamstring strain injuries are the predominant injury in many sports, costing athletes and clubs a significant financial and performance burden; therefore, the ability to identify and intervene with individuals who are considered at high risk of injury is important. One measure that has grown in popularity as an outcome variable following hamstring intervention/prevention studies and rehabilitation is the angle of peak knee flexor torque. This current opinion article will firstly introduce the measure and the processes behind it. Second, the article will summarise how the angle of peak knee flexor torque has been suggested to measure hamstring strain injury risk. Finally, the numerous limitations will be presented and the article will outline how these limitations may influence the usefulness of the angle of peak knee flexor torque measure. These include the lack of muscle specificity, the common concentric contraction mode of assessment, reliability of the measure, various neural contributions (such as rate of force development and neuromuscular inhibition), as well as the lack of prospective data showing any predictive value in the measure. PMID:26342386

  5. Effects of external pelvic compression on electromyographic activity of the hamstring muscles during unipedal stance in sportsmen with and without hamstring injuries.

    PubMed

    Arumugam, Ashokan; Milosavljevic, Stephan; Woodley, Stephanie; Sole, Gisela

    2015-06-01

    There is some evidence that hamstring function can be influenced by interventions focusing on the pelvis via an anatomic and neurophysiologic link between these two segments. Previous research demonstrated increased electromyographic activity from injured hamstrings during transition from bipedal to unipedal stance (BUS). The aim of this study was to investigate the effects of a pelvic compression belt (PCB) on electromyographic activity of selected muscles during BUS in sportsmen with and without hamstring injury. Electromyographic amplitudes (normalised to maximum voluntary isometric contraction [MVIC]) of the hamstrings, gluteus maximus, gluteus medius and lumbar multifidus were obtained during BUS from 20 hamstring-injured participants (both sides) and 30 healthy participants (one side, randomly selected). There was an increase in biceps femoris (by 1.23 ± 2.87 %MVIC; p = 0.027) and gluteus maximus (by 0.63 ± 1.13 %MVIC; p = 0.023) electromyographic activity for the hamstring-injured side but no significant differences other than a decrease in multifidus activity (by 1.36 ± 2.92 %MVIC; p = 0.023) were evident for healthy participants while wearing the PCB. However, the effect sizes for these findings were small. Wearing the PCB did not significantly change electromyographic activity of other muscles in either participant group (p > 0.050). Moreover, the magnitude of change induced by the PCB was not significantly different between groups (p > 0.050) for the investigated muscles. Thus, application of a PCB to decrease electromyographic activity of injured hamstrings during BUS is likely to have little effect. Similar research is warranted in participants with acute hamstring injury. PMID:25466292

  6. Field monitoring of sprinting power-force-velocity profile before, during and after hamstring injury: two case reports.

    PubMed

    Mendiguchia, J; Edouard, P; Samozino, P; Brughelli, M; Cross, M; Ross, A; Gill, N; Morin, J B

    2016-03-01

    Very little is currently known about the effects of acute hamstring injury on over-ground sprinting mechanics. The aim of this research was to describe changes in power-force-velocity properties of sprinting in two injury case studies related to hamstring strain management: Case 1: during a repeated sprint task (10 sprints of 40 m) when an injury occurred (5th sprint) in a professional rugby player; and Case 2: prior to (8 days) and after (33 days) an acute hamstring injury in a professional soccer player. A sports radar system was used to measure instantaneous velocity-time data, from which individual mechanical profiles were derived using a recently validated method based on a macroscopic biomechanical model. Variables of interest included: maximum theoretical velocity (V0) and horizontal force (FH0), slope of the force-velocity (F-v) relationship, maximal power, and split times over 5 and 20 m. For Case 1, during the injury sprint (sprint 5), there was a clear change in the F-v profile with a 14% greater value of FH0 (7.6-8.7 N/kg) and a 6% decrease in V0 (10.1 to 9.5 m/s). For Case 2, at return to sport, the F-v profile clearly changed with a 20.5% lower value of FH0 (8.3 vs. 6.6 N/kg) and no change in V0. The results suggest that the capability to produce horizontal force at low speed (FH0) (i.e. first metres of the acceleration phase) is altered both before and after return to sport from a hamstring injury in these two elite athletes with little or no change of maximal velocity capabilities (V0), as evidenced in on-field conditions. Practitioners should consider regularly monitoring horizontal force production during sprint running both from a performance and injury prevention perspective. PMID:26648237

  7. Effect of Varying Hamstring Tension on Anterior Cruciate Ligament Strain During in Vitro Impulsive Knee Flexion and Compression Loading

    PubMed Central

    Withrow, Thomas J.; Huston, Laura J.; Wojtys, Edward M.; Ashton-Miller, James A.

    2008-01-01

    Background: The hamstring muscles are well positioned to limit both anterior tibial translation and anterior cruciate ligament strain during the knee flexion phase of a jump landing. We hypothesized that systematically increasing or decreasing hamstring tension during the knee flexion phase of a simulated jump landing would significantly affect peak relative strain in the anterior cruciate ligament. Methods: Ten cadaveric knees from four male and six female donors (mean age [and standard deviation] at the time of death, 60.3 23.6 years) were mounted in a custom fixture to initially position the specimen in 25 of knee flexion and simulate axial impulsive loading averaging 1700 N to cause an increase in knee flexion. Quadriceps, hamstring, and gastrocnemius muscle forces were simulated with use of pretensioned linear springs, with the tension in the hamstrings arranged to be increased, held constant, decreased, at baseline, or absent during knee flexion. Impulsive loading applied along the tibia and femur was monitored with use of triaxial load transducers, while uniaxial load cells monitored quadriceps and medial and lateral hamstring forces. Relative strain in the anterior cruciate ligament was measured with use of a differential variable reluctance transducer, and tibiofemoral kinematics were measured optoelectronically. For each specimen, anterior cruciate ligament strains were recorded over eighty impact trials: ten preconditioning trials, ten baseline trials involving decreasing hamstring tension performed before and after three sets of ten trials conducted with increasing hamstring tension, constant hamstring tension, or no hamstring tension. Peak relative strains in the anterior cruciate ligament were normalized for comparison across specimens. Results: Increasing hamstring force during the knee flexion landing phase decreased the peak relative strain in the anterior cruciate ligament by >70% compared with the baseline condition (p = 0.005). Neither a constant hamstring muscle force nor the absence of a hamstring force significantly changed the peak strain in the anterior cruciate ligament relative to the baseline condition. Conclusions: Increasing hamstring muscle force during the knee flexion phase of a simulated jump landing significantly reduces the peak relative strain in the anterior cruciate ligament in vitro. Clinical Relevance: It may be possible to proactively limit peak anterior cruciate ligament strain during the knee flexion phase of jump landings by accentuating hip flexion, thereby increasing the tension in active hamstring muscles by lengthening them. PMID:18381320

  8. Static Stretching of the Hamstring Muscle for Injury Prevention in Football Codes: a Systematic Review

    PubMed Central

    Rogan, Slavko; Wüst, Dirk; Schwitter, Thomas; Schmidtbleicher, Dietmar

    2012-01-01

    Purpose Hamstring injuries are common among football players. There is still disagreement regarding prevention. The aim of this review is to determine whether static stretching reduces hamstring injuries in football codes. Methods A systematic literature search was conducted on the online databases PubMed, PEDro, Cochrane, Web of Science, Bisp and Clinical Trial register. Study results were presented descriptively and the quality of the studies assessed were based on Cochrane's ‘risk of bias’ tool. Results The review identified 35 studies, including four analysis studies. These studies show deficiencies in the quality of study designs. Conclusion The study protocols are varied in terms of the length of intervention and follow-up. No RCT studies are available, however, RCT studies should be conducted in the near future. PMID:23785569

  9. Platelet-rich plasma treatment improves outcomes for chronic proximal hamstring injuries in an athletic population

    PubMed Central

    Fader, Ryan R.; Mitchell, Justin J.; Traub, Shaun; Nichols, Roger; Roper, Michelle; Mei Dan, Omer; McCarty, Eric C.

    2014-01-01

    Summary Background: chronic proximal hamstring tendinopathies is a disabling activity related condition. Currently, there is no well-accepted or extensively documented non-operative treatment option that provides consistently successful results. Purpose: to evaluate the efficacy of ultrasound guided platelet-rich plasma injections in treating chronic proximal hamstring tendinopathies. Methods: a total of 18 consecutive patients were retrospectively analyzed. All patients received a single injection of platelet rich plasma via ultra-sound guidance by a single radiologist. Outcome measures included a questionnaire evaluating previous treatments, visual analog scale (VAS) for pain, subjective improvement, history of injury, and return to activity. Results: the patient population included 12 females and 6 males. The average age at the time of the injection was 42.6 years (19–60). Provocative activities included running, biking, swimming. The average body mass index of patients was 22.9 (17.2–30.2). The average time of chronic pain prior to receiving the first injection was 32.6 months (6–120). All patients had attempted other forms of non-surgical treatment prior to entering the study. The average VAS pre-injection was 4.6 (0–8). Six months after the injection, 10/18 patients had 80% or greater improvement in their VAS. Overall, the average improvement was 63% (5–100). The only documented side effect was post-injection discomfort that resolved within seventy-two hours. Conclusion: chronic hamstring tendinopathy is a debilitating condition secondary to the pain, which limits an athlete’s ability to perform. For refractory cases of chronic insertional proximal hamstring injuries, platelet-rich plasma injections are safe and show benefit in the majority of patients in our study, allowing return to pre-injury activities. Study Design: Case series; Level of evidence, 4. PMID:25767784

  10. Recurrent hamstring muscle injury: applying the limited evidence in the professional football setting with a seven-point programme

    PubMed Central

    Brukner, Peter; Nealon, Andrew; Morgan, Christopher; Burgess, Darren; Dunn, Andrew

    2014-01-01

    Recurrent hamstring injuries are a major problem in sports such as football. The aim of this paper was to use a clinical example to describe a treatment strategy for the management of recurrent hamstring injuries and examine the evidence for each intervention. A professional footballer sustained five hamstring injuries in a relatively short period of time. The injury was managed successfully with a seven-point programme—biomechanical assessment and correction, neurodynamics, core stability, eccentric strengthening, an overload running programme, injection therapies and stretching/relaxation. The evidence for each of these treatment options is reviewed. It is impossible to be definite about which aspects of the programme contributed to a successful outcome. Only limited evidence is available in most cases; therefore, decisions regarding the use of different treatment modalities must be made by using a combination of clinical experience and research evidence. PMID:23322894

  11. Recurrent hamstring muscle injury: applying the limited evidence in the professional football setting with a seven-point programme.

    PubMed

    Brukner, Peter; Nealon, Andrew; Morgan, Christopher; Burgess, Darren; Dunn, Andrew

    2014-06-01

    Recurrent hamstring injuries are a major problem in sports such as football. The aim of this paper was to use a clinical example to describe a treatment strategy for the management of recurrent hamstring injuries and examine the evidence for each intervention. A professional footballer sustained five hamstring injuries in a relatively short period of time. The injury was managed successfully with a seven-point programme-biomechanical assessment and correction, neurodynamics, core stability, eccentric strengthening, an overload running programme, injection therapies and stretching/relaxation. The evidence for each of these treatment options is reviewed. It is impossible to be definite about which aspects of the programme contributed to a successful outcome. Only limited evidence is available in most cases; therefore, decisions regarding the use of different treatment modalities must be made by using a combination of clinical experience and research evidence. PMID:23322894

  12. ‘Serious thigh muscle strains’: beware the intramuscular tendon which plays an important role in difficult hamstring and quadriceps muscle strains

    PubMed Central

    Brukner, Peter; Connell, David

    2016-01-01

    Why do some hamstring and quadriceps strains take much longer to repair than others? Which injuries are more prone to recurrence? Intramuscular tendon injuries have received little attention as an element in ‘muscle strain’. In thigh muscles, such as rectus femoris and biceps femoris, the attached tendon extends for a significant distance within the muscle belly. While the pathology of most muscle injures occurs at a musculotendinous junction, at first glance the athlete appears to report pain within a muscle belly. In addition to the musculotendinous injury being a site of pathology, the intramuscular tendon itself is occasionally injured. These injuries have a variety of appearances on MRIs. There is some evidence that these injuries require a prolonged rehabilitation time and may have higher recurrence rates. Therefore, it is important to recognise the tendon component of a thigh ‘muscle strain’. PMID:26519522

  13. The effect of a sports chiropractic manual therapy intervention on the prevention of back pain, hamstring and lower limb injuries in semi-elite Australian Rules footballers: a randomized controlled trial

    PubMed Central

    2010-01-01

    Background Hamstring injuries are the most common injury in Australian Rules football. It was the aims to investigate whether a sports chiropractic manual therapy intervention protocol provided in addition to the current best practice management could prevent the occurrence of and weeks missed due to hamstring and other lower-limb injuries at the semi-elite level of Australian football. Methods Sixty male subjects were assessed for eligibility with 59 meeting entry requirements and randomly allocated to an intervention (n = 29) or control group (n = 30), being matched for age and hamstring injury history. Twenty-eight intervention and 29 control group participants completed the trial. Both groups received the current best practice medical and sports science management, which acted as the control. Additionally, the intervention group received a sports chiropractic intervention. Treatment for the intervention group was individually determined and could involve manipulation/mobilization and/or soft tissue therapies to the spine and extremity. Minimum scheduling was: 1 treatment per week for 6 weeks, 1 treatment per fortnight for 3 months, 1 treatment per month for the remainder of the season (3 months). The main outcome measure was an injury surveillance with a missed match injury definition. Results After 24 matches there was no statistical significant difference between the groups for the incidence of hamstring injury (OR:0.116, 95% CI:0.013-1.019, p = 0.051) and primary non-contact knee injury (OR:0.116, 95% CI:0.013-1.019, p = 0.051). The difference for primary lower-limb muscle strains was significant (OR:0.097, 95%CI:0.011-0.839, p = 0.025). There was no significant difference for weeks missed due to hamstring injury (4 v14, χ2:1.12, p = 0.29) and lower-limb muscle strains (4 v 21, χ2:2.66, p = 0.10). A significant difference in weeks missed due to non-contact knee injury was noted (1 v 24, χ2:6.70, p = 0.01). Conclusions This study demonstrated a trend towards lower limb injury prevention with a significant reduction in primary lower limb muscle strains and weeks missed due to non-contact knee injuries through the addition of a sports chiropractic intervention to the current best practice management. Trial registration The study was registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12608000533392). PMID:20374662

  14. Repetitive strain injury.

    PubMed

    van Tulder, Maurits; Malmivaara, Antti; Koes, Bart

    2007-05-26

    Repetitive strain injury remains a controversial topic. The term repetitive strain injury includes specific disorders such as carpal tunnel syndrome, cubital tunnel syndrome, Guyon canal syndrome, lateral epicondylitis, and tendonitis of the wrist or hand. The diagnosis is usually made on the basis of history and clinical examination. Large high-quality studies using newer imaging techniques, such as MRI and ultrasonography are few. Consequently, the role of such imaging in diagnosis of upper limb disorders remains unclear. In many cases, no specific diagnosis can be established and complaints are labelled as non-specific. Little is known about the effectiveness of treatment options for upper limb disorders. Strong evidence for any intervention is scarce and the effect, if any, is mainly short-term pain relief. Exercise is beneficial for non-specific upper limb disorders. Immobilising hand braces and open carpal tunnel surgery release are beneficial for carpal tunnel syndrome, and topical and oral non-steroidal anti-inflammatory drugs, and corticosteroid injections are helpful for lateral epicondylitis. Exercise is probably beneficial for neck pain, as are corticosteroid injections and exercise for shoulder pain. Although upper limb disorders occur frequently in the working population, most trials have not exclusively included a working population or assessed effects on work-related outcomes. Further high-quality trials should aim to include sufficient sample sizes, working populations, and work-related outcomes. PMID:17531890

  15. Muscle and intensity based hamstring exercise classification in elite female track and field athletes: implications for exercise selection during rehabilitation

    PubMed Central

    Tsaklis, Panagiotis; Malliaropoulos, Nikos; Mendiguchia, Jurdan; Korakakis, Vasileios; Tsapralis, Kyriakos; Pyne, Debasish; Malliaras, Peter

    2015-01-01

    Background Hamstring injuries are common in many sports, including track and field. Strains occur in different parts of the hamstring muscle but very little is known about whether common hamstring loading exercises specifically load different hamstring components. The purpose of this study was to investigate muscle activation of different components of the hamstring muscle during common hamstring loading exercises. Methods Twenty elite female track and field athletes were recruited into this study, which had a single-sample, repeated-measures design. Each athlete performed ten hamstring loading exercises, and an electromyogram (EMG) was recorded from the biceps femoris and semitendinosus components of the hamstring. Hamstring EMG during maximal voluntary isometric contraction (MVIC) was used to normalize the mean data across ten repetitions of each exercise. An electrogoniometer synchronized to the EMG was used to determine whether peak EMG activity occurred during muscle-tendon unit lengthening, shortening, or no change in length. Mean EMG values were compared between the two recording sites for each exercise using the Student’s t-test. Results The lunge, dead lift, and kettle swings were low intensity (<50% MVIC) and all showed higher EMG activity for semitendinosus than for biceps femoris. Bridge was low but approaching medium intensity, and the TRX, hamstring bridge, and hamstring curl were all medium intensity exercises (≥50% or <80% MVIC). The Nordic, fitball, and slide leg exercises were all high intensity exercises. Only the fitball exercise showed higher EMG activity in the biceps femoris compared with the semitendinosus. Only lunge and kettle swings showed peak EMG in the muscle-tendon unit lengthening phase and both these exercises involved faster speed. Conclusion Some exercises selectively activated the lateral and medial distal hamstrings. Low, medium, and high intensity exercises were demonstrated. This information enables the clinician, strength and conditioning coach and physiotherapist to better understand intensity- and muscle-specific activation during hamstring muscle rehabilitation. Therefore, these results may help in designing progressive strengthening and rehabilitation and prevention programs. PMID:26170726

  16. Hamstring Fatigue and Muscle Activation Changes During Six Sets of Nordic Hamstring Exercise in Amateur Soccer Players.

    PubMed

    Marshall, Paul W M; Lovell, Ric; Knox, Michael F; Brennan, Scott L; Siegler, Jason C

    2015-11-01

    The Nordic hamstring exercise (NHE) is a bodyweight movement commonly prescribed to increase eccentric hamstring strength and reduce the incidence of strain injury in sport. This study examined hamstring fatigue and muscle activation responses throughout 6 sets of 5 repetitions of the NHE. Ten amateur-level soccer players performed a single session of 6 sets of 5 repetitions of NHE. Maximal eccentric and concentric torque output (in newton meters) was measured after every set. Hamstrings electromyograms (EMG) were measured during all maximal contractions and exercise repetitions. Hamstring maximal eccentric torque was reduced throughout the range of motion after only a single set of NHE between 7.9 and 17.1% (p ≤ 0.05), with further reductions in subsequent sets. Similarly, maximal concentric torque reductions between 7.8 and 17.2% were observed throughout the range of motion after 1 set of NHE (p ≤ 0.05). During the descent phase of the NHE repetitions, hamstring muscle activity progressively increased as the number of sets performed increased. These increases were observed in the first half of the range of motion. During the ascent phase, biceps femoris muscle activity but not medial hamstrings was reduced from the start of exercise during latter sets of repetitions. These data provide unique insight into the extent of fatigue induced from a bodyweight only exercise after a single set of 5 repetitions. Strength and conditioning coaches need to be aware of the speed and extent of fatigue induced from NHE, particularly in practical settings in which this exercise is now prescribed before sport-specific training sessions (i.e., the FIFA-11 before soccer training). PMID:25886019

  17. Influence on Strength and Flexibility of a Swing Phase-Specific Hamstring Eccentric Program in Sprinters' General Preparation.

    PubMed

    Guex, Kenny J; Lugrin, Véronique; Borloz, Stéphane; Millet, Grégoire P

    2016-02-01

    Guex, KJ, Lugrin, V, Borloz, S, and Millet, GP. Influence on strength and flexibility of a swing phase-specific hamstring eccentric program in sprinters' general preparation. J Strength Cond Res 30(2): 525-532, 2016-Hamstring injuries are common in sprinters and mainly occur during the terminal swing phase. Eccentric training has been shown to reduce hamstring injury rate by improving several risk factors. The aim of this study was to test the hypothesis that an additional swing phase-specific hamstring eccentric training in well-trained sprinters performed at the commencement of the winter preparation is more efficient to improve strength, ratio, optimum angle, and flexibility than a similar program without hamstring eccentric exercises. Twenty sprinters were randomly allocated to an eccentric (n = 10) or a control group (n = 10). Both groups performed their usual track and field training throughout the study period. Sprinters in the eccentric group performed an additional 6-week hamstring eccentric program, which was specific to the swing phase of the running cycle (eccentric high-load open-chain kinetic movements covering the whole hamstring length-tension relationship preformed at slow to moderate velocity). Isokinetic and flexibility measurements were performed before and after the intervention. The eccentric group increased hamstring peak torques in concentric at 60°·s by 16% (p < 0.001) and at 240°·s by 10% (p < 0.01), in eccentric at 30°·s by 20% (p < 0.001) and at 120°·s by 22% (p < 0.001), conventional and functional ratios by 12% (p < 0.001), and flexibility by 4° (p < 0.01), whereas the control group increased hamstring peak torques only in eccentric at 30°·s by 6% (p ≤ 0.05) and at 120°·s by 6% (p < 0.01). It was concluded that an additional swing phase-specific hamstring eccentric training in sprinters seems to be crucial to address different risk factors for hamstring strain injuries, such as eccentric and concentric strength, hamstring-to-quadriceps ratio ratio, and flexibility. PMID:26200198

  18. Ischiofemoral impingement resulting from a chronic avulsion injury of the hamstrings.

    PubMed

    Hayat, Zara; Konan, Sujith; Pollock, Rob

    2014-01-01

    Significantly reduced distance between the ischium and the femur can result in symptomatic hip pain as a result of impingement. We present the case of a 16-year-old boy who presented with groin pain which had been affecting him for a year and a half following an innocuous football injury. Plain radiograph revealed a chronic apophyseal avulsion fracture of the ischium with excessive callus formation. CT scan and MRI revealed that the bony protuberance was responsible for symptomatic ischiofemoral impingement. In this case, he was successfully treated with non-operative management involving slow re-introduction to exercise. An unusual example of acquired ischiofemoral impingement, unrelated to surgery or significant trauma, this case highlights the need to consider such a diagnosis in otherwise unexplained groin pain. PMID:24966262

  19. Elevated gastrocnemius forces compensate for decreased hamstrings forces during the weight-acceptance phase of single-leg jump landing: implications for anterior cruciate ligament injury risk.

    PubMed

    Morgan, Kristin D; Donnelly, Cyril J; Reinbolt, Jeffrey A

    2014-10-17

    Approximately 320,000 anterior cruciate ligament (ACL) injuries in the United States each year are non-contact injuries, with many occurring during a single-leg jump landing. To reduce ACL injury risk, one option is to improve muscle strength and/or the activation of muscles crossing the knee under elevated external loading. This study's purpose was to characterize the relative force production of the muscles supporting the knee during the weight-acceptance (WA) phase of single-leg jump landing and investigate the gastrocnemii forces compared to the hamstrings forces. Amateur male Western Australian Rules Football players completed a single-leg jump landing protocol and six participants were randomly chosen for further modeling and simulation. A three-dimensional, 14-segment, 37 degree-of-freedom, 92 muscle-tendon actuated model was created for each participant in OpenSim. Computed muscle control was used to generate 12 muscle-driven simulations, 2 trials per participant, of the WA phase of single-leg jump landing. A one-way ANOVA and Tukey post-hoc analysis showed both the quadriceps and gastrocnemii muscle force estimates were significantly greater than the hamstrings (p<0.001). Elevated gastrocnemii forces corresponded with increased joint compression and lower ACL forces. The elevated quadriceps and gastrocnemii forces during landing may represent a generalized muscle strategy to increase knee joint stiffness, protecting the knee and ACL from external knee loading and injury risk. These results contribute to our understanding of how muscle's function during single-leg jump landing and should serve as the foundation for novel muscle-targeted training intervention programs aimed to reduce ACL injuries in sport. PMID:25218505

  20. THE ROLE AND IMPLEMENTATION OF ECCENTRIC TRAINING IN ATHLETIC REHABILITATION: TENDINOPATHY, HAMSTRING STRAINS, AND ACL RECONSTRUCTION

    PubMed Central

    Reiman, Michael

    2011-01-01

    The benefits and proposed physiological mechanisms of eccentric exercise have previously been elucidated and eccentric exercise has been used for well over seventy years. Traditionally, eccentric exercise has been used as a regular component of strength training. However, in recent years, eccentric exercise has been used in rehabilitation to manage a host of conditions. Of note, there is evidence in the literature supporting eccentric exercise for the rehabilitation of tendinopathies, muscle strains, and in anterior cruciate ligament (ACL) rehabilitation. The purpose of this Clinical Commentary is to discuss the physiologic mechanism of eccentric exercise as well as to review the literature regarding the utilization of eccentric training during rehabilitation. A secondary purpose of this commentary is to provide the reader with a framework for the implementation of eccentric training during rehabilitation of tendinopathies, muscle strains, and after ACL reconstruction. PMID:21655455

  1. Hamstring Muscle Fatigue and Central Motor Output during a Simulated Soccer Match

    PubMed Central

    Marshall, Paul W. M.; Lovell, Ric; Jeppesen, Gitte K.; Andersen, Kristoffer; Siegler, Jason C.

    2014-01-01

    Purpose To examine changes in hamstring muscle fatigue and central motor output during a 90-minute simulated soccer match, and the concomitant changes in hamstring maximal torque and rate of torque development. Method Eight amateur male soccer players performed a 90-minute simulated soccer match, with measures performed at the start of and every 15-minutes during each half. Maximal torque (Nm) and rate of torque development (RTD; Nm.s–1) were calculated from maximal isometric knee flexor contractions performed at 10° of flexion. Hamstring peripheral fatigue was assessed from changes in the size and shape of the resting twitch (RT). Hamstring central motor output was quantified from voluntary activation (%) and normalized biceps femoris (BF) and medial hamstrings (MH) electromyographic amplitudes (EMG/M). Results Maximal torque was reduced at 45-minutes by 7.6±9.4% (p<0.05). RTD in time intervals of 0–25, 0–50, and 0–75 ms post-contraction onset were reduced after 15-minutes in the first-half between 29.6 to 46.2% (p<0.05), and were further reduced at the end of the second-half (p<0.05). Maximal EMG/M was reduced for biceps femoris only concomitant to the time-course of reductions in maximal torque (p = 0.007). The rate of EMG rise for BF and MH was reduced in early time periods (0–75 ms) post-contraction onset (p<0.05). No changes were observed for the size and shape of the RT, indicating no hamstring peripheral fatigue. Conclusion Centrally mediated reductions in maximal torque and rate of torque development provide insight into factors that may explain hamstring injury risk during soccer. Of particular interest were early reductions during the first-half of hamstring rate of torque development, and the decline in maximal EMG/M of biceps femoris in the latter stages of the half. These are important findings that may help explain why the hamstrings are particularly vulnerable to strain injury during soccer. PMID:25047547

  2. The proximal hamstring muscle-tendon-bone unit: a review of the normal anatomy, biomechanics, and pathophysiology.

    PubMed

    Beltran, Luis; Ghazikhanian, Varand; Padron, Mario; Beltran, Javier

    2012-12-01

    Proximal hamstring injuries occur during eccentric contraction with the hip and the knee on extension; hence they are relatively frequent lesions in specific sports such as water skiing and hurdle jumping. Additionally, the trend toward increasing activity and fitness training in the general population has resulted in similar injuries. Myotendinous strains are more frequent than avulsion injuries. Discrimination between the two types of lesions is relevant for patient management, since the former is treated conservatively and the latter surgically. MRI and Ultrasonography are both well suited techniques for the diagnosis and evaluation of hamstring tendon injuries. Each one has its advantages and disadvantages. The purpose of this article is to provide a comprehensive review of the anatomy and biomechanics of the proximal hamstring muscle-tendon-bone unit and the varied imaging appearances of hamstring injury, which is vital for optimizing patient care. This will enable the musculoskeletal radiologist to contribute accurate and useful information in the treatment of athletes at all levels of participation. PMID:21524864

  3. Electrophysiological Assessment of Injury to the Infra-patellar Branch(es) of the Saphenous Nerve during Anterior Cruciate Ligament Reconstruction Using Medial Hamstring Auto-grafts: Vertical versus Oblique Harvest Site Incisions

    PubMed Central

    Tavakoli Darestani, Reza; Bagherian Lemraski, Mohammad Mehdi; Hosseinpour, Mehrdad; Kamrani-Rad, Amin

    2013-01-01

    Background It was suggested that the direction of incision for medial hamstring tendons harvesting influences the incidence of injury to the infrapatellar branch of the saphenous nerve (IPBSN), a common complication following arthroscopically-assisted anterior cruciate ligament reconstruction (ACLR). Objectives The main purpose of current study was to compare the incidence of IPBSN injury between vertical and oblique incisions utilizing electrophysiological evaluation. Patients and Methods There were 60 patients underwent arthroscopically-assisted ACLR assigned to two equal vertical or oblique incision groups, randomly. One year postoperatively, the patients were electrophysiologically examined to detect whether IPBSN is injured. The Lysholm score was completed. The patients' satisfaction with surgical outcomes determined utilizing visual analogue scale (VAS). Finally, two groups were compared and the effect of IPBSN injury on function and satisfaction was investigated. Results The incidence of IPBSN injury was higher in the vertical group (4 patients vs. 10 patients), but the difference was not statistically significant. The mean of Lysholm and VAS scores were the same. Also, the mean of Lysholm score was the same in patients with and without IPBSN injury. However, patients without IPBSN injury were more satisfied (8.9 ± 9 vs. 7.4 ± 1.1; P < 0.001). Conclusions IPBSN injury is a common complication following arthroscopically-assisted ACLR and, if not significant, oblique direction of the incision is associated with decreased incidence of the injury. IPBSN injury has no effect on the function but because of the disturbance with patients' satisfaction, authors believe the oblique incision is preferable to avoid the nerve injury during medial hamstring tendons harvesting. PMID:24693521

  4. Immediate Effects of Neurodynamic Sliding versus Muscle Stretching on Hamstring Flexibility in Subjects with Short Hamstring Syndrome

    PubMed Central

    Castellote-Caballero, Yolanda; Valenza, Maríe C.; Puentedura, Emilio J.; Fernández-de-las-Peñas, César; Alburquerque-Sendín, Francisco

    2014-01-01

    Background. Hamstring injuries continue to affect active individuals and although inadequate muscle extensibility remains a commonly accepted factor, little is known about the most effective method to improve flexibility. Purpose. To determine if an isolated neurodynamic sciatic sliding technique would improve hamstring flexibility to a greater degree than stretching or a placebo intervention in asymptomatic subjects with short hamstring syndrome (SHS). Study Design. Randomized double-blinded controlled trial. Methods. One hundred and twenty subjects with SHS were randomized to 1 of 3 groups: neurodynamic sliding, hamstring stretching, and placebo control. Each subject's dominant leg was measured for straight leg raise (SLR) range of motion (ROM) before and after interventions. Data were analyzed with a 3 × 2 mixed model ANOVA followed by simple main effects analyses. Results. At the end of the study, more ROM was observed in the Neurodynamic and Stretching groups compared to the Control group and more ROM in the Neurodynamic group compared to Stretching group. Conclusion. Findings suggest that a neurodynamic sliding technique will increase hamstring flexibility to a greater degree than static hamstring stretching in healthy subjects with SHS. Clinical Relevance. The use of neurodynamic sliding techniques to improve hamstring flexibility in sports may lead to a decreased incidence in injuries; however, this needs to be formally tested. PMID:26464889

  5. Proximal Hamstring Repair Strength

    PubMed Central

    Harvey, Margaret Ann; Singh, Hardeep; Obopilwe, Elifho; Charette, Ryan; Miller, Suzanne

    2015-01-01

    Background: Proximal hamstring repair for complete ruptures has become a common treatment. There is no consensus in the literature about postoperative rehabilitation protocols following proximal hamstring repair. Some protocols describe bracing to prevent hip flexion or knee extension while others describe no immobilization. There are currently no biomechanical studies evaluating proximal hamstring repairs; nor are there any studies evaluating the effect of different hip flexion angles on these repairs. Hypothesis: As hip flexion increases from 0° to 90°, there will be a greater gap with cyclical loading. Study Design: Controlled laboratory study. Methods: Proximal hamstring insertions were detached from the ischial tuberosity in 24 cadavers and were repaired with 3 single-loaded suture anchors in the hamstring footprint with a Krakow suture technique. Cyclic loading from 10 to 125 N at 1 Hz was then performed for 0°, 45°, and 90° of hip flexion for 1500 cycles. Gap formation, stiffness, yield load, ultimate load, and energy to ultimate load were compared between groups using paired t tests. Results: Cyclic loading demonstrated the least amount of gap formation (P < .05) at 0° of hip flexion (2.39 mm) and most at 90° of hip flexion (4.19 mm). There was no significant difference in ultimate load between hip flexion angles (326, 309, and 338 N at 0°, 45°, and 90°, respectively). The most common mode of failure occurred with knot/suture failure (n = 17). Conclusion: Increasing hip flexion from 0° to 90° increases the displacement across proximal hamstring repairs. Postoperative bracing that limits hip flexion should be considered. Clinical Relevance: Repetitive motion involving hip flexion after a proximal hamstring repair may cause compromise of the repair. PMID:26665049

  6. The effect of fatigue and velocity on the relative timing of hamstring activation in relation to quadriceps.

    PubMed

    Abbaszadeh-Amirdehi, Maryam; Khademi-Kalantari, Khosro; Talebian, Saeed; Rezasoltani, Asghar; Hadian, Mohammad Reza

    2012-10-01

    Inter-muscular coordination has an important role in proper function and prevention of injuries in the knee joint. The purpose of this study was to characterize the effect of velocity and fatigue on the relative activation onset of hamstring to quadriceps muscles during knee extension. Thirty one healthy and non-athletic volunteers (24 women, 7 men) were recruited for the study. The onset time of vastus medialis, vastus lateralis, rectus femoris, medial and lateral hamstring were measured during maximum voluntary extension of the knee joint at velocities of 45° /s, 150° /s & 300° /s before and after fatigue and the mean delay onset of all pairs of H-Q were measured. A two-way repeated measures ANOVA test was used to compare across the mean delayed onset of hamstring related to quadriceps muscles at various velocities. Hamstring muscle showed a delayed activation related to quadriceps and increasing the velocity of shortening has a prominent effect on the inter-muscular coordination with early activation of hamstring related to quadriceps muscles (F = 6.7, p < 0.002 for Biceps-rectus femoris, F = 6.31, p < 0.003 for semitendinosus-rectus femoris, F = 6.26, p < 0.003 for biceps-vastus lateralis, F = 5.98, p < 0.004 for semitendinosus-vastus lateralis, F = 3.19, p < 0.04 for biceps-vastus medialis and F = 3.2, p < 0.04 for semitendinosus-vastus medialis). This could predispose these muscles to over strain and possible injuries. The main effect of fatigue condition and its interaction with velocity however, showed statistically nonsignificant result. PMID:23036879

  7. 'Nordic' hamstrings exercise - engagement characteristics and training responses.

    PubMed

    Iga, J; Fruer, C S; Deighan, M; Croix, M D S; James, D V B

    2012-12-01

    The present study examined the neuromuscular activation characteristics of the hamstrings during the 'Nordic' hamstrings exercise (NHE) and changes in the eccentric strength of the knee flexors with NHE training. Initially, the normalised root mean square electromyographic (EMG) activity of the hamstrings of both limbs during various phases (90-61°, 60-31° and 30-0° of knee extension) of the NHE were determined in 18 soccer players. Subsequently participants were randomly allocated to either a training (n=10) or control group. The isokinetic eccentric peak torques of the dominant and non-dominant limbs were recorded at 60, 120 and 240°/s pre- and post-training. The EMG values of both limbs were comparable (P=0.184) and greater EMG activity was recorded at more extended knee positions of the NHE (P=0.001). 4 weeks of NHE training significantly improved peak torque by up to 21% in all assessment conditions. Data indicate the hamstrings of both limbs are engaged identically during the NHE and training results in gains in the eccentric peak torque of the hamstrings of both limbs; these gains may augment the force that the hamstrings can withstand when forcefully stretched, attenuating injury risk. PMID:22895870

  8. Brain injury tolerance limit based on computation of axonal strain.

    PubMed

    Sahoo, Debasis; Deck, Caroline; Willinger, Rémy

    2016-07-01

    Traumatic brain injury (TBI) is the leading cause of death and permanent impairment over the last decades. In both the severe and mild TBIs, diffuse axonal injury (DAI) is the most common pathology and leads to axonal degeneration. Computation of axonal strain by using finite element head model in numerical simulation can enlighten the DAI mechanism and help to establish advanced head injury criteria. The main objective of this study is to develop a brain injury criterion based on computation of axonal strain. To achieve the objective a state-of-the-art finite element head model with enhanced brain and skull material laws, was used for numerical computation of real world head trauma. The implementation of new medical imaging data such as, fractional anisotropy and axonal fiber orientation from Diffusion Tensor Imaging (DTI) of 12 healthy patients into the finite element brain model was performed to improve the brain constitutive material law with more efficient heterogeneous anisotropic visco hyper-elastic material law. The brain behavior has been validated in terms of brain deformation against Hardy et al. (2001), Hardy et al. (2007), and in terms of brain pressure against Nahum et al. (1977) and Trosseille et al. (1992) experiments. Verification of model stability has been conducted as well. Further, 109 well-documented TBI cases were simulated and axonal strain computed to derive brain injury tolerance curve. Based on an in-depth statistical analysis of different intra-cerebral parameters (brain axonal strain rate, axonal strain, first principal strain, Von Mises strain, first principal stress, Von Mises stress, CSDM (0.10), CSDM (0.15) and CSDM (0.25)), it was shown that axonal strain was the most appropriate candidate parameter to predict DAI. The proposed brain injury tolerance limit for a 50% risk of DAI has been established at 14.65% of axonal strain. This study provides a key step for a realistic novel injury metric for DAI. PMID:27038501

  9. Injury incidence, risk factors and prevention in Australian rules football.

    PubMed

    Hrysomallis, Con

    2013-05-01

    Along with the enjoyment and the other positive benefits of sport participation, there is also the risk of injury that is elevated in contact sport. This review provides a summary of injury incidence in Australian rules football (ARF), identifies injury risk factors, assesses the efficacy of interventions to reduce injury risk and makes recommendations for future research. The most common injuries were found to be muscle strains, particularly hamstrings; joint ligament sprains, especially ankle; haematomas and concussion. The most severe joint injury was anterior cruciate ligament rupture. Mouthguards are commonly worn and have been shown to reduce orofacial injury. There is evidence that thigh pads can reduce the incidence of thigh haematomas. There is a reluctance to wear padded headgear and an attempt to assess its effectiveness was unsuccessful due to low compliance. The most readily identified risk factor was a history of that injury. There were conflicting findings as to the influence strength imbalances or deficit has on hamstring injury risk in ARF. Static hamstring flexibility was not related to risk but low hip flexor/quadriceps flexibility increased hamstring injury risk. High lower-limb and high hamstring stiffness were associated with an elevated risk of hamstring injury. Since stiffness can be modulated through strength or flexibility training, this provides an area for future intervention studies. Low postural balance ability was related to a greater risk of ankle injury in ARF, players with poor balance should be targeted for balance training. There are preliminary data signifying a link between deficiencies in hip range of motion and hip adductor strength with groin pain or injury. This provides support for future investigation into the effectiveness of an intervention for high-risk players on groin injury rate. Low cross-sectional area of core-region muscle has been associated with more severe injuries and a motor control exercise intervention that increased core muscle size and function resulted in fewer games missed due to injury. A randomized controlled trial of the effectiveness of eccentric hamstring exercise in decreasing hamstring injury rate in ARF players was unsuccessful due to poor compliance from muscle soreness; a progressive eccentric training intervention for ARF should be given future consideration. Jump and landing training reduced injury risk in junior ARF players and it would be advisable to include this component as part of a neuromuscular training intervention. A multifaceted programme of sport-specific drills for hamstring flexibility while fatigued, sport skills that load the hamstrings and high-intensity interval training to mimic match playing conditions showed some success in reducing the incidence of hamstring injuries in ARF. A countermeasure designed to reduce injury risk is more likely to be adopted by coaches and players if it also has the scope to enhance performance. PMID:23529288

  10. Concentric Versus Enhanced Eccentric Hamstring Strength Training: Clinical Implications

    PubMed Central

    Kaminski, Thomas W.; Wabbersen, Chuck V.; Murphy, Robert M.

    1998-01-01

    Objective: Hamstring injuries can be quite debilitating and often result in chronic problems. Eccentric muscle actions are often the last line of defense against muscle injury and ligament disruption. Traditionally, the focus of hamstring strength rehabilitation has been on concentric muscle actions. The purpose of our study was to compare hamstring muscle strength gains in concentric and eccentric hamstring strength training. Design and Setting: A randomized-group design was used to examine differences in 1-repetition maximum (1 RM) and isokinetic strength values among 3 groups of subjects. Subjects were tested in a biomechanics laboratory using an isokinetic dynamometer, while training was carried out in a physical therapy outpatient clinic. Subjects: Twenty-seven healthy male subjects (age = 22.9 ± 3.1 years, wt = 81.8 ± 12.9 kg, ht = 178.6 ± 7.2 cm) participated in this study. Subjects were randomly assigned to 1 of 3 treatment groups: eccentric training, concentric training, or control. Measurements: Subjects performed hamstring curls using an isotonic weight training device. Pretest 1 RM weight values were determined for all subjects using a standardized 1 RM protocol. In addition, maximum concentric and eccentric isokinetic strength values for knee-flexion strength were determined. Control group subjects refrained from weight training for 6 weeks. Subjects in the training groups trained 2 days per week for 6 weeks (12 sessions). After 6 weeks of training, all subjects returned for 1RM and isokinetic posttesting. Results: The concentric group improved 19%, while the eccentric group improved 29%. The control group subjects did not show any significant change over the 6 weeks. In addition, there were improvements in eccentric isokinetic peak torque/ body weight ratios at both 60 °s and 180° from pretesting to posttesting in the eccentric training group only. Conclusions: Our results demonstrate the effectiveness of isotonic strength training on the development of hamstring muscle strength. More important is the dramatic effect of eccentric strength training on overall hamstring muscle strength, both isotonic and isokinetic. Clinicians should consider using eccentric hamstring strengthening as part of their rehabilitation protocols for hamstring and knee injuries. ImagesFigure 1. PMID:16558513

  11. The effects of isometric and isotonic training on hamstring stiffness and anterior cruciate ligament loading mechanisms.

    PubMed

    Blackburn, J Troy; Norcross, Marc F

    2014-02-01

    Greater hamstring musculotendinous stiffness is associated with lesser ACL loading mechanisms. Stiffness is enhanced via training, but previous investigations evaluated tendon rather than musculotendinous stiffness, and none involved the hamstrings. We evaluated the effects of isometric and isotonic training on hamstring stiffness and ACL loading mechanisms. Thirty-six healthy volunteers were randomly assigned to isometric, isotonic, and control groups. Isometric and isotonic groups completed 6 weeks of training designed to enhance hamstring stiffness. Stiffness, anterior tibial translation, and landing biomechanics were measured prior to and following the interventions. Hamstring stiffness increased significantly with isometric training (15.7%; p=0.006), but not in the isotonic (13.5%; p=0.089) or control (0.4%; p=0.942) groups. ACL loading mechanisms changed in manners consistent with lesser loading, but these changes were not statistically significant. These findings suggest that isometric training may be an important addition to ACL injury prevention programs. The lack of significant changes in ACL loading mechanisms and effects of isotonic training were likely due to the small sample sizes per group and limited intervention duration. Future research using larger sample sizes and longer interventions is necessary to determine the effects of enhancing hamstring stiffness on ACL loading and injury risk. PMID:24268874

  12. Quadriceps and Hamstrings Coactivation During Common Therapeutic Exercises

    PubMed Central

    Begalle, Rebecca L.; DiStefano, Lindsay J.; Blackburn, Troy; Padua, Darin A.

    2012-01-01

    Context Anterior tibial shear force and knee valgus moment increase anterior cruciate ligament (ACL) loading. Muscle coactivation of the quadriceps and hamstrings influences anterior tibial shear force and knee valgus moment, thus potentially influencing ACL loading and injury risk. Therefore, identifying exercises that facilitate balanced activation of the quadriceps and hamstrings might be beneficial in ACL injury rehabilitation and prevention. Objective To quantify and compare quadriceps with hamstrings coactivation electromyographic (EMG) ratios during commonly used closed kinetic chain exercises. Design Cross-sectional study. Setting Research laboratory. Patients or Other Participants Twenty-seven healthy, physically active volunteers (12 men, 15 women; age = 22.1 ± 3.1 years, height = 171.4 ± 10 cm, mass = 72.4 ± 16.7 kg). Intervention(s) Participants completed 9 separate closed chain therapeutic exercises in a randomized order. Main Outcome Measure(s) Surface electromyography quantified the activity level of the vastus medialis (VM), vastus lateralis (VL), medial hamstrings (MH), and biceps femoris (BF) muscles. The quadriceps-to-hamstrings (Q:H) coactivation ratio was computed as the sum of average quadriceps (VM, VL) EMG amplitude divided by the sum of average hamstrings (MH, BF) EMG amplitude for each trial. We used repeated-measures analyses of variance to compare Q:H ratios and individual muscle contributions across exercises (α = .05), then used post hoc Tukey analyses. Results We observed a main effect for exercise (F3,79 = 22.6, P < .001). The post hoc Tukey analyses revealed smaller Q:H ratios during the single-limb dead lift (2.87 ± 1.77) than the single-limb squat (5.52 ± 2.89) exercise. The largest Q:H ratios were observed during the transverse-lunge (7.78 ± 5.51, P < .001), lateral-lunge (9.30 ± 5.53, P < .001), and forward-lunge (9.70 ± 5.90, P < .001) exercises. Conclusions The most balanced (smallest) coactivation ratios were observed during the single-limb dead-lift, lateral-hop, transverse-hop, and lateral band-walk exercises. These exercises potentially could facilitate balanced activation in ACL rehabilitation and injury-prevention programs. They also could be used in postinjury rehabilitation programs in a safe and progressive manner. PMID:22889655

  13. Evaluation of Axonal Strain as a Predictor for Mild Traumatic Brain Injuries Using Finite Element Modeling.

    PubMed

    Giordano, Chiara; Kleiven, Svein

    2014-11-01

    Finite element (FE) models are often used to study the biomechanical effects of traumatic brain injury (TBI). Measures based on mechanical responses, such as principal strain or invariants of the strain tensor, are used as a metric to predict the risk of injury. However, the reliability of inferences drawn from these models depends on the correspondence between the mechanical measures and injury data, as well as the establishment of accurate thresholds of tissue injury. In the current study, a validated anisotropic FE model of the human head is used to evaluate the hypothesis that strain in the direction of fibers (axonal strain) is a better predictor of TBI than maximum principal strain (MPS), anisotropic equivalent strain (AESM) and cumulative strain damage measure (CSDM). An analysis of head kinematics-based metrics, such as head injury criterion (HIC) and brain injury criterion (BrIC), is also provided. Logistic regression analysis is employed to compare binary injury data (concussion/no concussion) with continuous strain/kinematics data. The threshold corresponding to 50% of injury probability is determined for each parameter. The predictive power (area under the ROC curve, AUC) is calculated from receiver operating characteristic (ROC) curve analysis. The measure with the highest AUC is considered to be the best predictor of mTBI. Logistic regression shows a statistical correlation between all the mechanical predictors and injury data for different regions of the brain. Peaks of axonal strain have the highest AUC and determine a strain threshold of 0.07 for corpus callosum and 0.15 for the brainstem, in agreement with previously experimentally derived injury thresholds for reversible axonal injury. For a data set of mild TBI from the national football league, the strain in the axonal direction is found to be a better injury predictor than MPS, AESM, CSDM, BrIC and HIC. PMID:26192949

  14. Elastography Study of Hamstring Behaviors during Passive Stretching

    PubMed Central

    Le Sant, Guillaume; Ates, Filiz; Brasseur, Jean-Louis; Nordez, Antoine

    2015-01-01

    Introduction The mechanical properties of hamstring muscles are usually inferred from global passive torque/angle relationships, in combination with adjoining tissues crossing the joint investigated. Shear modulus measurement provides an estimate of changes in muscle-tendon stiffness and passive tension. This study aimed to assess the passive individual behavior of each hamstring muscle in different stretching positions using shear wave elastography. Methods/Results The muscle shear modulus of each hamstring muscle was measured during a standardized slow passive knee extension (PKE, 80% of maximal range of motion) on eighteen healthy male volunteers. Firstly, we assessed the reliability of the measurements. Results were good for semitendinosus (ST, CV: 8.9%-13.4%), semimembranosus (SM, CV: 10.3%-11.2%) and biceps femoris long-head (BF-lh, CV: 8.6%-13.3%), but not for biceps femoris short-head (BF-sh, CV: 20.3%-44.9%). Secondly, we investigated each reliable muscle in three stretch positions: 70°, 90° and 110° of hip flexion. The results showed different values of shear modulus for the same amount of perceived stretch, with the highest measurements in the high-flexed hip situation. Moreover, individual muscles displayed different values, with values increasing or BF-lh, SM and ST, respectively. The inter-subject variability was 35.3% for ST, 27.4% for SM and 30.2% for BF-lh. Conclusion This study showed that the hip needs to be high-flexed to efficiently tension the hamstrings, and reports a higher muscle-tendon stress tolerance at 110° of hip angle. In addition muscles have different passive behaviors, and future works will clarify if it can be linked with rate of injury. PMID:26418862

  15. Effects of hamstring-emphasized neuromuscular training on strength and sprinting mechanics in football players.

    PubMed

    Mendiguchia, J; Martinez-Ruiz, E; Morin, J B; Samozino, P; Edouard, P; Alcaraz, P E; Esparza-Ros, F; Mendez-Villanueva, A

    2015-12-01

    The objective of this study was to examine the effects of a neuromuscular training program combining eccentric hamstring muscle strength, plyometrics, and free/resisted sprinting exercises on knee extensor/flexor muscle strength, sprinting performance, and horizontal mechanical properties of sprint running in football (soccer) players. Sixty footballers were randomly assigned to an experimental group (EG) or a control group (CG). Twenty-seven players completed the EG and 24 players the CG. Both groups performed regular football training while the EG performed also a neuromuscular training during a 7-week period. The EG showed a small increases in concentric quadriceps strength (ES = 0.38/0.58), a moderate to large increase in concentric (ES = 0.70/0.74) and eccentric (ES = 0.66/0.87) hamstring strength, and a small improvement in 5-m sprint performance (ES = 0.32). By contrast, the CG presented lower magnitude changes in quadriceps (ES = 0.04/0.29) and hamstring (ES = 0.27/0.34) concentric muscle strength and no changes in hamstring eccentric muscle strength (ES = -0.02/0.11). Thus, in contrast to the CG (ES = -0.27/0.14), the EG showed an almost certain increase in the hamstring/quadriceps strength functional ratio (ES = 0.32/0.75). Moreover, the CG showed small magnitude impairments in sprinting performance (ES = -0.35/-0.11). Horizontal mechanical properties of sprint running remained typically unchanged in both groups. These results indicate that a neuromuscular training program can induce positive hamstring strength and maintain sprinting performance, which might help in preventing hamstring strains in football players. PMID:25556888

  16. Acute Lower Extremity Running Kinematics After a Hamstring Stretch

    PubMed Central

    Davis Hammonds, Autumn L.; Laudner, Kevin G.; McCaw, Steve; McLoda, Todd A.

    2012-01-01

    Context: Limited passive hamstring flexibility might affect kinematics, performance, and injury risk during running. Pre-activity static straight-leg raise stretching often is used to gain passive hamstring flexibility. Objective: To investigate the acute effects of a single session of passive hamstring stretching on pelvic, hip, and knee kinematics during the swing phase of running. Design: Randomized controlled clinical trial. Setting: Biomechanics research laboratory. Patients or Other Participants: Thirty-four male (age = 21.2 1.4 years) and female (age = 21.32.0 years) recreational athletes. Intervention(s): Participants performed treadmill running pretests and posttests at 70% of their age-predicted maximum heart rate. Pelvis, hip, and knee joint angles during the swing phase of 5 consecutive gait cycles were collected using a motion analysis system. Right and left hamstrings of the intervention group participants were passively stretched 3 times for 30 seconds in random order immediately after the pretest. Control group participants performed no stretching or movement between running sessions. Main Outcome Measure(s): Six 2-way analyses of variance to determine joint angle differences between groups at maximum hip flexion and maximum knee extension with an ? level of .008. Results: Flexibility increased between pretest and post-test in all participants (F1,30 = 80.61, P<.001). Anterior pelvic tilt (F1,30 = 0.73, P=.40), hip flexion (F1,30 = 2.44, P=.13), and knee extension (F1,30 = 0.06, P=.80) at maximum hip flexion were similar between groups throughout testing. Anterior pelvic tilt (F1,30 = 0.69, P=.41), hip flexion (F1,30 = 0.23, P=.64), and knee extension (F1,30 = 3.38, P=.62) at maximum knee extension were similar between groups throughout testing. Men demonstrated greater anterior pelvic tilt than women at maximum knee extension (F1,30 = 13.62, P=.001). Conclusions: A single session of 3 straight-leg raise hamstring stretches did not change pelvis, hip, or knee running kinematics. PMID:22488225

  17. Patterns of Hamstring Muscle Tears in the General Population: A Systematic Review

    PubMed Central

    Kuske, Barbara; Hamilton, David F.; Pattle, Sam B.; Simpson, A. Hamish R. W.

    2016-01-01

    Background Hamstring tears are well recognised in the sporting population. Little is known about these injuries in the general population. Purpose Evaluating the rates, patterns and risk factors of non-sporting hamstring tears, compared to sporting related hamstring tears. Data Sources MEDLINE, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials (1989–2015). Study Selection Studies reporting patients with a grade 2 or 3 hamstring muscle tear, identified clinically, confirmed by MRI imaging or direct visualisation during surgical exploration. Data Synthesis 144 sets of linked data were extracted for analysis. Most injuries were in males (81.3%), where mean age at injury was lower (30.2, 95% CI 29.1–31.3) than in females (35.4, 95% CI 32.4–38.4) p = 0.06. Key differences were found in the proportion of non-sporting injuries in patients under and over the age 40 (p = 0.001). The proportion of non-sporting injuries was significantly higher in females compared to males (25.9% female non-sporting injuries, versus 8.5% male; p = 0.02). Avulsions were more frequently reported in non-sporting activities (70.5%). The proportion of such injuries was notably higher in females, though this failed to meet significance (p = 0.124). Grouped by age category a bimodal distribution was noted, with the proportion of avulsions greater in younger (age <15) and older patients (age > 40) (p = 0.008). 86.8% of patients returned to pre-injury activity levels with a similar frequency across all study variables; age, activity (sporting vs non-sporting) and injury type (avulsion vs tear). Conclusion This review highlights a proportion of adults suffering grade 2 or 3 hamstring injuries from activities other than the classic sports trauma. The majority of these non-sporting injuries were avulsion injuries that clustered in older female and skeletally immature patients suggesting a potential link to bone mineral density. PMID:27144648

  18. Expert opinion: diagnosis and treatment of proximal hamstring tendinopathy

    PubMed Central

    Lempainen, Lasse; Johansson, Kristian; Banke, Ingo J.; Ranne, Juha; Mäkelä, Keijo; Sarimo, Janne; Niemi, Pekka; Orava, Sakari

    2015-01-01

    Summary Background: proximal hamstring tendinopathy (PHT) is a disabilitating disease often causing underperformance in the athletically demanding patients. The main symptom of PHT is lower gluteal pain especially during running or while prolonged sitting. Mainly affecting athletically active individuals, PHT is a considerable challenge for treating health care professionals. Purpose: this paper aims to concisely present the literature on PHT to guide health care professionals treating these patients and doing research on the subject. Methods: we reviewed the literature on PHT through literature search of scientific journal databases. Conclusions: as a tendinopathic pathology, it is a rather recently discovered exertion injury. As with other chronic tendon overuse injuries, current treatment strategies are unspecific with uncertain outcomes due to the unknown etiology of the tendon degeneration. Diagnostic features as well as both operative and non-operative treatments are evaluated from a clinical perspective, providing up to date information for clinicians and sports medicine therapists dealing with hamstring problems. Level of evidence: V. PMID:25878983

  19. Surgical treatment of partial tears of the proximal origin of the hamstring muscles

    PubMed Central

    Lempainen, L; Sarimo, J; Heikkilä, J; Mattila, K; Orava, S

    2006-01-01

    Background Hamstring injuries are common especially in athletes. Partial and complete tears of the proximal origin may cause pain and functional loss. Objective To evaluate the results of surgical treatment for partial proximal hamstring tears. Methods Between 1994 and 2005, 47 athletes (48 cases, 1 bilateral) with partial proximal hamstring tears were operated on. The cases were retrospectively analysed. Before surgery, 42 of the patients had undergone conservative treatment with unsatisfactory results, whereas in five patients the operation was performed within four weeks of the injury. Results The mean length of the follow up was 36 months (range 6–72). The result of the operation was rated excellent in 33 cases, good in nine, fair in four, and poor in two. Forty one patients were able to return to their former level of sport after an average of five months (range 1–12). Conclusion In most cases, excellent or good results can be expected after surgical repair of partial proximal hamstring tears even after conservative treatment has failed. PMID:16790482

  20. Too Much of a Good Thing: Prevention of Computer-Related Repetitive Strain Injuries among Children.

    ERIC Educational Resources Information Center

    Linden, Paul

    1998-01-01

    Examines computer use and repetitive strain injury (RSI) among children and young adults, emphasizing body-awareness training that teaches people to notice and feel body components; understand principles of relaxation, balance, and movement efficiency; and use economical and strain-free ways of accomplishing movements. Outlines elements of safety…

  1. Too Much of a Good Thing: Prevention of Computer-Related Repetitive Strain Injuries among Children.

    ERIC Educational Resources Information Center

    Linden, Paul

    1998-01-01

    Examines computer use and repetitive strain injury (RSI) among children and young adults, emphasizing body-awareness training that teaches people to notice and feel body components; understand principles of relaxation, balance, and movement efficiency; and use economical and strain-free ways of accomplishing movements. Outlines elements of safety

  2. Predictors of Work-Related Repetitive Strain Injuries in a Population Cohort

    PubMed Central

    Cole, Donald C.; Ibrahim, Selahadin; Shannon, Harry S.

    2005-01-01

    Objectives. We assessed predictors of work-related repetitive strain injuries using data from 4 waves of the Canadian National Population Health Survey. Methods. Participants were 2806 working adults who completed an abbreviated version of the Job Content Questionnaire in 1994–1995 and did not experience repetitive strain injuries prior to 2000–2001. Potential previous wave predictors of work-related repetitive strain injuries were modeled via multivariate logistic regression. Results. Female gender (odds ratio [OR] = 1.98; 95% confidence interval [CI]=1.24, 3.18), some college or university education (OR=1.98; 95% CI=1.06, 3.70), job insecurity (OR=1.76; 95% CI=1.07, 2.91), high physical exertion levels (OR = 2.00; 95% CI = 1.29, 3.12), and high levels of psychological demands (OR = 1.61; 95% CI = 1.02, 2.52) were all positively associated with work-related repetitive strain injuries, whereas working less than 30 hours per week exhibited a negative association with such injuries (OR=0.2; 95% CI=0.1, 0.7). Conclusions. Modifiable job characteristics are important predictors of work-related repetitive strain injuries. PMID:15933237

  3. Strain-related differences after experimental traumatic brain injury in rats.

    PubMed

    Reid, Wendy Murdock; Rolfe, Andrew; Register, David; Levasseur, Joseph E; Churn, Severn B; Sun, Dong

    2010-07-01

    The present study directly compares the effects of experimental brain injury in two commonly used rat strains: Fisher 344 and Sprague-Dawley. We previously found that Fisher rats have a higher mortality rate and more frequent seizure attacks at the same injury level than Sprague-Dawley rats. Although strain differences in rats are commonly accepted as contributing to variability among studies, there is a paucity of literature addressing strain influence in experimental neurotrauma. Therefore this study compares outcome measures in two rat strains following lateral fluid percussion injury. Fisher 344 and Sprague-Dawley rats were monitored for changes in physiological measurements, intracranial pressure, and electroencephalographic activity. We further analyzed neuronal degeneration and cell death in the injured brain using Fluoro-Jade-B (FJB) histochemistry and caspase-3 immunostaining. Behavioral studies using the beam walk and Morris water maze were conducted to characterize strain differences in both motor and cognitive functional recovery following injury. We found that Fisher rats had significantly higher intracranial pressure, prolonged seizure activity, increased FJB-positive staining in the injured cortex and thalamus, and increased caspase-3 expression than Sprague-Dawley rats. On average, Fisher rats displayed a greater amount of total recording time in seizure activity and had longer ictal durations. The Fisher rats also had increased motor deficits, correlating with the above results. In spite of these results, Fisher rats performed better on cognitive tests following injury. The results demonstrate that different rat strains respond to injury differently, and thus in preclinical neurotrauma studies strain influence is an important consideration when evaluating outcomes. PMID:20392137

  4. Strain-Related Differences after Experimental Traumatic Brain Injury in Rats

    PubMed Central

    Rolfe, Andrew; Register, David; Levasseur, Joseph E.; Churn, Severn B.; Sun, Dong

    2010-01-01

    Abstract The present study directly compares the effects of experimental brain injury in two commonly used rat strains: Fisher 344 and Sprague-Dawley. We previously found that Fisher rats have a higher mortality rate and more frequent seizure attacks at the same injury level than Sprague-Dawley rats. Although strain differences in rats are commonly accepted as contributing to variability among studies, there is a paucity of literature addressing strain influence in experimental neurotrauma. Therefore this study compares outcome measures in two rat strains following lateral fluid percussion injury. Fisher 344 and Sprague-Dawley rats were monitored for changes in physiological measurements, intracranial pressure, and electroencephalographic activity. We further analyzed neuronal degeneration and cell death in the injured brain using Fluoro-Jade-B (FJB) histochemistry and caspase-3 immunostaining. Behavioral studies using the beam walk and Morris water maze were conducted to characterize strain differences in both motor and cognitive functional recovery following injury. We found that Fisher rats had significantly higher intracranial pressure, prolonged seizure activity, increased FJB-positive staining in the injured cortex and thalamus, and increased caspase-3 expression than Sprague-Dawley rats. On average, Fisher rats displayed a greater amount of total recording time in seizure activity and had longer ictal durations. The Fisher rats also had increased motor deficits, correlating with the above results. In spite of these results, Fisher rats performed better on cognitive tests following injury. The results demonstrate that different rat strains respond to injury differently, and thus in preclinical neurotrauma studies strain influence is an important consideration when evaluating outcomes. PMID:20392137

  5. The Effect of Hamstring Muscle Tightness on Knee Joint Proprioceptive Sense

    PubMed Central

    Tamer, Seval; Yakut, Yavuz; Can, Filiz; Ülger, Özlem

    2014-01-01

    Objectives: Hamstring muscle tightness is a major musculoskeletal problem that predisposes the knee to injury . Proprioception sense is an important factor for injuries and we have not found any studies on the effect of hamstring muscle tightness on knee joint proprioceptive . Therefore, the aim of this study was to determine the effect of hamstring muscle tightness on knee joint proprioceptive sense. Methods: 61 healthy individuals, without any orthopedic or neurological symptoms that affect the knee joint proprioception sense, were included in this study. Individuals' socio-demographic data were recorded. Hamstring muscle tightness was measured with active knee extension (ACE) method by using goniometer. Individuals with hamstring muscle tightness (ACE over of 20 °) was Group 1 and individuals without tightness (ACE 20 ° and under) was Group 2. Proprioceptive component of joint position sense and kinaesthesia was evaluated for the sense of proprioception. Prosport 1000 PMS (Tümer Machine Ankara, Turkey) instrument was used and visual, auditory, tactile, sensory input have been eliminated. Passive placement method and 20 and 40 degrees of knee flexion target angles was used for measurement. For joint position sense target angle predict degree, for kinesthesia perceive movement sense degree was recorded. Instrument moved 10 degrees/sec for joint position sense and 0.4 degrees/sec for kinesthesia. All measurements were repeated three times for dominant and non-dominant side. SPSS version 21 was used for statistical analysis and p values of 0.05 and less were considered evidence of statistically significant findings. Mann-Whitney U rank test was used to compare findings of two groups. Results: Individuals’ socio-demographic data were similar (p> 0.05). No difference was found between the groups’ dominant and non-dominant sides’ AKE values (p> 0.05). Similarly for dominant and non-dominant side kinaesthesia values in 20 °and 40°, joint position sense values in 20 ° and 40 ° did not show statistically significant differences between the groups (p> 0.05). Conclusion: This study showed that hamstring muscle tightness was not effective on knee joint kinesthesia and joint position sense for both dominant and non-dominant side. This result indicates that joint position and kinesthesia were not effective enough to show the effect of hamstring muscle tightness on knee joint proprioception, so other proprioceptive components like muscle strength, range of motion, strength and agility could be considered.

  6. Acute effects of static and dynamic stretching on hamstring eccentric isokinetic strength and unilateral hamstring to quadriceps strength ratios.

    PubMed

    Ayala, Francisco; De Ste Croix, Mark; Sainz De Baranda, Pilar; Santonja, Fernando

    2013-01-01

    The main purposes of this study were to investigate the acute effects of static and dynamic lower limb stretching routines: (a) on peak torque, total external work and joint angle at peak torque of the hamstrings during maximal eccentric isokinetic leg flexion; (b) on unilateral hamstring to quadriceps (H/Q) strength ratios; as well as (c) to determine whether static and dynamic routines elicit similar responses. A total of 49 active adults completed the following intervention protocols in a randomised order on separate days: (a) non-stretching (control condition), (b) static stretching, and (c) dynamic stretching. After the stretching or control intervention, eccentric isokinetic peak torque, the angle of peak torque and total external work were assessed with participants prone at 1.04 and 3.14 rad · s(-1). Unilateral strength ratios of the knee were also recorded. Measures were compared via a fully-within-groups factorial analysis of variance (ANOVA). There were no main effects for eccentric isokinetic peak torque, angle of peak torque, total external work and unilateral H/Q strength ratios. The results suggest that dynamic and static stretching has no influence on eccentric strength profile and unilateral H/Q strength ratios and hence both forms of stretching do not reduce these two primary risk factors for muscle injury. PMID:23230900

  7. Injury in the National Basketball Association

    PubMed Central

    Drakos, Mark C.; Domb, Benjamin; Starkey, Chad; Callahan, Lisa; Allen, Answorth A.

    2010-01-01

    Background: Injury patterns in elite athletes over long periods continue to evolve. The goal of this study was to review of the injuries and medical conditions afflicting athletes competing in the National Basketball Association (NBA) over a 17-year period. Design: Descriptive epidemiological study. Methods: Injuries and player demographic information were reported by each team’s athletic trainer. Criteria for reportable injuries were those that resulted in (1) physician referral, (2) a practice or game being missed, or (3) emergency care. The demographics, frequency of injury, time lost, and game exposures were tabulated, and game-related injury rates and 95% confidence intervals were calculated. Results: A total of 1094 players appeared in the database 3843 times (3.3 ± 2.6 seasons). Lateral ankle sprains were the most frequent orthopaedic injury (n, 1658; 13.2%), followed by patellofemoral inflammation (n, 1493; 11.9%), lumbar strains (n, 999; 7.9%), and hamstring strains (n, 413; 3.3%). The most games missed were related to patellofemoral inflammation (n, 10 370; 17.5%), lateral ankle sprains (n, 5223; 8.8%), knee sprains (n, 4369; 7.4%), and lumbar strains (n, 3933; 6.6%). No correlations were found between injury rate and player demographics, including age, height, weight, and NBA experience. Conclusion: Professional athletes in the NBA experience a high rate of game-related injuries. Patellofemoral inflammation is the most significant problem in terms of days lost in competition, whereas ankle sprains are the most common injury. True ligamentous injuries of the knee were surprisingly rare. Importantly, player demographics were not correlated with injury rates. Further investigation is necessary regarding the consequences and sport-specific treatment of various injuries in NBA players. Clinical Relevance: Knowledge of these injury patterns can help to guide treatments and provide more accurate guidelines for an athlete to return to play. PMID:23015949

  8. High-strain-rate brain injury model using submerged acute rat brain tissue slices.

    PubMed

    Sarntinoranont, Malisa; Lee, Sung J; Hong, Yu; King, Michael A; Subhash, Ghatu; Kwon, Jiwoon; Moore, David F

    2012-01-20

    Blast-induced traumatic brain injury (bTBI) has received increasing attention in recent years due to ongoing military operations in Iraq and Afghanistan. Sudden impacts or explosive blasts generate stress and pressure waves that propagate at high velocities and affect sensitive neurological tissues. The immediate soft tissue response to these stress waves is difficult to assess using current in vivo imaging technologies. However, these stress waves and resultant stretching and shearing of tissue within the nano- to microsecond time scale of blast and impact are likely to cause initial injury. To visualize the effects of stress wave loading, we have developed a new ex vivo model in which living tissue slices from rat brain, attached to a ballistic gelatin substrate, were subjected to high-strain-rate loads using a polymer split Hopkinson pressure bar (PSHPB) with real-time high-speed imaging. In this study, average peak fluid pressure within the test chamber reached a value of 1584±63.3 psi. Cavitation due to a trailing underpressure wave was also observed. Time-resolved images of tissue deformation were collected and large maximum eigenstrains (0.03-0.42), minimum eigenstrains (-0.33 to -0.03), maximum shear strains (0.09-0.45), and strain rates (8.4×10³/sec) were estimated using digital image correlation (DIC). Injury at 4 and 6 h was quantified using Fluoro-Jade C. Neuronal injury due to PSHPB testing was found to be significantly greater than injury associated with the tissue slice paradigm alone. While large pressures and strains were encountered for these tests, this system provides a controllable test environment to study injury to submerged brain slices over a range of strain rate, pressure, and strain loads. PMID:21970544

  9. DISEASE-SPECIFIC SUSCEPTIBILITY TO ACUTE OZONE-INDUCED INJURY AND INFLAMMATION IN EIGHT RAT STRAINS

    EPA Science Inventory

    Susceptibility to environmental pollutant-induced injuries may be influenced by presence of disease and genetic make-up. To identify disease-specific susceptibility phenotype, we used eight rat strains with or without genetic cardiovascular disease. Male 12-15 wk old Sprague Dawl...

  10. Gender-based analysis of hamstring and quadriceps muscle activation during jump landings and cutting.

    PubMed

    Ebben, William P; Fauth, McKenzie L; Petushek, Erich J; Garceau, Luke R; Hsu, Brittni E; Lutsch, Brittney N; Feldmann, Christina R

    2010-02-01

    This study evaluated gender differences in the magnitude and timing of hamstring and quadriceps activation during activities that are believed to cause anterior cruciate ligament (ACL) injuries. Twelve men (age = 21.0 +/- 1.2 years; body mass = 81.61 +/- 13.3 kg; and jump height = 57.61 +/- 10.15 cm) and 12 women (age = 19.91 +/- 0.9 years; body mass = 64.36 +/- 6.14 kg; and jump height = 43.28 +/- 7.5) performed 3 repetitions each of the drop jump (jump) normalized to the subject's vertical jump height, and a sprint and cut at a 45-degree angle (cut). Electromyography (EMG) was used to quantify rectus femoris (RF), vastus lateralis (VL), vastus medialis (VM), lateral hamstring (LH), and medial hamstrings (MH) activation, timing, activation ratios, and timing ratios before and after foot contact for the jump and cut and normalized to each subject's hamstring and quadriceps maximum voluntary isometric contraction. Data were analyzed using an analysis of variance with results demonstrating that during the postcontact phase of the cut, men demonstrated greater LH and MH activation than women. In the precontact phase of the jump, men showed earlier activation of the VL and VM, than women. Women produced longer RF and VM muscle bursts during the postcontact phase of the cut. Additionally, men showed a trend toward higher hamstring to quadriceps activation ratio than women for the postcontact phase of the cut. This study provides evidence that men are LH dominant during the postcontact phase of the cut compared with women, whereas women sustain RF activation longer than men during this phase. Men activate quadriceps muscles earlier than women in the precontact phase of the jump. Training interventions may offer the potential for increasing the rate and magnitude of hamstring muscle activation. These outcomes should be evaluated using EMG during movements that are similar to those that cause ACL injuries to determine if gender differences in muscle activation can be reduced. PMID:20124793

  11. Sprains and Strains

    MedlinePlus

    ... happens. A strain is a stretched or torn muscle or tendon. Tendons are tissues that connect muscle to bone. Twisting or pulling these tissues can ... suddenly or develop over time. Back and hamstring muscle strains are common. Many people get strains playing ...

  12. The 5-strand hamstring graft in anterior cruciate ligament reconstruction.

    PubMed

    Lee, Rushyuan Jay; Ganley, Theodore J

    2014-10-01

    The use of anterior cruciate ligament reconstruction in the pediatric and adolescent population has been increasing in recent years. Autograft hamstring graft is favored in this population, but these patients often have smaller hamstring tendons that yield smaller final graft constructs. These smaller grafts are associated with an increased need for revision surgery. We describe a technique for obtaining a larger-diameter anterior cruciate ligament graft construct from autologous hamstring graft without allograft supplementation. PMID:25473619

  13. Nodal versus Total Axonal Strain and the Role of Cholesterol in Traumatic Brain Injury.

    PubMed

    Zhu, Feng; Gatti, Domenico L; Yang, King H

    2016-05-01

    Traumatic brain injury (TBI) is a health threat that affects every year millions of people involved in motor vehicle and sporting accidents, and thousands of soldiers in battlefields. Diffuse axonal injury (DAI) is one of the most frequent types of TBI leading to death. In DAI, the initial traumatic event is followed by a cascade of biochemical changes that take time to develop in full, so that symptoms may not become apparent until days or weeks after the original injury. Hence, DAI is a dynamic process, and the opportunity exists to prevent its progression provided the initial trauma can be predicted at the molecular level. Here, we present preliminary evidence from micro-finite element (FE) simulations that the mechanical response of central nervous system myelinated fibers is dependent on the axonal diameter, the ratio between axon diameter and fiber diameter (g-ratio), the microtubules density, and the cholesterol concentration in the axolemma and myelin. A key outcome of the simulations is that there is a significant difference between the overall level of strain in a given axonal segment and the level of local strain in the Ranvier nodes contained in that segment, with the nodal strain being much larger than the total strain. We suggest that the acquisition of this geometric and biochemical information by means of already available high resolution magnetic resonance imaging techniques, and its incorporation in current FE models of the brain will enhance the models capacity to predict the site and magnitude of primary axonal damage upon TBI. PMID:26393780

  14. Snapping Knee Syndrome of the Medial Hamstrings.

    PubMed

    Protzman, Nicole M; Conkle, Sean B; Busch, Michael F

    2015-10-01

    Snapping of the medial hamstrings is a rare condition, with few cases reported throughout the literature. The snapping sensation reportedly occurs when a hamstring tendon passes over the medial tibial condyle, a muscle belly, or another tendon. The semitendinosus tendon is frequently involved, but concomitant involvement of the semitendinosus and gracilis tendons has also been described. Although the exact etiology remains unclear, authors have theorized that the condition results from a congenital malformation or degradation of the accessory tendinous expansions of the semitendinosus. Whereas most cases resolve with conservative treatments, select cases require surgical intervention. Both the distal surgical release and tendon harvest have proved viable surgical procedures, achieving symptom alleviation with minimal patient morbidity. In this article, a case of medial snapping hamstring tendons involving both the semitendinosus and gracilis tendons is reviewed. A 17-year-old African American girl presented with extreme pain and snapping on the posteromedial aspect of her knee was appreciated. Radiographs were ordered and showed no acute fracture, no acute dislocation, normal medial joint space, normal lateral joint space, and normal patellofemoral space. Conservative and surgical options were reviewed, and the patient elected to undergo harvest of the tendons. Four weeks postoperatively, the patient reported complete resolution of symptoms. To date, there has been no recurrence of symptoms. The authors hope to increase awareness of this condition and add to the existing body of literature. PMID:26488792

  15. Diagnosis and treatment of hind limb muscle strain injuries in 22 dogs.

    PubMed

    Nielsen, C; Pluhar, G E

    2005-01-01

    The anamnesis was obtained from the medical records of 22 dogs diagnosed with hind limb muscle strain injury over a four-year period. The signalment, history, diagnostic imaging and clinical findings, treatment and outcome are described. The affected dogs were primarily from large breeds. Although only a few clients reported a specific injury, 11 dogs were admitted for an acute onset of lameness of unknown origin. The hip adductor muscles were affected in 21 dogs, and 11 dogs had previously undergone orthopaedic surgery of the affected limb. The dogs were primarily diagnosed by physical examination, although the diagnosis was confirmed with ultrasound imaging in the two most recent cases. Neither concurrent orthopoedic nor neurological disease was found during the study period in four of 22 dogs, and another three dogs had only mild radiographic coxofemoral osteoarthritis that did not cause any clinical signs during the study period. All of the dogs were treated medically with some combination of rest, physical therapy, methocarbamol, and a non-steroidol anti-inflammatory drug (NSAID). The injury-associated lameness improved, or completely resolved, with conservative, non-surgical therapy in most dogs. Of the 15 dogs available for follow-up (mean 577 days), eight had complete resolution of their clinical signs, two showed significant improvement, and one showed some improvement. Muscle strain injury may be an under-diagnosed cause or contributor to acute hind limb lameness in large breed dogs, either alone or following orthopoedic surgery. PMID:16594394

  16. Acute effects of static and dynamic stretching on hamstrings' response times.

    PubMed

    Ayala, Francisco; De Ste Croix, Mark; Sainz de Baranda, Pilar; Santonja, Fernando

    2014-01-01

    The main purposes of this study were to (a) investigate acute effects of static and dynamic lower limb stretching routines on total response time, pre-motor time and motor time of the medial and lateral hamstrings during maximal eccentric isokinetic knee flexion; and (b) determine whether static and dynamic routines elicit similar responses. A total of 38 active adults completed the following intervention protocols in a randomised order on separate days: (a) non-stretching (control condition), (b) static stretching and (c) dynamic stretching. After the stretching or control intervention, total response time, pre-motor time and motor time of the medial and lateral hamstrings were assessed during eccentric knee flexion movements with participants prone. Measures were compared via a mixed-design factorial ANOVA. There were no main effects for total response time, pre-motor time and motor time. The results suggest that dynamic and static stretching has no influence on hamstrings response times (total response time, pre-motor time and motor time) and hence neither form of stretching reduces this primary risk factor for anterior cruciate ligament injury. PMID:24405028

  17. Association of Nrf2 Polymorphism Haplotypes with Acute Lung Injury Phenotypes in Inbred Strains of Mice

    PubMed Central

    Jedlicka, Anne E.; Gladwell, Wesley; Marzec, Jacqui; McCaw, Zackary R.; Bienstock, Rachelle J.; Kleeberger, Steven R.

    2015-01-01

    Abstract Aims: Nrf2 is a master transcription factor for antioxidant response element (ARE)-mediated cytoprotective gene induction. A protective role for pulmonary Nrf2 was determined in model oxidative disorders, including hyperoxia-induced acute lung injury (ALI). To obtain additional insights into the function and genetic regulation of Nrf2, we assessed functional single nucleotide polymorphisms (SNPs) of Nrf2 in inbred mouse strains and tested whether sequence variation is associated with hyperoxia susceptibility. Results: Nrf2 SNPs were compiled from publicly available databases and by re-sequencing DNA from inbred strains. Hierarchical clustering of Nrf2 SNPs categorized the strains into three major haplotypes. Hyperoxia susceptibility was greater in haplotypes 2 and 3 strains than in haplotype 1 strains. A promoter SNP −103 T/C adding an Sp1 binding site in haplotype 2 diminished promoter activation basally and under hyperoxia. Haplotype 3 mice bearing nonsynonymous coding SNPs located in (1862 A/T, His543Gln) and adjacent to (1417 T/C, Thr395Ile) the Neh1 domain showed suppressed nuclear transactivation of pulmonary Nrf2 relative to other strains, and overexpression of haplotype 3 Nrf2 showed lower ARE responsiveness than overexpression of haplotype 1 Nrf2 in airway cells. Importantly, we found a significant correlation of Nrf2 haplotypes and hyperoxic lung injury phenotypes. Innovation and Conclusion: The results indicate significant influence of Nrf2 polymorphisms and haplotypes on gene function and hyperoxia susceptibility. Our findings further support Nrf2 as a genetic determinant in ALI pathogenesis and provide useful tools for investigators who use mouse strains classified by Nrf2 haplotypes to elucidate the role for Nrf2 in oxidative disorders. Antioxid. Redox Signal. 22, 325–338. PMID:25268541

  18. Angle-specific hamstring-to-quadriceps ratio: a comparison of football players and recreationally active males.

    PubMed

    Evangelidis, Pavlos Eleftherios; Pain, Matthew Thomas Gerard; Folland, Jonathan

    2015-01-01

    It is currently unclear how football participation affects knee-joint muscle balance, which is widely considered a risk factor for hamstrings injury. This study compared the angle-specific functional hamstring-to-quadriceps (H:Q) ratio (hamstrings eccentric torque as a ratio of quadriceps concentric torque at the same knee-joint angle) of football players with recreationally active controls. Ten male footballers and 14 controls performed maximal voluntary isometric and isovelocity concentric and eccentric contractions (60, 240 and 400° s(-1)) of the knee extensors and flexors. Gaussian fitting to the raw torque values was used to interpolate torque values for knee-joint angles of 100-160° (60° s(-1)), 105-160° (240° s(-1)) and 115-145° (400° s(-1)). The angle-specific functional H:Q ratio was calculated from the knee flexors eccentric and knee extensors concentric torque at the same velocity and angle. No differences were found for the angle-specific functional H:Q ratio between groups, at any velocity. Quadriceps and hamstrings strength relative to body mass of footballers and controls was similar for all velocities, except concentric knee flexor strength at 400° s(-1) (footballers +40%; P < 0.01). In previously uninjured football players, there was no intrinsic muscle imbalance and therefore the high rate of hamstring injuries seen in this sport may be due to other risk factors and/or simply regular exposure to a high-risk activity. PMID:25073098

  19. Comparison of hamstring and gluteus muscles electromyographic activity while performing the razor curl vs. the traditional prone hamstring curl.

    PubMed

    Oliver, Gretchen D; Dougherty, Christopher P

    2009-11-01

    This study examined the muscle activation of the razor curl functional hamstring exercise (the razor curl has the total body extended and then requires the hips and knees to flex to 90 degrees simultaneously with full contraction of the hamstrings to further the knee flexion) to the traditional prone hamstring curl. Eight healthy, female intercollegiate athletes participated (mean age 20.8 +/- 3.9 y; mean height, 177.8 +/- 10.9 cm; mean weight, 67.3 +/- 9.9 kg). Electromyographic (EMG) data were collected on the following muscles: medial hamstring (semimembranosus and semitendinosus), biceps femoris, gluteus medius, and gluteus maximus while participants performed the 2 exercises: razor curl and the traditional prone curl. Results revealed no significant differences between muscle activations during the 2 exercises (p hamstring curl does, indeed, target the musculature of the hamstrings. However, it has been shown here that the more functional position of the razor curl does, indeed, achieve activation of not only the hamstring muscle group but also the gluteus medius and maximus. Both the traditional prone hamstring and the razor curl allow for hamstring and gluteals activation. However, if one wants to fully train the hamstrings functionally, one should focus on the razor curl. Due to its functionality, the razor curl is designed to increase hamstring contractibility by placing the hip into flexion. The razor curl is easily implemented on a back extension machine, where first one should focus on the form and then on functional speed. PMID:19826301

  20. Empirical Assessment of Dynamic Hamstring Function during Human Walking

    PubMed Central

    Thelen, Darryl G.; Lenz, Amy L.; Francis, Carrie; Lenhart, Rachel; Hernández, Antonio

    2013-01-01

    The hamstrings are often associated with the development of crouch gait, a fatiguing form of walking characterized by excessive hip flexion, knee flexion and ankle dorsiflexion during stance. However, recent studies have called into question whether abnormally active hamstrings induce the limb to move into a crouch posture. The purpose of this study was to directly measure the influence of the hamstrings on limb posture during stance. Nineteen healthy young adults walked on an instrumented treadmill at their preferred speed. A 90 ms long pulse train was used to stimulate the medial hamstrings during either terminal swing or loading response of random gait cycles. Induced motion was defined as the difference in joint angle trajectories between stimulated and non-stimulated strides. A dynamic musculoskeletal simulation of normal gait was generated and similarly perturbed by increasing hamstring excitation. The experiments show that hamstring stimulation induced a significant increase in posterior pelvic tilt, knee flexion and ankle dorsiflexion during stance, while having relatively less influence on the hip angular trajectory. The induced motion patterns were similar whether the hamstrings were stimulated during late swing or early stance, and were generally consistent with the direction of induced motion predicted by gait simulation models. Hence, we conclude that overactive hamstrings have the potential to induce the limb to move toward a crouch gait posture. PMID:23540723

  1. Male and female runners demonstrate different sagittal plane mechanics as a function of static hamstring flexibility

    PubMed Central

    Williams III, D. S. Blaise; Welch, Lee M.

    2015-01-01

    ABSTRACT Background: Injuries to runners are common. However, there are many potential contributing factors to injury. While lack of flexibility alone is commonly related to injury, there are clear differences in hamstring flexibility between males and females. Objective: To compare the effect of static hamstring length on sagittal plane mechanics between male and female runners. Method: Forty subjects (30.0±6.4 years) participated and were placed in one of 4 groups: flexible males (n=10), inflexible males (n=10), flexible females (n=10), and inflexible females (n=10). All subjects were free of injury at the time of data collection. Three-dimensional kinematics and kinetics were collected while subjects ran over ground across 2 force platforms. Sagittal plane joint angles and moments were calculated at the knee and hip and compared with a 2-way (sex X flexibility) ANOVA (α=0.05). Results: Males exhibited greater peak knee extension moment than females (M=2.80±0.47, F=2.48±0.52 Nm/kg*m, p=0.05) and inflexible runners exhibited greater peak knee extension moment than flexible runners (In=2.83±0.56, Fl=2.44±0.51 Nm/kg*m, p=0.01). For hip flexion at initial contact, a significant interaction existed (p<0.05). Flexible females (36.7±7.4º) exhibited more hip flexion than inflexible females (27.9±4.6º, p<0.01) and flexible males (30.1±9.5º, p<0.05). No differences existed for knee angle at initial contact, peak knee angle, peak hip angle, or peak hip moment. Conclusion: Hamstring flexibility results in different mechanical profiles in males and females. Flexibility in the hamstrings may result in decreased moments via active or passive tension. These differences may have implications for performance and injury in flexible female runners. PMID:26537812

  2. Determination of future prevention strategies in elite track and field: analysis of Daegu 2011 IAAF Championships injuries and illnesses surveillance

    PubMed Central

    Alonso, Juan-Manuel; Edouard, Pascal; Fischetto, Giuseppe; Adams, Bob; Depiesse, Frédéric; Mountjoy, Margo

    2012-01-01

    Objective To determine the incidence and characteristics of newly incurred injuries and illnesses during international Athletics Championships, by improving the medical surveillance coverage, in order to determine future prevention strategies. Design Prospective recording of newly occurred injuries and illnesses. Setting 13th International Association of Athletics Federations World Championships in Athletics 2011 in Daegu, Korea. Participants National team and Local Organising Committee physicians; and 1851 registered athletes. Main outcome measures Incidence and characteristics of newly incurred injuries and illnesses. Results 82% of athletes were covered by medical teams participating with a response rate of 94%. A total of 249 injuries were reported, representing an incidence of 134.5 injuries per 1000 registered athletes, and 119 (48%) resulted in time loss from sport. A total of 185 injuries affected the lower limb (74%). Hamstring strain was the main diagnosis and 67% resulted in absence from sport. Overuse (n=148; 59%) was the predominant cause. A total of 126 illnesses were reported, signifying an incidence of 68.1 per 1000 registered athletes. Upper respiratory tract infection was the most common reported diagnosis (18%), followed by exercise-induced dehydration (12%), and gastroenteritis/diarrhoea (10%). The highest incidences of injuries were found in combined events and middle and long-distance events, and of illness in race walking events. Conclusion During elite Athletics World Championships, 135 injuries, 60 time-loss injuries and 68 illnesses per 1000 registered athletes were reported. Higher risks of injuries were found in combined events and long-distance runs. Preventive interventions should focus on overuse injuries and hamstring strains, decreasing the risk of transmission of infectious diseases, appropriate event scheduling and heat acclimatisation. PMID:22522588

  3. Effect of Fatigue on Hamstring Reflex Responses and Posterior-Anterior Tibial Translation in Men and Women

    PubMed Central

    Behrens, Martin; Mau-Moeller, Anett; Wassermann, Franziska; Bruhn, Sven

    2013-01-01

    Anterior cruciate ligament (ACL) rupture ranks among the most common injuries in sports. The incidence of ACL injuries is considerably higher in females than in males and the underlying mechanisms are still under debate. Furthermore, it has been suggested that muscle fatigue can be a risk factor for ACL injuries. We investigated gender differences in hamstring reflex responses and posterior-anterior tibial translation (TT) before and after fatiguing exercise. We assessed the isolated movement of the tibia relative to the femur in the sagittal plane as a consequence of mechanically induced TT in standing subjects. The muscle activity of the hamstrings was evaluated. Furthermore, isometric maximum voluntary torque (iMVT) and rate of torque development (RTD) of the hamstrings (H) and quadriceps (Q) were measured and the MVT H/Q as well as the RTD H/Q ratios were calculated. After fatigue, reflex onset latencies were enhanced in women. A reduction of reflex responses associated with an increased TT was observed in females. Men showed no differences in these parameters. Correlation analysis revealed no significant associations between parameters for TT and MVT H/Q as well as RTD H/Q. The results of the present study revealed that the fatigue protocol used in this study altered the latency and magnitude of reflex responses of the hamstrings as well as TT in women. These changes were not found in men. Based on our results, it is conceivable that the fatigue-induced decrease in neuromuscular function with a corresponding increase in TT probably contributes to the higher incidence of ACL injuries in women. PMID:23573178

  4. Muscle activation during various hamstring exercises.

    PubMed

    McAllister, Matt J; Hammond, Kelley G; Schilling, Brian K; Ferreria, Lucas C; Reed, Jacob P; Weiss, Lawrence W

    2014-06-01

    The dorsal muscles of the lower torso and extremities have often been denoted the "posterior chain." These muscles are used to support the thoracic and lumbar spine and peripheral joints, including the hip, knee, and ankle on the dorsal aspect of the body. This study investigated the relative muscle activity of the hamstring group and selected surrounding musculature during the leg curl, good morning, glute-ham raise, and Romanian deadlift (RDL). Twelve healthy, weight-trained men performed duplicate trials of single repetitions at 85% 1-repetition maximum for each lift in random order, during which surface electromyography and joint angle data were obtained. Repeated measures analysis of variance across the 4 exercises was performed to compare the activity from the erector spinae (ES), gluteus medius (GMed), semitendinosus (ST), biceps femoris (BF), and medial gastrocnemius (MGas). Significant differences (p ≤ 0.05) were noted in eccentric muscle activity between exercise for the MGas (p < 0.027), ST (p < 0.001), BF (p < 0.001), and ES (p = 0.032), and in concentric muscle activity, for the ES (p < 0.001), BF (p = 0.010), ST (p = 0.009), MGas (p < 0.001), and the GMed (p = 0.018). Bonferroni post hoc analysis revealed significant pairwise differences during eccentric actions for the BF, ST, and MGas. Post hoc analysis also revealed significant pairwise differences during concentric actions for the ES, BF, ST, MGas, and GMed. Each of these showed effect sizes that are large or greater. The main findings of this investigation are that the ST is substantially more active than the BF among all exercises, and hamstring activity was maximized in the RDL and glute-ham raise. Therefore, athletes and coaches who seek to maximize the involvement of the hamstring musculature should consider focusing on the glute-ham raise and RDL. PMID:24149748

  5. Short medial approach harvesting of hamstring tendons.

    PubMed

    Lanternier, H; de Cussac, J B; Collet, T

    2016-04-01

    Harvesting the hamstring tendons for anterior cruciate ligament reconstruction is not straightforward to perform or to teach: the incision is small, the work-space is narrow and the surgeon's tactile feedback using the stripper is difficult to explain to juniors. The purpose of this short note is to describe a reliable means of harvesting the semitendinosus, gracilis or both. Patient and tourniquet positioning, instrumentation and landmarks are detailed; then the 6 steps (speed-bump 1, speed-bump 2, bubble, hook, expansions, stripper) are explained. PMID:26896410

  6. Strain differences in mice in carbon tetrachloride-induced liver injury.

    PubMed Central

    Bhathal, P. S.; Rose, N. R.; Mackay, I. R.; Whittingham, S.

    1983-01-01

    A study was made in inbred mice of genetic determinants of toxic liver cell injury, and the subsequent occurrence of autoantibodies to mouse liver-specific protein (M-LSP). Carbon tetrachloride was injected s.c. in sublethal doses to induce liver cell damage in 4 strains of mice, BALB/c, C3H, C57BL/6 and SJL/J. The degree of liver cell damage was assessed by blood cholylglycine levels and by semiquantitative histological analysis 1, 4, 7, 14, 21 and 45 days after dosing. Striking differences were observed among the 4 strains in degrees of liver necrosis, cellular infiltration and rate of removal of the necrotic tissue. BALB/c was the strain most susceptible to the necrotizing effects of CCl4. These mice showed confluent areas of hepatocellular necrosis from Day 1 and histological recovery was protracted up to 3 weeks, and was accompanied by pronounced macrophage activity and a cellular inflammatory response. Mice of the SJL/J strain were the least susceptible and showed minor hepatocellular necrosis, which resolved by Day 7, and a slight histiocytic response. C3H and C57BL/6 showed lesions which were intermediate between the other 2 strains. The autoantibody response to LSP was weak, transient and detected only in C57BL/6 mice. This study indicates the presence of genetic control, either H-2 or non-H-2 linked, over the degree of liver cell necrosis resulting from toxic liver injury, and the ensuing cellular infiltrate and rate of removal of the necrotic tissue. Images Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 9 Fig. 1 Fig. 2 Fig. 3 Fig. 10 Fig. 11 PMID:6639871

  7. Low back pain, radiculopathy, and bilateral proximal hamstring ruptures: a case report.

    PubMed

    Deren, Matthew E; DeFroda, Steven F; Mukand, Nita H; Mukand, Jon A

    2015-12-01

    Low back pain (LBP) is a common complaint in the United States, with an incidence of 6.3%-15.4% and yearly recurrence in 54%-90% of patients.1 Trends show more frequent diagnostic testing, opioid use, and surgical intervention as the incidence of LBP increases.2 LBP is defined as pain at and near the lumbosacral region that can vary with physical activity and time. LBP is usually related to pathology of muscles, ligaments, spinal column joints, nerve roots, and the spinal cord. During the assessment of LBP, practitioners must also consider less common causes of pain in that region. For instance, patients with indolent or nighttime pain may have infectious or malignant processes. Referred pain from injuries to pelvic musculature or abdominal contents should be considered, especially following a traumatic event. One of these injuries, which can present as acute low back pain, is rupture of the proximal hamstring tendon. On rare occasion, concomitant LBP, radiculopathy, and hamstring injuries can occur;. This diagnostic challenge is described in the following case. PMID:26623451

  8. Influence of Hamstring Tightness in Pelvic, Lumbar and Trunk Range of Motion in Low Back Pain and Asymptomatic Volunteers during Forward Bending

    PubMed Central

    Macedo, Adriana Ribeiro

    2015-01-01

    Study Design Cross-sectional study. Purpose To verify the association of hamstring tightness and range of motion in anterior pelvic tilt (PT), lumbar motion (LM), and trunk flexion (TF) during forward bending. Overview of Literature Increased hamstring stiffness could be a possible contributing factor to low back injuries. Clinical observations have suggested that hamstring tightness influences lumbar pelvic rhythm. Movement restrictions or postural asymmetry likely lead to compensatory movement patterns of the lumbar spine, and subsequently to increased stress on the spinal soft tissues and an increased risk of low back pain (LBP). Methods Hamstring muscle tightness was measured using the self-monitored active knee extension (AKE) test. A bubble inclinometer was used to determine the range of motion of PT, LM, and TF during forward bending. Statistical analysis included descriptive statistics, comparisons between groups and a correlation between hamstring tightness (AKE) and anterior PT, TF, and regional LM with p≤0.05. Results The LBP group was composed of 36 participants, and the asymptomatic group consisted of 32 participants. The mean for PT in the control group was 66.7°, 64.5° for LM and 104.6° for TF. Respective values in the symptomatic group were 57.0°, 79.8°, and 82.2°. Conclusions Participants with LBP showed restriction in the pelvis and TF range of motion, but had higher amplitudes in the lumbar spine during forward bending. PMID:26240711

  9. Repetitive strain injury. 1. An overview of the problem and the patients. The Goff Group.

    PubMed

    Sheon, R P

    1997-10-01

    Assembly-line workers, house painters, and many others whose activities entail repetitive motions can end up with swelling, pain, and limited movement in the affected muscles. Often, use of the six steps described in this article brings fairly rapid functional improvement and prevents recurrences, with a minimum of medical intervention. In some cases, though, recovery is prolonged or the outcome is unusual. The authors present additional factors to consider in such cases, such as psychosocial concerns, worker fraud, and ergonomic problems. Part 2 of this article, beginning on page 72, details six common repetitive strain injuries. PMID:9336596

  10. Outcome of Simultaneous Arthroscopic Anterior Cruciate Ligament and Posterior Cruciate Ligament Reconstruction With Hamstring Tendon Autograft: A Multicenter Prospective Study

    PubMed Central

    Panigrahi, Ranajit; Kumari Mahapatra, Amita; Priyadarshi, Ashok; Singha Das, Dibya; Palo, Nishit; Ranjan Biswal, Manas

    2016-01-01

    Background: Multiligamentous injuries of knee are a complex problem in orthopaedics. Combined ACL-PCL injuries are uncommon, usually associated with knee dislocations. Extremity vascular status is essential because of possible arterio-venous compromise. These complex injuries require a systematic evaluation and treatment. Single setting simultaneous arthroscopic ACL and PCL reconstruction or a staged approach can be adopted to treat these cases. Objectives: To evaluate functional outcome of simultaneous arthroscopic ACL and PCL reconstruction with hamstring tendon autograft in multiligamentous knee injuries. Patients and Methods: This prospective study was performed on 20 patients with combined ACL-PCL injuries who underwent simultaneous arthroscopic ACL-PCL reconstruction with hamstring tendon. Evaluation of functional outcome was by IKDC and Lysholm-Tegner scores. Results: In 20 patients, mean age 34 years, return to full-time work and to full sports was 8 weeks and 6.2 months respectively. All patients had full range of motion except 2 patients with < 5 degrees flexion loss; 90% had negative Lachmann test; 95% had negative pivot shift and 10% patients had mild posterior drawer at 90 degrees (1+) at final follow up. Mean IKDC score was 90 (range 81 - 94); mean Tegner activity score was 7 and mean Lysholm knee score was 89. 85% returned to preinjury activity level and a 90% satisfaction rate. Conclusions: Simultaneous arthroscopic ACL and PCL reconstructions using hamstring tendon for combined ACL and PCL injuries is a clinically effective, safe, time saving and cost-effective procedure with better patient compliance and reproducible for a timely return of motion, strength, and function with favorable outcome.

  11. High rate shear strain of three-dimensional neural cell cultures: a new in vitro traumatic brain injury model.

    PubMed

    LaPlaca, Michelle C; Cullen, D Kacy; McLoughlin, Justin J; Cargill, Robert S

    2005-05-01

    The fidelity of cell culture simulations of traumatic brain injury (TBI) that yield tolerance and mechanistic information relies on both the cellular models and mechanical insult parameters. We have designed and characterized an electro-mechanical cell shearing device in order to produce a controlled high strain rate injury (up to 0.50 strain, 30 s(-1) strain rate) that deforms three-dimensional (3-D) neural cultures (neurons or astrocytes in an extracellular matrix scaffold). Theoretical analysis revealed that these parameters generate a heterogeneous 3-D strain field throughout the cultures that is dependent on initial cell orientation within the matrix, resulting in various combinations of normal and shear strain. The ability to create a linear shear strain field over a range of input parameters was verified by tracking fluorescent microbeads in an acellular matrix during maximal displacement for a range of strains and strain rates. In addition, cell death was demonstrated in rat cortical astrocytes and neurons in response to high rate, high magnitude shear strain. Furthermore, cell response within the 3-D neuronal cultures depended on orientation, with higher predicted shear strain correlating with an increased loss of neurites, indicating that culture configuration may be an important factor in the mechanical, and hence cellular, response to traumatic insults. Collectively, these results suggest that differential responses exist within a 3-D culture subjected to mechanical insult, perhaps mimicking the in vivo environment, and that this new model can be used to investigate the complex cellular mechanisms associated with TBI. PMID:15797591

  12. Regional differences in muscle activation during hamstrings exercise.

    PubMed

    Schoenfeld, Brad J; Contreras, Bret; Tiryaki-Sonmez, Gul; Wilson, Jacob M; Kolber, Morey J; Peterson, Mark D

    2015-01-01

    It is believed that regional activation within a muscle may lead to greater site-specific muscular adaptations in the activated portion of the muscle. Because the hamstrings are a biarticular muscle, it can be theorized that single-joint exercises where movement originates at the hip vs. the knee will result in differential activation of the muscle complex. The purpose of the present study was to assess electromyographic activity in the proximal and distal aspects of the medial and lateral hamstrings during performance of the stiff-legged deadlift (SLDL), a hip-dominant exercise, and the lying leg curl (LLC), a knee-dominant exercise. Ten young, resistance-trained men were recruited from a university population to participate in the study. Employing a within-subject design, participants performed the SLDL and LLC to muscular failure using a load equating to their 8 repetition maximum for each exercise. The order of performance of exercises was counterbalanced between participants so that approximately half of the subjects performed SLDL first and the other half performed LLC first. Surface electromyography was used to record mean normalized muscle activity of the upper lateral hamstrings, lower lateral hamstrings, upper medial hamstrings, and lower medial hamstrings. Results showed that the LLC elicited significantly greater normalized mean activation of the lower lateral and lower medial hamstrings compared with the SLDL (p ≤ 0.05). These findings support the notion that the hamstrings can be regionally targeted through exercise selection. Further investigations are required to determine whether differences in activation lead to greater muscular adaptations in the muscle complex. PMID:24978835

  13. Use of Ultrasound to Monitor Biceps Femoris Mechanical Adaptations after Injury in a Professional Soccer Player

    PubMed Central

    Kellis, Eleftherios; Galanis, Nikiforos; Chrysanthou, Chrysanthos; Kofotolis, Nikolaos

    2016-01-01

    This study examined the use of ultrasound to monitor changes in the long head of the biceps femoris (BF) architecture of aprofessional soccer player with acute first-time hamstring strain. The player followed a 14 session physiotherapy treatment until return to sport. The pennation angle and aponeurosis strain of the long head of the biceps femoris (BF) were monitored at 6 occasions (up until 1 year) after injury. The size of the scar / hematoma was reduced by 63.56% (length) and 67.9% (width) after the intervention and it was almost non-traceable one year after injury. The pennation angle of the fascicles underneath the scar showed a decline of 51.4% at the end of the intervention while an increase of 109.2% of the fascicles which were closer to deep aponeurosis was observed. In contrast, pennation angle of fascicles located away from the injury site were relatively unaffected. The treatment intervention resulted in a 57.9% to 77.3% decline of maximum strain per unit of MVC moment and remained similar one year after the intervention. This study provided an example of the potential use of ultrasound-based parameters to link the mechanical adaptations of the injured muscle to specific therapeutic intervention. Key points Changes in fascicle orientation after biceps femoris mild tear were reduced after a 28 day intervention and remained similar one year after injury. Tendon/aponeurosis strain per unit of moment of force decreased during the course of the therapeutic intervention. Future studies could utilize ultrasonography to monitor mechanical responses after various types of hamstring injury and interventions in order to improve criteria for a safe return to sport. PMID:26957929

  14. Use of Ultrasound to Monitor Biceps Femoris Mechanical Adaptations after Injury in a Professional Soccer Player.

    PubMed

    Kellis, Eleftherios; Galanis, Nikiforos; Chrysanthou, Chrysanthos; Kofotolis, Nikolaos

    2016-03-01

    This study examined the use of ultrasound to monitor changes in the long head of the biceps femoris (BF) architecture of aprofessional soccer player with acute first-time hamstring strain. The player followed a 14 session physiotherapy treatment until return to sport. The pennation angle and aponeurosis strain of the long head of the biceps femoris (BF) were monitored at 6 occasions (up until 1 year) after injury. The size of the scar / hematoma was reduced by 63.56% (length) and 67.9% (width) after the intervention and it was almost non-traceable one year after injury. The pennation angle of the fascicles underneath the scar showed a decline of 51.4% at the end of the intervention while an increase of 109.2% of the fascicles which were closer to deep aponeurosis was observed. In contrast, pennation angle of fascicles located away from the injury site were relatively unaffected. The treatment intervention resulted in a 57.9% to 77.3% decline of maximum strain per unit of MVC moment and remained similar one year after the intervention. This study provided an example of the potential use of ultrasound-based parameters to link the mechanical adaptations of the injured muscle to specific therapeutic intervention. Key pointsChanges in fascicle orientation after biceps femoris mild tear were reduced after a 28 day intervention and remained similar one year after injury.Tendon/aponeurosis strain per unit of moment of force decreased during the course of the therapeutic intervention.Future studies could utilize ultrasonography to monitor mechanical responses after various types of hamstring injury and interventions in order to improve criteria for a safe return to sport. PMID:26957929

  15. Fluoroscopically Guided Peritendinous Corticosteroid Injection for Proximal Hamstring Tendinopathy

    PubMed Central

    Nicholson, Luke T.; DiSegna, Steven; Newman, Joel S.; Miller, Suzanne L.

    2014-01-01

    Background: Proximal hamstring tendinopathy is an uncommon but debilitating cause of posterior thigh pain in athletes subjected to repetitive eccentric hamstring contraction, such as runners. Minimal data exist evaluating treatment options for proximal hamstring tendinopathy. Purpose: This retrospective study evaluates the effectiveness of fluoroscopically guided corticosteroid injections in treating proximal hamstring tendinopathy. Study Design: Case series; Level of evidence, 4. Methods: Eighteen athletes with 22 cases of magnetic resonance imaging–confirmed proximal hamstring tendinopathy were treated with corticosteroid injection and later contacted to evaluate the efficacy of the injection with the use of a questionnaire. Results: The visual analog score decreased from 7.22 preinjection to 3.94 postinjection (P < .001), level of athletic participation increased from 28.76% to 68.82% (P < .001) at a mean follow-up of 21 months, and 38.8% of patients experienced complete resolution at a mean follow-up of 24.8 months. The mean lower extremity function score at the time of follow-up was 60. Conclusion: A trial of fluoroscopically guided corticosteroid injection is warranted in patients presenting with symptoms of proximal hamstring tendinopathy refractory to conservative therapy. PMID:26535310

  16. Probiotic Lactobacillus casei strain Shirota prevents indomethacin-induced small intestinal injury: involvement of lactic acid.

    PubMed

    Watanabe, Toshio; Nishio, Hikaru; Tanigawa, Tetsuya; Yamagami, Hirokazu; Okazaki, Hirotoshi; Watanabe, Kenji; Tominaga, Kazunari; Fujiwara, Yasuhiro; Oshitani, Nobuhide; Asahara, Takashi; Nomoto, Koji; Higuchi, Kazuhide; Takeuchi, Koji; Arakawa, Tetsuo

    2009-09-01

    Inflammatory responses triggered by activation of the lipopolysaccharide (LPS)/Toll-like receptor (TLR) 4 signaling pathway are a key mechanism in nonsteroidal anti-inflammatory drug-induced enteropathy. The aim of this study was to investigate the probiotic effect of Lactobacillus casei strain Shirota (LcS) on indomethacin-induced small intestinal injury. Rats pretreated with viable LcS or heat-killed LcS once or once daily for a week were administered indomethacin by gavage to induce injury. Anti-inflammatory effects of L-lactic acid (1-15 mM) were evaluated in vitro by use of THP-1 cells. One-week treatment with viable LcS prevented indomethacin-induced intestinal injury with increase in the concentration of lactic acid in small intestinal content and inhibited increases in myeloperoxidase activity and expression of mRNA for tumor necrosis factor-alpha (TNF-alpha) while affecting neither TLR4 expression nor the number of gram-negative bacteria in intestinal content, whereas neither heat-killed LcS nor a single dose of viable LcS inhibited intestinal injury. Prevention of this injury was also observed in rats given l-lactic acid in drinking water. Both L-lactic acid and LcS culture supernatant containing 10 mM lactic acid inhibited NF-kappaB activation and increases in TNF-alpha mRNA expression and TNF-alpha protein secretion in THP-1 cells treated with LPS. Western blot analyses showed that both L-lactic acid and LcS culture supernatants suppressed phosphorylation and degradation of I-kappaB-alpha induced by LPS without affecting expression of TLR4. These findings suggest that LcS exhibits a prophylactic effect on indomethacin-induced enteropathy by suppressing the LPS/TLR4 signaling pathway and that this probiotic effect of LcS may be mediated by L-lactic acid. PMID:19589943

  17. How much hamstring graft needs to be in the femoral tunnel? A MOON cohort study

    PubMed Central

    Mariscalco, Michael W.; Magnussen, Robert A.; Mitchell, Joshua; Pedroza, Angela D.; Jones, Morgan H.; Andrish, Jack T.; Parker, Richard D.; Kaeding, Christopher C.; Flanigan, David C.

    2014-01-01

    Background Recent evidence that smaller hamstring graft diameter is associated with increased failure risk following anterior cruciate ligament (ACL) reconstruction has increased the popularity of graft configurations that increase graft diameter at the expense of graft length. A key question is how much graft needs to be in contact with the femoral tunnel to ensure that healing occurs. We hypothesize that no difference in two-year patient-reported outcomes or failure risk exists based on the amount of graft in the femoral tunnel. Methods Through the use of prospectively collected cohort data augmented with retrospective chart review, 120 of 181 consecutive patients (66.3 %) undergoing primary ACL reconstruction with hamstring autograft were evaluated. Patient and surgical factors along with pre-operative and two-year postoperative knee injury and osteoarthritis outcome score (KOOS) and International Knee Documentation Committee (IKDC) scores and whether each patient underwent revision ACL reconstruction during the two-year follow-up period were recorded. Results No differences in two-year patient-reported outcome scores were noted between patients with graft length in the femoral tunnel less than 25 mm and those with graft length in the femoral tunnel of at least 25 mm. Controlling for age, sex, BMI, and femoral tunnel technique, no correlation was noted between KOOS or IKDC scores and either the length of graft in the femoral tunnel or the contact area between the graft and the tunnel. Conclusions Variation of the length of hamstring autograft in the femoral tunnel between 14 and 35 mm does not predict KOOS or IKDC scores at 2 years postoperative. PMID:25984246

  18. Nerve Wrapping of the Sciatic Nerve With Acellular Dermal Matrix in Chronic Complete Proximal Hamstring Ruptures and Ischial Apophyseal Avulsion Fractures

    PubMed Central

    Haus, Brian M.; Arora, Danny; Upton, Joseph; Micheli, Lyle J.

    2016-01-01

    Background: Patients with chronic injuries of the proximal hamstring can develop significant impairment because of weakness of the hamstring muscles, sciatic nerve compression from scar formation, or myositis ossificans. Purpose: To describe the surgical outcomes of patients with chronic injury of the proximal hamstrings who were treated with hamstring repair and sciatic neurolysis supplemented with nerve wrapping with acellular dermal matrix. Study Design: Retrospective case series; Level of evidence, 4. Methods: Fifteen consecutive patients with a diagnosis of chronic complete proximal hamstring rupture or chronic ischial tuberosity apophyseal avulsion fracture (mean age, 39.67 years; range, 14-69 years) were treated with proximal hamstring repair and sciatic neurolysis supplemented with nerve wrapping with acellular dermal matrix. Nine patients had preoperative sciatica, and 6 did not. Retrospective chart review recorded clinical outcomes measured by the degree of pain relief, the rate of return to activities, and associated postoperative complications. Results: All 15 patients were followed in the postoperative period for an average of 16.6 months. Postoperatively, there were 4 cases of transient sciatic nerve neurapraxia. Four patients (26%) required postoperative betamethasone sodium phosphate (Celestone Soluspan) injectable suspension USP 6 mg/mL. Among the 9 patients with preoperative sciatica, 6 (66%) had a good or excellent outcome and were able to return to their respective activities/sports; 3 (33%) had persistent chronic pain. One of these had persistent sciatic neuropathy that required 2 surgical reexplorations and scar excision after development of recurrent extraneural scar formation. Among the 6 without preoperative sciatica, 100% had a good or excellent outcomes and 83% returned to their respective activities/sports. Better outcomes were observed in younger patients, as the 3 cases of persistent chronic sciatic pain were in patients older than 45 years. Conclusion: This study suggests that when used as an adjunct to sciatic neurolysis, nerve wrapping with acellular dermal matrix can be a safe and effective method of treating younger patients with and preventing the development of sciatic neuropathic pain after chronic injury of the proximal hamstrings. PMID:27081655

  19. Changes to injury profile (and recommended cricket injury definitions) based on the increased frequency of Twenty20 cricket matches.

    PubMed

    Orchard, John; James, Trefor; Kountouris, Alex; Portus, Marc

    2010-01-01

    This study analyzes injuries occurring prospectively in Australian men's cricket at the state and national levels over 11 seasons (concluding in season 2008-09). In the last four of these seasons, there was more cricket played, with most of the growth being a new form of the game - Twenty20 cricket. Since the introduction of a regular Twenty20 program, injury incidence rates in each form of cricket have been fairly steady. Because of the short match duration, Twenty20 cricket exhibits a high match injury incidence, expressed as injuries per 10,000 hours of play. Expressed as injuries per days of play, Twenty20 cricket injury rates compare more favorably to other forms of cricket. Domestic level Twenty20 cricket resulted in 145 injuries per 1000 days of play (compared to 219 injuries per 1000 days of domestic one day cricket, and 112 injuries per 1000 days of play in first class domestic cricket). It is therefore recommended that match injury incidence measures be expressed in units of injuries per 1000 days of play. Given the high numbers of injuries which are of gradual onset, seasonal injury incidence rates (which typically range from 15-20 injuries per team per defined 'season') are probably a superior incidence measure. Thigh and hamstring strains have become clearly the most common injury in the past two years (greater than four injuries per team per season), perhaps associated with the increased amount of Twenty20 cricket. Injury prevalence rates have risen in conjunction with an increase in the density of the cricket calendar. Annual injury prevalence rates (average proportion of players missing through injury) have exceeded 10% in the last three years, with the injury prevalence rates for fast bowlers exceeding 18%. As the amount of scheduled cricket is unlikely to be reduced in future years, teams may need to develop a squad rotation for fast bowlers, similar to pitching staff in baseball, to reduce the injury rates for fast bowlers. Consideration should be given to rule changes which may reduce the impact of injury. In particular, allowing the 12th man to play as a full substitute in first class cricket (and therefore take some of the bowling workload in the second innings) would probably reduce bowling injury prevalence in cricket. PMID:24198544

  20. The management of bilateral high hamstring tendinopathy with ASTYM® treatment and eccentric exercise: a case report

    PubMed Central

    McCormack, Joshua R

    2012-01-01

    High hamstring tendinopathy (HHT) is an overuse injury that occurs most commonly in runners. The management of HHT is often challenging and the research supporting many interventions is limited. Eccentric exercise has been proven effective in the treatment of various tendinopathies but has not been thoroughly studied with HHT. Soft tissue mobilization, including ASTYM, is often utilized in the treatment of tendinopathies, though there is limited evidence supporting this approach. The purpose of this paper is to present the case of a patient referred to physical therapy with bilateral HHT. The patient was a 41-year-old recreational runner that had an insidious onset of right buttock pain 12 months prior to initiating therapy and left buttock pain 9 months prior. Her primary complaints included an inability to run, pain with prolonged or brisk walking, and pain with sitting on hard surfaces. The patient was treated in physical therapy two times per week for 16 visits with treatment focused on eccentric hamstring strengthening and ASTYM. By her eighth visit, the patient was able to walk 2·5 miles without pain and by her 12 visit, she was able to jog 1 mile before the onset of pain. After 16 visits, the patient reported that she was approximately 95% improved, was able to run 2·5 miles without pain, and had no pain with sitting on hard surfaces. This case suggests that eccentric exercise combined with ASTYM may be an effective treatment for HHT. PMID:23904753

  1. Musculotendon variability influences tissue strains experienced by the biceps femoris long head muscle during high-speed running

    PubMed Central

    Fiorentino, Niccolo M.; Blemker, Silvia S.

    2014-01-01

    The hamstring muscles frequently suffer injury during high-speed running, though the factors that make an individual more susceptible to injury remain poorly understood. The goals of this study were to measure the musculotendon dimensions of the biceps femoris long head (BFlh) muscle, the hamstring muscle injured most often, and to use computational models to assess the influence of variability in the BFlh’s dimensions on internal tissue strains during high-speed running. High-resolution magnetic resonance (MR) images were acquired over the thigh in 12 collegiate athletes, and musculotendon dimensions were measured in the proximal free tendon/aponeurosis, muscle and distal free tendon/aponeurosis. Finite element meshes were generated based on the average, standard deviation and range of BFlh dimensions. Simulation boundary conditions were defined to match muscle activation and musculotendon length change in the BFlh during high-speed running. Muscle and connective tissue dimensions were found to vary between subjects, with a coefficient of variation (CV) of 17 ± 6% across all dimensions. For all simulations peak local strain was highest along the proximal myotendinous junction, which is where injury typically occurs. Model variations showed that peak local tissue strain increased as the proximal aponeurosis width narrowed and the muscle width widened. The aponeurosis width and muscle width variation models showed that the relative dimensions of these structures influence internal muscle tissue strains. The results of this study indicate that a musculotendon unit’s architecture influences its strain injury susceptibility during high-speed running. PMID:25189094

  2. Effects of nutritional supplementation with l-arginine on repair of injuries due to muscle strain: experimental study on rats☆

    PubMed Central

    Couto, Lauren Izabel Medeiros; Wuicik, William Luiz; Kuhn, Ivan; Capriotti, Juan Rodolfo Vilela; Repka, João Carlos

    2015-01-01

    Objective To evaluate the influence of oral supplementation with arginine on regeneration of injuries due to straining of the anterior tibial muscle of rats. Methods Twenty-four Wistar rats of weight 492.5 ± 50.45 g were used. Injuries were induced through straining the anterior tibial muscles. The rats were separated into three groups of eight rats each. In the untreated group (UTG), after induction of injuries, the rats were observed for 24 h. In the simulation group (SG) and the arginine group (AG) respectively, the rats received isotonic saline solution and arginine solution via direct gavage, over a seven-day period. At the end of the period, blood samples were collected for serum evaluations of creatine kinase (CK), lactic dehydrogenase (LDH), aspartate aminotransferase (AST) and C-reactive protein (CRP). The right and left anterior tibial muscles were resected for histopathological evaluations on the muscle injuries, investigating edema, hemorrhage and disorganization or morphometric alteration of the muscle fibers. The tissue repair was investigated in terms of proliferation of adipose tissue, angiogenesis and collagen fibers. The ANOVA and Student's t methods were used and p ≤ 0.05 was taken to be statistically significant. Results In the serum evaluations, the AG showed lower CK assay values and higher AST values. In the histopathological evaluation, the UTG presented edema and hemorrhage compatible with injuries due to strain; the SG presented edema and hemorrhage with proliferation of adipose tissue and collagen fibers; and the AG presented not only the findings of the SG but also, especially, intense angiogenesis. Conclusion Oral supplementation with arginine did not cause any significant metabolic alterations that would contraindicate its use and it induced angiogenesis during the repair of muscles injured due to strain. PMID:26401505

  3. Influence of passive stiffness of hamstrings on postural stability.

    PubMed

    Kuszewski, Michał; Gnat, Rafał; Sobota, Grzegorz; Myśliwiec, Andrzej

    2015-03-29

    The aim of the study was to explore whether passive stiffness of the hamstrings influences the strategy of maintaining postural stability. A sample of 50 subjects was selected; the final analyses were based on data of 41 individuals (33 men, 8 women) aged 21 to 29 (mean = 23.3, SD = 1.1) years. A quasi- experimental ex post facto design with repeated measures was used. Categories of independent variables were obtained directly prior to the measurement of the dependent variables. In stage one of the study, passive knee extension was measured in the supine position to assess hamstring stiffness. In stage two, the magnitude of postural sway in antero-posterior direction was measured, while varying the body position on a stabilometric platform, both with and without visual control. The margin of safety was used as a measure of postural control. The magnitude of the margin of safety increased significantly between the open-eye and closed-eye trials. However, although we registered a visible tendency for a larger increase of the margin of safety associated with lower levels of passive hamstrings stiffness, no significant differences were found. Therefore, this study demonstrated that hamstring stiffness did not influence the strategy used to maintain postural stability. PMID:25964809

  4. Influence of Passive Stiffness of Hamstrings on Postural Stability

    PubMed Central

    Kuszewski, Michał; Gnat, Rafał; Sobota, Grzegorz; Myśliwiec, Andrzej

    2015-01-01

    The aim of the study was to explore whether passive stiffness of the hamstrings influences the strategy of maintaining postural stability. A sample of 50 subjects was selected; the final analyses were based on data of 41 individuals (33 men, 8 women) aged 21 to 29 (mean = 23.3, SD = 1.1) years. A quasi- experimental ex post facto design with repeated measures was used. Categories of independent variables were obtained directly prior to the measurement of the dependent variables. In stage one of the study, passive knee extension was measured in the supine position to assess hamstring stiffness. In stage two, the magnitude of postural sway in antero-posterior direction was measured, while varying the body position on a stabilometric platform, both with and without visual control. The margin of safety was used as a measure of postural control. The magnitude of the margin of safety increased significantly between the open-eye and closed-eye trials. However, although we registered a visible tendency for a larger increase of the margin of safety associated with lower levels of passive hamstrings stiffness, no significant differences were found. Therefore, this study demonstrated that hamstring stiffness did not influence the strategy used to maintain postural stability. PMID:25964809

  5. Single-Tunnel Double-Bundle Anterior Cruciate Ligament Reconstruction With Anatomical Placement of Hamstring Tendon Graft

    PubMed Central

    Gadikota, Hemanth R.; Wu, Jia-Lin; Seon, Jong Keun; Sutton, Karen; Gill, Thomas J.; Li, Guoan

    2013-01-01

    Background Anatomical reconstruction techniques that can restore normal joint kinematics without increasing surgical complications could potentially improve clinical outcomes and help manage anterior cruciate ligament injuries more efficiently. Hypothesis Single-tunnel double-bundle anterior cruciate ligament reconstruction with anatomical placement of hamstring tendon graft can more closely restore normal knee anterior-posterior, medial-lateral, and internal-external kinematics than can conventional single-bundle anterior cruciate ligament reconstruction. Study Design Controlled laboratory study. Methods Kinematic responses after single-bundle anterior cruciate ligament reconstruction and single-tunnel double-bundle anterior cruciate ligament reconstruction with anatomical placement of hamstring tendon graft were compared with the intact knee in 9 fresh-frozen human cadaveric knee specimens using a robotic testing system. Kinematics of each knee were determined under an anterior tibial load (134 N), a simulated quadriceps load (400 N), and combined torques (10 Nm valgus and 5 Nm internal tibial torques) at 0, 15, 30, 60, and 90 of flexion. Results Anterior tibial translations were more closely restored to the intact knee level after single-tunnel double-bundle reconstruction with anatomical placement of hamstring tendon graft than with a single-bundle reconstruction under the 3 external loading conditions. Under simulated quadriceps load, the mean internal tibial rotations after both reconstructions were lower than that of the anterior cruciate ligamentintact knee with no significant differences between these 3 knee conditions at 0 and 30 of flexion (P > .05).The increased medial tibial shifts of the anterior cruciate ligamentdeficient knees were restored to the intact level by both reconstruction techniques under the 3 external loading conditions. Conclusion Single-tunnel double-bundle anterior cruciate ligament reconstruction with anatomical placement of hamstring tendon graft can better restore the anterior knee stability compared with a conventional single-bundle reconstruction. Both reconstruction techniques are efficient in restoring the normal medial-lateral stability but overcorrect the internal tibial rotations. Clinical Relevance Single-tunnel double-bundle anterior cruciate ligament reconstruction with anatomical placement of hamstring tendon graft could provide improved clinical outcomes over a conventional single-bundle reconstruction. PMID:20139332

  6. Development of a strain rate dependent material model of human cortical bone for computer-aided reconstruction of injury mechanisms.

    PubMed

    Asgharpour, Zahra; Zioupos, Peter; Graw, Matthias; Peldschus, Steffen

    2014-03-01

    Computer-aided methods such as finite-element simulation offer a great potential in the forensic reconstruction of injury mechanisms. Numerous studies have been performed on understanding and analysing the mechanical properties of bone and the mechanism of its fracture. Determination of the mechanical properties of bones is made on the same basis used for other structural materials. The mechanical behaviour of bones is affected by the mechanical properties of the bone material, the geometry, the loading direction and mode and of course the loading rate. Strain rate dependency of mechanical properties of cortical bone has been well demonstrated in literature studies, but as many of these were performed on animal bones and at non-physiological strain rates it is questionable how these will apply in the human situations. High strain-rates dominate in a lot of forensic applications in automotive crashes and assault scenarios. There is an overwhelming need to a model which can describe the complex behaviour of bone at lower strain rates as well as higher ones. Some attempts have been made to model the viscoelastic and viscoplastic properties of the bone at high strain rates using constitutive mathematical models with little demonstrated success. The main objective of the present study is to model the rate dependent behaviour of the bones based on experimental data. An isotropic material model of human cortical bone with strain rate dependency effects is implemented using the LS-DYNA material library. We employed a human finite element model called THUMS (Total Human Model for Safety), developed by Toyota R&D Labs and the Wayne State University, USA. The finite element model of the human femur is extracted from the THUMS model. Different methods have been employed to develop a strain rate dependent material model for the femur bone. Results of one the recent experimental studies on human femur have been employed to obtain the numerical model for cortical femur. A forensic application of the model is explained in which impacts to the arm have been reconstructed using the finite element model of THUMS. The advantage of the numerical method is that a wide range of impact conditions can be easily reconstructed. Impact velocity has been changed as a parameter to find the tolerance levels of injuries to the lower arm. The method can be further developed to study the assaults and the injury mechanism which can lead to severe traumatic injuries in forensic cases. PMID:24529781

  7. The genetic basis of strain-dependent differences in the early phase of radiation injury in mouse lung

    SciTech Connect

    Franko, A.J.; Sharplin, J.; Ward, W.F.; Hinz, J.M. )

    1991-06-01

    Substantial differences between mouse strains have been reported in the lesions present in the lung during the early phase of radiation injury. Some strains show only classical pneumonitis, while other strains develop substantial fibrosis and hyaline membranes which contribute appreciably to respiratory insufficiency, in addition to pneumonitis. Other strains are intermediate between these extremes. These differences correlate with intrinsic differences in activities of lung plasminogen activator and angiotensin converting enzyme. The genetic basis of these differences was assessed by examining histologically the early reaction in lungs of seven murine hybrids available commercially after whole-thorax irradiation. Crosses between fibrosing and nonfibrosing parents were uniformly nonfibrosing, and crosses between fibrosing and intermediate parents were uniformly intermediate. No evidence of sex linkage was seen. Thus the phenotype in which fibrosis is found is controlled by autosomal recessive determinants. Strains prone to radiation-induced pulmonary fibrosis and hyaline membranes exhibited intrinsically lower activities of lung plasminogen activator and angiotensin converting enzyme than either the nonfibrosing strains or the nonfibrosing hybrid crosses. The median time of death of the hybrids was genetically determined primarily by the longest-lived parent regardless of the types of lesions expressed.

  8. Rapid Hamstrings/Quadriceps Strength Capacity in Professional Soccer Players with Different Conventional Isokinetic Muscle Strength Ratios

    PubMed Central

    Greco, Camila C.; Da Silva, Wendell L.; Camarda, Sérgio R.A.; Denadai, Benedito S.

    2012-01-01

    Muscle strength imbalance can be an important factor in hamstrings muscle strain. A hamstrings/quadriceps (H/Q) strength ratio based on concentric peak torque values (Hcon:Qcon) has traditionally been used to describe the potential for knee-joint destabilization. Because certain standard actions in soccer are explosive, the analysis of the H/Q strength ratio based on the rate of torque development (Hrtd:Qrtd) might also be useful in the evaluation of joint stability. The objective of this study was to compare the Hrtd:Qrtd between professional soccer players with heterogeneous values of Hcon:Qcon. Thirty-nine professional soccer players took part in the following procedures on different days: 1) Familiarization session with the isokinetic dynamometer, and 2) Two maximal isometric actions and five maximal concentric actions at 60°·s-1 for hamstrings (H) and quadriceps (Q). Participants were ranked according to their Hcon:Qcon ratio. The median third was excluded to form a high torque group (HTG), and a low torque group (LTG). Peak isometric (H) and concentric (H and Q) torques and rate of torque development (H) were significantly greater in the HTG group. Similarly, Hcon:Qcon (0.68 ± 0.02 vs. 0.52 ± 0.03) and Hrtd:Qrtd (0.54 ± 0.12 vs. 0.43 ± 0.16) were significantly greater in the HTG group than in the LTG group. There was no significant correlation between Hcon:Qcon and Hrtd:Qrtd. It can be concluded that Hcon:Qcon and Hrtd:Qrtd are determined, but not fully defined, by shared putative physiological mechanisms. Thus, the physiologic and clinical significance of Hcon:Qcon and Hrtd:Qrtd to an athlete’s individual evaluation might be different. Key pointsSoccer players with high (0.66-0.70) and low (0.50-0.54) conventional concentric hamstrings:quadriceps ratios (Hcon:Qcon) tend to demonstrate similar profiles (i.e., high and low, respectively) in their rate of the torque development H/Q ratio (Hrtd:Qrtd).The lack of a significant relationship between Hcon:Qcon and Hrtd:Qrtd suggests that these ratios are determined, but not fully defined, by shared putative physiological mechanisms.Preseason screening programs that monitor hamstrings:quadriceps ratios should recognize that the physiologic and clinical significance of Hcon:Qcon and Hrfd:Qrfd to an athlete’s individual evaluation might be different. PMID:24149348

  9. Patellar tendon or hamstring graft anterior cruciate ligament reconstructions in patients aged above 50 years

    PubMed Central

    Bali, Tarun; Nagraj, Raghu; Kumar, Malhar N; Chandy, Thomas

    2015-01-01

    Background: The treatment of anterior cruciate ligament (ACL) injury consists of arthroscopic ACL reconstruction with patellar tendon or hamstring graft. Satisfactory results have been reported so far in the younger age group. Dilemma arises regarding the suitability of ACL reconstruction in patients aged 50 years and above. This retrospective analyses the outcome of ACL reconstruction in patients aged 50 years and above. Materials and Methods: 55 patients aged 50 years and above presented to our institution with symptomatic ACL tear and were managed with arthroscopic reconstruction with patellar tendon/hamstring graft. 22 patients underwent ACL reconstruction with bone- patellar tendon-bone graft and the remaining 33 with a hamstring graft. Evaluation of functional outcome was performed using International Knee Documentation Committee (IKDC) and Lysholm scoring in the preoperative period, at the end of 1 year and at the final followup. Radiographic evaluation was performed using the Kellgren–Lawrence grading system. Results: The mean preoperative IKDC score was 39.7 ± 3.3. At the end of 1-year following the operation, the mean IKDC score was 73.6 ± 4.9 and at the final followup was 67.8 ± 7.7. The mean preoperative Lysholm score was 40.4 ± 10.3. At the end of 1-year following the intervention, the mean Lysholm score was 89.7 ± 2.1 and at final followup was 85.3 ± 2.5. Overall, 14 out of 42 patients who underwent radiographic assessment showed progression of osteoarthritis changes at the final followup after the intervention. Conclusion: In our study, there was a statistically significant improvement in the IKDC and Lysholm scores following the intervention. There was a slight deterioration in the scores at the final followup but the overall rate of satisfaction was still high and most of the patients were able to do their routine chores and light exercises suitable for their age group. Around one-third of patients show progression of radiographic changes in the postoperative period and this requires long term evaluation. PMID:26806968

  10. Murine patellar tendon biomechanical properties and regional strain patterns during natural tendon-to-bone healing after acute injury

    PubMed Central

    Gilday, Steven D.; Casstevens, E. Chris; Kenter, Keith; Shearn, Jason T.; Butler, David L.

    2014-01-01

    Tendon-to-bone healing following acute injury is generally poor and often fails to restore normal tendon biomechanical properties. In recent years, the murine patellar tendon (PT) has become an important model system for studying tendon healing and repair due to its genetic tractability and accessible location within the knee. However, the mechanical properties of native murine PT, specifically the regional differences in tissue strains during loading, and the biomechanical outcomes of natural PT-to-bone healing have not been well characterized. Thus, in this study, we analyzed the global biomechanical properties and regional strain patterns of both normal and naturally healing murine PT at three time points (2, 5, and 8 weeks) following acute surgical rupture of the tibial enthesis. Normal murine PT exhibited distinct regional variations in tissue strain, with the insertion region experiencing approximately 2.5 times greater strain than the midsubstance at failure (10.80 ± 2.52% vs. 4.11 ± 1.40%; mean ± SEM). Injured tendons showed reduced structural (ultimate load and linear stiffness) and material (ultimate stress and linear modulus) properties compared to both normal and contralateral sham-operated tendons at all healing time points. Injured tendons also displayed increased local strain in the insertion region compared to contralateral shams at both physiologic and failure load levels. 93.3% of injured tendons failed at the tibial insertion, compared to only 60% and 66.7% of normal and sham tendons, respectively. These results indicate that 8 weeks of natural tendon-to-bone healing does not restore normal biomechanical function to the murine PT following injury. PMID:24210849

  11. Hamstring graft size and anthropometry in south Indian population

    PubMed Central

    Challa, Supradeeptha; Satyaprasad, Jonnalagedda

    2013-01-01

    Background and Aim The role of anthropometric measurements in the prediction of hamstring autograft size in Indian population remains unclear. Till now, no studies have been done on Indian population. Methods We evaluated 41 consecutive patients (34 males, 7 females) prospectively with anterior cruciate ligament deficiency scheduled for reconstruction using hamstring autograft at our institution between June 2011 and June 2013. Preoperatively we recorded age, gender, height, weight, body mass index, and activity level. Intraoperative measurements of semitendinosus tendon like absolute length, diameter before fashioning the graft and final diameter of the tripled graft using sizing tubes calibrated to 1 mm. Correlation coefficient (Pearson's r) analysis was used. Results As per study there is no correlation between graft diameter, age, sex, weight, activity, and body mass index, of patients. Height of patients correlated to graft diameter in both Indian men and women (p < 0.001). Conclusion Anthropometric measurements such as weight, gender, activity level cannot be used as definitive predictors for the hamstring graft diameter during harvest but height of the patients can be taken as good predictor in Indian population. PMID:26403553

  12. Gender Dimorphic ACL Strain In Response to Combined Dynamic 3D Knee Joint Loading: Implications for ACL Injury Risk

    PubMed Central

    Mizuno, Kiyonori; Andrish, Jack T.; van den Bogert, Antonie J.; McLean, Scott G.

    2009-01-01

    While gender-based differences in knee joint anatomies/laxities are well documented, the potential for them to precipitate gender-dimorphic ACL loading and resultant injury risk has not been considered. To this end, we generated gender-specific models of ACL strain as a function of any six degrees of freedom (6DOF) knee joint load state via a combined cadaveric and analytical approach. Continuously varying joint forces and torques were applied to five male and five female cadaveric specimens and recorded along with synchronous knee flexion and ACL strain data. All data (~10,000 samples) were submitted to specimen-specific regression analyses, affording ACL strain predictions as a function of the combined 6 DOF knee loads. Following individual model verifications, generalized gender-specific models were generated and subjected to 6 DOF external load scenarios consistent with both a clinical examination and a dynamic sports maneuver. The ensuing model-based strain predictions were subsequently examined for gender-based discrepancies. Male and female specimen specific models predicted ACL strain within 0.51% 0.10% and 0.52% 0.07% of the measured data respectively, and explained more than 75% of the associated variance in each case. Predicted female ACL strains were also significantly larger than respective male values for both of simulated 6 DOF load scenarios. Outcomes suggest that the female ACL will rupture in response to comparatively smaller external load applications. Future work must address the underlying anatomical/laxity contributions to knee joint mechanical and resultant ACL loading, ultimately affording prevention strategies that may cater to individual joint vulnerabilities. PMID:19464897

  13. Repetitive jumping and sprinting until exhaustion alters hamstring reflex responses and tibial translation in males and females.

    PubMed

    Behrens, Martin; Mau-Moeller, Anett; Wassermann, Franziska; Plewka, Antje; Bader, Rainer; Bruhn, Sven

    2015-11-01

    The incidence of anterior cruciate ligament injuries is considerably higher in females than in males and the underlying mechanisms are still under debate. Research indicates that the neuromuscular system of females and males might respond differently to the same fatigue protocol due to differences in muscle activation during movement tasks. This study analyzed sex differences in hamstring reflex responses and posterior-anterior tibial translation (TT) before and after fatiguing exercise. We measured the isolated movement of the tibia relative to the femur as a consequence of mechanically induced TT in standing subjects as well as muscle activity of the hamstrings before and after repetitive jumping and sprinting until exhaustion. Muscle fatigue delayed reflex onset latencies in females and males. A reduction in reflex responses associated with an increased TT was observed after fatiguing exercise for both sexes. Data indicate that the used fatigue protocol altered the latency and magnitude of reflex responses as well as TT in females and males. Based on the results of previous research and the outcome of this study, it might be that sex-specific effects of fatigue on reflex activity and mechanical stability of the knee depend on the kind of fatiguing exercise. PMID:25941064

  14. A Comparative Analysis of Lesion Development and Intraspinal Inflammation in Four Strains of Mice Following Spinal Contusion Injury

    PubMed Central

    KIGERL, KRISTINA A.; McGAUGHY, VIOLETA M.; POPOVICH, PHILLIP G.

    2009-01-01

    Susceptibility to neuroinflammatory disease is influenced in part by genetics. Recent data indicate that survival of traumatized neurons is strain-dependent and influenced by polygenic loci that control resistance/susceptibility to experimental autoimmune encephalomyelitis (EAE), a model of CNS autoimmune disease. Here, we describe patterns of neurodegeneration and intraparenchymal inflammation after traumatic spinal cord injury (SCI) in mice known to exhibit varying degrees of EAE susceptibility [EAE-resistant (r) or EAE-susceptible (s) mice]. Spinal cords from C57BL/6 (EAE-s), C57BL/10 (EAE-r), BALB/c (EAE-r) and B10.PL (EAE-s) mice were prepared for stereological and immunohistochemical analysis at 6 hrs, 3, 7, 14, 28 or 42 days following mid-thoracic (T9) spinal contusion injury. In general, genetic predisposition to EAE predicted the magnitude of intraparenchymal inflammation but not lesion size/length or locomotor recovery. Specifically, microglia/macrophage activation, recruitment of neutrophils and lymphocytes and de novo synthesis of MHC class II was greatest in C57BL/6 mice and least in BALB/c mice at all times examined. However, lesion volume and axial spread of neurodegeneration were similar in C57BL/6 and BALB/c mice and were significantly greater than in C57BL/10 or B10.PL mice. Strains with marked intraspinal inflammation also developed the most intense lesion fibrosis. Thus, strain-dependent neuroinflammation was observed after SCI but without a consistent relationship to EAE susceptibility or lesion progression. Only in C57BL/6 mice was the magnitude of intraspinal inflammation predictive of secondary neurodegeneration, functional recovery or fibrosis. PMID:16374800

  15. Knee flexor strength recovery following hamstring tendon harvest for anterior cruciate ligament reconstruction: a systematic review.

    PubMed

    Ardern, Clare L; Webster, Kate E

    2009-10-10

    The hamstring tendons are an increasingly popular graft choice for anterior cruciate ligament reconstruction due to preservation of quadriceps function and the absence of anterior knee pain post-operatively. Two commonly used hamstring grafts are a quadruple strand semitendinosus graft (4ST) and a double strand semitendinosus-double strand gracilis graft (2ST-2G). It has been suggested that concurrent harvest of the semitendinsous and gracilis tendons may result in sub-optimal hamstring strength recovery as the gracilis may play a role in reinforcing the semitendinosus particularly in deep knee flexion angles. The objective of this systematic review was to synthesize the findings of available literature and determine whether semitendinosus and gracilis harvest lead to post-operative hamstring strength deficits when compared to semitendinosus harvest alone. Seven studies were identified which compared hamstring strength outcomes between the common hamstring graft types. The methodological quality of each paper was assessed, and where possible effect sizes were calculated to allow comparison of results across studies. No differences were reported between the groups in isokinetic hamstring strength. Deficits in hamstring strength were reported in the 2ST-2G groups when compared to the 4ST groups in isometric strength testing at knee flexion angles ≥70°, and in the standing knee flexion angle. Preliminary evidence exists to support the hypothesis that harvesting the semitendinosus tendon alone is preferable to harvesting in combination with the gracilis tendon for minimizing post-operative hamstring strength deficits at knee flexion angles greater than 70°. However, due to the paucity of research comparing strength outcomes between the common hamstring graft types, further investigation is warranted to fully elucidate the implications for graft harvest. PMID:21808674

  16. Ultrasound assessment of hamstring muscle size using posterior thigh muscle thickness.

    PubMed

    Abe, Takashi; Loenneke, Jeremy P; Thiebaud, Robert S

    2016-05-01

    Several studies have investigated the relationship between ultrasound-measured muscle thickness (MT) and individual muscle cross-sectional area (CSA) and muscle volume (MV) in extremity and trunk muscles; however, the hamstring muscle has not been studied. The purpose of this study was to examine the relationship between posterior thigh MT by ultrasound and the muscle CSA and MV of the hamstring obtained by magnetic resonance imaging (MRI). Ten young women aged 20-31 had MT measured by ultrasound at three sites on the medial anterior (50% of thigh length; TL) and posterior (50% and 70% of TL) aspects of the thigh. On the same day, a series of continuous muscle CSA along the thigh was measured by MRI. In each slice, the anatomical CSA of the hamstring (biceps femoris, semitendinosus and semimembranosus) and quadriceps muscle was analysed, and the CSAs at 50% and 70% of TL and maximal CSA of the hamstring (CSAmax ) were determined. MV was calculated by multiplying CSA by slice thickness. A significant correlation was observed between posterior 50% MT and 50% hamstring CSA (r = 0·848, P = 0·002) and between posterior 70% MT and 70% hamstring CSA (r = 0·679, P = 0·031). Posterior 50% MT (r = 0·732, P = 0·016) and 50% MTxTL (r = 0·873, P = 0·001) were also correlated to hamstring MV. Anterior:posterior 50% thigh MT ratio was correlated to MV ratio of quadriceps and hamstring muscles (r = 0·803, P = 0·005). Our results suggest that posterior thigh MT reflects hamstring muscle CSA and MV. The anterior:posterior MT ratio may serve as a surrogate for MV ratio of quadriceps and hamstring. PMID:25363847

  17. Albuminuria indicates the pressure-associated injury of juxtamedullary nephrons and cerebral strain vessels in spontaneously hypertensive stroke-prone rats

    PubMed Central

    Nagasawa, Tasuku; Mori, Takefumi; Ohsaki, Yusuke; Yoneki, Yoshimi; Guo, Qi; Sato, Emiko; Oba, Ikuko; Ito, Sadayoshi

    2012-01-01

    Albuminuria is an indicator of renal injury and is closely linked with cardiovascular disease (CVD). However, the mechanism by which albumin is excreted in the urine remains unclear. As the juxtamedullary region of the kidney is highly susceptible to pressure increase, juxtamedullary injury is observed from an early phase in hypertensive rat models. Anatomical similarities are observed between the pre-glomerular vessels of the juxtamedullary nephron and the cerebral vasculature. We previously named these ‘strain vessels' for their high vascular tone and exposure to higher pressures. The current studies were designed to determine whether albuminuria is the result of juxtamedullary nephron injury, indicating the presence of pressure injury to the strain vessels in spontaneously hypertensive stroke-prone rats (SHR-SP) fed a high-salt diet. Albuminuria was associated with juxtamedullary nephron injury, and the enhanced expression of monocyte chemotactic protein-1 (MCP-1) and tumor growth factor-beta (TGF-β) in 12-week-old SHR-SP rats fed a 4% high-salt diet from the age of 6 weeks. The wall thickness of the pre-glomerular vessels of the juxtamedullary nephron was also associated with that of the perforating artery of the middle cerebral artery. Reducing the blood pressure with nifedipine reduced the degree of albuminuria and juxtamedullary nephron injury as well as MCP-1 and TGF-β expression in the SHR-SP rats fed an 8% high-salt diet from the age of 9 weeks. Nifedipine inhibited stroke events in these animals until they were 14 weeks old. These results indicate that albuminuria is a result of juxtamedullary nephron injury and a marker of pressure-induced injury of the strain vessels. PMID:22914555

  18. Assessment of in vivo revival, growth, and pathogenicity of Escherichia coli strains after copper- and chlorine-induced injury

    SciTech Connect

    Singh, A.; Yeager, R.; McFeters, G.A.

    1986-10-01

    Cells of one enteroinvasive and three enterotoxigenic strains of Escherichia coli were exposed to sublethal concentrations of copper and chlorine to produce 85 to 94% injury. Injured cells were introluminally inoculated into ligated ileal loops of anesthetized mice, and injury was assessed at timed intervals. Substantial recovery (72-84%) of copper- and chlorine-injured cells was observed in the inoculated loops at 4 and 3 h, respectively. No appreciable increase in total numbers was observed during these time intervals. In vitro revival of copper-injured cells in phosphate-buffered saline alone after incubation at 35/sup 0/C for 4 h was not observed. However, a 60 to 70% revival occurred when 200 ..mu..g of protein per ml of mouse intestinal mucosal homogenate was incorporated into saline cell suspensions. The enterotoxigenic activity of copper-injured cells in rabbit ileal loops was somewhat reduced compared with that of chlorine-injured or uninjured cells. These results show that injured pathogenic E. coli cells can revive in the small intestine and appear to retain their enterotoxigenic activity.

  19. Complete tear of the distal hamstring tendons in a professional football player: a case report and review of the literature.

    PubMed

    Aldebeyan, Sultan; Boily, Mathieu; Martineau, Paul A

    2016-03-01

    Semimembranosus tendon ruptures are rare and are often associated with involvement of the cruciate ligaments. We present a 24-year-old American football player who sustained a complete rupture of the semimembranosus tendon near its insertion associated with an avulsion fracture of the conjoint attachment of the lateral collateral ligament (LCL) and biceps femoris with intact cruciate ligaments and menisci during practice. At the scene he was immobilized and was taken to the hospital immediately. The diagnosis was reached after radiographs and an MRI of the affected knee were obtained. The semimembranosus tendon and the avulsion of the biceps femoris insertion were repaired surgically. We also review the literature for previously reported cases of distal hamstring injuries. PMID:26668066

  20. Magnitudes of muscle activation of spine stabilizers, gluteals, and hamstrings during supine bridge to neutral position.

    PubMed

    Youdas, James W; Hartman, James P; Murphy, Brooke A; Rundle, Ashley M; Ugorowski, Jenna M; Hollman, John H

    2015-01-01

    The aim of this study was to compare the magnitude of selective core muscle activation during supine bridging to neutral exercises (three on a stable and three on an unstable surface). Surface EMG analysis was performed on the lumbar multifidus, gluteus medius, gluteus maximus, and hamstrings from 13 male and 13 female subjects. Lumbar multifidus recruitment was not influenced by exercise or condition and ranged between 29.2 and 35.9% of maximum voluntary isometric contraction (MVIC). Peak gluteus medius activation (42.0% MVIC) occurred in unstable single-leg bridge. Maximum recruitment of gluteus maximus (32.6% MVIC) appeared during stable single-leg bridge. Peak hamstring activation (59.6% MVIC) occurred during stable double-leg hamstring curl. Regardless of condition, hamstrings demonstrated high (51.9-59.6% MVIC) muscle recruitment during double-leg hamstring curls compared with the single-leg bridge or double-leg bridge. Various supine bridging to neutral exercises activated the hamstrings at levels conducive to strengthening, whereas recruitment of lumbar multifidus, gluteus medius, and gluteus maximus promoted endurance training. Clinically, we were unable to conclude the unstable support surface was preferable to the stable surface for boosting muscle recruitment of spine stabilizers, gluteals, and hamstring muscles during supine bridge to neutral position. PMID:25671354

  1. Hip extension strength following hamstring tendon harvest for ACL reconstruction.

    PubMed

    Geoghegan, John M; Geutjens, Guido G; Downing, Nicholas D; Colclough, Karen; King, Richard J

    2007-10-01

    Hamstring autograft harvest for ACL reconstruction may have an effect on hip extension strength and this may be important especially in sports that involve high speed running such as soccer, rugby, American football and the sprint disciplines of track and field. This aspect of hamstring tendon harvesting has not been looked at before. We have performed a non-randomised prospective case control study comparing isokinetic hip extension strength following four strand semitendinosus and gracilis tendons (4SHS) and bone-patellar tendon-bone (BPTB) autografts in ACL reconstruction. Isokinetic hip extension was assessed at 3 and 12 months post-operatively using a Kin-Com machine at a speed of 30 degrees per second. Three months post-operatively there was a significant decrease (p<0.05) in the peak force of concentric hip extension in the 4SHS group. There was no evidence that hip extension is weaker following ACL reconstruction with 4SHS tendon autograft than ACL reconstruction with BPTB autograft at 12 months post-operatively. We find no contra-indication to the use of 4SHS tendon autografts in ACL reconstruction in patients who wish to preserve hip extension strength for their sporting activities. PMID:17627827

  2. Injuries in professional football: current concepts.

    PubMed

    Olson, David; Sikka, Robby S; Labounty, Abby; Christensen, Trent

    2013-01-01

    Professional football is one of the most popular sports in the United States. There is a common constellation of injuries that are seen frequently. Much attention has been focused on concussions and their long-term outcomes in this population. Other common causes of morbidity include cervical spine injuries, knee injuries including anterior cruciate ligament and other ligamentous injuries, ankle sprains, and medical issues including cardiac and sickle trait. Several recent studies have focused on hip impingement and hamstring injuries, among others, as sources of missed playing time as well. This review describes some of the frequently seen injuries and medical issues in professional football players. Proper management of both medical disease and on-field injuries can reduce morbidity and may lead to faster return to play and reduced risk of future injury. PMID:24225523

  3. EFFECT OF AXIAL TIBIAL TORQUE DIRECTION ON ACL RELATIVE STRAIN AND STRAIN RATE IN AN IN VITRO SIMULATED PIVOT LANDING

    PubMed Central

    Oh, Youkeun K.; Kreinbrink, Jennifer L.; Wojtys, Edward M.; Ashton-Miller, James A.

    2011-01-01

    Anterior cruciate ligament (ACL) injuries most frequently occur under the large loads associated with a unipedal jump landing involving a cutting or pivoting maneuver. We tested the hypotheses that internal tibial torque would increase the anteromedial (AM) bundle ACL relative strain and strain rate more than would the corresponding external tibial torque under the large impulsive loads associated with such landing maneuvers. Twelve cadaveric female knees [mean (SD) age: 65.0 (10.5) years] were tested. Pretensioned quadriceps, hamstring and gastrocnemius muscle-tendon unit forces maintained an initial knee flexion angle of 15°. A compound impulsive test load (compression, flexion moment and internal or external tibial torque) was applied to the distal tibia while recording the 3-D knee loads and tibofemoral kinematics. AM-ACL relative strain was measured using a 3mm DVRT. In this repeated measures experiment, the Wilcoxon Signed-Rank test was used to test the null hypotheses with p<0.05 considered significant. The mean (± SD) peak AM-ACL relative strains were 5.4±3.7 % and 3.1±2.8 % under internal and external tibial torque, respectively. The corresponding mean (± SD) peak AM-ACL strain rates reached 254.4±160.1 %/sec and 179.4±109.9 %/sec, respectively. The hypotheses were supported in that the normalized mean peak AM-ACL relative strain and strain rate were 70% and 42% greater under internal than external tibial torque, respectively (p=0.023, p=0.041). We conclude that internal tibial torque is a potent stressor of the ACL because it induces a considerably (70%) larger peak strain in the AM-ACL than does a corresponding external tibial torque. PMID:22025178

  4. Contributors to Fatigue Resistance of the Hamstrings and Quadriceps in Cerebral Palsy

    PubMed Central

    Moreau, Noelle G; Li, Li; Geaghan, James P; Damiano, Diane L

    2009-01-01

    Background The purpose of this study was to elucidate relationships between quadriceps and hamstrings voluntary muscle fatigue and upper motor lesion impairments in cerebral palsy in order to gain a better understanding of their contribution to the observed fatigue resistance. Methods Seventeen ambulatory subjects with cerebral palsy (mean age: 17.0, SD = 4.8 years) were recruited. Quantitative measures of strength, spasticity, cocontraction, and stiffness for both muscle groups were collected on an isokinetic dynamometer and entered in a factor analysis. The resulting factors were used as independent variables in a multiple regression analysis with quadriceps and hamstrings fatigue as dependent variables. Findings Five independent factors explained 90% of the variance. In order of loadings, higher hamstring cocontraction and spasticity and lower hamstring strength were associated with lower levels of hamstring fatigue. Higher quadriceps cocontraction and lower quadriceps strength were the most predictive of lower levels of quadriceps fatigue. Interpretation Greater motor impairments of the agonist muscle, particularly cocontraction, spasticity, and weakness, were associated with lower rates of muscle fatigue of the same muscle during performance of a voluntary fatigue protocol for the hamstrings and quadriceps. Muscles are highly adaptable; therefore, the results of this study suggest that the observed fatigue resistance may be due to the effect of the primary neural insult on motor unit recruitment and rate modulation or the result of secondary adaptations to spasticity, weakness, or excessive cocontraction. PMID:19264384

  5. Integrative Metabolome and Transcriptome Profiling Reveals Discordant Energetic Stress between Mouse Strains with Differential Sensitivity to Acrolein-Induced Acute Lung Injury

    PubMed Central

    Fabisiak, James P.; Medvedovic, Mario; Alexander, Danny C.; McDunn, Jonathan E.; Concel, Vincent J.; Bein, Kiflai; Jang, An Soo; Brendt, Annerose; Vuga, Louis J.; Brant, Kelly A.; Pope-Varsalona, Hannah; Dopico, Richard A.; Ganguly, Koustav; Upadhyay, Swapna; Li, Qian; Hu, Zhen; Kaminski, Naftali; Leikauf, George D.

    2012-01-01

    A respiratory irritant, acrolein is generated by overheating cooking oils or by domestic cooking using biomass fuels, and is in tobacco smoke, an occupational health hazard in the restaurant workplace. To better understand the metabolic role of the lung and to generate insights into the pathogenesis of acrolein-induced acute lung injury, SM/J (sensitive) and 129×1/SvJ (resistant) inbred mouse strains were exposed and the lung metabolome was integrated with the transcriptome profile. A total of 280 small molecules were identified and mean values (log 2 >0.58 or <−0.58, .p<0.05) were considered different for between-strain comparisons or within-strain responses to acrolein treatment. At baseline, 24 small molecules increased and 33 small molecules decreased in the SM/J mouse lung as compared to 129×1/SvJ mouse lung. Notable among the increased compounds was malonyl carnitine. Following acrolein exposure, several compounds indicative of glycolysis and branched chain amino acid metabolism increased similarly in both strains, whereas SM/J mice were less effective in generating metabolites related to fatty acid β-oxidation. These findings suggest management of energetic stress varies between these strains, and that the ability to evoke auxiliary energy generating pathways rapidly and effectively may be critical in enhancing survival during acute lung injury in mice. PMID:21823223

  6. Effects of Sacroiliac Joint Mobilization on Hamstring Muscle Flexibility and Quadriceps Muscle Strength

    PubMed Central

    Tamer, Seval; Öz, Müzeyyen; Ülger, Özlem

    2014-01-01

    Objectives: The aim of this study was to determine the effect of sacroiliac joint mobilization (SJM) in cases with sacroiliac joint dysfunction (SJD) on hamstring muscle flexibility and quadriceps muscle strength. Methods: Seven subjects age average (min- max) was 21.85 (21-23) years with SJD were included. Hamstring muscle flexibility was measured with passive knee extension (PKE) method by using goniometer; quadriceps muscle strength was measured by using a hand dynamometer. After osteopathic evaluation (sacroiliac joint stress and mobility tests) appropriate mobilization methods (ilium anterior, ilium posterior and sacrum R / R dysfunction mobilization) were performed in patients with sacroiliac joint dysfunction. All measurements were repeated before, immediately and 4 days after application. For statistical analysis, Friedman and Wilcoxon-Signed test was used. Results: Immediately after SIJ mobilization for 7 patients, hamstring muscle flexibility was evaluated and compared with pretreatment status; bilateral hamstring muscle flexibility improvement was observed (p <0.05). When the results at 4 days were compared with the pretreatment measurements, generated effect continued in the dominant side (p <0.05) and there were no changes observed in the non-dominant side (p> 0.05). When immediate and 4th-day measurements were compared, bilateral improvement was maintained(p> 0.05). When pretreatment and immediate posttreatment rsults were analysed, bilateral quadriceps muscle strength was found to be increased (p <0.05). When 4th- day and pretreatment measures were compared the effects were bilaterally maintained (p <0.05). Comparison of immediate postapplication and 4th-day measurements revealed that bilateral improvement continued (p> 0.05). Conclusion: In SJD patients known with hamstring muscle flexibility loss and quadriceps muscle weakness, private sacroiliac joint mobilization is effective in enhancing hamstring muscle flexibility and quadriceps muscle strength, so SJD could be considered for increasing quadriceps muscle strength and hamstring muscle flexibility.

  7. Lower hamstring extensibility in men compared to women is explained by differences in stretch tolerance

    PubMed Central

    2014-01-01

    Background This study examined whether passive hamstring tissue stiffness and/or stretch tolerance explain the relationship between sex and hamstring extensibility. Methods Ninety healthy participants, 45 men and 45 women (mean ± SD; age 24.6 ± 5.9 years, height 1.72 ± 0.09 m, weight 74.6 ± 14.1 kg) volunteered for this study. The instrumented straight leg raise was used to determine hamstring extensibility and allow measurement of stiffness and stretch tolerance (visual analog pain score, VAS). Results Hamstring extensibility was 9.9° greater in women compared to men (p = 0.003). VAS scores were 16 mm lower in women (p = 0.001). Maximal stiffness (maximal applied torque) was not different between men and women (p = 0.42). Passive stiffness (slope from 20-50° hip flexion) was 0.09 Nm.°-1 lower in women (p = 0.025). For women, linear and stepwise regression showed that no predictor variables were associated with hamstring extensibility (adjusted r2 = -0.03, p = 0.61). For men, 44% of the variance in hamstring extensibility was explained by VAS and maximal applied torque (adjusted r2 = 0.44, p < 0.001), with 41% of the model accounted for by the relationship between higher VAS scores and lower extensibility (standardized β coefficient = -0.64, p < 0.001). Conclusions The results of this study suggest that stretch tolerance and not passive stiffness explains hamstring extensibility, but this relationship is only manifest in men. PMID:25000977

  8. The association between antagonist hamstring coactivation and episodes of knee joint shifting and buckling

    PubMed Central

    Segal, N.A.; Nevitt, M.C.; Welborn, R.D.; Nguyen, U.-S.D.T.; Niu, J.; Lewis, C.E.; Felson, D.T.; Frey-Law, L.

    2016-01-01

    SUMMARY Objective Hamstring coactivation during quadriceps activation is necessary to counteract the quadriceps pull on the tibia, but coactivation can be elevated with symptomatic knee osteoarthritis (OA). To guide rehabilitation to attenuate risk for mobility limitations and falls, this study evaluated whether higher antagonistic open kinetic chain hamstring coactivation is associated with knee joint buckling (sudden loss of support) and shifting (a sensation that the knee might give way). Design At baseline, median hamstring coactivation was assessed during maximal isokinetic knee extensor strength testing and at baseline and 24-month follow-up, knee buckling and shifting was self-reported. Associations between tertiles of co-activation and knee (1) buckling, (2) shifting and (3) either buckling or shifting were assessed using logistic regression, adjusted for age, sex, knee OA and pain. Results 1826 participants (1089 women) were included. Mean ± SD age was 61.7 ± 7.7 years, BMI was 30.3 ± 5.5 kg/m2 and 38.2% of knees had OA. There were no consistent statistically significant associations between hamstring coactivation and ipsilateral prevalent or incident buckling or the combination of buckling and shifting. The odds ratios for incident shifting in the highest in comparison with the lowest tertile of coactivation had similar magnitudes in the combined and medial hamstrings, but only reached statistical significance for lateral hamstring coactivation, OR(95%CI) 1.53 (0.99, 2.36). Conclusions Hamstring coactivation during an open kinetic chain quadriceps exercise was not consistently associated with prevalent or incident self-reported knee buckling or shifting in older adults with or at risk for knee OA. PMID:25765501

  9. Sports Injuries

    MedlinePlus

    ... sometimes you can injure yourself when you play sports or exercise. Accidents, poor training practices, or improper gear can cause them. Some people get hurt because they are not in shape. Not warming up or stretching enough can also ... injuries are Sprains and strains Knee injuries Swollen ...

  10. The Interday Measurement Consistency of and Relationships Between Hamstring and Leg Musculo-articular Stiffness.

    PubMed

    Waxman, Justin P; Schmitz, Randy J; Shultz, Sandra J

    2015-10-01

    Hamstring stiffness (K(HAM)) and leg stiffness (K(LEG)) are commonly examined relative to athletic performance and injury risk. Given these may be modifiable, it is important to understand day-to-day variations inherent in these measures before use in training studies. In addition, the extent to which K(HAM) and K(LEG) measure similar active stiffness characteristics has not been established. We investigated the interday measurement consistency of K(HAM) and K(LEG), and examined the extent to which K(LEG) predicted K(HAM) in 6 males and 9 females. K(HAM) was moderately consistent day-to-day (ICC(2,5) = .71; SEM = 76.3 Nm(-1)), and 95% limits of agreement (95% LOA) revealed a systematic bias with considerable absolute measurement error (95% LOA = 89.6 224.8 Nm(-1)). Day-to-day differences in procedural factors explained 59.4% of the variance in day-to-day differences in K(HAM). Bilateral and unilateral K(LEG) was more consistent (ICC(2,3) range = .87-.94; SEM range = 1.0-2.91 kNm(-1)) with lower absolute error (95% LOA bilateral= -2.0 10.3; left leg = -0.36 3.82; right leg = -1.05 3.61 kNm(-1)). K(LEG) explained 44% of the variance in K(HAM) (P < .01). Findings suggest that procedural factors must be carefully controlled to yield consistent and precise K(HAM) measures. The ease and consistency of K(LEG), and moderate correlation with K(HAM), may steer clinicians toward K(LEG) when measuring lower-extremity stiffness for screening studies and monitoring the effectiveness of training interventions over time. PMID:26035860

  11. Influence of Anterior Cruciate Ligament Tear on Thigh Muscle Strength and Hamstring-to-Quadriceps Ratio: A Meta-Analysis

    PubMed Central

    Ahn, Sung-Eun; Park, Min-Ji; Lee, Dae-Hee

    2016-01-01

    Theoretical compensation after anterior cruciate ligament (ACL) tear could cause quadriceps weakness and hamstring activation, preventing anterior tibial subluxation and affecting the expected hamstring-to-quadriceps ratio. Although quadriceps weakness often occurs after ACL tears, it remains unclear whether hamstring strength and hamstring-to-quadriceps ratio increase in ACL deficient knees. This meta-analysis compared the isokinetic muscle strength of quadriceps and hamstring muscles, and the hamstring-to-quadriceps ratio, of the injured and injured limbs of patients with ACL tears. This meta-analysis included all studies comparing isokinetic thigh muscle strengths and hamstring-to-quadriceps ratio in the injured and uninjured legs of patients with ACL tear, without or before surgery. Thirteen studies were included in the meta-analysis. Quadriceps and hamstring strengths were 22.3 N∙m (95% CI: 15.2 to 29.3 N∙m; P<0.001) and 7.4 N∙m (95% CI: 4.3 to 10.5 N∙m; P<0.001) lower, respectively, on the injured than on the uninjured side. The mean hamstring-to-quadriceps ratio was 4% greater in ACL deficient than in uninjured limbs (95% CI: 1.7% to 6.3%; P<0.001). Conclusively, Decreases were observed in both the quadriceps and hamstring muscles of patients with ACL tear, with the decrease in quadriceps strength being 3-fold greater. These uneven reductions slightly increase the hamstring-to-quadriceps ratio in ACL deficient knees. PMID:26745808

  12. Effects of voluntary wheel running on the kidney at baseline and after ischaemia-reperfusion-induced acute kidney injury: a strain difference comparison.

    PubMed

    Moningka, Natasha C; Cunningham, Mark W; Sterling, Myrline; West, Crystal A; Verlander, Jill W; Croker, Byron P; Ahlgren, Joslyn; Hayward, Linda; Baylis, Chris

    2013-03-01

    Exercise-induced vascular endothelial adaptations in the kidney are not well understood. Therefore, we investigated the impact of voluntary wheel running (VWR) on the abundance of endothelial nitric oxide synthase (eNOS) and extracellular superoxide dismutase (EC SOD), in kidney and lung, and other SOD isoforms and total antioxidant capacity (TAC), in kidney. We also determined whether VWR influences susceptibility to acute kidney injury (AKI). Male Sprague-Dawley and Fisher 344 rats, VWR or sedentary for 12 weeks, were subjected to AKI (uninephrectomy (UNX) and 35 min of left kidney ischaemia-24 h reperfusion, IR). We measured glomerular filtration rate (GFR) and renal plasma flow (RPF), and analysed renal structural injury. Running was comparable between strains and VWR reduced body weight. In Sprague-Dawley rats, VWR reduced eNOS and EC SOD, but increased Mn SOD in kidney. Similar changes were seen after 6 weeks of VWR in Sprague-Dawley rats. In Fisher 344 rats, VWR increased eNOS, all SOD isoforms and TAC in kidney. Both strains increased eNOS and EC SOD in lung with VWR. Compared to UNX alone, UNX-IR injury markedly reduced renal function for both strains; however, in the Sprague-Dawley rats, VWR exacerbated falls in GFR and RPF due to UNX-IR, whereas in the Fisher 344 rats, GFR was unaffected by VWR. Some indices of renal structural injury due to UNX-IR tended to be worse in SD vs. F344. Our study demonstrates that genetic background influences the effect of exercise on kidney eNOS and EC SOD, which in turn influence the susceptibility to AKI. PMID:23266936

  13. Treatment of knee osteoarthritis in relation to hamstring and quadriceps strength.

    PubMed

    Hafez, Ashraf Ramadan; Al-Johani, Ahmed H; Zakaria, Abdul Rahim; Al-Ahaideb, Abdulaziz; Buragadda, Syamala; Melam, Ganeswara Rao; Kachanathu, Shaji J

    2013-11-01

    [Purpose] To assess the effect of hamstring and quadriceps strengthening exercises on pain intensity, gait velocity, maximum isometric strength, and activities of daily living of patients with knee osteoarthritis (OA). [Subjects and Methods] A total of 20 patients with knee OA, 50 to 65 years of age (57.65 ± 4.78 years), received hot packs, strengthening exercises for the quadriceps and the hamstring muscles and stretching exercises for hamstring muscles. Outcome measures included: the Western Ontario and McMaster Universities OA index questionnaire (WOMAC) scores for assessing health status and health outcomes of knee OA; self-reported pain intensity scores, measured using a visual analogue scale; the 50 ft walk test (a measure of gait velocity and function); and handheld dynamometry (a tool used to measure maximum isometric strength of knee extension and flexion). [Results] There was a significant difference between pre- and post-intervention measures of pain intensity, 50 ft walk times, hamstring strength, and quadriceps strength. Significant differences in WOMAC measures were also observed in the subscales of pain, stiffness and physical function, as well as WOMAC total scores. [Conclusion] Strengthening the hamstring muscles in addition to strengthening the quadriceps muscles proved to be beneficial for perceived knee pain, range of motion, and decreasing the limitation of functional performance of patients with knee OA. PMID:24396198

  14. Joint infection unique to hamstring tendon harvester used during anterior cruciate ligament reconstruction surgery.

    PubMed

    Tuman, Jeffrey; Diduch, David R; Baumfeld, Joshua A; Rubino, L Joseph; Hart, Joseph M

    2008-05-01

    Joint infection after anterior cruciate ligament (ACL) reconstruction is a rare but important clinical issue that must be resolved quickly to prevent secondary joint damage and preserve the graft. After careful analysis, we observed 3 infection cases within a 12-month period after ACL reconstruction, which represented an abnormally elevated risk. All reconstructions were performed by the same surgeon and used hamstring tendon allograft. For each surgery, the Target Tendon Harvester (DePuy Mitek, Raynham, MA) was used to harvest hamstring tendons. Through our review, we learned that this instrument was sterilized while assembled. It is our belief that ineffective sterilization of this hamstring graft harvester served as the origin for these infections. We have determined that appropriate sterilization technique involves disassembly of this particular hamstring tendon harvester before sterilization because of the tube-within-a-tube configuration. We have since continued to use the Target Tendon Harvester, disassembling it before sterilization. There have been no infections in the ensuing 12 months during which the surgeon performed over 40 primary ACL reconstructions via hamstring autograft. The information from this report is intended to provide arthroscopists with information about potential sources of infection after ACL reconstruction surgery. PMID:18442698

  15. Comparative study of hamstring and quadriceps strengthening treatments in the management of knee osteoarthritis.

    PubMed

    Al-Johani, Ahmed H; Kachanathu, Shaji John; Ramadan Hafez, Ashraf; Al-Ahaideb, Abdulaziz; Algarni, Abdulrahman D; Meshari Alroumi, Abdulmohesn; Alanezi, Aqeel M

    2014-06-01

    [Purpose] Osteoarthritis (OA) of the knee is the most common form of joint disease. It is one of the major causes of impaired function that reduces quality of life (QOL) worldwide. The purpose of this study was to compare exercise treatments for hamstring and quadriceps strength in the management of knee osteoarthritis. [Subjects and Methods] Forty patients with OA knee, aged 50-65 years were divided into 2 groups. The first group (57.65±4.78 years) received hot packs and performed strengthening exercises for the quadriceps and hamstring, and stretching exercises for the hamstring. The second group (58.15±5.11 years) received hot packs and performed strengthening exercises for only the quadriceps, and stretching exercise for the hamstring. Outcome measures were the WOMAC (Western Ontario and McMaster Universities OA index questionnaire), Visual Analogue Scale (VAS) assessment of pain, the Fifty-Foot Walk Test (FWS), and Handheld dynamometry. [Results] There was a significant difference between the groups. The first group showed a more significant result than the second group. [Conclusion] Strengthening of the hamstrings in addition to strengthening of the quadriceps was shown to be beneficial for improving subjective knee pain, range of motion and decreasing the limitation of functional performance of patients with knee osteoarthritis. PMID:25013274

  16. Comparative Study of Hamstring and Quadriceps Strengthening Treatments in the Management of Knee Osteoarthritis

    PubMed Central

    Al-Johani, Ahmed H; Kachanathu, Shaji John; Ramadan Hafez, Ashraf; Al-Ahaideb, Abdulaziz; Algarni, Abdulrahman D; Meshari Alroumi, Abdulmohsen; Alenazi, Aqeel M.

    2014-01-01

    [Purpose] Osteoarthritis (OA) of the knee is the most common form of joint disease. It is one of the major causes of impaired function that reduces quality of life (QOL) worldwide. The purpose of this study was to compare exercise treatments for hamstring and quadriceps strength in the management of knee osteoarthritis. [Subjects and Methods] Forty patients with OA knee, aged 50–65 years were divided into 2 groups. The first group (57.65±4.78 years) received hot packs and performed strengthening exercises for the quadriceps and hamstring, and stretching exercises for the hamstring. The second group (58.15±5.11 years) received hot packs and performed strengthening exercises for only the quadriceps, and stretching exercise for the hamstring. Outcome measures were the WOMAC (Western Ontario and McMaster Universities OA index questionnaire), Visual Analogue Scale (VAS) assessment of pain, the Fifty-Foot Walk Test (FWS), and Handheld dynamometry. [Results] There was a significant difference between the groups. The first group showed a more significant result than the second group. [Conclusion] Strengthening of the hamstrings in addition to strengthening of the quadriceps was shown to be beneficial for improving subjective knee pain, range of motion and decreasing the limitation of functional performance of patients with knee osteoarthritis. PMID:25013274

  17. Muscle strain treatment

    MedlinePlus

    Treatment - muscle strain ... Question: How do you treat a muscle strain ? Answer: Rest the strained muscle and apply ice for the first few days after the injury. Anti-inflammatory medicines or acetaminophen ( ...

  18. Dry Endoscopic-Assisted Mini-Open Approach With Neuromonitoring for Chronic Hamstring Avulsions and Ischial Tunnel Syndrome

    PubMed Central

    Gómez-Hoyos, Juan; Reddy, Manoj; Martin, Hal D.

    2015-01-01

    Chronic hamstring origin avulsions and ischial tunnel syndrome are common causes of posterior hip pain. Although physical therapy has shown benefits in some cases, recent evidence has reported better outcomes with surgical treatment in appropriately selected patients. The full-open approach has been the classic procedure to address this problem. However, the complications related to extensive tissue exposure and the proximity of the incision to the perianal zone have led to the description of full-endoscopic techniques. Achieving an accurate hamstring repair could be technically demanding with a full-endoscopic procedure. Accurate reattachment is crucial in hamstring repair because of the functional demand of the muscles crossing of 2 major joints (hip and knee). This surgical note describes a mixed technique including a mini-open approach, neuromonitoring, and dry endoscopic-assisted repair of the hamstring origin as an alternative for treating patients with chronic hamstring avulsions and ischial tunnel syndrome that remain symptomatic despite nonoperative treatment. PMID:26258031

  19. The effects of a Feldenkrais program and relaxation procedures on hamstring length.

    PubMed

    James, Michelle; Kolt, Gregory; McConville, Janet; Bate, Patricia

    1998-01-01

    Despite the growing popularity of the Feldenkrais method in Australia (Wildman 1990b), little research is available investigating its efficacy. The current study investigated the effects of the Feldenkrais method on hamstring length. Forty-eight healthy undergraduate participants were randomly allocated into either Feldenkrais, relaxation, or control groups. All subjects had their right hamstring measured using a modified active knee extension test prior to the first session, prior to the fourth (final) session, and after the final session of intervention. Two-way analysis of variance with time of measurement repeated revealed no significant differences between the groups. The findings are discussed in relation to apparent ineffectiveness of the Feldenkrais Awareness Through Movement lessons used on hamstring length, exposure time to the technique, and attitudes towards the Feldenkrais method. PMID:11676714

  20. Using squat repetition maximum testing to determine hamstring resistance training exercise loads.

    PubMed

    Ebben, William P; Long, Nicholas J; Pawlowski, Zach D; Chmielewski, Lauren M; Clewien, Rustin W; Jensen, Randall L

    2010-02-01

    The purpose of this study was to determine whether there is a linear relationship between the squat and a variety of hamstring resistance training exercises, and whether this relationship differs on the basis of sex. This study also sought to create prediction equations for the determination of hamstring exercise load based on the squat load. Repetition maximums of the squat, as well as 4 common hamstring resistance training exercises including the seated leg curl, stiff leg dead lift, single leg dead lift, and good morning exercise, were determined for each subject. Subjects included 21 men and 13 women collegiate athletes. Data were evaluated using linear regression analysis to predict hamstring exercise loads from 6 repetition maximum squat data. Results of the analysis of all subjects indicated that squat load was a significant predictor of loads for each of the hamstring exercises. However, separate analysis of women revealed that squat load was not a significant predictor of loads for any of the hamstring exercises. Analysis of the men revealed that squat was a significant predictor of load for the seated leg curl (R = 0.58, p < 0.001), stiff leg dead lift (R = 0.82, p < 0.001), single leg stiff leg dead lift (R = 0.80, p < 0.001), and good morning (R = 0.79, p < 0.001) exercises. On the basis of the analysis of the men, the following prediction equations were devised for each exercise: (1) seated leg curl load = squat load (0.186) + 10.935 kg, (2) stiff leg deadlift load = squat load (1.133) - 86.331 kg, (3) single leg stiff leg deadlift load = squat load (0.443) - 3.425 kg, and (4) good morning load = squat load (0.961) - 105.505 kg. Thus, results from testing core exercises such as the squat can provide useful data for the assignment of loads for assistance exercises. PMID:20072071

  1. Functional and neuromuscular changes in the hamstrings after drop jumps and leg curls.

    PubMed

    Sarabon, Nejc; Panjan, Andrej; Rosker, Jernej; Fonda, Borut

    2013-01-01

    The purpose of this study was to use a holistic approach to investigate changes in jumping performance, kinaesthesia, static balance, isometric strength and fast stepping on spot during a 5-day recovery period, following an acute bout of damaging exercise consisted of drop jumps and leg curls, where specific emphasis was given on the hamstring muscles. Eleven young healthy subjects completed a series of highly intensive damaging exercises for their hamstring muscles. Prior to the exercise, and during the 5-day recovery period, the subjects were tested for biochemical markers (creatine kinase, aspartate aminotransferase, and lactate dehydrogenase), perceived pain sensation, physical performance (squat jump, counter movement jump, maximal frequency leg stamping, maximal isometric torque production and maximally explosive isometric torque production), kinaesthesia (active torque tracking) and static balance. We observed significant decreases in maximal isometric knee flexion torque production, the rate of torque production, and majority of the parameters for vertical jump performance. No alterations were found in kinaesthesia, static balance and fast stepping on spot. The highest drop in performance and increase in perceived pain sensation generally occurred 24 or 48 hours after the exercise. Damaging exercise substantially alters the neuromuscular functions of the hamstring muscles, which is specifically relevant for sports and rehabilitation experts, as the hamstrings are often stretched to significant lengths, in particular when the knee is extended and hip flexed. These findings are practically important for recovery after high-intensity trainings for hamstring muscles. Key PointsHamstring function is significantly reduced following specifically damaging exercise.It fully recovers 120 hours after the exercise.Prevention of exercise-induced muscle damage is cruicial for maintaining normal training regime. PMID:24149148

  2. Serial Changes of Quadriceps and Hamstring Muscle Strength Following Total Knee Arthroplasty: A Meta-Analysis

    PubMed Central

    Ahn, Hyeong-Sik; Lee, Dae-Hee

    2016-01-01

    This meta-analysis was performed to analyze serial changes in thigh muscles, including quadriceps and hamstring muscles, from before to one year after total knee arthroplasty (TKA). All studies sequentially comparing isokinetic quadriceps and hamstring muscle strengths between the TKA side and the contralateral uninjured limb were included in this meta-analysis. Five studies with 7 cohorts were included in this meta-analysis. The mean differences in the strengths of quadriceps and hamstring muscles between the TKA and uninjured sides were greatest three months after surgery (26.8 N∙m, 12.8 N∙m, P<0.001), but were similar to preoperative level at six months (18.4 N∙m, 7.4 N∙m P<0.001) and were maintained for up to one year (15.9 N∙m, 4.1 N∙m P<0.001). The pooled mean differences in changes in quadriceps and hamstring strengths relative to preoperative levels were 9.2 N∙m and 4.9 N∙m, respectively, three months postoperatively (P = 0.041), but were no longer significant after six months and one year. During the year after TKA, quadriceps and hamstring muscle strengths were lowest after 3 months, recovering to preoperative level after six months, but not reaching the muscle strength on the contralateral side. Relative to preoperative levels, the difference in muscle strength between the TKA and contralateral knees was only significant at three months. Because decrease of strength of the quadriceps was significantly greater than decrease in hamstring muscle strength at postoperative three months, early rehabilitation after TKA should focus on recovery of quadriceps muscle strength. PMID:26849808

  3. Viscoelasticity of Tau Proteins Leads to Strain Rate-Dependent Breaking ofMicrotubules during Axonal Stretch Injury: Predictions from a Mathematical Model

    PubMed Central

    Ahmadzadeh, Hossein; Smith, DouglasH.; Shenoy, VivekB.

    2014-01-01

    The unique viscoelastic nature of axons is thought to underlie selective vulnerability to damage during traumatic brain injury. In particular, dynamic loading of axons has been shown to mechanically break microtubules at the time of injury. However, the mechanism of this rate-dependent response has remained elusive. Here, we present a microstructural model of the axonal cytoskeleton to quantitatively elucidate the interaction between microtubules and tau proteins under mechanical loading. Mirroring the axon ultrastructure, the microtubules were arranged in staggered arrays, cross-linked by tau proteins. We found that the viscoelastic behavior specifically of tau proteins leads to mechanical breaking of microtubules at high strain rates, whereas extension of tau allows for reversible sliding of microtubules without any damage at small strain rates. Based on the stiffness and viscosity of tau proteins inferred from single-molecule force spectroscopy studies, we predict the critical strain rate for microtubule breaking to be in the range 2244 s?1, in excellent agreement with recent experiments on dynamic loading of micropatterned neuronal cultures. We also identified a characteristic length scale for load transfer that depends on microstructural properties and have derived a phase diagram in the parameter space spanned by loading rate and microtubule length that demarcates those regions where axons can be loaded and unloaded reversibly and those where axons are injured due to breaking of the microtubules. PMID:24606936

  4. Direct measurement of intervertebral disc maximum shear strain in six degrees of freedom: Motions that place disc tissue at risk of injury

    PubMed Central

    Costi, JJ; Stokes, I A; Gardner-Morse, M; Laible, J P; Scoffone, HM; Iatridis, JC

    2007-01-01

    Human intervertebral disc specimens were tested to determine the regions of largest maximum shear strain experienced by disc tissues in each of three principal displacements and three rotations, and to identify the physiological rotations and displacements that may place the disc at greatest risk for large tissue strains and injury. Tearing of disc annulus may be initiated by large interlamellar shear strains. Nine human lumbar discs were tagged with radiographic markers on the endplates, disc periphery and with a grid of wires in the mid-transverse plane and subjected to each of the six principal displacements and rotations. Stereo-radiographs were taken in each position and digitized for reconstruction of the 3-D position of each marker. Maximum tissue shear strains were calculated from relative marker displacements and normalized by the input displacement or rotation. Lateral shear, compression, and lateral bending were the motions that produced the mean (95% confidence interval) largest regional maximum shear strains (MSS) of 9.6 (0.7) %/mm, 9.0 (0.5) %/mm, and 5.8 (1.6) %/° respectively, and which occurred in the posterior, posterolateral and lateral peripheral regions of the disc. After taking into account the reported maximum physiological range of motion for each degree of freedom, motions producing the highest physiological MSS were lateral bending (57.8 (16.2)%) and flexion (38.3 (3.3)%), followed by lateral shear (14.4 (1.1)%) and compression (12.6 (0.7)%). PMID:17198708

  5. Leg Injuries and Disorders

    MedlinePlus

    ... can damage your legs. Common leg injuries include sprains and strains, joint dislocations, and fractures. These injuries can affect the entire leg, or just the foot, ankle, knee, or hip. Certain diseases also lead to leg ...

  6. Hip Injuries and Disorders

    MedlinePlus

    ... or falling can all sometimes lead to hip injuries. These include Strains Bursitis Dislocations Fractures Certain diseases also lead to hip injuries or problems. Osteoarthritis can cause pain and limited ...

  7. Agreement Between Face-to-Face and Free Software Video Analysis for Assessing Hamstring Flexibility in Adolescents.

    PubMed

    Moral-Muñoz, José A; Esteban-Moreno, Bernabé; Arroyo-Morales, Manuel; Cobo, Manuel J; Herrera-Viedma, Enrique

    2015-09-01

    The objective of this study was to determine the level of agreement between face-to-face hamstring flexibility measurements and free software video analysis in adolescents. Reduced hamstring flexibility is common in adolescents (75% of boys and 35% of girls aged 10). The length of the hamstring muscle has an important role in both the effectiveness and the efficiency of basic human movements, and reduced hamstring flexibility is related to various musculoskeletal conditions. There are various approaches to measuring hamstring flexibility with high reliability; the most commonly used approaches in the scientific literature are the sit-and-reach test, hip joint angle (HJA), and active knee extension. The assessment of hamstring flexibility using video analysis could help with adolescent flexibility follow-up. Fifty-four adolescents from a local school participated in a descriptive study of repeated measures using a crossover design. Active knee extension and HJA were measured with an inclinometer and were simultaneously recorded with a video camera. Each video was downloaded to a computer and subsequently analyzed using Kinovea 0.8.15, a free software application for movement analysis. All outcome measures showed reliability estimates with α > 0.90. The lowest reliability was obtained for HJA (α = 0.91). The preliminary findings support the use of a free software tool for assessing hamstring flexibility, offering health professionals a useful tool for adolescent flexibility follow-up. PMID:26313580

  8. Immediate effect of passive and active stretching on hamstrings flexibility: a single-blinded randomized control trial

    PubMed Central

    Nishikawa, Yuichi; Aizawa, Junya; Kanemura, Naohiko; Takahashi, Tetsuya; Hosomi, Naohisa; Maruyama, Hirofumi; Kimura, Hiroaki; Matsumoto, Masayasu; Takayanagi, Kiyomi

    2015-01-01

    [Purpose] This study compared the efficacy of passive and active stretching techniques on hamstring flexibility. [Subjects] Fifty-four healthy young subjects were randomly assigned to one of three groups (2 treatment groups and 1 control group). [Methods] Subjects in the passive stretching group had their knees extended by an examiner while lying supine 90° of hip flexion. In the same position, subjects in the active stretching group extended their knees. The groups performed 3 sets of the assigned stretch, with each stretch held for 10 seconds at the point where tightness in the hamstring muscles was felt. Subjects in the control group did not perform stretching. Before and immediately after stretching, hamstring flexibility was assessed by a blinded assessor, using the active knee-extension test. [Results] After stretching, there was a significant improvement in the hamstring flexibilities of the active and passive stretching groups compared with the control group. Furthermore, the passive stretching group showed significantly greater improvement in hamstring flexibility than the active stretching group. [Conclusion] Improvement in hamstring flexibility measured by the active knee-extension test was achieved by both stretching techniques; however, passive stretching was more effective than active stretching at achieving an immediate increase in hamstring flexibility. PMID:26644667

  9. Evaluation of Hip Internal and External Rotation Range of Motion as an Injury Risk Factor for Hip, Abdominal and Groin Injuries in Professional Baseball Players

    PubMed Central

    Ma, Richard; Zhou, Hanbing; Thompson, Matthew; Dawson, Courtney; Nguyen, Joseph; Coleman, Struan

    2015-01-01

    Normal hip range of motion (ROM) is essential in running and transfer of energy from lower to upper extremities during overhead throwing. Dysfunctional hip ROM may alter lower extremity kinematics and predispose athletes to hip and groin injuries. The purpose of this study is characterize hip internal/external ROM (Arc) and its effect on the risk of hip, hamstring, and groin injuries in professional baseball players. Bilateral hip internal and external ROM was measured on all baseball players (N=201) in one professional organization (major and minor league) during spring training. Players were organized according to their respective positions. All injuries were documented prospectively for an entire MLB season (2010 to 2011). Data was analyzed according to position and injuries during the season. Total number of players (N=201) with an average age of 24±3.6 (range=17-37). Both pitchers (N=93) and catchers (N=22) had significantly decreased mean hip internal rotation and overall hip arc of motion compared to the positional players (N=86). Players with hip, groin, and hamstring injury also had decreased hip rotation arc when compared to the normal group. Overall, there is a correlation between decreased hip internal rotation and total arc of motion with hip, hamstring, and groin injuries. PMID:26793294

  10. Evaluation of Hip Internal and External Rotation Range of Motion as an Injury Risk Factor for Hip, Abdominal and Groin Injuries in Professional Baseball Players.

    PubMed

    Li, Xinning; Ma, Richard; Zhou, Hanbing; Thompson, Matthew; Dawson, Courtney; Nguyen, Joseph; Coleman, Struan

    2015-12-28

    Normal hip range of motion (ROM) is essential in running and transfer of energy from lower to upper extremities during overhead throwing. Dysfunctional hip ROM may alter lower extremity kinematics and predispose athletes to hip and groin injuries. The purpose of this study is characterize hip internal/external ROM (Arc) and its effect on the risk of hip, hamstring, and groin injuries in professional baseball players. Bilateral hip internal and external ROM was measured on all baseball players (N=201) in one professional organization (major and minor league) during spring training. Players were organized according to their respective positions. All injuries were documented prospectively for an entire MLB season (2010 to 2011). Data was analyzed according to position and injuries during the season. Total number of players (N=201) with an average age of 24±3.6 (range=17-37). Both pitchers (N=93) and catchers (N=22) had significantly decreased mean hip internal rotation and overall hip arc of motion compared to the positional players (N=86). Players with hip, groin, and hamstring injury also had decreased hip rotation arc when compared to the normal group. Overall, there is a correlation between decreased hip internal rotation and total arc of motion with hip, hamstring, and groin injuries. PMID:26793294

  11. Criterion-Related Validity of Sit-and-Reach Tests for Estimating Hamstring and Lumbar Extensibility: a Meta-Analysis

    PubMed Central

    Mayorga-Vega, Daniel; Merino-Marban, Rafael; Viciana, Jesús

    2014-01-01

    The main purpose of the present meta-analysis was to examine the scientific literature on the criterion-related validity of sit-and-reach tests for estimating hamstring and lumbar extensibility. For this purpose relevant studies were searched from seven electronic databases dated up through December 2012. Primary outcomes of criterion-related validity were Pearson´s zero-order correlation coefficients (r) between sit-and-reach tests and hamstrings and/or lumbar extensibility criterion measures. Then, from the included studies, the Hunter- Schmidt´s psychometric meta-analysis approach was conducted to estimate population criterion- related validity of sit-and-reach tests. Firstly, the corrected correlation mean (rp), unaffected by statistical artefacts (i.e., sampling error and measurement error), was calculated separately for each sit-and-reach test. Subsequently, the three potential moderator variables (sex of participants, age of participants, and level of hamstring extensibility) were examined by a partially hierarchical analysis. Of the 34 studies included in the present meta-analysis, 99 correlations values across eight sit-and-reach tests and 51 across seven sit-and-reach tests were retrieved for hamstring and lumbar extensibility, respectively. The overall results showed that all sit-and-reach tests had a moderate mean criterion-related validity for estimating hamstring extensibility (rp = 0.46-0.67), but they had a low mean for estimating lumbar extensibility (rp = 0. 16-0.35). Generally, females, adults and participants with high levels of hamstring extensibility tended to have greater mean values of criterion-related validity for estimating hamstring extensibility. When the use of angular tests is limited such as in a school setting or in large scale studies, scientists and practitioners could use the sit-and-reach tests as a useful alternative for hamstring extensibility estimation, but not for estimating lumbar extensibility. Key Points Overall sit-and-reach tests have a moderate mean criterion-related validity for estimating hamstring extensibility, but they have a low mean validity for estimating lumbar extensibility. Among all the sit-and-reach test protocols, the Classic sit-and-reach test seems to be the best option to estimate hamstring extensibility. End scores (e.g., the Classic sit-and-reach test) are a better indicator of hamstring extensibility than the modifications that incorporate fingers-to-box distance (e.g., the Modified sit-and-reach test). When angular tests such as straight leg raise or knee extension tests cannot be used, sit-and-reach tests seem to be a useful field test alternative to estimate hamstring extensibility, but not to estimate lumbar extensibility. PMID:24570599

  12. The Carry-Over Effects of Diathermy and Stretching in Developing Hamstring Flexibility

    PubMed Central

    Draper, David O.; Miner, Lisa; Knight, Kenneth L.; Ricard, Mark D.

    2002-01-01

    Objective: To compare the effects of low-load, short-duration stretching with or without high-intensity, pulsed short-wave diathermy on hamstring flexibility. Design and Setting: We used a single-blind, repeated-measures design (pretest and posttest for all treatments) that included a placebo. The 3 independent variables were treatment mode, pretest and posttest measurements, and day. Treatment mode had 3 levels: diathermy and stretching, stretching alone, and control. The dependent variable was range of motion. Subjects were randomly assigned to the diathermy and stretching, stretching-only, or control group. Subjects were treated and tested each day (at approximately the same time) for 5 days, with a follow-up test administered 72 hours later. Hamstring flexibility was tested using a sit-and-reach box before and after each treatment. Diathermy and stretching subjects received a 15-minute diathermy treatment on the right hamstring at a setting of 7000 pulses per second, with an average pulse width of 95 μsec. Stretching-only subjects received a 15-minute sham diathermy treatment. Both diathermy and stretching and stretching-only subjects then performed three 30-second stretches (short duration) before being retested. Control subjects lay prone for 15 minutes before being retested. Subjects: Thirty-seven healthy college students (11 men, 26 women, age = 20.46 ± 1.74 years) volunteered. Measurements: Hamstring flexibility was measured using a sit-and-reach box before and after each treatment. Results: The average increases in hamstring flexibility over the 5 treatment days for the diathermy and stretching, stretching-only, and control groups were 6.06 cm (19.6%), 5.27 cm (19.7%), and 3.38 cm (10.4%), respectively. Three days later (after no treatment), the values for the diathermy and stretching, stretching-only, and control groups were 8.27 cm (26.7%), 6.83 cm (25.3%), and 4.15 cm (14.2%), respectively. No significant differences in hamstring flexibility were noted among the groups. Conclusions: Diathermy and short-duration stretching were no more effective than short-duration stretching alone at increasing hamstring flexibility. The effects of diathermy with longer stretching times need to be researched. PMID:12937442

  13. The effect of accelerated, brace free, rehabilitation on bone tunnel enlargement after ACL reconstruction using hamstring tendons: a CT study.

    PubMed

    Vadalà, Antonio; Iorio, Raffaele; De Carli, Angelo; Argento, Giuseppe; Di Sanzo, Vincenzo; Conteduca, Fabio; Ferretti, Andrea

    2007-04-01

    The mechanism of bone tunnel enlargement following anterior cruciate ligament (ACL) reconstruction is not yet clearly understood. Many authors hypothesized that aggressive rehabilitation protocols may be a potential factor for bone tunnel enlargement, especially in reconstructions performed with hamstrings autograft. The purpose of this study was to evaluate the effect of a brace free rehabilitation on the tunnel enlargement after ACL reconstruction using doubled semitendinosus and gracilis tendons (DGST): our hypothesis was that early post-operative knee motion increase the diameters of the tibial and femoral bone tunnels. Forty-five consecutive patients undergoing ACL reconstruction for chronic ACL deficiency were selected. All patients were operated by the same surgeon using autologous DGST and the same fixation devices. Patients with associated ligaments injuries and or severe chondral damage were excluded. The patients were randomly assigned to enter the control group (group A, standard post-operative rehabilitation) and the study group (group B, brace free accelerated rehabilitation). A CT scan was used to exactly determine the diameters of both femoral and tibial tunnels at various levels of lateral femoral condyle and proximal tibia, using a previously described method [17]. Measurements were done by an independent radiologist in a blinded fashion the day after the operation and at a mean follow-up of 10 months (range 9-11). Statistical analysis was performed using paired t-test. The mean femoral tunnel diameter increased significantly from 9.04 +/- 0.05 (post-operative) to 9.30 +/- 0.8 mm (follow-up) in group A and from 9.04 +/- 0.03 to 9.94 +/- 1.12 mm in group B. The mean tibial tunnel diameter increased significantly from 9.03 +/- 0.04 to 10.01 +/- 0.80 mm in group A and from 9.04 +/- 0.03 to 10.60 +/- 0.78 mm in group B. The increase in femoral and tunnel diameters observed in the study group was significantly higher than that observed in the control group. Our results suggest that bone tunnel enlargement after ACL reconstruction using hamstrings autograft can be increased by an accelerated, brace free, rehabilitation protocol. PMID:17149647

  14. Hamstring Graft Technique for Stabilization of Canine Cranial Cruciate Ligament Deficient Stifles

    PubMed Central

    LOPEZ, MANDI J.; MARKEL, MARK D.; KALSCHEUR, VICKI; LU, YAN; MANLEY, PAUL A.

    2007-01-01

    Objective To investigate the harvest and application of hamstring grafts for canine cranial cruciate ligament (CrCL) reconstruction. Study Design Experimental study. Animals Four adult female hounds, weighing 26.3 ± 1.6 kg (mean ± SEM). Methods One stifle in each dog was randomly chosen for hamstring graft CrCL reconstruction after native CrCL transection. Arthroscopy was performed to evaluate graft integrity at 12 weeks. Gait analysis and stifle radiographs were performed preoperatively and up to 52 weeks after graft placement. Dogs were killed 12 (n = 2) or 52 weeks (n = 2) after CrCL reconstruction. Tissues were evaluated grossly and with light and confocal laser microscopy. Results Hamstring grafts were intact in all stifles at 12 weeks (n = 4) and 52 weeks (n = 2). Grossly, there was no osteoarthritis in stifles at 12 weeks and only chondrophytes along the trochlear ridges at 52 weeks. Minimal radiographic evidence of osteoarthritis developed in stifles with grafts during the study. Lameness in limbs with grafts resolved by 52 weeks. Graft tissue was highly vascular, ligamentized, and undergoing active remodeling at 12 weeks. Fifty-two weeks after graft placement, intraarticular graft tissue was well vascularized, mature, and encapsulated by synovium, and graft-bone interfaces were characterized by Sharpey’s fiber insertions. There was no evidence of graft necrosis using confocal laser microscopy at either time point. Conclusions The hamstring graft technique may be a viable method of canine CrCL reconstruction. Clinical Relevance Hamstring grafts may be an alternative technique for canine CrCL reconstruction. Further study is needed before clinical application. PMID:12866003

  15. Arthroscopy-assisted anterior cruciate ligament reconstruction with patellar tendon or hamstring autografts.

    PubMed

    Doral, M N; Leblebicioglu, G; Atay, O A; Baydar, M L; Tetik, O; Atik, S

    2000-01-01

    Isolated ACL reconstructions were performed in 138 patients between 1994 and 1998. Patellar bone-patellar tendon-bone, and hamstring tendon autografts were used in 88 patients, and allografts were used in 50 patients. Eighty-eight knees of 88 patients with autograft reconstructions (17 female, 71 male) were included in this study and evaluation of the patients with allograft reconstruction reported separately. The mean age at the time of the operation was 32 years. All ACL reconstructions were performed arthroscopically. Twenty-seven bone-patellar tendon-bone, and 61 hamstring tendon autografts were used. The mean follow-up was 29 months. In the postoperative course the Lachman test was negative in 62 patients, 1+ in 22 patients, and 2+ in 4 patients. In 17 patients, anterior drawer sign were 1+ in comparison to the contralateral side. Pivot shift test was moderately positive only in 5 cases in the bone-patellar tendon-bone and hamstring tendon autograft groups postoperatively. There were 3 patients with subjective "giving way" symptoms. Second look arthroscopy revealed rupture of the neo-ligament. Arthroscopic washout and debridement were performed, and no revision ligamentoplasties were performed. Two of these patients improved with accelerated proprioceptive physical therapy, and one had to decrease his previous level of activity. There were no cases of arthrofibrosis, infection, or extension lag. Clinical results of patellar bone-tendon-bone and hamstring groups did not show any significant clinical difference. Avoiding the disturbance of the extensor mechanism of the knee is probably the most significant advantage of the hamstring autograft. PMID:10983256

  16. Piriformis syndrome surgery causing severe sciatic nerve injury.

    PubMed

    Justice, Phillip E; Katirji, Bashar; Preston, David C; Grossman, Gerald E

    2012-09-01

    Piriformis syndrome is a controversial entrapment neuropathy in which the sciatic nerve is thought to be compressed by the piriformis muscle. Two patients developed severe left sciatic neuropathy after piriformis muscle release. One had a total sciatic nerve lesion, whereas the second had a predominantly high common peroneal nerve lesion. Follow-up studies showed reinnervation of the hamstrings only. We conclude that piriformis muscle surgery may be hazardous and result in devastating sciatic nerve injury. PMID:22922582

  17. Interactive effects of tunnel dilation on the mechanical properties of hamstring grafts fixed in the tibia with interference screws.

    PubMed

    Rittmeister, M E; Noble, P C; Bocell, J R; Alexander, J W; Conditt, M A; Kohl, H W

    2001-09-01

    The effect of dilation of the tibial tunnel on the strength of hamstring graft fixation using interference screws was evaluated. In all, 28 RCI screws were tested in male human tibia-hamstring constructs with tibial tunnels reamed or dilated to the respective size of the graft diameter. Dilation of the tibial tunnel failed to significantly enhance hamstring fixation. Grafts secured in dilated tunnels displayed an 11% greater resistance to the initiation of graft slippage (174+/-112 N) compared to their undilated controls (156+/-77 N, P=0.63). Dilation of the tibial tunnel increased the failure load by an average of 4%, independent of screw diameter (dilated specimens: 360+/-120 N, controls: 345+/-88 N, P=0.74). Biomechanical research on the effect of tibial tunnel dilation in hamstring fixation has not provided satisfactory evidence as to the benefits of this additional surgical step during anterior cruciate ligament (ACL) reconstruction. PMID:11685357

  18. Crossover Cutting During Hamstring Fatigue Produces Transverse Plane Knee Control Deficits

    PubMed Central

    Nyland, John A.; Caborn, David N.M.; Shapiro, Robert; Johnson, Darren L.

    1999-01-01

    Objective: To assess the effects of eccentric work-induced hamstring fatigue on sagittal and transverse plane (axial) knee and ankle biodynamics and kinetics during a running crossover cut directional change (functional pivot shift). Design and Setting: A pretest-posttest, single-group intervention experimental design was employed. All data were collected in a biodynamics laboratory. Subjects: Twenty healthy athletic females were trained for 3 weeks in crossover cutting before testing. Measurements: Data were sampled during 3 unfatigued and 3 fatigued (20% eccentric isokinetic knee-flexor torque reduction) crossover cut trials. Three-dimensional kinematic and ground reaction-force data were sampled at 200 Hz and 1000 Hz, respectively, and joint moment estimates were calculated. Data were standardized to initial force-plate heelstrike for comparisons of mean differences between conditions using paired t tests with Bonferroni adjustments. Pearson product-moment correlations compared kinematic and eccentric hamstring-torque relationships. Results: During internal rotation phase 1, between heelstrike and impact absorption, mean internal rotation velocity increased by 21.2°/s ± 114°/s. During internal rotation phase II, mean peak transverse plane knee rotation during propulsion decreased by 3.1° ± 9°. During internal rotation phase II, mean peak ankle plantar flexor moment onsets occurred 12.7 ± 53 milliseconds earlier, and this activation demonstrated a moderately positive relationship with the onset of mean peak knee internal rotation during propulsion and a weak negative relationship with mean peak hamstring torque/lean body weight. Conclusions: The increased knee internal rotation velocity during phase I indicates transverse plane dynamic knee-control deficits during hamstring fatigue. Earlier peak ankle plantar-flexor moments and decreased internal rotation during phase II in the presence of hamstring fatigue may represent compensatory attempts at dynamic knee stabilization from the posterior lower leg musculature during the pivot shift portion of the crossover cut. The weak relationship between decreased hamstring torque/lean body weight and delayed knee internal rotation during propulsion further supports greater dependence on ankle plantar flexors for dynamic knee stabilization compensation ImagesFigure 1.Figure 2.Figure 3. PMID:16558556

  19. Knee and Hip Joint Kinematics Predict Quadriceps and Hamstrings Neuromuscular Activation Patterns in Drop Jump Landings

    PubMed Central

    Malfait, Bart; Dingenen, Bart; Smeets, Annemie; Staes, Filip; Pataky, Todd; Robinson, Mark A.; Vanrenterghem, Jos; Verschueren, Sabine

    2016-01-01

    Purpose The purpose was to assess if variation in sagittal plane landing kinematics is associated with variation in neuromuscular activation patterns of the quadriceps-hamstrings muscle groups during drop vertical jumps (DVJ). Methods Fifty female athletes performed three DVJ. The relationship between peak knee and hip flexion angles and the amplitude of four EMG vectors was investigated with trajectory-level canonical correlation analyses over the entire time period of the landing phase. EMG vectors consisted of the {vastus medialis(VM),vastus lateralis(VL)}, {vastus medialis(VM),hamstring medialis(HM)}, {hamstring medialis(HM),hamstring lateralis(HL)} and the {vastus lateralis(VL),hamstring lateralis(HL)}. To estimate the contribution of each individual muscle, linear regressions were also conducted using one-dimensional statistical parametric mapping. Results The peak knee flexion angle was significantly positively associated with the amplitudes of the {VM,HM} and {HM,HL} during the preparatory and initial contact phase and with the {VL,HL} vector during the peak loading phase (p<0.05). Small peak knee flexion angles were significantly associated with higher HM amplitudes during the preparatory and initial contact phase (p<0.001). The amplitudes of the {VM,VL} and {VL,HL} were significantly positively associated with the peak hip flexion angle during the peak loading phase (p<0.05). Small peak hip flexion angles were significantly associated with higher VL amplitudes during the peak loading phase (p = 0.001). Higher external knee abduction and flexion moments were found in participants landing with less flexed knee and hip joints (p<0.001). Conclusion This study demonstrated clear associations between neuromuscular activation patterns and landing kinematics in the sagittal plane during specific parts of the landing. These findings have indicated that an erect landing pattern, characterized by less hip and knee flexion, was significantly associated with an increased medial and posterior neuromuscular activation (dominant hamstrings medialis activity) during the preparatory and initial contact phase and an increased lateral neuromuscular activation (dominant vastus lateralis activity) during the peak loading phase. PMID:27101130

  20. Rowing injuries.

    PubMed

    Rumball, Jane S; Lebrun, Constance M; Di Ciacca, Stephen R; Orlando, Karen

    2005-01-01

    Participation in the sport of rowing has been steadily increasing in recent decades, yet few studies address the specific injuries incurred. This article reviews the most common injuries described in the literature, including musculoskeletal problems in the lower back, ribs, shoulder, wrist and knee. A review of basic rowing physiology and equipment is included, along with a description of the mechanics of the rowing stroke. This information is necessary in order to make an accurate diagnosis and treatment protocol for these injuries, which are mainly chronic in nature. The most frequently injured region is the low back, mainly due to excessive hyperflexion and twisting, and can include specific injuries such as spondylolysis, sacroiliac joint dysfunction and disc herniation. Rib stress fractures account for the most time lost from on-water training and competition. Although theories abound for the mechanism of injury, the exact aetiology of rib stress fractures remains unknown. Other injuries discussed within, which are specific to ribs, include costochondritis, costovertebral joint subluxation and intercostal muscle strains. Shoulder pain is quite common in rowers and can be the result of overuse, poor technique, or tension in the upper body. Injuries concerning the forearm and wrist are also common, and can include exertional compartment syndrome, lateral epicondylitis, deQuervain's and intersection syndrome, and tenosynovitis of the wrist extensors. In the lower body, the major injuries reported include generalised patellofemoral pain due to abnormal patellar tracking, and iliotibial band friction syndrome. Lastly, dermatological issues, such as blisters and abrasions, and miscellaneous issues, such as environmental concerns and the female athlete triad, are also included in this article.Pathophysiology, mechanism of injury, assessment and management strategies are outlined in the text for each injury, with special attention given to ways to correct biomechanical or equipment problems specific to rowing. By gaining an understanding of basic rowing biomechanics and training habits, the physician and/or healthcare provider will be better equipped to treat and prevent injuries in the rowing population. PMID:15974636

  1. Rotator Cuff Injuries.

    ERIC Educational Resources Information Center

    Connors, G. Patrick

    Many baseball players suffer from shoulder injuries related to the rotator cuff muscles. These injuries may be classified as muscular strain, tendonitis or tenosynovitis, and impingement syndrome. Treatment varies from simple rest to surgery, so it is important to be seen by a physician as soon as possible. In order to prevent these injuries, the

  2. Rotator Cuff Injuries.

    ERIC Educational Resources Information Center

    Connors, G. Patrick

    Many baseball players suffer from shoulder injuries related to the rotator cuff muscles. These injuries may be classified as muscular strain, tendonitis or tenosynovitis, and impingement syndrome. Treatment varies from simple rest to surgery, so it is important to be seen by a physician as soon as possible. In order to prevent these injuries, the…

  3. Virulence from vesicles: novel mechanisms of host cell injury by escherichia coli O104:H4 outbreak strain

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The highly virulent Escherichia coli O104:H4 that caused the large 2011 outbreak of diarrhoea and haemolytic uraemic syndrome secretes blended virulence factors of enterohaemorrhagic and enteroaggregative E. coli, but their secretion pathways are unknown. We demonstrate that the outbreak strain rele...

  4. MRP-1 expression levels determine strain-specific susceptibility to sodium arsenic-induced renal injury between C57BL/6 and BALB/c mice.

    PubMed

    Kimura, Akihiko; Ishida, Yuko; Wada, Takashi; Yokoyama, Hitoshi; Mukaida, Naofumi; Kondo, Toshikazu

    2005-02-15

    To clarify the pathophysiological mechanism underlying acute renal injury caused by acute exposure to arsenic, we subcutaneously injected both BALB/c and C57BL/6 mice with sodium arsenite (NaAs; 13.5 mg/kg). BALB/c mice exhibited exaggerated elevation of serum blood urea nitrogen (BUN) and creatinine (CRE) levels, compared with C57BL/6 mice. Moreover, half of BALB/c mice died by 24 h, whereas all C57BL/6 mice survived. Histopathological examination on kidney revealed severe hemorrhages, acute tubular necrosis, neutrophil infiltration, cast formation, and disappearance of PAS-positive brush borders in BALB/c mice, later than 10 h. These pathological changes were remarkably attenuated in C57BL/6 mice, accompanied with lower intrarenal arsenic concentrations, compared with BALB/c mice. Among heavy metal inducible proteins including multidrug resistance-associated protein (MRP)-1, multidrug resistance gene (MDR)-1, metallothionein (MT)-1, and arsenite inducible, cysteine- and histidine-rich RNA-associated protein (AIRAP), intrarenal MDR-1, MT-1, and AIRAP gene expression was enhanced to a similar extent in both strains, whereas NaAs challenge augmented intrarenal MRP-1 mRNA and protein expression levels in C57BL/6 but not BALB/c mice. Moreover, the administration of a specific inhibitor of MRP-1, MK-571, significantly exaggerated acute renal injury in C57BL/6 mice. Thus, MRP-1 is crucially involved in arsenic efflux and eventually prevention of acute renal injury upon acute exposure to NaAs. PMID:15694464

  5. MRP-1 expression levels determine strain-specific susceptibility to sodium arsenic-induced renal injury between C57BL/6 and BALB/c mice

    SciTech Connect

    Kimura, Akihiko; Ishida, Yuko; Wada, Takashi; Yokoyama, Hitoshi; Mukaida, Naofumi; Kondo, Toshikazu . E-mail: kondot@wakayama-med.ac.jp

    2005-02-15

    To clarify the pathophysiological mechanism underlying acute renal injury caused by acute exposure to arsenic, we subcutaneously injected both BALB/c and C57BL/6 mice with sodium arsenite (NaAs; 13.5 mg/kg). BALB/c mice exhibited exaggerated elevation of serum blood urea nitrogen (BUN) and creatinine (CRE) levels, compared with C57BL/6 mice. Moreover, half of BALB/c mice died by 24 h, whereas all C57BL/6 mice survived. Histopathological examination on kidney revealed severe hemorrhages, acute tubular necrosis, neutrophil infiltration, cast formation, and disappearance of PAS-positive brush borders in BALB/c mice, later than 10 h. These pathological changes were remarkably attenuated in C57BL/6 mice, accompanied with lower intrarenal arsenic concentrations, compared with BALB/c mice. Among heavy metal inducible proteins including multidrug resistance-associated protein (MRP)-1, multidrug resistance gene (MDR)-1, metallothionein (MT)-1, and arsenite inducible, cysteine- and histidine-rich RNA-associated protein (AIRAP), intrarenal MDR-1, MT-1, and AIRAP gene expression was enhanced to a similar extent in both strains, whereas NaAs challenge augmented intrarenal MRP-1 mRNA and protein expression levels in C57BL/6 but not BALB/c mice. Moreover, the administration of a specific inhibitor of MRP-1, MK-571, significantly exaggerated acute renal injury in C57BL/6 mice. Thus, MRP-1 is crucially involved in arsenic efflux and eventually prevention of acute renal injury upon acute exposure to NaAs.

  6. Effects on hamstring muscle extensibility, muscle activity, and balance of different stretching techniques.

    PubMed

    Lim, Kyoung-Il; Nam, Hyung-Chun; Jung, Kyoung-Sim

    2014-02-01

    [Purpose] The purpose of this study was to investigate the effects of two different stretching techniques on range of motion (ROM), muscle activation, and balance. [Subjects] For the present study, 48 adults with hamstring muscle tightness were recruited and randomly divided into three groups: a static stretching group (n=16), a PNF stretching group (n=16), a control group (n=16). [Methods] Both of the stretching techniques were applied to the hamstring once. Active knee extension angle, muscle activation during maximum voluntary isometric contraction (MVC), and static balance were measured before and after the application of each stretching technique. [Results] Both the static stretching and the PNF stretching groups showed significant increases in knee extension angle compared to the control group. However, there were no significant differences in muscle activation or balance between the groups. [Conclusion] Static stretching and PNF stretching techniques improved ROM without decrease in muscle activation, but neither of them exerted statistically significant effects on balance. PMID:24648633

  7. Back injuries in college athletes.

    PubMed

    Keene, J S; Albert, M J; Springer, S L; Drummond, D S; Clancy, W G

    1989-09-01

    Frequency and types of back injuries sustained by intercollegiate athletes were determined by examining medical records of 4,790 athletes that competed in 17 varsity sports over a 10-year period. These athletes sustained 333 back injuries, an injury rate of 7 per 100 participants. Injury rates were significantly higher in football and gymnastics, and 80% of the injuries occurred in practice, 6% in competition, and 14% during preseason conditioning. Muscle strains occurred with much greater frequency than other types of injuries, and acute back injuries were much more prevalent (59%) than overuse injuries (12%) or injuries associated with pre-existing conditions (29%). PMID:2520075

  8. A dynamic warm-up model increases quadriceps strength and hamstring flexibility.

    PubMed

    Aguilar, Alain J; DiStefano, Lindsay J; Brown, Cathleen N; Herman, Daniel C; Guskiewicz, Kevin M; Padua, Darin A

    2012-04-01

    Research suggests that static stretching can negatively influence muscle strength and power and may result in decreased functional performance. The dynamic warm-up (DWU) is a common alternative to static stretching before physical activity, but there is limited research investigating the effects of a DWU. The purpose of this study was to compare the acute effects of a DWU and static stretching warm-up (SWU) on muscle flexibility, strength, and vertical jump using a randomized controlled trial design. Forty-five volunteers were randomly assigned into a control (CON), SWU, or DWU group. All participants rode a stationary bicycle for 5 minutes and completed a 10-minute warm-up protocol. During this protocol, the DWU group performed dynamic stretching and running, the SWU group performed static stretching, and the CON group rested. Dependent variables were measured immediately before and after the warm-up protocol. A digital inclinometer measured flexibility (degrees) for the hamstrings, quadriceps, and hip flexor muscles. An isokinetic dynamometer measured concentric and eccentric peak torque (N·m/kg) for the hamstrings and quadriceps. A force plate was used to measure vertical jump height (meters) and power (watts). In the DWU group, there was a significant increase in hamstring flexibility (pretest: 26.4 ± 13.5°, posttest: 16.9 ± 9.4°; p < .0001) and eccentric quadriceps peak torque (pretest: 2.49 ± 0.83 N·m/kg, posttest: 2.78 ± 0.69 N·m/kg; p = 0.04). The CON and SWU did not significantly affect any flexibility, strength, or vertical jump measures (p > 0.05). The DWU significantly improved eccentric quadriceps strength and hamstrings flexibility, whereas the SWU did not facilitate any positive or negative changes in muscle flexibility, strength, power, or vertical jump. Therefore, the DWU may be a better preactivity warm-up choice than an SWU. PMID:22446678

  9. Morphologic Characteristics Help Explain the Gender Difference in Peak Anterior Cruciate Ligament Strain During a Simulated Pivot Landing

    PubMed Central

    Lipps, David B.; Oh, Youkeun K.; Ashton-Miller, James A.; Wojtys, Edward M.

    2015-01-01

    Background Gender differences exist in anterior cruciate ligament (ACL) cross-sectional area and lateral tibial slope. Biomechanical principles suggest that the direction of these gender differences should induce larger peak ACL strains in females under dynamic loading. Hypothesis Peak ACL relative strain during a simulated pivot landing is significantly greater in female ACLs than male ACLs. Study Design Controlled laboratory study. Methods Twenty cadaveric knees from height- and weight-matched male and female cadavers were subjected to impulsive 3-dimensional test loads of 2 times body weight in compression, flexion, and internal tibial torque starting at 15° of flexion. Load cells measured the 3-dimensional forces and moments applied to the knee, and forces in the pretensioned quadriceps, hamstring, and gastrocnemius muscle equivalents. A novel, gender-specific, nonlinear spring simulated short-range and longer range quadriceps muscle tensile stiffness. Peak relative strain in the anteromedial bundle of the ACL (AM-ACL) was measured using a differential variable reluctance transducer, while ACL cross-sectional area and lateral tibial slope were measured using magnetic resonance imaging. A repeated-measures Mann-Whitney signed-rank test was used to test the hypothesis. Results Female knees exhibited 95% greater peak AM-ACL relative strain than male knees (6.37% [22.53%] vs 3.26% [11.89%]; P = .004). Anterior cruciate ligament cross-sectional area and lateral tibial slope were significant predictors of peak AM-ACL relative strain (R2 = .59; P = .001). Conclusion Peak AM-ACL relative strain was significantly greater in female than male knees from donors of the same height and weight. This gender difference is attributed to a smaller female ACL cross-sectional area and a greater lateral tibial slope. Clinical Relevance Since female ACLs are systematically exposed to greater strain than their male counterparts, training and injury prevention programs should take this fact into consideration. PMID:21917612

  10. Concurrent validity of clinical tests for measuring hamstring flexibility in school age children.

    PubMed

    Muyor, J M; Zemková, E; Štefániková, G; Kotyra, M

    2014-07-01

    The objectives were 1) to evaluate the hamstring muscle flexibility in children and adolescents; 2) to examine the relative contribution of the spinal curvatures, pelvic tilt and hamstring flexibility on the sit-and-reach (SR) score; and 3) to determine the validity of the sit-and-reach test through both active and passive hip flexion tests. 118 children and adolescents (aged 7-18 years; 60 males and 58 females) were tested for sit-and-reach (SR), passive straight leg raise (PSLR) and active straight leg raise (ASLR). The spinal curvatures and pelvic tilt were assessed during the SR test by means of the Spinal Mouse system. Females showed a statistically greater anterior pelvic tilt, distance reached in the SR test and hip flexion in both PSLR and ASLR tests than males. The pelvic tilt independently explained more than 60% of the variance (distance reached in the SR test) and in conjunction with lumbar flexion explained more than 80% of the variance. In conclusion, the pelvic tilt is the main determinant of SR test in school age children. The SR test can be considered an appropriate and valid test for evaluating pelvic tilt and lumbar flexion in school age children, but not to measure hamstring flexibility. PMID:24424962

  11. Virulence from vesicles: Novel mechanisms of host cell injury by Escherichia coli O104:H4 outbreak strain

    PubMed Central

    Kunsmann, Lisa; Rüter, Christian; Bauwens, Andreas; Greune, Lilo; Glüder, Malte; Kemper, Björn; Fruth, Angelika; Wai, Sun Nyunt; He, Xiaohua; Lloubes, Roland; Schmidt, M. Alexander; Dobrindt, Ulrich; Mellmann, Alexander; Karch, Helge; Bielaszewska, Martina

    2015-01-01

    The highly virulent Escherichia coli O104:H4 that caused the large 2011 outbreak of diarrhoea and haemolytic uraemic syndrome secretes blended virulence factors of enterohaemorrhagic and enteroaggregative E. coli, but their secretion pathways are unknown. We demonstrate that the outbreak strain releases a cocktail of virulence factors via outer membrane vesicles (OMVs) shed during growth. The OMVs contain Shiga toxin (Stx) 2a, the major virulence factor of the strain, Shigella enterotoxin 1, H4 flagellin, and O104 lipopolysaccharide. The OMVs bind to and are internalised by human intestinal epithelial cells via dynamin-dependent and Stx2a-independent endocytosis, deliver the OMV-associated virulence factors intracellularly and induce caspase-9-mediated apoptosis and interleukin-8 secretion. Stx2a is the key OMV component responsible for the cytotoxicity, whereas flagellin and lipopolysaccharide are the major interleukin-8 inducers. The OMVs represent novel ways for the E. coli O104:H4 outbreak strain to deliver pathogenic cargoes and injure host cells. PMID:26283502

  12. Virulence from vesicles: Novel mechanisms of host cell injury by Escherichia coli O104:H4 outbreak strain.

    PubMed

    Kunsmann, Lisa; Rüter, Christian; Bauwens, Andreas; Greune, Lilo; Glüder, Malte; Kemper, Björn; Fruth, Angelika; Wai, Sun Nyunt; He, Xiaohua; Lloubes, Roland; Schmidt, M Alexander; Dobrindt, Ulrich; Mellmann, Alexander; Karch, Helge; Bielaszewska, Martina

    2015-01-01

    The highly virulent Escherichia coli O104:H4 that caused the large 2011 outbreak of diarrhoea and haemolytic uraemic syndrome secretes blended virulence factors of enterohaemorrhagic and enteroaggregative E. coli, but their secretion pathways are unknown. We demonstrate that the outbreak strain releases a cocktail of virulence factors via outer membrane vesicles (OMVs) shed during growth. The OMVs contain Shiga toxin (Stx) 2a, the major virulence factor of the strain, Shigella enterotoxin 1, H4 flagellin, and O104 lipopolysaccharide. The OMVs bind to and are internalised by human intestinal epithelial cells via dynamin-dependent and Stx2a-independent endocytosis, deliver the OMV-associated virulence factors intracellularly and induce caspase-9-mediated apoptosis and interleukin-8 secretion. Stx2a is the key OMV component responsible for the cytotoxicity, whereas flagellin and lipopolysaccharide are the major interleukin-8 inducers. The OMVs represent novel ways for the E. coli O104:H4 outbreak strain to deliver pathogenic cargoes and injure host cells. PMID:26283502

  13. Strains and Sprains

    MedlinePlus

    ... are caused by injuries, such as twisting your ankle. This kind of injury is common in sports, but can also happen any time you trip or fall. What if I Get a Strain or Sprain? If you get a strain or sprain, try ...

  14. Effects of Motorized vs Non-Motorized Treadmill Training on Hamstring/Quadriceps Strength Ratios

    PubMed Central

    Franks, Kelly A.; Brown, Lee E.; Coburn, Jared W.; Kersey, Robert D.; Bottaro, Martim

    2012-01-01

    Previous literature suggests that muscular involvement and biomechanical changes elicit different responses between overground and treadmill training. The objective of this study was to examine the effects of training on two different treadmill designs on the conventional (CR; concentric only) and functional (FR; eccentric to concentric) hamstring and quadriceps strength ratios. Fifteen men and sixteen women were randomly divided into three groups: motorized (MT), non-motorized (NMT) or control (C). Subjects completed pre and post-test isokinetic concentric and eccentric quadriceps and hamstring testing of both legs. Subjects completed 4 weeks of training on their respective treadmills with mileage increasing ½ mile each week, beginning with 2 miles. The C group did not participate in any training. The CR revealed a significant two way interaction of group x time with MT increasing (pre: 0.80 ± 0.09 to post: 0.84 ± 0.09), NMT decreasing (pre: 0.76 ± 0.13 to post: 0.74 ± 0.10), and C showing no change (pre: 0.79 ± 0.10 to post: 0.79 ± 0.09. The FR revealed a significant two way interaction of speed x sex with the FR increasing as speeds increased for men (60 degrees.s-1: 1.04 ± 0.11; 180 degrees.s-1: 1.66 ± 0.27; 300 degrees.s-1: 2.36 ± 0.45) and women (60 degrees.s-1: 1.05 ± 0.16; 180 degrees.s-1: 1.90 ± 0.26; 300 degrees.s-1: 2.75 ± 0.47) but women increased greater relative to men. Training mode elicited a specific change in concentric hamstring and quadriceps strength resulting in specific changes to the CR; however, neither training mode had an effect on eccentric hamstrings nor the FR. Special attention should be given to the mode of endurance training when the goal is to alter the hamstring/quadriceps CR. Key points Specificity of treadmill training had different effects on concentric strength. Specificity of treadmill training had little or no effect on eccentric strength. Conventional and functional strength ratios may give different results based on training mode. Four weeks is long enough for strength results to be apparent in untrained people. PMID:24137064

  15. Prospective Comparative Study of ACL Reconstruction Between Using Hamstring Autograft and Soft Tissue Allograft

    PubMed Central

    Song, Eun Kyoo; Seon, Jong Keun; Kim, Hasung

    2014-01-01

    Objectives: Nowadays, two most commonly used grafts in the anterior cruciate ligament reconstruction are hamstring autograft and soft tissue allograft. Although the short-term clinical outcomes between two grafts were similar, only a few studies reported mid-term clinical outcomes. The purpose of this prospective study was to compare clinical outcomes of ACL reconstruction between using hamstring autograft and soft tissue allograft after mid-term follow-up. Methods: One-hundred sixty-one patients that underwent ACL reconstruction (78 in the hamstring group and 83 in the fresh frozen soft tissue (tibialis anterior) allograft) were followed up for a minimum of 4 years.We compared clinical outcomes (IKDC scores and Tegner activity scores, and Lachman and pivot shift test findings) For the radiologic evaluation, we determined the degree of osteoarthritis based on Kellgren and Lawrence grade system at the time of final follow-up and compared the number of patient with progression of osteoarthritis more than grade I. The muscle strength and position sense using iso-kinetic dynamometer was compared at the final follow-up. We also compared complication rate including graft failures and infection during the follow-up. Among them, we did the 2nd-look arthroscopies to evaluate the partial rupture and extent of synovial coverage on grafts for 27 patients in each group. Results: Stability results of the Lachman test, pivot-shift test, and knee joint laxity test failed to reveal any significant inter-group differences (P > 0.05). In the pivot-shift result, autograft group showed 7 cases of grade II and allograft group11 cases of grade II (p=0.09). The clinical outcomes, including Lysholm knee and Tegner activity scores, showed no significant differences between the two groups. Concerning osteoarthritis at the final follow-up, seven patients in the autograft group and eight patients in the allograft group progressed osteoarthritis more than one Kellgren-Lawrence grade at final follow-up (P=0.82). Moreover, extension and flexion muscle power deficits and position sense were similar in both groups. However, the complications were more in allograft group (5 failures and 2 infection in the allograft group and 2 failures and no infection in the autograft group) during the follow-up (P = 0.06). We observed the less partial rupture and better synovial coverage of graft in autograft than allograft under 2nd look arthroscopic findings. Conclusion: Although hamstring autograft and soft tissue allograft ACL reconstruction showed similar functional and radiological outcomes after mid-term follow-up, hamstring autograft group showed fewer complications including failure and better arthroscopic findings compared with soft tissue allograft group.

  16. A Taxonomically Unique Acinetobacter Strain with Proteolytic and Hemolytic Activities Recovered from a Patient with a Soft Tissue Injury

    PubMed Central

    Almuzara, Marisa; Traglia, German Matías; Krizova, Lenka; Barberis, Claudia; Montaña, Sabrina; Bakai, Romina; Tuduri, Alicia; Vay, Carlos

    2014-01-01

    A taxonomically unique bacterial strain, Acinetobacter sp. A47, has been recovered from several soft tissue samples from a patient undergoing reconstructive surgery owing to a traumatic amputation. The results of 16S rRNA, rpoB, and gyrB gene comparative sequence analyses showed that A47 does not belong to any of the hitherto-known taxa and may represent an as-yet-unknown Acinetobacter species. The recognition of this novel organism contributes to our knowledge of the taxonomic complexity underlying infections caused by Acinetobacter. PMID:25392359

  17. Epidemiology of time-loss injuries in English community-level rugby union

    PubMed Central

    Roberts, Simon P; Trewartha, Grant; England, Mike; Shaddick, Gavin; Stokes, Keith A

    2013-01-01

    Objectives Using a prospective cohort study design, to establish the incidence and nature of time-loss injuries in English community rugby and to assess the differences between different playing levels. Setting English community rugby clubs. Participants Injury information for 4635 matches was collected during seasons 2009/2010 (46 clubs), 2010/2011(67 clubs) and 2011/2012 (76 clubs). Clubs were subdivided into groups A (semiprofessional), B (amateur) and C (recreational) for analysis. Primary and secondary outcome measures Any injury resulting in 8 days or greater absence from match play was reported by injury management staff at the clubs. The primary outcome measure was injury incidence (per 1000 player match-hours) and the secondary outcome measure was severity (ie, days absence). Results Overall match injury incidence was 16.9 injuries per 1000 player match-hours. Incidence was higher for group A (21.7; 95% CI 19.8 to 23.6) compared with group B (16.6; 95% CI 15.2 to 17.9) and C (14.2; 95% CI 13.0 to 15.5, both p<0.001). The mean time-loss was 7.6 weeks absence, with knee and shoulder injuries the most severe with mean absences of 11.6 and 9.3 weeks, respectively. Half of all injuries occurred to the lower limb, with knee and ankle joint/ligament injuries the most common diagnoses. Shoulder joint/ligament injuries were the most common and severe upper limb injuries. Contact events accounted for 80% of all injuries and tackles accounted for 50%. Running was the most common non-contact injury event, of which 56% were hamstring injuries. Conclusions More time-loss injuries occur at higher levels of community rugby. Injury prevention strategies should focus on good technique in the tackle and conditioning exercises for the knee, ankle, hamstrings and shoulder. PMID:24240143

  18. Is the Modified Tardieu Scale in Semi-Standing Position Better Associated with Knee Extension and Hamstring Activity in Terminal Swing than the Supine Tardieu?

    ERIC Educational Resources Information Center

    Faber, Irene R.; Nienhuis, Bart; Rijs, Nique P. A. M.; Geurts, Alexander C. H.; Duysens, Jacques

    2008-01-01

    The aim of this study was to investigate whether the modified Tardieu scale (MTS) in a semi-standing position, used for the assessment of hamstrings spasticity, was better associated with knee extension and hamstrings activity in terminal swing than the MTS in a supine position in children with cerebral palsy (CP). Seven children diagnosed with

  19. Is the Modified Tardieu Scale in Semi-Standing Position Better Associated with Knee Extension and Hamstring Activity in Terminal Swing than the Supine Tardieu?

    ERIC Educational Resources Information Center

    Faber, Irene R.; Nienhuis, Bart; Rijs, Nique P. A. M.; Geurts, Alexander C. H.; Duysens, Jacques

    2008-01-01

    The aim of this study was to investigate whether the modified Tardieu scale (MTS) in a semi-standing position, used for the assessment of hamstrings spasticity, was better associated with knee extension and hamstrings activity in terminal swing than the MTS in a supine position in children with cerebral palsy (CP). Seven children diagnosed with…

  20. An investigation of the action of the hamstring muscles during standing in crouch using functional electrical stimulation (FES).

    PubMed

    Stewart, C; Postans, N; Schwartz, M H; Rozumalski, A; Roberts, A P

    2008-10-01

    The hamstring muscle moment arms indicate that they act as hip extensors and knee flexors. Previous work using induced acceleration (IA) analysis and functional electrical stimulation (FES) has, however, revealed counter-intuitive muscle actions, particularly for biarticular muscles during the stance phase of normal gait. In conditions such as cerebral palsy the hamstrings have been associated with the development of pathological gait patterns, particularly crouch gait. This study examines the role of these muscles in the control of crouched standing postures. Five unimpaired adult subjects had their muscles stimulated during quiet standing in different degrees of crouch. Kinematic and kinetic changes were observed and measured using a 3D motion analysis system. The hamstring muscles were shown to act strongly to retrovert the pelvis and extend the hip. The action at the knee changes as crouch increases, moving from flexing to extending. PMID:18579383

  1. Effect of an eccentrically biased hamstring strengthening home program on knee flexor strength and the length-tension relationship.

    PubMed

    Orishimo, Karl F; McHugh, Malachy P

    2015-03-01

    The purposes of this study were to document relative activation intensities of the hamstrings and gluteus maximus during 4 eccentric hamstring strengthening exercises and to assess the effects of a short-term strengthening program comprised of these exercises on knee flexor strength and the length-tension relationship. Twelve healthy subjects participated in this study. Electromyographic (EMG) activities from the biceps femoris, semitendinosus, and gluteus maximus were recorded as subjects performed (a) standing hip extension with elastic resistance, (b) trunk flexion in single limb stance (diver), (c) standing split (glider), and (d) supine sliding bridge (slider). Baseline isometric knee flexor strength was measured at 90, 70, 50, and 30° of flexion at the knee with the subject seated and the hip flexed to 50° from horizontal. After completing the 4-week training program, strength tests were repeated. Repeated-measures analysis of variance were used to compare EMG activity between muscles and to assess angle-specific strength improvements. Hamstring activity exceeded gluteus maximus activity for resisted hip extension, glider, and slider exercises (p < 0.001) but not for the diver (p = 0.087). Hamstring activation was greatest during the slider and resisted hip extension and lowest during the glider and the diver. Knee flexor strength improved by 9.0% (p = 0.005) but was not angle specific (training by angle p = 0.874). The short-term home training program effectively targeted the hamstrings and resulted in strength gains that were similar at short and long muscle lengths. These data demonstrate that hamstring strength can be improved using eccentrically biased unilateral exercises without the use of weights or other equipments. PMID:25226327

  2. Effect of modified hold-relax stretching and static stretching on hamstring muscle flexibility.

    PubMed

    Ahmed, Hashim; Iqbal, Amir; Anwer, Shahnawaz; Alghadir, Ahmad

    2015-02-01

    [Purpose] The aim of present study was to compare the effectiveness of modified hold-relax stretching and static stretching in improving the hamstring muscle flexibility. [Subjects and Methods] Forty-five male subjects with hamstring tightness were included in this study. The subjects were randomly placed into three groups: the modified hold-relax stretching, static stretching and control groups. The modified hold-relax stretching group performed 7 seconds of isometric contraction and then relaxed for 5 seconds, and this was repeated five times daily for five consecutive days. The static stretching group received 10 minutes of static stretching with the help of a pulley and weight system for five consecutive days. The control group received only moist heat for 20 minutes for five consecutive days. A baseline reading of passive knee extension (PKE) was taken prior to the intervention; rest measurements were taken immediate post intervention on day 1, day 3, day 5, and after a 1 week follow-up, i.e., at the 12th day. [Results] On comparing the baseline readings of passive knee extension (PKE), there was no difference noted between the three groups. On comparing the posttest readings on day 5 between the 3 groups, a significant difference was noted. However, post hoc analysis revealed an insignificant difference between the modified hold-relax stretching and static stretching groups. There was a significant difference between the static stretching and control groups and between the modified hold-relax stretching and control groups. [Conclusion] The results of this study indicate that both the modified hold-relax stretching technique and static stretching are equally effective, as there was no significant difference in improving the hamstring muscle flexibility between the two groups. PMID:25729210

  3. Effect of modified hold-relax stretching and static stretching on hamstring muscle flexibility

    PubMed Central

    Ahmed, Hashim; Iqbal, Amir; Anwer, Shahnawaz; Alghadir, Ahmad

    2015-01-01

    [Purpose] The aim of present study was to compare the effectiveness of modified hold-relax stretching and static stretching in improving the hamstring muscle flexibility. [Subjects and Methods] Forty-five male subjects with hamstring tightness were included in this study. The subjects were randomly placed into three groups: the modified hold-relax stretching, static stretching and control groups. The modified hold-relax stretching group performed 7 seconds of isometric contraction and then relaxed for 5 seconds, and this was repeated five times daily for five consecutive days. The static stretching group received 10 minutes of static stretching with the help of a pulley and weight system for five consecutive days. The control group received only moist heat for 20 minutes for five consecutive days. A baseline reading of passive knee extension (PKE) was taken prior to the intervention; rest measurements were taken immediate post intervention on day 1, day 3, day 5, and after a 1 week follow-up, i.e., at the 12th day. [Results] On comparing the baseline readings of passive knee extension (PKE), there was no difference noted between the three groups. On comparing the posttest readings on day 5 between the 3 groups, a significant difference was noted. However, post hoc analysis revealed an insignificant difference between the modified hold-relax stretching and static stretching groups. There was a significant difference between the static stretching and control groups and between the modified hold-relax stretching and control groups. [Conclusion] The results of this study indicate that both the modified hold-relax stretching technique and static stretching are equally effective, as there was no significant difference in improving the hamstring muscle flexibility between the two groups. PMID:25729210

  4. A comparison of two stretching programs for hamstring muscles: A randomized controlled assessor-blinded study.

    PubMed

    Demoulin, Christophe; Wolfs, Sébastien; Chevalier, Madeline; Granado, Caroline; Grosdent, Stéphanie; Depas, Yannick; Roussel, Nathalie; Hage, Renaud; Vanderthommen, Marc

    2016-01-01

    Most parameters regarding hamstring flexibility training programs have been investigated; however, the joint (i.e. hip or knee) on which the stretching should preferentially be focused needs to be further explored. This randomized controlled assessor-blinded study aimed to investigate the influence of this parameter. We randomly assigned 111 asymptomatic participants with tight hamstring muscles in three groups: a control group and two groups following a different home-based 8-week (five 10-minute sessions per week) hamstring stretching program (i.e. stretching performed by flexing the hip while keeping the knee extended [SH] or by first flexing the hip with a flexed knee and then extending the knee [SK]). Range of motion (ROM) of hip flexion and knee extension were measured before and after the stretching program by means of the straight leg raising test and the passive knee extension angle test, respectively. Eighty-nine participants completed the study. A significant increase in ROM was observed at post-test. Analyses showed significant group-by-time interactions for changes regarding all outcomes. Whereas the increase in hip flexion and knee extension ROM was higher in the stretching groups than in the CG (especially for the SH group p < 0.05), no differences between the two stretching groups were observed (p > 0.05). In conclusion, the fact that both stretching programs resulted in similar results suggests no influence of the joint at which the stretching is focused upon, as assessed by the straight leg raising and knee extension angle tests. PMID:26756214

  5. Prediction of quadruple hamstring graft diameter for anterior cruciate ligament reconstruction by anthropometric measurements

    PubMed Central

    Asif, Naiyer; Ranjan, Rahul; Ahmed, Sohail; Sabir, Aamir B; Jilani, Latif Z; Qureshi, Owais A

    2016-01-01

    Background: The literature is scanty regarding the anthropometric predictors on the diameter of quadruple hamstring graft obtained in anterior cruciate ligament (ACL) reconstruction in Indian population. Minimum diameter of the graft for ACL reconstruction should be >7 mm to preclude failure. The objective of this study was to assess the prediction of the hamstring graft diameter by several anthropometric parameters including age, thigh circumference, weight, height and body mass index (BMI). Materials and Methods: 46 consecutive patients who had undergone ACL reconstruction by the same surgeon using quadruple hamstring grafts were evaluated. The age, thigh circumference of the normal side, height, weight and BMI were recorded preoperatively and Pearson correlation was done using these parameters with graft diameter measured intraoperatively. Regression analysis in a stepwise manner was undertaken to assess the influence of individual anthropometric parameters on the graft diameter. Results: There were 44 males and 2 females. Mean age was 29.4 years, mean height was 172.6 cm, mean weight was 70.9 kg, mean BMI was 23.8 kg/m2, mean thigh circumference was 47.1 cm and mean graft diameter was 7.9 mm. There was a positive correlation individually between the thigh circumference and graft diameter obtained (r = 0.8, P < 0.01, n = 46), and between the height and graft diameter (r = 0.8, P < 0.01, n = 46). On the regression analysis thigh circumference and height were found to be significant predictors of graft diameter giving the following equation: Graft diameter (mm) = 0. 079 height (cm) +0.068 thigh circumference (cm) −9.031. Conclusion: Preoperatively using the above equation if graft diameter came out to be <7 mm then alternate options of graft material must be kept in mind in order to prevent failure. PMID:26955176

  6. Effect of frequency of static stretching on flexibility, hamstring tightness and electromyographic activity.

    PubMed

    Marques, A P; Vasconcelos, A A P; Cabral, C M N; Sacco, I C N

    2009-10-01

    We compared the effect of the number of weekly repetitions of a static stretching program on the flexibility, hamstring tightness and electromyographic activity of the hamstring and of the triceps surae muscles. Thirty-one healthy subjects with hamstring tightness, defined as the inability to perform total knee extension, and shortened triceps surae, defined by a tibiotarsal angle wider than 90 degrees during trunk flexion, were divided into three groups: G1 performed the stretching exercises once a week; G2, three times a week, and G3, five times a week. The parameters were determined before and after the stretching program. Flexibility improved in all groups after intervention, from 7.65 +/- 10.38 to 3.67 +/- 12.08 in G1, from 10.73 +/- 12.07 to 0.77 +/- 10.45 in G2, and from 14.20 +/- 10.75 to 6.85 +/- 12.19 cm in G3 (P < 0.05 for all comparisons). The increase in flexibility was higher in G2 than in G1 (P = 0.018), while G2 and G3 showed no significant difference (G1: 4 +/- 2.17, G2: 10 +/- 5.27; G3: 7.5 +/- 4.77 cm). Hamstring tightness improved in all groups, from 37.90 +/- 6.44 to 29 +/- 11.65 in G1, from 39.82 +/- 9.63 to 21.91 +/- 8.40 in G2, and from 37.20 +/- 6.63 to 26.10 +/- 5.72 degrees in G3 (P < 0.05 for all comparisons). During stretching, a statistically significant difference was observed in electromyographic activity of biceps femoris muscle between G1 and G3 (P = 0.048) and G2 and G3 (P = 0.0009). No significant differences were found in electromyographic activity during maximal isometric contraction. Stretching exercises performed three times a week were sufficient to improve flexibility and range of motion compared to subjects exercising once a week, with results similar to those of subjects who exercised five times a week. PMID:19784479

  7. Neck Injuries and Disorders

    MedlinePlus

    ... another common cause of neck pain. Whiplash, a soft tissue injury to the neck, is also called neck sprain or strain. Treatment depends on the cause, but may include applying ice, taking pain relievers, getting physical therapy or wearing ...

  8. Evaluation of hamstring muscle strength and morphology after anterior cruciate ligament reconstruction.

    PubMed

    Nomura, Y; Kuramochi, R; Fukubayashi, T

    2015-06-01

    This study aimed to clarify the relationship between knee flexor strength and hamstring muscle morphology after anterior cruciate ligament (ACL) reconstruction using the semitendinosus (ST) tendon and to determine the causative factors of decreased knee flexor muscle strength. Fourteen male and ten female patients who resumed sports activities after surgery participated in the experiment. Isometric knee flexion torque was measured at 30°, 45°, 60°, 90°, and 105° of knee flexion. Magnetic resonance imaging (MRI) was used to calculate ST muscle length and hamstring muscle volume, and to confirm the status of ST tendon regeneration. The correlation between the MRI findings and flexor strength was analyzed. Regenerated ST tendon was confirmed in 21 of the 24 patients, but muscle volume (87.6%) and muscle length (74.5%) of the ST in the operated limb were significantly smaller than those in the normal limb. The percentage of the knee flexion torque of the operated limb compared with that of the normal was apparently lower at 105° (69.1%) and 90° (68.6%) than at 60° (84.4%). Tendon regeneration, ST muscle shortening, and ST muscle atrophy correlated with decreased knee flexion torque. These results indicated that preserving the morphology of the ST muscle-tendon complex is important. PMID:24646218

  9. Road Cycling and Mountain Biking Produces Adaptations on the Spine and Hamstring Extensibility.

    PubMed

    Muyor, J M; Zabala, M

    2016-01-01

    The purposes of this study were as follows: 1) to analyse the influence of training in road cycling or cross-country mountain biking on sagittal spinal curvatures, pelvic tilt and trunk inclination in cyclists of both cycling modalities; 2) to evaluate the specific spinal posture and pelvic tilt adopted on the road bicycle and cross-country mountain bike; and 3) to compare the spinal sagittal capacity of flexion and pelvic tilt mobility as well as hamstring muscle extensibility among road cyclists, cross-country mountain bikers and non-cyclists. Thirty matched road cyclists, 30 mountain bikers and 30 non-cyclists participated in this study. The road cyclists showed significantly greater thoracic kyphosis and trunk inclination than did the mountain bikers and non-cyclists in a standing posture. On the bicycle, the road bicycling posture was characterised by greater lumbar flexion and more significant anterior pelvic tilt and trunk inclination compared with the mountain biking posture. The thoracic spine was more flexed in mountain biking than in road cycling. Road cyclists had significantly greater hamstring muscle extensibility in the active knee extension test, and showed greater anterior pelvic tilt and trunk inclination capacity in the sit-and-reach test, compared with mountain bikers and non-cyclists. PMID:26509372

  10. The Effect of Foam Rolling Duration on Hamstring Range of Motion

    PubMed Central

    Couture, Grace; Karlik, Dustin; Glass, Stephen C; Hatzel, Brian M

    2015-01-01

    Musculoskeletal health benefits from flexibility training and maintaining a functional, or sport specific, range of motion is important to one’s overall fitness. Commercial foam rollers are commonly used in gyms, therapy clinics and homes, yet data are lacking on the optimal rolling duration and effect on range of motion. Purpose : The purpose of this study was to examine the effect of varied durations of a commercial foam roller treatment on hamstring range of motion. Methods : The knee extension range of motion of 33 college aged men and women (age= 20±1.5y, mass= 72.2±10.8 kg) was assessed after a short (2 sets of 10s) and long (4 sets of 30s) duration of hamstring self-administered myofascial release using a commercial foam roller. A one way ANOVA was performed to compare the mean knee extension angle for each condition to baseline measures. Results : Results indicated that neither the short duration (67.30 ± 10.60 deg) nor long duration (67.41 ± 10.81 deg) rolling condition produced significant increases in knee extension compared to baseline (67.70 ± 9.90 deg). Conclusion : Self-administered foam rolling for a total duration of up to 2 minutes is not adequate to induce improvements in knee joint flexibility. Contributing factors may include the amount of pressure imparted by the commercial roller as well as duration of treatment. PMID:26587061

  11. Sprint Acceleration Mechanics: The Major Role of Hamstrings in Horizontal Force Production

    PubMed Central

    Morin, Jean-Benoît; Gimenez, Philippe; Edouard, Pascal; Arnal, Pierrick; Jiménez-Reyes, Pedro; Samozino, Pierre; Brughelli, Matt; Mendiguchia, Jurdan

    2015-01-01

    Recent literature supports the importance of horizontal ground reaction force (GRF) production for sprint acceleration performance. Modeling and clinical studies have shown that the hip extensors are very likely contributors to sprint acceleration performance. We experimentally tested the role of the hip extensors in horizontal GRF production during short, maximal, treadmill sprint accelerations. Torque capabilities of the knee and hip extensors and flexors were assessed using an isokinetic dynamometer in 14 males familiar with sprint running. Then, during 6-s sprints on an instrumented motorized treadmill, horizontal and vertical GRF were synchronized with electromyographic (EMG) activity of the vastus lateralis, rectus femoris, biceps femoris, and gluteus maximus averaged over the first half of support, entire support, entire swing and end-of-swing phases. No significant correlations were found between isokinetic or EMG variables and horizontal GRF. Multiple linear regression analysis showed a significant relationship (P = 0.024) between horizontal GRF and the combination of biceps femoris EMG activity during the end of the swing and the knee flexors eccentric peak torque. In conclusion, subjects who produced the greatest amount of horizontal force were both able to highly activate their hamstring muscles just before ground contact and present high eccentric hamstring peak torque capability. PMID:26733889

  12. Sprint Acceleration Mechanics: The Major Role of Hamstrings in Horizontal Force Production.

    PubMed

    Morin, Jean-Benoît; Gimenez, Philippe; Edouard, Pascal; Arnal, Pierrick; Jiménez-Reyes, Pedro; Samozino, Pierre; Brughelli, Matt; Mendiguchia, Jurdan

    2015-01-01

    Recent literature supports the importance of horizontal ground reaction force (GRF) production for sprint acceleration performance. Modeling and clinical studies have shown that the hip extensors are very likely contributors to sprint acceleration performance. We experimentally tested the role of the hip extensors in horizontal GRF production during short, maximal, treadmill sprint accelerations. Torque capabilities of the knee and hip extensors and flexors were assessed using an isokinetic dynamometer in 14 males familiar with sprint running. Then, during 6-s sprints on an instrumented motorized treadmill, horizontal and vertical GRF were synchronized with electromyographic (EMG) activity of the vastus lateralis, rectus femoris, biceps femoris, and gluteus maximus averaged over the first half of support, entire support, entire swing and end-of-swing phases. No significant correlations were found between isokinetic or EMG variables and horizontal GRF. Multiple linear regression analysis showed a significant relationship (P = 0.024) between horizontal GRF and the combination of biceps femoris EMG activity during the end of the swing and the knee flexors eccentric peak torque. In conclusion, subjects who produced the greatest amount of horizontal force were both able to highly activate their hamstring muscles just before ground contact and present high eccentric hamstring peak torque capability. PMID:26733889

  13. Effects of whole-body cryotherapy on recovery after hamstring damaging exercise: a crossover study.

    PubMed

    Fonda, B; Sarabon, N

    2013-10-01

    The purpose of this study was to examine the effects of whole-body cryotherapy (WBC) on biochemical, pain, and performance parameters during the 5-day recovery period after damaging exercise for hamstrings. Participants completed a bout of damaging exercise for the hamstring muscles on two separate occasions (control and experimental condition) separated by 10 weeks. During the control condition, subjects received no treatment after the damaging exercise. The experimental condition consisted of WBC everyday during the recovery period. WBC included single 3-min daily exposures to low temperatures (-140 to -19 °C) in the cryo-cabin. During the recovery period, subjects were tested for biochemical markers, perceived pain sensation, and physical performance (squat jump, counter movement jump, maximal isometric torque production, and maximally explosive isometric torque production). Majority of the observed variables showed statistically significant time effects (P < 0.05) in control group, which indicates the presence of muscle damage. Significant interaction between the control and WBC condition was evident for the rate of torque development (P < 0.05). Pain measures substantially differed between the WBC and the control condition after the exercise. Results of this study are not completely supportive of the use of WBC for recovery enhancement after strenuous training. PMID:23614691

  14. Hamstrings functional properties in athletes with high musculo-skeletal flexibility.

    PubMed

    Moltubakk, M M; Eriksrud, O; Paulsen, G; Seynnes, O R; Bojsen-Møller, J

    2016-06-01

    The purpose of this study was to examine whether athletes with highly flexible hamstring muscle-tendon units display different passive and contractile mechanical properties compared with controls. Flexibility, passive, and active torque-angle properties were assessed in 21 female elite rhythmic gymnasts and 16 female age-matched athletes. Passive resistance to stretch was measured during knee extension with the hip fixed at 100° of flexion. Concentric isokinetic maximal voluntary knee flexion and extension torques were measured at 60°/s in the same position. Tests of flexibility and passive resistance to stretch indicated a greater flexibility in the gymnasts. Despite no differences between groups in knee flexion and extension peak torque, gymnasts reached knee flexion peak torque at more extended positions (longer muscle lengths) and displayed significantly different torque-angle relations. When active torque was corrected for passive resistance to stretch, differences increased, gymnasts producing more work, and maintaining ≥ 70% of peak torque over a larger range of joint excursion. In conclusion, individuals with a higher flexibility of the hamstrings MTU present a different torque-angle profile, favoring the production of flexion torque toward extended knee positions, displaying larger functional range of motion and a higher mechanical work output during knee flexion. PMID:26031482

  15. Plasma microRNAs are sensitive indicators of inter-strain differences in the severity of liver injury induced in mice by a choline- and folate-deficient diet

    SciTech Connect

    Tryndyak, Volodymyr P.; Latendresse, John R.; Montgomery, Beverly; Ross, Sharon A.; Beland, Frederick A.; Rusyn, Ivan; Pogribny, Igor P.

    2012-07-01

    MicroRNAs (miRNAs) are a class of small, conserved, tissue-specific regulatory non-coding RNAs that modulate a variety of biological processes and play a fundamental role in the pathogenesis of major human diseases, including nonalcoholic fatty liver disease (NAFLD). However, the association between inter-individual differences in susceptibility to NAFLD and altered miRNA expression is largely unknown. In view of this, the goals of the present study were (i) to determine whether or not individual differences in the extent of NAFLD-induced liver injury are associated with altered miRNA expression, and (ii) assess if circulating blood miRNAs may be used as potential biomarkers for the noninvasive evaluation of the severity of NAFLD. A panel of seven genetically diverse strains of inbred male mice (A/J, C57BL/6J, C3H/HeJ, 129S/SvImJ, CAST/EiJ, PWK/PhJ, and WSB/EiJ) were fed a choline- and folate-deficient (CFD) diet for 12 weeks. This diet induced liver injury in all mouse strains; however, the extent of NAFLD-associated pathomorphological changes in the livers was strain-specific, with A/J, C57BL/6J, and C3H/HeJ mice being the least sensitive and WSB/EiJ mice being the most sensitive. The morphological changes in the livers were accompanied by differences in the levels of hepatic and plasma miRNAs. The levels of circulating miR-34a, miR-122, miR-181a, miR-192, and miR-200b miRNAs were significantly correlated with a severity of NAFLD-specific liver pathomorphological features, with the strongest correlation occurring with miR-34a. These observations suggest that the plasma levels of miRNAs may be used as biomarkers for noninvasive monitoring the extent of NAFLD-associated liver injury and susceptibility to NAFLD. -- Highlights: ► Choline- and folate-deficiency induces a strain-specific fatty liver injury in mice. ► The extent of liver pathology was accompanied by the changes in microRNA expression. ► The levels of circulating microRNAs mirror the magnitude of fatty liver injury. ► Plasma microRNAs may be sensitive noninvasive indicators of the fatty liver injury.

  16. Prevalence and associations of symptoms of upper extremities, repetitive strain injuries (RSI) and 'RSI-like condition'. A cross sectional study of bank workers in Northeast Brazil

    PubMed Central

    Lacerda, Eliana M; Nácul, Luis C; da S Augusto, Lia G; Olinto, Maria Teresa A; Rocha, Dyhanne C; Wanderley, Danielle C

    2005-01-01

    Background The repetitive strain injury syndrome (RSI) is a worldwide occupational health problem affecting all types of economic activities. We investigated the prevalence and some risk factors for RSI and related conditions, namely 'symptoms of upper limbs' and 'RSI-like condition'. Methods We conducted a cross-sectional study with 395 bank workers in Recife, Northeast Brazil. Symptoms of upper limbs and 'RSI-like condition' were assessed by a simple questionnaire, which was used to screen probable cases of RSI. The diagnosis of RSI was confirmed by clinical examination. The associations of potential risk factors and the outcomes were assessed by multiple logistic regression analysis. Results We found prevalence rates of 56% for symptoms of the upper limbs and 30% for 'RSI-like condition'. The estimated prevalence of clinically confirmed cases of RSI was 22%. Female sex and occupation (as cashier or clerk) increased the risk of all conditions, but the associations were stronger for cases of RSI than for less specific diagnoses of 'RSI-like condition' and symptoms of upper limbs. Age was inversely related to the risk of symptoms of upper limbs but not to 'RSI-like' or RSI. Conclusion The variation in the magnitude of risk according to the outcome assessed suggests that previous studies using different definitions may not be immediately comparable. We propose the use of a simple instrument to screen cases of RSI in population based studies, which still needs to be validated in other populations. The high prevalence of RSI and related conditions in this population suggests the need for urgent interventions to tackle the problem, which could be directed to individuals at higher risk and to changes in the work organization and environment of the general population. PMID:16219095

  17. Comparison of Lower Body Specific Resistance Training on the Hamstring to Quadriceps Strength Ratios in Men and Women

    ERIC Educational Resources Information Center

    Dorgo, Sandor; Edupuganti, Pradeep; Smith, Darla R.; Ortiz, Melchor

    2012-01-01

    In this study, we compared hamstring (H) and quadriceps (Q) strength changes in men and women, as well as changes in conventional and functional H:Q ratios following an identical 12-week resistance training program. An isokinetic dynamometer was used to assess 14 male and 14 female participants before and after the intervention, and conventional

  18. Stability training of the lumbo-pelvo-hip complex influence stiffness of the hamstrings: a preliminary study.

    PubMed

    Kuszewski, M; Gnat, R; Saulicz, E

    2009-04-01

    An analysis of data obtained in an experiment investigating the influence of stability training of the lumbo-pelvo-hip complex (LPHC) on stiffness of the hamstrings is presented. Randomized controlled trial. The study included 30 subjects (aged 18-42 years) with increased stiffness of the hamstrings at baseline. Over a period of 4 weeks, stability training aiming to activate the deep stabilizing muscle subsystem and to integrate its action with the superficial subsystem was introduced in the experimental group. The control group remained unaffected. Three series of measurements were applied (baseline, after 2 weeks, and after 4 weeks). A digital inclinometer was used to measure outcomes of passive knee extension in the supine test. In the experimental group, a tendency to decrease stiffness of the hamstrings was observed. It was the opposite in the control group. Significant intra-group differences in the experimental group between series 1 and 3 measurements for both the right and left lower extremities were revealed. Stability training of the LPHC showed a tendency to be effective in reducing stiffness of the hamstrings. PMID:18384489

  19. Lack of Correlation between Dynamic Balance and Hamstring-to-Quadriceps Ratio in Patients with Chronic Anterior Cruciate Ligament Tears

    PubMed Central

    Lee, Jin-Hyuck; Jeong, Hye-Jin; Lee, Seok-Joo

    2015-01-01

    Purpose The purpose of this study was to evaluate the quadriceps and hamstring muscle strength and hamstring-to-quadriceps (HQ) ratio, as well as the relationships of these parameters with dynamic balance, in patients with anterior cruciate ligament (ACL) rupture. Materials and Methods We compared 25 patients diagnosed with chronic unilateral ACL tears and 25 age-matched healthy volunteers. The maximal torque of the quadriceps and hamstring and dynamic balance were measured. Results Although the isokinetic maximal peak torques were about 50% lower in the quadriceps (57%, p<0.001) and hamstring (56%, p=0.001) muscles in the chronic ACL tear group than in the control group, their HQ ratios were similar (56%±17% vs. 58%±6%, p=0.591). HQ ratio was significantly correlated with anterior-posterior stability index (r=-0.511, p=0.021) and overall stability index (r=-0.476, p=0.034) in control group, but these correlations were not observed in chronic ACL tear group. Conclusions Thigh muscle strength was about 50% lower in the chronic ACL tear group than in the control group, but the HQ ratio was similar. The dynamic balance of the knee was not influenced by thigh muscle strength but was influenced by HQ ratio in healthy young individuals. However, HQ ratio was not correlated with dynamic knee balance in chronic ACL tear patients. PMID:26060609

  20. Comparison of Lower Body Specific Resistance Training on the Hamstring to Quadriceps Strength Ratios in Men and Women

    ERIC Educational Resources Information Center

    Dorgo, Sandor; Edupuganti, Pradeep; Smith, Darla R.; Ortiz, Melchor

    2012-01-01

    In this study, we compared hamstring (H) and quadriceps (Q) strength changes in men and women, as well as changes in conventional and functional H:Q ratios following an identical 12-week resistance training program. An isokinetic dynamometer was used to assess 14 male and 14 female participants before and after the intervention, and conventional…

  1. Sprains, Strains and Fractures

    MedlinePlus

    ... Sprains, Strains & Fractures What is a Foot or Ankle Sprain or Fracture? The feet and ankles work together ... and mobility to the body. A foot or ankle sprain is a soft tissue injury. Most often, a ...

  2. Role of anthropometric data in the prediction of 4-stranded hamstring graft size in anterior cruciate ligament reconstruction.

    PubMed

    Ho, S W L; Tan, T J L; Lee, K T

    2016-03-01

    To evaluate whether pre-operative anthropometric data can predict the optimal diameter and length of hamstring tendon autograft for anterior cruciate ligament (ACL) reconstruction. This was a cohort study that involved 169 patients who underwent single-bundle ACL reconstruction (single surgeon) with 4-stranded MM Gracilis and MM Semi-Tendinosus autografts. Height, weight, body mass index (BMI), gender, race, age and -smoking status were recorded pre-operatively. Intra-operatively, the diameter and functional length of the 4-stranded autograft was recorded. Multiple regression analysis was used to determine the relationship between the anthropometric measurements and the length and diameter of the implanted autografts. The strongest correlation between 4-stranded hamstring autograft diameter was height and weight. This correlation was stronger in females than males. BMI had a moderate correlation with the diameter of the graft in females. Females had a significantly smaller graft both in diameter and length when compared with males. Linear regression models did not show any significant correlation between hamstring autograft length with height and weight (p > 0.05). Simple regression analysis demonstrated that height and weight can be used to predict hamstring graft diameter. The following regression equation was obtained for females: Graft diameter = 0.012 + 0.034*Height + 0.026*Weight (R2 = 0.358, p = 0.004) The following regression equation was obtained for males: Graft diameter = 5.130 + 0.012*Height + 0.007*Weight (R2 = 0.086, p = 0.002). Pre-operative anthropometric data has a positive correlation with the diameter of 4 stranded hamstring autografts but no significant correlation with the length. This data can be utilised to predict the autograft diameter and may be useful for pre-operative planning and patient counseling for graft selection. PMID:26984657

  3. THE EFFECTS OF INJURY PREVENTION WARM-UP PROGRAMMES ON KNEE STRENGTH IN MALE SOCCER PLAYERS

    PubMed Central

    Mokhtar, AH.; Rahnama, N.; Yusof, A.

    2013-01-01

    The study investigates the effects of the 11+ and HarmoKnee injury prevention programmes on knee strength in male soccer players. Under-21-year-old players (n=36) were divided equally into: the 11+, HarmoKnee and control groups. The programmes were performed for 24 sessions (20-25 min each). The hamstrings and quadriceps strength were measured bilaterally at 60°·s-1, 180°·s-1 and 300°·s-1. The concentric quadriceps peak torque (PT) of the 11+ increased by 27.7% at 300°·s-1 in the dominant leg (p<0.05). The concentric quadriceps PT of HarmoKnee increased by 36.6%, 36.2% and 28% in the dominant leg, and by 31.3%, 31.7% and 20.05% at 60°·s-1, 180°·s-1 and 300°·s-1 in the non-dominant leg respectively. In the 11+ group the concentric hamstring PT increased by 22%, 21.4% and 22.1% at 60°·s-1, 180°·s-1 and 300°·s-1, respectively in the dominant leg, and by 22.3%, and 15.7% at 60°·s-1 and 180°·s-1, in the non-dominant leg. In the HarmoKnee group the hamstrings in the dominant leg showed an increase in PT by 32.5%, 31.3% and 14.3% at 60°·s-1, 180°·s-1 and 300°·s-1, and in the non-dominant leg hamstrings PT increased by 21.1% and 19.3% at 60°·s-1 and 180°·s-1 respectively. The concentric hamstrings strength was significantly different between the 11+ and control groups in the dominant (p=0.01) and non-dominant legs (p=0.02). The HarmoKnee programme enhanced the concentric strength of quadriceps. The 11+ and HarmoKnee programmes are useful warm-up protocols for improving concentric hamstring strength in young professional male soccer players. The 11+ programme is more advantageous for its greater concentric hamstring strength improvement compared to the HarmoKnee programme. PMID:24795499

  4. Common American football injuries.

    PubMed

    Saal, J A

    1991-08-01

    As many as 1.5 million young men participate in American football in the United States. An estimated 1.2 million football-related injuries are sustained annually. Since the 1970s epidemiological studies have shown that the risk of injury is higher in older athletes and lower in teams with more experienced coaches and more assistant coaches. 51% of injuries occurred at training; contact sessions were 4.7 times more likely to produce injuries than controlled sessions. Injury rates were reduced by wearing shorter cleats and preseason conditioning. Overall, lower extremity injuries accounted for 50% of all injuries (with knee injuries accounting for up to 36%). Upper extremity injuries accounted for 30%. In general, sprains and strains account for 40% of injuries, contusions 25%, fractures 10%, concussions 5% and dislocations 15%. Cervical spine injuries have the potential to be catastrophic, but they declined dramatically in the decade 1975 to 1984, due to the impact of rule changes modifying tackling and blocking techniques and improved fitness, equipment and coaching. Appropriate diagnostic evaluation of cervical injuries is mandatory. The evidence supporting prophylactic knee bracing is not compelling and does not mandate compulsory or routine use. Return to play criteria include: full range of motion; normal strength; normal neurological evaluation; no joint swelling or instability; ability to run and sustain contact without pain; no intake of pain medication; player education about preventive measures and future risks. These criteria should be strictly observed. In addition to ankle and knee rehabilitation, lumbar spine injuries present a challenge for the physician. Repetitive flexion, extension and torsional stresses predispose the lumbar spine to injury. Rehabilitation consists of pain control and training. The training phase aims to eliminate repetitive injuries by minimising stress at the intervertebral joint. Football is a high risk sport. Coaches, players, trainers and physicians must all become aware of the proper means to prevent injuries. PMID:1947533

  5. Failure strengths of concentric and eccentric implants for hamstring graft fixation.

    PubMed

    Gwynne-Jones, David P; Draffin, Joanne; Vane, Andrew G S; Craig, Roy A; McMahon, Simon F

    2008-03-01

    The purpose of this study is to compare the initial failure strengths of various interference screw devices used for tibial fixation of hamstring grafts in anterior cruciate ligament reconstruction and the effect of concentric or eccentric screw position. Quadrupled tendon grafts were harvested from freshly killed sheep. The grafts were then prepared and fixed in the distal femur using various devices (Intrafix (DePuy Mitek Raynham, MA, USA), RCI screw (Smith and Nephew Acufex, Mansfield, MA, USA), Wedge screw (Stryker Endoscopy, San Jose, CA, USA) in concentric position and Wedge screw in eccentric position with an interlock pin). The load required to cause mechanical failure of each construct was measured. The Intrafix device had a significantly greater mean strength to failure than all the other implants (mean 941 +/- 280 N) (P = 0.015 to P < 0.0001). The wedge screw inserted concentrically (737 +/- 134 N) had significantly greater initial failure strength than the wedge eccentric with interlock pin (458 +/- 266 N) (P = 0.03) and the RCI screw (464 +/- 107 N) (P = 0.00036). In this sheep model the Intrafix device with sheath inserted concentrically had significantly greater initial failure strength than the other interference screws. Concentric positioning of the wedge interference screw gave significantly greater initial failure strength of a quadruple tendon graft than eccentric positioning. The use of the Intrafix device or concentric positioning of an interference screw should result in increased initial fixation strength of hamstring grafts. This may allow more vigorous early rehabilitation and may result in less late graft laxity after anterior cruciate ligament reconstruction. PMID:18269483

  6. Knee Extension Strength and Hamstrings-to-Quadriceps Imbalances in Elite Soccer Players.

    PubMed

    Bogdanis, G C; Kalapotharakos, V I

    2016-02-01

    This study examined the relationship between hamstrings-to-quadriceps strength ratio (H:Q) and relative strength of the knee extensors in elite soccer players. Peak torque was measured during isokinetic knee extension/flexion at angular velocities of 60°·s(-1), 180°·s(-1) and 300°·s(-1). 18 professional players were divided into 2 groups, depending on their H:Q at 60°·s(-1). Players in the lower H:Q group (n=7) had significantly smaller H:Q ratios compared with the higher H:Q group (n=11) at all angular velocities (60°·s(-1): 49.2%; 95% CI: 61.3-57.8% vs. 59.5%; 95% CI: 52.2-46.2%, p=0.001). Players in the lower H:Q group had greater knee-extension peak torque compared with the higher H:Q group (60°·s(-1): 313; 95% CI: 335-291 vs. 269; 95% CI: 289-250 N·m, p=0.01). No differences were found in hamstrings' strength between the 2 groups (60°·s(-1): 156; 95% CI: 170-143 vs. 160; 95% CI: 173-148 N·m, p=0.96). Negative correlations between knee extension peak torque and H:Q ratio were observed at all angular velocities (r=-0.65 to -0.67, p<0.01). In conclusion, a low H:Q strength ratio measured during isokinetic strength testing in professional soccer players, is observed mainly in those with strong quadriceps muscles, while players with lower quadriceps strength have H:Q ratios around the recommended values. PMID:26509377

  7. Diminished sub-maximal quadriceps force control in anterior cruciate ligament reconstructed patients is related to quadriceps and hamstring muscle dyskinesia.

    PubMed

    Telianidis, Stacey; Perraton, Luke; Clark, Ross A; Pua, Yong-Hao; Fortin, Karine; Bryant, Adam L

    2014-08-01

    The aim of this study was to determine the effects of anterior cruciate ligament reconstruction (ACLR) on sub-maximal quadriceps force control with respect to quadriceps and hamstring muscle activity. Thirty ACLR individuals together with 30 healthy individuals participated. With real-time visual feedback of muscle force output and electromyographic electrodes attached to the quadriceps and hamstring muscles, subjects performed an isometric knee extension task where they increased and decreased their muscle force output at 0.128Hz within a range of 5-30% maximum voluntary capacity. The ACLR group completed the task with more error and increased medial hamstring and vastus medialis activation (p<0.05). Moderate negative correlations (p<0.05) were observed between quadriceps force control and medial (Spearman's rho=-0.448, p=0.022) and lateral (Spearman's rho=-0.401, p=0.034) hamstring activation in the ACLR group. Diminished quadriceps sub-maximal force control in ACLR subjects was reflective of medial quadriceps and hamstring dyskinesia (i.e., altered muscle activity patterns and coordination deficits). Within the ACLR group however, augmented hamstring co-activation was associated with better quadriceps force control. Future studies should explore the convergent validity of quadriceps force control in ACLR patients. PMID:24875460

  8. Acute effects of static stretching on peak and end-range hamstring-to-quadriceps functional ratios

    PubMed Central

    Sekir, Ufuk; Arabaci, Ramiz; Akova, Bedrettin

    2015-01-01

    AIM: To evaluate if static stretching influences peak and end-range functional hamstring-to-quadriceps (H/Q) strength ratios in elite women athletes. METHODS: Eleven healthy female athletes in an elite competitive level participated to the study. All the participants fulfilled the static stretching or non-stretching (control) intervention protocol in a randomized design on different days. Two static unassisted stretching exercises, one in standing and one in sitting position, were used to stretch both the hamstring and quadriceps muscles during these protocols. The total time for the static stretching was 6 ± 1 min. The isokinetic peak torque measurements for the hamstring and quadriceps muscles in eccentric and concentric modes and the calculations for the functional H/Q strength ratios at angular velocities of 60°/s and 180°/s were made before (pre) and after (post) the control or stretching intervention. The strength measurements and functional strength ratio calculations were based during the entire- and end-range of knee extension. RESULTS: The pre-test scores for quadriceps and hamstring peak torque and end range values were not significantly different between the groups (P > 0.05). Subsequently, although the control group did not exhibit significant changes in quadriceps and hamstring muscle strength (P > 0.05), static stretching decreased eccentric and concentric quadriceps muscle strength at both the 60°/s and 180°/s test speeds (P < 0.01). Similarly, static stretching also decreased eccentric and concentric hamstring muscle strength at both the 60°/s and 180°/s test speeds (P < 0.01). On the other hand, when the functional H/Q strength ratios were taken into consideration, the pre-intervention values were not significant different between the groups both during the entire and end range of knee extension (P > 0.05). Furthermore, the functional H/Q strength ratios exhibited no significant alterations during the entire and end ranges of knee extension both in the static stretching or the control intervention (P > 0.05). CONCLUSION: According to our results, static stretching routine does not influence functional H/Q ratio. Athletes can confidently perform static stretching during their warm-up routines. PMID:26495249

  9. Descriptive Epidemiology of Musculoskeletal Injuries and Concussions in the National Football League, 2012-2014

    PubMed Central

    Lawrence, David W.; Hutchison, Michael G.; Comper, Paul

    2015-01-01

    Background: The risk of all-cause injury and concussion associated with football is significant. The National Football League (NFL) has implemented changes to increase player safety warranting investigation into the incidence and patterns of injury. Purpose: To document the incidence and patterns of all-cause injury and concussions in the NFL. Study Design: Descriptive epidemiology study. Methods: Injury data were collected prospectively from official NFL injury reports over 2 regular seasons from 2012 to 2014, with identification of injury incidence rates and patterns. Concussion rate ratios were calculated using previously reported NFL rates. Results: A total of 4284 injuries were identified, including 301 concussions. The all-cause injury rate was 395.8 per 1000 athletes at risk (AAR) and concussion incidence was 27.8 per 1000 AAR. Only 2.3% of team games were injury free. Wide receivers, tight ends, and defensive backs had the highest incidence of injury and concussion. Concussion incidence was 1.61-fold higher in 2012 to 2014 compared with 2002 to 2007. The knee was injured most frequently, followed by the ankle, hamstring, shoulder, and head. Conclusion: The incidence of all-cause injury and concussion in the NFL is significant. Concussion injury rates are higher than previous reports, potentially reflecting an improvement in recognition and awareness. Injury prevention efforts should continue to reduce the prevalence of injury associated with football. PMID:26675321

  10. Injuries, Matches Missed and the Influence of Minimum Medical Standards in the A-League Professional Football: A 5-Year Prospective Study

    PubMed Central

    Gouttebarge, Vincent; Hughes Schwab, Brendan A.; Vivian, Adam; M. M. J. Kerkhoffs, Gino

    2016-01-01

    Background: Epidemiological data on the occurrence of time-loss injuries over several A-League seasons remains lacking, while the effect of the mandatory implementation of ‘Minimum Medical Standards’ as a part of the collective bargaining agreement (CBA) needs to be explored. Objectives: To explore the 5 year evolution of hamstring, groin, knee, ankle and total time-loss injuries among professional footballers in the A-League; to evaluate the consequences of these time-loss injuries in terms of total matches missed and costs incurred; and to explore whether the mandatory implementation of ‘Minimum Medical Standards’ in the A-League had led to a decrease in the occurrence of total time-loss injuries and total matches missed. Patients and Methods: An observational prospective study has been carried out since 2008. Data were collected weekly during the seasons 2008 - 2009 to 2012 - 2013 through official match previews/reviews, official media releases, official websites and/or self-reports by players. Total and specific (hamstring, groin, knee and ankle) numbers of time-loss injuries and matches missed were obtained for each season and the related financial costs calculated. Results: The total number of time-loss injuries and matches missed rose from 129 and 506 respectively in 2008 - 2009 to 202 and 1110 in 2010 - 2011. Following the introduction of ‘Minimum Medical Standards’, both categories decreased (significantly for matches missed). These time-loss injuries and matches missed led to high costs of up to AUD$ 37,317,029.29 (2012 - 2013 season). The same trend was found for knee injuries, while hamstring and ankle injuries remained almost the same. However, time-loss due to groin injuries increased despite the introduction of “Minimum Medical Standards”. Conclusions: The introduction of “Minimum Medical Standards” in the A-League had a favorable effect on the number of total, hamstring, knee and ankle injuries and on the number of matches missed due to these injuries, but not on the number of groin injuries. The costs related to time-loss injuries and related matches missed remained high.

  11. Comparison of the effects of hamstring stretching using proprioceptive neuromuscular facilitation with prior application of cryotherapy or ultrasound therapy

    PubMed Central

    Magalhães, Francisco Elezier Xavier; Junior, Arlindo Rodrigues de Mesquita; Meneses, Harnold’s Tyson de Sousa; Moreira dos Santos, Rayele Pricila; Rodrigues, Ezaine Costa; Gouveia, Samara Sousa Vasconcelos; Gouveia, Guilherme Pertinni de Morais; Orsini, Marco; Bastos, Victor Hugo do Vale; Machado, Dionis de Castro Dutra

    2015-01-01

    [Purpose] Stretching using proprioceptive neuromuscular facilitation involve physiological reflex mechanisms through submaximal contraction of agonists which activate Golgi organ, promoting the relaxation reflex. The aim of this study was to evaluate the effects of proprioceptive neuromuscular facilitation alone and with prior application of cryotherapy and thermotherapy on hamstring stretching. [Subjects and Methods] The sample comprised of 32 young subjects with hamstring retraction of the right limb. The subjects were randomly allocated to four groups: the control, flexibility PNF, flexibility PNF associated with cryotherapy, flexibility PNF in association with ultrasound therapy. [Results] After 12 stretching sessions, experimental groups showed significant improvements compared to the control group. Moreover, we did not find any significant differences among the experimental groups indicating PNF stretching alone elicits similar results to PNF stretching with prior administration of cryotherapy or thermotherapy. [Conclusion] PNF without other therapy may be a more practical and less expensive choice for clinical care. PMID:26157261

  12. Comparison of the effects of hamstring stretching using proprioceptive neuromuscular facilitation with prior application of cryotherapy or ultrasound therapy.

    PubMed

    Magalhães, Francisco Elezier Xavier; Junior, Arlindo Rodrigues de Mesquita; Meneses, Harnold's Tyson de Sousa; Moreira Dos Santos, Rayele Pricila; Rodrigues, Ezaine Costa; Gouveia, Samara Sousa Vasconcelos; Gouveia, Guilherme Pertinni de Morais; Orsini, Marco; Bastos, Victor Hugo do Vale; Machado, Dionis de Castro Dutra

    2015-05-01

    [Purpose] Stretching using proprioceptive neuromuscular facilitation involve physiological reflex mechanisms through submaximal contraction of agonists which activate Golgi organ, promoting the relaxation reflex. The aim of this study was to evaluate the effects of proprioceptive neuromuscular facilitation alone and with prior application of cryotherapy and thermotherapy on hamstring stretching. [Subjects and Methods] The sample comprised of 32 young subjects with hamstring retraction of the right limb. The subjects were randomly allocated to four groups: the control, flexibility PNF, flexibility PNF associated with cryotherapy, flexibility PNF in association with ultrasound therapy. [Results] After 12 stretching sessions, experimental groups showed significant improvements compared to the control group. Moreover, we did not find any significant differences among the experimental groups indicating PNF stretching alone elicits similar results to PNF stretching with prior administration of cryotherapy or thermotherapy. [Conclusion] PNF without other therapy may be a more practical and less expensive choice for clinical care. PMID:26157261

  13. Head Injuries

    MedlinePlus

    ... before. Usually, the injury is minor because your skull is hard and it protects your brain. But ... injuries can be more severe, such as a skull fracture, concussion, or traumatic brain injury. Head injuries ...

  14. Back Injuries

    MedlinePlus

    ... extending from your neck to your pelvis. Back injuries can result from sports injuries, work around the house or in the garden, ... back is the most common site of back injuries and back pain. Common back injuries include Sprains ...

  15. Conservative Treatment of Subacute Proximal Hamstring Tendinopathy Using Eccentric Exercises Performed With a Treadmill: A Case Report

    PubMed Central

    CUSHMAN, DANIEL; RHO, MONICA E.

    2015-01-01

    STUDY DESIGN Case report. BACKGROUND Proximal hamstring tendinopathy in runners is characterized by pain with passive hip flexion with the knee extended, active hip extension, and pain with sitting. Relatively little literature exists on the condition, and publications on nonsurgical treatment protocols are even more scarce. Surgical intervention, which comprises the majority of literature for treatment of this condition, is an option for cases that fail to respond to nonsurgical treatment. CASE DESCRIPTION The patient was a 34-year-old, otherwise healthy male triathlete with unilateral proximal hamstring tendinopathy diagnosed by ultrasound, who had pain only with running and prolonged sitting. After he failed to respond to 4 weeks of eccentric knee flexion and lumbopelvic musculature strengthening exercises, an eccentric hip extensor strengthening program using a treadmill was initiated. This treadmill exercise was performed on a daily basis, in addition to a lumbopelvic musculature strengthening program. OUTCOMES The patient noted a decrease in pain within 2 weeks of initiating the new exercise, and was able to return to gradual running after 4 weeks and to speed training after 12 weeks. He returned to competition shortly thereafter and had no recurrence for 12 months after the initiation of therapy. His score on the Victorian Institute of Sport Assessment-proximal hamstring tendons improved from 23 on initial presentation to 83 at 12 weeks after the initiation of therapy. DISCUSSION We described the management of a triathlete with subacute proximal hamstring tendinopathy, who responded well to nonsurgical treatment using eccentric hip extension strengthening using a treadmill. LEVEL OF EVIDENCE Therapy, level 4. PMID:25996362

  16. Relationship between hamstring activation rate and heel contact velocity: Factors influencing age-related slip-induced falls

    PubMed Central

    Lockhart, Thurmon E.; Kim, Sukwon

    2010-01-01

    The purpose of this research was to determine whether a decreased hamstring activation rate among the elderly is responsible for a higher horizontal heel contact velocity and increased likelihood of slip-induced falls compared to their younger counterparts. Twenty-eight subjects from two age groups (14 young and 14 old) walked across a linear walking track with embedded force platforms while wearing a fall arresting harness attached to an overhead arresting rig for safety. In order to obtain realistic unexpected slip-induced fall data, a soapy vinyl floor surface was hidden from the subjects and unexpectedly introduced. Synchronized kinematics, kinetic and electromyography (EMG) analyses during the heel contact phase of the gait cycle while walking over slippery and non-slippery floor surfaces were examined in the study. Normalized EMG data were examined in terms of hamstring activation rate and evaluated with heel contact velocity and friction demand characteristic (as measured by peak required coefficient of friction (RCOF)) on the dry vinyl floor surface. Furthermore, slip parameters (i.e. slip distances and slipping velocity) were assessed on the soapy vinyl floor surface. The results indicated that younger adults’ hamstring activation rate was higher than older adults, whereas younger adults’ heel contact velocity was not different from older adults. These results suggested that heel contact velocity in younger adults was sufficiently reduced before the heel contact phase of the gait cycle. This could be due to the outcome of higher hamstring activation rate in younger adults in comparison to older adults. However, lower friction demand (peak RCOF), shorter slip distances, slower peak sliding heel velocity and more falls among older adults suggested that the slip initiation characteristics were not the only factors contributing to slip-induced falls among the elderly. PMID:16112575

  17. Dynamic neuromuscular analysis training for preventing anterior cruciate ligament injury in female athletes.

    PubMed

    Hewett, Timothy E; Myer, Gregory D; Ford, Kevin R; Slauterbeck, James R

    2007-01-01

    Female athletes are four to six times more likely to sustain an anterior cruciate ligament (ACL) injury than male athletes. Since the enactment of Title IX, male athletic participation at the high school level has remained steady (3.8 million), whereas female athletic participation has increased tenfold (from 0.3 to 3.0 million). Geometric growth in athletic participation and the higher injury rate in female athletes have led to gender inequity in ACL injury rates. Most ACL injuries occur as a result of noncontact mechanisms such as during landing from a jump or while making a lateral pivot. Dynamic knee instability, caused by ligament dominance (decreased dynamic neuromuscular control of the joint), quadriceps dominance (decreased hamstring strength and recruitment), and leg dominance (side-to-side differences in strength and coordination) may be responsible for gender inequity in ACL injury rates. PMID:17472323

  18. Tissue Strain Reorganizes Collagen With a Switchlike Response That Regulates Neuronal Extracellular Signal-Regulated Kinase Phosphorylation In Vitro: Implications for Ligamentous Injury and Mechanotransduction.

    PubMed

    Zhang, Sijia; Cao, Xuan; Stablow, Alec M; Shenoy, Vivek B; Winkelstein, Beth A

    2016-02-01

    Excessive loading of ligaments can activate the neural afferents that innervate the collagenous tissue, leading to a host of pathologies including pain. An integrated experimental and modeling approach was used to define the responses of neurons and the surrounding collagen fibers to the ligamentous matrix loading and to begin to understand how macroscopic deformation is translated to neuronal loading and signaling. A neuron-collagen construct (NCC) developed to mimic innervation of collagenous tissue underwent tension to strains simulating nonpainful (8%) or painful ligament loading (16%). Both neuronal phosphorylation of extracellular signal-regulated kinase (ERK), which is related to neuroplasticity (R2 ≥ 0.041; p ≤ 0.0171) and neuronal aspect ratio (AR) (R2 ≥ 0.250; p < 0.0001), were significantly correlated with tissue-level strains. As NCC strains increased during a slowly applied loading (1%/s), a "switchlike" fiber realignment response was detected with collagen reorganization occurring only above a transition point of 11.3% strain. A finite-element based discrete fiber network (DFN) model predicted that at bulk strains above the transition point, heterogeneous fiber strains were both tensile and compressive and increased, with strains in some fibers along the loading direction exceeding the applied bulk strain. The transition point identified for changes in collagen fiber realignment was consistent with the measured strain threshold (11.7% with a 95% confidence interval of 10.2-13.4%) for elevating ERK phosphorylation after loading. As with collagen fiber realignment, the greatest degree of neuronal reorientation toward the loading direction was observed at the NCC distraction corresponding to painful loading. Because activation of neuronal ERK occurred only at strains that produced evident collagen fiber realignment, findings suggest that tissue strain-induced changes in the micromechanical environment, especially altered local collagen fiber kinematics, may be associated with mechanotransduction signaling in neurons. PMID:26549105

  19. The combined effect of cycling cadence and crank resistance on hamstrings and quadriceps muscle activities during cycling.

    PubMed

    Katona, P; Pilissy, T; Tihanyi, A; Laczkó, József

    2014-12-01

    The effect of cycling cadence and crank resistance on the activity of hamstrings and quadriceps muscles was investigated during cycling movements of able-bodied subjects on a stationary bike with slow and fast speed against different resistance conditions. The ratio of average EMG amplitudes obtained in the two speed conditions (fast/slow) was computed in each resistance condition. This ratio is higher for both muscles if cycling against higher resistance. This shows that in higher resistance condition muscle activities are not only increased but the change of muscle activities with respect to cadence change varied according to resistance condition. Average EMG amplitudes increased at a higher rate with respect to change of cadence when cycling was performed in higher resistance condition. Besides, when cycling faster, hamstrings activity increased generally at a higher rate than that of quadriceps. The correlation between cadence and EMG amplitudes were also investigated. Considering hamstrings, this correlation was low and decreased as resistance increased. The correlation between the time required to drive one cycle and EMG amplitude is negative but in absolute value it is larger than the correlation of cadence and EMG amplitude. PMID:25532958

  20. Comparison of hamstring muscle behavior for anterior cruciate ligament (ACL) patient and normal subject during local marching

    NASA Astrophysics Data System (ADS)

    Amineldin@Aminudin, Nurul Izzaty Bt.; Rambely, A. S.

    2014-09-01

    This study aims to investigate the hamstring muscle activity after the surgery by carrying out an electromyography experiment on the hamstring and to compare the behavior of the ACL muscle activity between ACL patient and control subject. Electromyography (EMG) is used to study the behavior of muscles during walking activity. Two hamstring muscles involved which are semitendinosus and bicep femoris. The EMG data for both muscles were recorded while the subject did maximum voluntary contraction (MVC) and marching. The study concluded that there were similarities between bicep femoris of the ACL and control subjects. The analysis showed that the biceps femoris muscle of the ACL subject had no abnormality and the pattern is as normal as the control subject. However, ACL patient has poor semitendinosus muscle strength compared to that of control subject because the differences of the forces produced. The force of semitendinosus value for control subject was two times greater than that of the ACL subject as the right semitendinosus muscle of ACL subject was used to replace the anterior cruciate ligament (ACL) that was injured.

  1. Cross Pins versus Endobutton Femoral Fixation in Hamstring Anterior Cruciate Ligament Reconstruction: Minimum 4-Year Follow-Up

    PubMed Central

    Kong, Chae-Gwan; Kim, Geon-Hyeong; Ahn, Chi-Young

    2012-01-01

    Purpose We aimed to compare cross-pin fixation and Endobutton femoral fixation for hamstring anterior cruciate ligament (ACL) reconstruction with respect to clinical and radiographic results, including tunnel widening and the progression of knee osteoarthritis (OA). Materials and Methods Between August 2002 and August 2005, 126 autogenous hamstring ACL reconstructions were performed using either cross pins or Endobutton for femoral fixation. Fifty-six of 75 patients in the cross-pin group and 35 of 51 patients in the Endobutton group were followed up for a minimum of 4 years. We compared the clinical and radiological results between the groups using the International Knee Documentation Committee (IKDC) evaluation form, the KT-2000 arthrometer side to side difference, the amount of tunnel widening and the advancement of OA on radiographs. Results There were no significant differences in the IKDC grades between the groups at the 4 year follow-up. There was no significant difference in the side to side difference according to KT-2000 arthrometer testing. Also, there were no significant differences in terms of tunnel widening or advancement of OA on radiographs. Conclusions Endobutton femoral fixation showed good results that were comparable to those of cross pins fixation in hamstring ACL reconstruction. PMID:22570850

  2. Reducing muscle injuries and reinjuries in one italian professional male soccer team

    PubMed Central

    Melegati, Gianluca; Tornese, Davide; Gevi, Maurizio; Trabattoni, Alessandro; Pozzi, Grazia; Schonhuber, Herbert; Volpi, Piero

    2013-01-01

    Summary Background. The incidence rate of muscle injuries and re-injuries in professional elite soccer players actually is very high and may interfere with the fate of a championship. Purpose. To investigate the effect of a two-tiered injury prevention programme on first injury and re-injury incidence in top level male soccer players. Study design Case Series Study. Muscle injuries and re-injuries sustained by a group of 36 soccer player of an italian elite soccer team have been collected during 2010–2011 season. These data have been compared with those collected during the previous season in the same elite soccer team. Results. A total of 64 injuries occurred, 36 (56%) of which during practice and 28 (44%) during matches. Muscle injuries accounted for 31.3% of the total (n=20), 70% (n=14) of which occurred during practice and 30% (n=6) during matches. Hamstring were the muscles most often injured (n=11) In all, 3 re-injuries occurred (15% of muscle injuries). No early re-injuries occurred. The incidence was 2.5 injuries/1000 hours and the burden was 37 days absence/1000 hours. Conclusions. Through the implementation of a group and personalized injury prevention program, we were able to reduce the total number of muscle injuries and days absent because of injury, in a team of elite soccer players, as compared to the previous season. Specifically, muscle injuries accounted for 31% of all injuries, as compared to 59% of all injuries sustained by the team during the previous season. The number of injuries/1000 hours of exposure was reduced by half (from 5.6 to 2.5) and the days absent/1000 hours fell from 106 to 37. PMID:24596697

  3. Effects of a Stretching Development and Maintenance Program on Hamstring Extensibility in Schoolchildren: A Cluster-Randomized Controlled Trial

    PubMed Central

    Mayorga-Vega, Daniel; Merino-Marban, Rafael; Manzano-Lagunas, Jorge; Blanco, Humberto; Viciana, Jesús

    2016-01-01

    The main purpose of the present study was to examine the effects of a physical education-based stretching development and maintenance program on hamstring extensibility in schoolchildren. A sample of 150 schoolchildren aged 7-10 years old from a primary school participated in the present study (140 participants were finally included). The six classes balanced by grade were cluster randomly assigned to the experimental group 1 (n = 51), experimental group 2 (n = 51) or control group (n = 49) (i.e., a cluster randomized controlled trial design was used). During the physical education classes, the students from the experimental groups 1 and 2 performed a four-minute stretching program twice a week for nine weeks (first semester). Then, after a five-week period of detraining coinciding with the Christmas holidays, the students from the experimental groups 1 and 2 completed another stretching program twice a week for eleven weeks (second semester). The students from the experimental group 1 continued performing the stretching program for four minutes while those from the experimental group 2 completed a flexibility maintenance program for only one minute. The results of the two-way analysis of variance showed that the physical education-based stretching development program significantly improved the students’ hamstring extensibility (p < 0.001), as well as that these gains obtained remained after the stretching maintenance program (p < 0.001). Additionally, statistically significant differences between the two experimental groups were not found (p > 0.05). After a short-term stretching development program, a physical education-based stretching maintenance program of only one-minute sessions twice a week is effective in maintaining hamstring extensibility among schoolchildren. This knowledge could help and guide teachers to design programs that allow a feasible and effective development and maintenance of students’ flexibility in the physical education setting. Key points A physical education-based stretching maintenance program of only one-minute sessions twice a week is effective in maintaining hamstring extensibility among schoolchildren. A four-minute maintenance program shows similar effects that the one-minute maintenance program on hamstring extensibility among schoolchildren. Physical education teachers and other practitioners could carry out one-minute programs for a feasible and effective maintenance of students’ flexibility. PMID:26957928

  4. Effects of a Stretching Development and Maintenance Program on Hamstring Extensibility in Schoolchildren: A Cluster-Randomized Controlled Trial.

    PubMed

    Mayorga-Vega, Daniel; Merino-Marban, Rafael; Manzano-Lagunas, Jorge; Blanco, Humberto; Viciana, Jesús

    2016-03-01

    The main purpose of the present study was to examine the effects of a physical education-based stretching development and maintenance program on hamstring extensibility in schoolchildren. A sample of 150 schoolchildren aged 7-10 years old from a primary school participated in the present study (140 participants were finally included). The six classes balanced by grade were cluster randomly assigned to the experimental group 1 (n = 51), experimental group 2 (n = 51) or control group (n = 49) (i.e., a cluster randomized controlled trial design was used). During the physical education classes, the students from the experimental groups 1 and 2 performed a four-minute stretching program twice a week for nine weeks (first semester). Then, after a five-week period of detraining coinciding with the Christmas holidays, the students from the experimental groups 1 and 2 completed another stretching program twice a week for eleven weeks (second semester). The students from the experimental group 1 continued performing the stretching program for four minutes while those from the experimental group 2 completed a flexibility maintenance program for only one minute. The results of the two-way analysis of variance showed that the physical education-based stretching development program significantly improved the students' hamstring extensibility (p < 0.001), as well as that these gains obtained remained after the stretching maintenance program (p < 0.001). Additionally, statistically significant differences between the two experimental groups were not found (p > 0.05). After a short-term stretching development program, a physical education-based stretching maintenance program of only one-minute sessions twice a week is effective in maintaining hamstring extensibility among schoolchildren. This knowledge could help and guide teachers to design programs that allow a feasible and effective development and maintenance of students' flexibility in the physical education setting. Key pointsA physical education-based stretching maintenance program of only one-minute sessions twice a week is effective in maintaining hamstring extensibility among schoolchildren.A four-minute maintenance program shows similar effects that the one-minute maintenance program on hamstring extensibility among schoolchildren.Physical education teachers and other practitioners could carry out one-minute programs for a feasible and effective maintenance of students' flexibility. PMID:26957928

  5. Autologous Hamstring Anterior Cruciate Ligament Graft Failure Using the Anteromedial Portal Technique With Suspensory Femoral Fixation

    PubMed Central

    Galdi, Balazs; Reyes, Allan; Brabston, Eugene W.; Levine, William N.

    2015-01-01

    Background: The anteromedial portal technique for drilling of the femoral tunnel during anterior cruciate ligament (ACL) reconstruction has been advocated by many surgeons as allowing improved access to the anatomical footprint. Furthermore, suspensory fixation of soft tissue grafts has become popularized because of complications associated with cross-pin fixation. Concerns regarding the use of both have recently arisen. Purpose: To raise awareness of the increased risk of graft failure when using the anteromedial portal technique with suspensory femoral fixation during ACL reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: From November 1998 to August 2012, a total of 465 primary ACL reconstructions were performed using quadrupled hamstring autograft tendons, with drilling of the femoral tunnel performed via the transtibial portal. Graft fixation on the femur was achieved with cross-pin fixation, while interference screw fixation was used on the tibia. From September 2012 to October 2013, there were 69 reconstructions performed through an anteromedial portal. While there was no change in graft choice, a change was made to using suspensory femoral fixation. No other surgical or postoperative rehabilitation changes were made. Results: During the 14-year period in which ACL reconstructions were performed via the transtibial portal and with cross-pin fixation, 2 graft failures (0.4% failure rate) were reported. After switching to the anteromedial portal with suspensory fixation, 7 graft failures (10.1% failure rate) were reported over a 13-month period. These were 5 male and 2 female patients, with a mean age of 18.8 years—all elite athletes. The same surgical technique was used in all patients, and all patients had at least an 8 mm–diameter graft. Patients were cleared to return to sport at an average of 8.4 months postoperatively, after completing functional performance tests. Of the 7 patients, 6 sustained a rerupture of the graft within 2 weeks of returning to full competition. The final patient sustained a rerupture 10 months after being cleared to play. Conclusion: Compared with the transtibial technique with cross-pin graft fixation, there is an increased risk of graft failure when performing autologous hamstring ACL reconstructions using the anteromedial portal technique with cortical suspensory fixation. PMID:26535370

  6. A survey of badminton injuries.

    PubMed Central

    Hensley, L. D.; Paup, D. C.

    1979-01-01

    A Badminton Injury Questionnaire (BIQ) was developed to survey the type and frequency of injuries that are likely to occur from playing competitive badminton. Two hundred and thirty-one players, ranging from club players to international champions, completed the survey which indicated an injury incidence rate of .09 and .14 injuries per person per year for male and female badminton players respectively. Badminton participation resulted in relatively few injuries, most of which were cramps, blisters, strains and sprains of the lower extremities and a surprisingly low incidence of tennis elbow. PMID:526780

  7. Prospective Comparison of Auto and Allograft Hamstring Tendon Constructs for ACL Reconstruction

    PubMed Central

    Edgar, Cory M.; Zimmer, Scott; Kakar, Sanjeev; Jones, Hugh

    2008-01-01

    Although allograft use for primary anterior cruciate ligament reconstruction has continued to increase during the last 10 years, concerns remain regarding the long-term function of allografts (primarily that they may stretch with time) and clinical efficacy compared with autograft tendons. We attempted to address these issues by prospectively comparing identical quadrupled hamstring autografts with allograft constructs for primary anterior cruciate ligament reconstruction in patients with a minimum followup of 3 years. Eighty-four patients (37 with autografts and 47 with allografts) were enrolled; the mean followup was 52 ± 11 months for the autograft group and 48 ± 8 months for the allograft group. Outcome measurements included objective and subjective International Knee Documentation Committee scores, Lysholm scores, Tegner activity scales, and KT-1000 arthrometer measurements. The two cohorts were similar in average age, acute or chronic nature of the anterior cruciate ligament rupture, and incidence of concomitant meniscal surgeries. At final followup, we found no difference in terms of Tegner, Lysholm, KT-1000, or International Knee Documentation Committee scores. Five anterior cruciate ligament reconstructions failed: three in the autograft group and two in the allograft group. Our data suggest laxity is not increased in allograft tendons compared with autografts and clinical outcome scores 3 to 6 years after surgery are similar. Level of Evidence: Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18575944

  8. Differences in activation properties of the hamstring muscles during overground sprinting.

    PubMed

    Higashihara, Ayako; Nagano, Yasuharu; Ono, Takashi; Fukubayashi, Toru

    2015-09-01

    The purpose of this study was to quantify activation of the biceps femoris (BF) and medial hamstring (MH) during overground sprinting. Lower-extremity kinematics and electromyography (EMG) of the BF and MH were recorded in 13 male sprinters performing overground sprinting at maximum effort. Mean EMG activity was calculated in the early stance, late stance, mid-swing, and late-swing phases. Activation of the BF was significantly greater during the early stance phase than the late stance phase (p<0.01). Activation of the BF muscle was significantly lower during the first half of the mid-swing phase than the other phases (p<0.05). The MH had significantly greater EMG activation relative to its recorded maximum values compared to that for the BF during the late stance (p<0.05) and mid-swing (p<0.01) phases. These results indicate that the BF shows high activation before and after foot contact, while the MH shows high activation during the late stance and mid-swing phases. We concluded that the activation properties of the BF and MH muscles differ within the sprinting gait cycle. PMID:26213185

  9. Hamstrings-to-quadriceps strength and size ratios of male professional soccer players with muscle imbalance.

    PubMed

    Denadai, Benedito Sérgio; de Oliveira, Felipe Bruno Dias; Camarda, Sérgio Ricardo de Abreu; Ribeiro, Leandro; Greco, Camila Coelho

    2016-03-01

    The aim of this study was to determine the correlation between the concentric hamstrings/quadriceps muscle strength (Hcon :Qcon ) and cross-sectional area ratios (Hcsa :Qcsa ) in professional soccer players with Hcon :Qcon imbalance. Nine male professional soccer players (25·3 ± 4·1 years) performed five maximal concentric contractions of the knee extensors (KE) and flexors (KF) at 60 s(-1) to assess Hcon :Qcon . The test was performed using the dominant (preferred kicking), and non-dominant limb with a 5-min recovery period was allowed between them. Only players with Hcon :Qcon  < 0·60 (range: 0·45-0·59) in both limbs were included in this study. The muscle cross-sectional area (CSA) of KE and KF was determined by magnetic resonance imaging. The correlations between Hcon :Qcon and Hcsa :Qcsa in the dominant leg (r = -0·33), non-dominant leg (r = 0·19) and in the both legs combined (r = 0·28) were not statistically significant (P>0·05). Thus, the Hcon :Qcon seems not to be determined by Hcsa :Qcsa in professional soccer players with Hcon :Qcon imbalance. PMID:25348722

  10. The Injury Profile of an Australian Specialist Policing Unit

    PubMed Central

    Larsen, Brianna; Aisbett, Brad; Silk, Aaron

    2016-01-01

    This study investigated the injuries sustained by an Australian specialist police division. Injury records spanning four-years were analyzed. The role being performed when the injury occurred, injury cause, body part injured, and injury-related costs were quantified. The percentage of personnel injured multiple times was documented. One hundred and thirty eight personnel reported injuries, 58 of these on multiple occasions. This resulted in 229 injuries and 76 claims being raised. Half of the injuries occurred during operational policing tasks, however training activities accounted for >30% of injuries. The most common injury was strain/sprain, and upper body injuries were 2.5-times more common than lower-body or torso injuries. 1107 shifts were lost, and injuries cost the organization $487,159 (Australian Dollars) over the four-year period. The injury costs (both financial and in manpower) may prompt policy makers to review the current training and post-injury rehabilitation protocols. PMID:27023586

  11. Groin Injuries in Sports Medicine

    PubMed Central

    Tyler, Timothy F.; Silvers, Holly J.; Gerhardt, Michael B.; Nicholas, Stephen J.

    2010-01-01

    Context: An in-season groin injury may be debilitating for the athlete. Proper diagnosis and identification of the pathology are paramount in providing appropriate intervention. Furthermore, an adductor strain that is treated improperly can become chronic and career threatening. Any one of the 6 muscles of the adductor muscle group can be involved. The degree of injury can range from a minor strain (grade 1), where minimal playing time is lost, to a severe strain (grade 3), in which there is complete loss of muscle function. Persistent groin pain and muscle imbalance may lead to athletic pubalgia. Evidence Acquisition: Relevant studies were identified through a literature search of MEDLINE and the Cochrane database from 1990 to 2009, as well as a manual review of reference lists of identified sources. Results: Ice hockey and soccer players seem particularly susceptible to adductor muscle strains. In professional ice hockey and soccer players throughout the world, approximately 10% to 11% of all injuries are groin strains. These injuries have been linked to hip muscle weakness, a previous injury to that area, preseason practice sessions, and level of experience. This injury may be prevented if these risk factors are addressed before each season. Conclusion: Despite the identification of risk factors and strengthening intervention for athletes, adductor strains continue to occur throughout sport. If groin pain persists, the possibility of athletic pubalgia needs to be explored, because of weakening or tears in the abdominal wall muscles. A diagnosis is confirmed by exclusion of other pathology. PMID:23015943

  12. Crush injury

    MedlinePlus

    A crush injury occurs when force or pressure is put on a body part. This type of injury most often happens when part of the body is squeezed between two heavy objects. Damage related to crush injuries ...

  13. Pediatric Injury

    MedlinePlus

    ... NICHD Research Information Clinical Trials Resources and Publications Pediatric Injury: Condition Information Skip sharing on social media links Share this: Page Content What is pediatric injury? Pediatric injuries (or traumas) are quite diverse ...

  14. Eye Injuries

    MedlinePlus

    The structure of your face helps protect your eyes from injury. Still, injuries can damage your eye, sometimes severely enough that you could lose your vision. Most eye injuries are preventable. If you play sports or ...

  15. Tibial Fixation Properties of a Continuous-Loop ACL Hamstring Graft Construct with Suspensory Fixation in Porcine Bone.

    PubMed

    Smith, Patrick A; DeBerardino, Thomas M

    2015-12-01

    The aim of this article is to compare tibial fixation strength of suspensory fixation for a quadrupled semitendinosus continuous loop all-inside anterior cruciate ligament (ACL) construct versus a doubled semitendinosus and gracilis graft fixated with an interference screw. Biomechanical testing was conducted using human hamstring allografts and porcine tibias. Constructs were cycled from 50 to 250 N for 500 cycles followed by a pull to failure. The average load to failure of tibial suspensory fixation of the all-inside continuous loop construct (1,012 N) was statistically different compared with the tibial interference screw group (612 N) (p < 0.001). The cyclic displacement of the continuous loop construct (2.5 mm) was not statistically different from the interference screw construct (1.9 mm). For both the groups, approximately half the overall cyclic displacement occurred with the first cycle. Tibial side suspensory fixation of a novel all-inside continuous loop hamstring graft provided suitable strength for tibial fixation for ACL reconstruction. The continuous loop construct had a significantly higher load to failure compared with the use of an interference screw, and cyclic loading was comparable. Use of hamstring soft tissue grafts is very common for ACL reconstruction. An all-inside ACL reconstruction is based on a continuous loop construct utilizing a single semitendinosus graft that is quadrupled employing suspensory fixation on both the femoral and tibial side. Suspensory fixation on the femoral side been previously reported, but this is the first report of strength of this method of suspensory fixation on the tibia. PMID:25347056

  16. COMPARATIVE STUDY OF ACL RECONSTRUCTION WITH ANATOMICAL POSITIONING OF THE TUNNELS USING THE PATELLAR TENDON VERSUS HAMSTRING TENDON

    PubMed Central

    de Pádua, Vitor Barion Castro; Maldonado, Hilário; Vilela, Júlio César Rodrigues; Provenza, Alexandre Ribeira; Monteiro, Cleverson; de Oliveira Neto, Heleno Cavalcante

    2015-01-01

    Objective: To compare ACL reconstruction with anatomical positioning of the tunnels using the hamstring or patellar tendons. Methods: We prospectively evaluated 52 patients who underwent ACL reconstruction using the Chambat's technique, with anatomical positioning of the tunnels drilled outside in. They were divided into group A, with 27 patients, using the patellar tendon as a graft, and group B, with 25 patients, using the hamstring. Results: In group A 26 patients were very satisfied or satisfied and 1 unhappy, in group B. 25 patients were very satisfied or satisfied with the procedure (p = 0.990). According to the Lysholm scale, group A had a mean score of 96.11 and group B, 95.32 (p=0.594). In relation to preoperative IKDC, 100% of the patients in group A and 92% of those in group B were IKDC C or D (p = 0.221); in the assessment with a minimum of two-year follow-up, 96% of group A and 92% of group B were IKDC A or B (p = 0.256). The Lachman test, pivot shift, return to sports activities, and the comparative difference in anterior translation (RolimeterTM) also showed no statistically significant difference. In group A, 5 patients (18.5%) were unable to kneel on a hard surface, whereas no patient in group B had this complaint. Conclusion: The anterior cruciate ligament reconstruction presents similar results using the hamstring or patellar tendon with anatomical positioning of the tunnels. Drilling the femoral tunnel outside in is a reproducible and accurate option in the correct placement the femoral tunnel. PMID:27027082

  17. Injury Rates and Profiles of Elite Competitive Weightlifters

    PubMed Central

    Calhoon, Gregg; Fry, Andrew C.

    1999-01-01

    Objective: To determine injury types, natures, anatomical locations, recommended amount of time missed, and injury rates during weightlifting training. Design and Setting: We collected and analyzed medical injury records of resident athletes and during numerous training camps to generate an injury profile. Subjects: Elite US male weightlifters who were injured during training at the United States Olympic Training Centers. Measurements: United States Olympic Training Center weightlifting injury reports from a 6-year period were analyzed. Data were expressed as percentages and were analyzed via x2 tests. Results: The back (primarily low back), knees, and shoulders accounted for the most significant number of injuries (64.8%). The types of injuries most prevalent in this study were strains and tendinitis (68.9%). Injuries of acute (59.6%) or chronic (30.4%) nature were significantly more common than recurrent injuries and complications. The recommended number of training days missed for most injuries was 1 day or fewer (90.5%). Injuries to the back primarily consisted of strains (74.6%). Most knee injuries were tendinitis (85.0%). The majority of shoulder injuries were classified as strains (54.6%). Rates of acute and recurring injuries were calculated to be 3.3 injuries/1000 hours of weightlifting exposure. Conclusions: The injuries typical of elite weightlifters are primarily overuse injuries, not traumatic injuries compromising joint integrity. These injury pattems and rates are similar to those reported for other sports and activities. ImagesFigure 1.Figure 2. PMID:16558570

  18. Fatigue and rapid hamstring/quadriceps force capacity in professional soccer players.

    PubMed

    Greco, Camila C; da Silva, Wendell L; Camarda, Sérgio R A; Denadai, Benedito S

    2013-01-01

    The aim of this study was to investigate the effect of fatigue induced by an exhaustive laboratory-based soccer-specific exercise on different hamstrings/quadriceps (H:Q) ratios of soccer players. Twenty-two male professional soccer players (23·1 ± 3·4 year) performed maximal eccentric (ecc) and concentric (con) contractions for knee extensors (KE) and flexors (KF) at 60° s(-1) and 180° s(-1) to assess conventional (H(con) :Q(con)) and functional (H(ecc) :Q(con)) ratios. Additionally, they performed maximal voluntary isometric contraction for KE and KF, from which the maximal muscle strength, rate of force development (RFD) and RFD H:Q strength ratio (RFDH:Q) were extracted. Thereafter, subjects were performed an exhaustive laboratory-based soccer-specific exercise and a posttest similar to the pretest. There was significant reduction in H(con) :Q(con) (0·60 ± 0·06 versus 0·58 ± 0·06, P<0·05) and in H(ecc) :Q(con) (1·29 ± 0·2 versus 1·16 ± 0·2, P<0·01) after the soccer-specific exercise. However, no significant difference between Pre and Post exercise conditions was found for RFDH:Q at 0-50 (0·53 ± 0·23 versus 0·57 ± 0·24, P>0·05) and 0-100 ms (0·53 ± 0·17 versus 0·55 ± 0·17, P>0·05). In conclusion, H:Q strength ratios based on peak force values are more affected by fatigue than RFDH:Q obtained during early contraction phase. Thus, fatigue induced by soccer-specific intermittent protocol seems not reduce the potential for knee joint stabilization during the initial phase of voluntary muscle contraction. PMID:23216761

  19. Injuries in women's ice hockey: special considerations.

    PubMed

    Abbott, Kristin

    2014-01-01

    Ice hockey is a popular collision sport with a growing number of female athletes participating each year. As participation among girls and women continues to increase, it will be important to recognize common injuries occurring during women's games. Despite difference in the rules that prohibit body checking in women's and girls' games, injury profiles are similar to those of their male counterparts. Concussions, contusions, acromioclavicular joint injuries, ligamentous knee injuries, and muscle strains occur during women's ice hockey games, with groin strains accounting for the most common practice injury. This article will review both injury rates and common injuries occurring in women's ice hockey, with a focus on the observed concussion rate and groin injuries. PMID:25391093

  20. Sprains, Strains, and Tears

    MedlinePlus

    ... have attempted to do too much. Throughout your recovery you can still maintain an aerobic training program. Options for training include stationary bicycling, swimming, walking or running in the water. If the injury is more than mild sprain or strain, it is ...

  1. Isokinetic strength of the quadriceps and hamstrings and functional ability of anterior cruciate deficient knees in recreational athletes.

    PubMed Central

    Li, R C; Maffulli, N; Hsu, Y C; Chan, K M

    1996-01-01

    OBJECTIVE: To test the hypothesis that increasing the hamstrings and quadriceps (H:Q) isokinetic strength ratio will, in the short term, improve the functional ability of an anterior cruciate ligament (ACL) deficient knee. METHODS: The isokinetic muscular characteristics at a speed of 60 degrees s-1 and 180 degrees s-1 of 46 recreational athletes with an arthroscopically confirmed ACL tear were determined using the Cybex II+ isokinetic dynamometer. The variables tested included peak torque, endurance ratio, total work output, and explosive power. Functional ability was scored with the Cincinnati rating system, measuring the severity of pain and swelling, the degree of giving way, and the overall ability to walk, run, ascent and descent stairs, jump and twist. RESULTS: Among all muscular characteristics, the H:Q ratio at 180 degrees s-1 at 30 degrees of knee flexion was shown to have the highest correlation to the functional score (r = 0.6249, P < 0.001). All variables involving hamstring strength were shown to be significantly correlated to the functional ability score (P < 0.01), while none of the variables involving quadriceps strength showed significant correlation with the functional ability of the injured knee. CONCLUSIONS: The H:Q ratio is strongly correlated to the functional ability of ACL deficient knees in Chinese recreational athletes. It could be used as an additional measure to guide in the decision making process in the management of ACL deficient knees. PMID:8799604

  2. Injuries in Competitive Dragon Boating

    PubMed Central

    Mukherjee, Swarup; Leong, Hin Fong; Chen, Simin; Foo, Yong Xiang Wayne; Pek, Hong Kiat

    2014-01-01

    Background: Dragon boating is a fast-growing team water sport and involves forceful repetitive motions that predispose athletes to overuse injuries. Despite the rising popularity of the sport, there is a lack of studies on injury epidemiology in dragon boating. Purpose: To investigate the injury epidemiology in competitive dragon boating athletes. Study Design: Descriptive epidemiological study. Methods: A total of 95 dragon boaters (49 males, 46 females) representing their respective universities took part in this study. Data were collected retrospectively using a reliable and valid self-report questionnaire. The study period was from August 2012 to July 2013. Results: A total of 104 musculoskeletal injuries were reported (3.82 injuries/1000 athlete-exposures), 99% of which occurred during training. The most commonly injured regions were the lower back (22.1%), shoulder (21.1%), and wrist (17.3%). The majority of injuries were due to overuse (56.3%), and incomplete muscle-tendon strain was the most prevalent type of injury (50.5%). The time loss from injuries varied. In addition, a significant majority of the dragon boating athletes incurred nonmusculoskeletal injuries, with abrasions (90.5%), blisters (78.9%), and sunburns (72.6%) being the most common. Conclusion: Competitive dragon boating has a moderately high injury incidence, and there seems to be a direct relationship between exposure time and injury rate. A majority of the injuries are overuse in nature, and the body parts most actively involved in paddling movement are at higher risk of injuries. The high incidence of nonmusculoskeletal injuries in dragon boaters suggested that these injuries are likely outcomes of participation in the sport. PMID:26535280

  3. Effect of kinesio taping on the isokinetic muscle function in football athletes with a knee injury.

    PubMed

    Hong, SoonKwon; Shim, JeMyung; Kim, SungJoong; Namkoong, Seung; Roh, HyoLyun

    2016-01-01

    [Purpose] The purpose of this study was to determine the difference in isokinetic muscle function in football athletes with a knee injury with and without kinesio taping. [Subjects] The subjects for this study were 10 football athletes (males) with a knee injury. [Methods] Measurements were performed by using Cybex dynamometer under uniform motion before and after the application of kinesio tape to the quadriceps and hamstring muscle. Maximal concentric knee extension and flexion at three angular velocities (60°/s, 120°/s, and 180°/s) were measured. [Results] A significant difference was found in peak torque and total work of the flexion at 120°/s and 180°/s, as well as in the average power of extension at 180°/s. [Conclusion] Though it is not the main therapy for muscle function in football athletes with injury, kinesio taping was an effective adjunct therapy. PMID:26957761

  4. Effect of kinesio taping on the isokinetic muscle function in football athletes with a knee injury

    PubMed Central

    Hong, SoonKwon; Shim, JeMyung; Kim, SungJoong; Namkoong, Seung; Roh, HyoLyun

    2016-01-01

    [Purpose] The purpose of this study was to determine the difference in isokinetic muscle function in football athletes with a knee injury with and without kinesio taping. [Subjects] The subjects for this study were 10 football athletes (males) with a knee injury. [Methods] Measurements were performed by using Cybex dynamometer under uniform motion before and after the application of kinesio tape to the quadriceps and hamstring muscle. Maximal concentric knee extension and flexion at three angular velocities (60°/s, 120°/s, and 180°/s) were measured. [Results] A significant difference was found in peak torque and total work of the flexion at 120°/s and 180°/s, as well as in the average power of extension at 180°/s. [Conclusion] Though it is not the main therapy for muscle function in football athletes with injury, kinesio taping was an effective adjunct therapy. PMID:26957761

  5. Effect of Hamstring Flexibility on Hip and Lumbar Spine Joint Excursions During Forward Reaching Tasks in Individuals With and Without Low Back Pain

    PubMed Central

    Johnson, Erica N.; Thomas, James S.

    2010-01-01

    Objective To examine the correlation between hamstring flexibility and hip and lumbar spine joint excursions during standardized reaching and forward bending tasks. Design Retrospective analysis of data obtained during two previous prospective studies that examined kinematics and kinetics during forward bending tasks in individuals with and without low back pain (LBP). Setting The two previous studies were conducted in the Motor Control Lab at Ohio University. Participants Data from a total of 122 subjects from two previous studies. Study 1: 86 subjects recovered from an episode of acute LBP (Recovered). Study 2 (unpublished findings): 18 chronic low back pain subjects (LBP) and 18 healthy matched controls (Healthy). Interventions Not Applicable. Main Outcome Measure Correlation values between hamstring flexibility as measured by straight leg raise (SLR) and amount of hip and lumbar spine joint excursions used during standardized reaching and forward bending tasks. Results No significant correlation was found between hamstring flexibility and hip and lumbar joint excursions during forward bending tasks in the LBP or Recovered groups. Straight leg raise had a significant negative correlation with lumbar spine excursions during reaching tasks to a low target in the Healthy group (Right SLR: P=.011, Left SLR: P=.004). Conclusions Hamstring flexibility is not strongly related to the amount of lumbar flexion used to perform forward bending tasks in individuals who have chronic LBP or who have recovered from LBP. More research needs to be conducted to examine the influence of hamstring flexibility on observed movement patterns to further evaluate the efficacy of flexibility training in the rehabilitation of patients with low back pain. PMID:20599054

  6. Selective contribution of each hamstring muscle to anterior cruciate ligament protection and tibiofemoral joint stability in leg-extension exercise: a simulation study.

    PubMed

    Biscarini, Andrea; Botti, Fabio Massimo; Pettorossi, Vito Enrico

    2013-09-01

    A biomechanical model was developed to simulate the selective effect of the co-contraction force provided by each hamstring muscle on the shear and compressive tibiofemoral joint reaction forces, during open kinetic-chain knee-extension exercises. This model accounts for instantaneous values of knee flexion angle [Formula: see text], angular velocity and acceleration, and for changes in magnitude, orientation, and application point of external resistance. The tibiofemoral shear force (TFSF) largely determines the tensile force on anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL). Biceps femoris is the most effective hamstring muscle in decreasing the ACL-loading TFSF developed by quadriceps contractions for [Formula: see text]. In this range, the semimembranosus generates the dominant tibiofemoral compressive force, which enhances joint stability, opposes anterior/posterior tibial translations, and protects cruciate ligaments. The semitendinosus force provides the greatest decreasing gradient of ACL-loading TFSF for [Formula: see text], and the greatest increasing gradient of tibiofemoral compressive force for [Formula: see text]. However, semitendinosus efficacy is strongly limited by its small physiological section. Hamstring muscles behave as a unique muscle in enhancing the PCL-loading TFSF produced by quadriceps contractions for [Formula: see text]. The levels of hamstrings co-activation that suppress the ACL-loading TFSF considerably shift when the knee angular acceleration is changed while maintaining the same level of knee extensor torque by a concurrent adjustment in the magnitude of external resistance. The knowledge of the specific role and the optimal activation level of each hamstring muscle in ACL protection and tibiofemoral stability are fundamental for planning safe and effective rehabilitative knee-extension exercises. PMID:23670482

  7. Multi-Strain Probiotics Inhibit Cardiac Myopathies and Autophagy to Prevent Heart Injury in High-Fat Diet-Fed Rats.

    PubMed

    Lai, Chao-Hung; Tsai, Cheng-Chih; Kuo, Wei-Wen; Ho, Tsung-Jung; Day, Cecilia-Hsuan; Pai, Pei-Ying; Chung, Li-Chin; Huang, Chun-Chih; Wang, Hsueh-Fang; Liao, Po-Hsiang; Huang, Chih-Yang

    2016-01-01

    High-fat diets induce obesity, leading to cardiomyocyte fibrosis and autophagy imbalance. In addition, no previous studies have indicated that probiotics have potential health effects associated with cardiac fibrosis and autophagy in obese rats. This study investigates the effects of probiotics on high-fat (HF) diet-induced obesity and cardiac fibrosis and autophagy in rat hearts. Eight-week-old male Wistar rats were separated randomly into five equally sized experimental groups: Normal diet (control) and high-fat (HF) diet groups and groups fed a high-fat diet supplemented with low (HL), medium (HM) or high (HH) doses of multi-strain probiotic powders. These experiments were designed for an 8-week trial period. The myocardial architecture of the left ventricle was evaluated using Masson's trichrome staining and immunohistochemistry staining. Key probiotics-related pathway molecules were analyzed using western blotting. Abnormal myocardial architecture and enlarged interstitial spaces were observed in HF hearts. These interstitial spaces were significantly decreased in groups provided with multi-strain probiotics compared with HF hearts. Western blot analysis demonstrated that key components of the TGF/MMP2/MMP9 fibrosis pathways and ERK5/uPA/ANP cardiac hypertrophy pathways were significantly suppressed in probiotic groups compared to the HF group. Autophagy balance is very important in cardiomyocytes. In this study, we observed that the beclin-1/LC3B/Atg7 autophagy pathway in HF was increased after probiotic supplementation was significantly decreased. Together, these results suggest that oral administration of probiotics may attenuate cardiomyocyte fibrosis and cardiac hypertrophy and the autophagy-signaling pathway in obese rats. PMID:27076784

  8. Multi-Strain Probiotics Inhibit Cardiac Myopathies and Autophagy to Prevent Heart Injury in High-Fat Diet-Fed Rats

    PubMed Central

    Lai, Chao-Hung; Tsai, Cheng-Chih; Kuo, Wei-Wen; Ho, Tsung-Jung; Day, Cecilia-Hsuan; Pai, Pei-ying; Chung, Li-Chin; Huang, Chun-Chih; Wang, Hsueh-Fang; Liao, Po-Hsiang; Huang, Chih-Yang

    2016-01-01

    High-fat diets induce obesity, leading to cardiomyocyte fibrosis and autophagy imbalance. In addition, no previous studies have indicated that probiotics have potential health effects associated with cardiac fibrosis and autophagy in obese rats. This study investigates the effects of probiotics on high-fat (HF) diet-induced obesity and cardiac fibrosis and autophagy in rat hearts. Eight-week-old male Wistar rats were separated randomly into five equally sized experimental groups: Normal diet (control) and high-fat (HF) diet groups and groups fed a high-fat diet supplemented with low (HL), medium (HM) or high (HH) doses of multi-strain probiotic powders. These experiments were designed for an 8-week trial period. The myocardial architecture of the left ventricle was evaluated using Masson's trichrome staining and immunohistochemistry staining. Key probiotics-related pathway molecules were analyzed using western blotting. Abnormal myocardial architecture and enlarged interstitial spaces were observed in HF hearts. These interstitial spaces were significantly decreased in groups provided with multi-strain probiotics compared with HF hearts. Western blot analysis demonstrated that key components of the TGF/MMP2/MMP9 fibrosis pathways and ERK5/uPA/ANP cardiac hypertrophy pathways were significantly suppressed in probiotic groups compared to the HF group. Autophagy balance is very important in cardiomyocytes. In this study, we observed that the beclin-1/LC3B/Atg7 autophagy pathway in HF was increased after probiotic supplementation was significantly decreased. Together, these results suggest that oral administration of probiotics may attenuate cardiomyocyte fibrosis and cardiac hypertrophy and the autophagy-signaling pathway in obese rats. PMID:27076784

  9. Skateboard injuries.

    PubMed

    Cass, D T; Ross, F

    1990-08-01

    The recent increase in skateboard injuries is causing concern. Over a 30-month period there were 80 admissions (69 children) to Westmead Hospital because of skateboard injuries. Among children most injuries were minor, involving fractures to the upper limbs (47) or minor head injuries (8). The only serious injuries were a ruptured urethra and a closed head injury. Over the same time period skateboard riding caused five deaths in New South Wales. These all involved head injuries and in four instances collisions with cars. The data strongly support other studies that show skateboard riding is particularly dangerous near traffic and should be proscribed. However, in parkland and around the home the skateboard is an enjoyable toy with an acceptable risk of minor injury. Helmets should be worn and would have prevented all the head injury admissions in this series. Children under 10 have a higher risk of fractures and head injuries due to insufficient motor development to control the boards and the resultant falls. Skateboard injuries are an example of injuries caused by a "fad epidemic". To cope with these types of periodic events up-to-date data collection is needed, followed rapidly by an intervention programme so that serious injuries can be kept to a minimum. PMID:2377116

  10. Sports Injuries

    MedlinePlus

    ... tear). Areas of the body most vulnerable to sprains are ankles, knees, and wrists. Signs of a sprain include ... to rest following an injury. All injuries need time to heal; proper rest will help the process. Your health ...

  11. Corneal injury

    MedlinePlus

    ... as sand or dust Ultraviolet injuries: Caused by sunlight, sun lamps, snow or water reflections, or arc- ... a corneal injury if you: Are exposed to sunlight or artificial ultraviolet light for long periods of ...

  12. Ocular Injury

    MedlinePlus

    ... by blunt trauma from a ball or fist, sharp trauma such as a stick or projectile, scratches ... Eyelid injuries usually occur as a result of sharp trauma such as injuries from sticks or projectiles ...

  13. Inhalation Injuries

    MedlinePlus

    ... types of inhalation injury associated with burn injury, carbon monoxide gas is a by-product of combustion. During ... than 10%. • Other products , which may give off carbon monoxide poisoning, may include faulty furnaces, charcoal burners, use ...

  14. Blast Injuries

    MedlinePlus

    ... Search Basket Contact Us DVBIC Defense and Veterans Brain Injury Center About DVBIC Leadership History Newsroom Contact Us FAQs About Traumatic Brain Injury TBI & the Military DoD Worldwide Numbers for TBI ...

  15. Inhalation Injuries

    MedlinePlus

    ... you can inhale that can cause acute internal injuries. Particles in the air from fires and toxic ... and lung diseases worse. Symptoms of acute inhalation injuries may include Coughing and phlegm A scratchy throat ...

  16. Orienteering injuries

    PubMed Central

    Folan, Jean M.

    1982-01-01

    At the Irish National Orienteering Championships in 1981 a survey of the injuries occurring over the two days of competition was carried out. Of 285 individual competitors there was a percentage injury rate of 5.26%. The article discusses the injuries and aspects of safety in orienteering. Imagesp236-ap237-ap237-bp238-ap239-ap240-a PMID:7159815

  17. Acute traumatic injuries in automotive manufacturing.

    PubMed

    Warner, M; Baker, S P; Li, G; Smith, G S

    1998-10-01

    Motor vehicle manufacturing, with its varied tasks, challenging work environment, and diverse worker populations, presents many hazards to employees. This study examined routinely collected surveillance data from a major motor vehicle manufacturer to identify injury types, high-risk workers, causes of injury, and factors associated with work loss. Injury and personnel data were used to calculate injury rates. Injury data were from the routinely collected medical and safety surveillance system on occupational injuries. The number of persons working in the plants was estimated using year-end personnel reports. Key word searches supplementing the analyses provided insight into the specific circumstances of injury. The most common injuries were sprains/strains (39% of the total), lacerations (22%), and contusions (15%). Forty-nine percent of the injuries resulted in one or more lost or restricted workdays; 25% resulted in 7 or more lost or restricted workdays. The injuries most likely to result in work loss were amputations, hernias and fractures. Sprains/strains accounted for 65% of all lost workdays. Injury rates ranged from 13.8 per 100 person-years at stamping plants to 28.7 at parts depots. Even within similar types of plants, injury rates varied widely, with a twofold difference among the individual assembly plants in overall injury rates. Injury surveillance systems with descriptive data on injury events shed light on the circumstances under which certain types of injuries occur and can provide the basis for preventive interventions. Sources of variation and potential biases are discussed, providing guidance for those interested in designing and using surveillance systems for occupational injuries. PMID:9750941

  18. Knee flexor strength after ACL reconstruction: comparison between hamstring autograft, tibialis anterior allograft, and non-injured controls.

    PubMed

    Landes, Sarah; Nyland, John; Elmlinger, Brian; Tillett, Ed; Caborn, David

    2010-03-01

    Hamstring muscle group dysfunction following anterior cruciate ligament reconstruction (ACL) using a semitendinosus-gracilis autograft is a growing concern. This study compared the mean peak isometric knee flexor torque of the following three groups: subjects 2 years following ACL reconstruction using semitendinosus-gracilis autografts (Group 1), subjects 2 years following ACL reconstruction using tibialis anterior allografts (Group 2), and a non-injured, activity-level-matched control group (Group 3). We hypothesized that Group 1 would have greater mean involved lower extremity peak isometric knee flexor torque deficits than the other groups. Handheld dynamometry with subjects in prone and the test knee at 90 degrees flexion was used to determine bilateral peak isometric knee flexor torque. Group 1 (86.4 +/- 11) and Group 2 (80.5 +/- 13) had similar 2000 IKDC Subjective Knee Evaluation Form scores (P = NS). Group 1 had a mean involved lower extremity peak isometric knee flexor torque deficit of -17.0 +/- 14 Nm. Group 2 had a mean involved lower extremity peak isometric knee flexor torque deficit of -0.8 +/- 9 Nm. Group 3 (control) had a mean left and right lower extremity peak isometric knee flexor torque difference of -0.7 +/- 14 Nm. Group 1 had decreased involved lower extremity peak isometric knee flexor torque compared to Groups 2 and 3 (two-way ANOVA; group x side interaction P < 0.05, Tukey HSD = 0.008). Long-term knee flexor strength deficits exist following hamstring autograft use for ACL reconstruction that does not occur when a tibialis anterior allograft is used. Early identification of impaired knee flexor strength among this group and modified rehabilitation may reduce these deficits. Adding quantitative biomechanical testing of sprinting and sudden directional change movements to the standard physical therapy evaluation will better elucidate the clinical and functional significance of the observed knee flexor strength impairments and aid in determining sport specific activity training readiness. PMID:19898836

  19. Influence of Hamstring Fatigue on the Estimated Percentage of Fast-Twitch Muscle Fibers for the Vastus Lateralis.

    PubMed

    Mota, Jacob A; Stock, Matt S; Carrillo, Elias C; Olinghouse, Kendra D; Drusch, Alexander S; Thompson, Brennan J

    2015-12-01

    A previous study has demonstrated the ability to roughly estimate the percentage of fast-twitch muscle fibers for the vastus lateralis through the analysis of peak torque values during fatiguing isokinetic testing. We examined whether use of the hamstrings influenced peak torque and electromyographic (EMG) responses for the quadriceps during fatiguing isokinetic muscle actions. On 2 separate occasions, 21 men (mean age = 23 years) performed 50 repeated, maximal concentric isokinetic muscle actions of the left leg extensors at a velocity of 180°·s. For 1 trial, the subjects maximally flexed the knee joint after each full extension to bring the dynamometer's lever arm back to the starting position. For the other trial, the subjects relaxed after each maximal extension and an investigator assisted in returning the lever arm. Surface EMG signals were detected from the vastus lateralis and biceps femoris throughout testing. Dependent variables that assessed the decline in peak torque and EMG mean frequency for the vastus lateralis were examined using dependent samples t-tests, effect size statistics, and the number of subjects who exceeded the minimal difference needed to be considered real. Our results showed small mean differences between the trials (Cohen's d ≤0.136). For the estimated percentage of fast-twitch fibers, none of the subjects showed a difference between trials that we considered meaningful. The mean estimated percentages of fast-twitch fibers were 61.6 and 60.1. Collectively, use of the hamstrings during fatiguing isokinetic testing of the quadriceps had little influence on peak torque and EMG. PMID:26219026

  20. Cheerleading injuries: epidemiology and recommendations for prevention.

    PubMed

    LaBella, Cynthia R; Mjaanes, Jeffrey

    2012-11-01

    Over the last 30 years, cheerleading has increased dramatically in popularity and has evolved from leading the crowd in cheers at sporting events into a competitive, year-round sport involving complex acrobatic stunts and tumbling. Consequently, cheerleading injuries have steadily increased over the years in both number and severity. Sprains and strains to the lower extremities are the most common injuries. Although the overall injury rate remains relatively low, cheerleading has accounted for approximately 66% of all catastrophic injuries in high school girl athletes over the past 25 years. Risk factors for injuries in cheerleading include higher BMI, previous injury, cheering on harder surfaces, performing stunts, and supervision by a coach with low level of training and experience. This policy statement describes the epidemiology of cheerleading injuries and provides recommendations for injury prevention. PMID:23090348

  1. Feet injuries in rock climbers

    PubMed Central

    Schöffl, Volker; Küpper, Thomas

    2013-01-01

    While injuries of the upper extremity are widely discussed in rock climbers, reports about the lower extremity are rare. Nevertheless almost 50 percent of acute injuries involve the leg and feet. Acute injuries are either caused by ground falls or rock hit trauma during a fall. Most frequently strains, contusions and fractures of the calcaneus and talus. More rare injuries, as e.g., osteochondral lesions of the talus demand a highly specialized care and case presentations with combined iliac crest graft and matrix associated autologous chondrocyte transplantation are given in this review. The chronic use of tight climbing shoes leads to overstrain injuries also. As the tight fit of the shoes changes the biomechanics of the foot an increased stress load is applied to the fore-foot. Thus chronic conditions as subungual hematoma, callosity and pain resolve. Also a high incidence of hallux valgus and hallux rigidus is described. PMID:24147257

  2. Gunshot injuries.

    PubMed

    Hinkle, J; Betz, S

    1995-05-01

    If current trends for this nation continue, by the year 2003 the number of people killed by firearms will exceed the number of people killed in motor vehicle accidents. Critical care practitioners must understand the mechanism of injury associated with firearm injuries to provide optimal care. This article reviews internal, exterior, and terminal ballistics, bullet design, wound classification, and initial assessment and treatment of firearm injuries. PMID:7743422

  3. Skiing Injuries

    PubMed Central

    Bartlett, L. H.

    1975-01-01

    In the broad spectrum of orthopedic skiing injuries, ‘second aid’ on the mountain and at the base by the physician is very important. All skiing physicians should carry minimal medical supplies, including narcotic medication. Diagnosis and treatment of injuries at the hospital are outlined. Most ski fractures of the tibia can be treated by conservative methods. A more aggressive approach to diagnosis and treatment of ligamentous injuries of the knee is recommended. PMID:20469236

  4. Back injuries

    SciTech Connect

    Peay, J.M.

    1983-01-01

    These proceedings consist of papers presented at two Bureau of Mines Technology Transfer symposia on reducing back injuries in the mining industry. The symposia were held in August 1983 and covered a wide range of topics related to a more fundamental understanding of factors that lead to back injuries and aproaches for reducing the frequency and severity of such injuries. Ten papers have been entered individually into EDB and ERA; one paper had been entered previously from other sources. (LTN)

  5. Blast injuries.

    PubMed

    Wolf, Stephen J; Bebarta, Vikhyat S; Bonnett, Carl J; Pons, Peter T; Cantrill, Stephen V

    2009-08-01

    Health-care providers are increasingly faced with the possibility of needing to care for people injured in explosions, but can often, however, feel undertrained for the unique aspects of the patient's presentation and management. Although most blast-related injuries (eg, fragmentation injuries from improvised explosive devices and standard military explosives) can be managed in a similar manner to typical penetrating or blunt traumatic injuries, injuries caused by the blast pressure wave itself cannot. The blast pressure wave exerts forces mainly at air-tissue interfaces within the body, and the pulmonary, gastrointestinal, and auditory systems are at greatest risk. Arterial air emboli arising from severe pulmonary injury can cause ischaemic complications-especially in the brain, heart, and intestinal tract. Attributable, in part, to the scene chaos that undoubtedly exists, poor triage and missed diagnosis of blast injuries are substantial concerns because injuries can be subtle or their presentation can be delayed. Management of these injuries can be a challenge, compounded by potentially conflicting treatment goals. This Seminar aims to provide a thorough overview of these unique primary blast injuries and their management. PMID:19631372

  6. Skurfing Injuries

    PubMed Central

    Liver, J. A.; Wiley, J. J.

    1965-01-01

    Skurfboarding is currently enjoying a phase of popularity, but it is not without hazards. Among 75 consecutive cases of skurfboard injuries seen in an emergency department, 29 fractures were encountered, 16 of which were in the region of the ankle and foot. The majority of injuries, however, consisted of sprains, contusions and abrasions. Six patients required hospital admission, three for operative management of fractures and three because of head injuries. The concrete playground, the instability of the board, the lack of protective clothing and the exhibitionist instincts of the teen-age enthusiast are suggested as factors responsible, at least in part, for the injuries sustained on skurfboards. PMID:14348550

  7. Criterion-related validity of sit-and-reach and toe-touch tests as a measure of hamstring extensibility in athletes.

    PubMed

    Muyor, José M; Vaquero-Cristóbal, Raquel; Alacid, Fernando; López-Miñarro, Pedro A

    2014-02-01

    The aims of this study were (a) to determine and compare the concurrent hamstring criterion-related validity of the sit-and-reach (SR) and toe-touch (TT) tests in different athletes (tennis players, kayakers, canoeists, and cyclists); (b) to determine the criterion-related validity of the pelvic tilt assessed by the Spinal Mouse system as a measure of hamstring flexibility in athletes; and (c) to evaluate the influence of spinal posture, pelvic tilt, and hamstring muscle flexibility in the SR and TT scores. Twenty-four tennis players, 30 canoeists, 43 kayakers, and 44 cyclists were recruited. Passive straight leg raise (PSLR), SR, and TT tests were randomly performed. Spinal curvatures and pelvic tilt were evaluated with a Spinal Mouse system when the maximal trunk flexion was achieved in the SR and TT tests. Tennis players and cyclists showed moderate correlations between PSLR with respect to SR (β = 0.78 and β = 0.76, respectively) and TT (β = 0.77 and β = 0.74, respectively). Correlations were slightly lower in canoeists (SR, β = 0.64; TT, β = 0.75). Kayakers showed the lowest correlation values (SR, β = 0.53; TT, β = 0.57). Correlation values between PSLR and pelvic tilt angle in both the SR and TT tests were β < 0.70 in all the groups of athletes. Stepwise multiple regression analysis showed a high variance explained from pelvic tilt and lumbar spine in the SR score. In conclusion, the SR and TT tests can be appropriate measures to determine spine flexibility and pelvic tilt range of motion but not to evaluate the hamstring muscle flexibility in tennis players, canoeists, kayakers, and cyclists. PMID:24476746

  8. Isokinetic dynamometer evaluation of the effects of early thigh diameter difference on thigh muscle strength in patients undergoing anterior cruciate ligament reconstruction with hamstring tendon graft

    PubMed Central

    Kılınç, Bekir Eray; Kara, Adnan; Camur, Savas; Oc, Yunus; Celik, Haluk

    2015-01-01

    After anterior cruciate ligament (ACL) reconstruction, which muscle groups are more affected from frequently developing thigh muscle atrophy is a matter of debate. We evaluate the effect of thigh circumference difference between patients’ knees who were administered the ACL reconstruction with hamstring tendon autograft and intact knees, on torque between the hamstring and quadriceps muscles. Fifty-five patients at least 6 months follow-up period available were included in our study. Power measurements of quadriceps and hamstring muscle groups in patients’ extremities were done by using isokinetic dynamometer. The maximum torque values at 60°/sec, 240°/sec in frequency, positions of flexion and extension were determined. In accordance with our findings it is still possible to encounter the thigh atrophy in average 28 months after ACL reconstruction surgery even under physical rehabilitation programs and appropriate follow-up. It is inevitable for the clinician to consider these changes in diagnosis and rehabilitation stages. It can’t be ignored that muscle weakness mechanisms developing in the thigh circumference vary according to the thigh muscle group and knee flexors play an important role in thigh atrophy when determining an appropriate rehabilitation program after reconstruction application. PMID:25960982

  9. Fingertip Injuries

    MedlinePlus

    ... Injuries Hand Fracture See More... Español Quistes sinoviales Síndrome del túnel carpiano Artritis de la base del pulgar Dedo en ... Injuries Hand Fracture See More... Español Quistes sinoviales Síndrome del túnel carpiano Artritis de la base del pulgar Dedo en ...

  10. Head Injuries

    MedlinePlus

    ... to happen to someone who is in a car wreck and isn't wearing a seat belt. Other major causes of head injuries include bicycle or motorcycle wrecks, sports injuries, falls from windows (especially among children who live in the city) and falls around the house (especially among toddlers ...

  11. Trampoline injuries

    PubMed Central

    Nysted, M; Drogset, J O

    2006-01-01

    Objective To describe the mechanism, location and types of injury for all patients treated for trampoline‐associated injuries at St Olav's University Hospital, Trondheim, Norway, from March 2001to October 2004. Materials and methods Patients were identified from a National Injury Surveillance System. All patients were asked to complete a standard questionnaire at their first visit at the hospital. Most data were recorded prospectively, but data on the mechanism of injury, the number of participants on the trampoline at the time of injury, adult supervision and whether the activity occurred at school or in another organised setting were collected retrospectively. Results A total of 556 patients, 56% male and 44% female, were included. The mean age of patients was 11 (range 1–62) years. 77% of the injuries occurred on the body of the trampoline, including falls on to the mat, collisions with another jumper, falls on to the frame or the springs, and performing a somersault, whereas 22% of the people fell off the trampoline. In 74% of the cases, more than two people were on the trampoline, with as many as nine trampolinists noted at the time of injury. For children <11 years, 22% had adult supervision when the injury occurred. The most common types of injuries were fractures (36%) and injury to ligaments (36%). Injuries to the extremities predominated (79%), and the lower extremities were the most commonly injured part of the body (44%). A ligament injury in the ankle was the most often reported diagnosis (20%), followed by an overstretching of ligaments in the neck (8%) and a fracture of the elbow (7%). Regarding cervical injuries, two patients had cervical fractures and one patient had an atlantoaxial subluxation. Three patients with fractures in the elbow region reported an ulnar nerve neuropathy. 13% of the patients were hospitalised for a mean of 2.2 days. Conclusion Trampolining can cause serious injuries, especially in the neck and elbow areas of young children. The use of a trampoline is a high‐risk activity. However, a ban is not supported. The importance of having safety guidelines for the use of trampolines is emphasised. PMID:17000711

  12. Volleyball injuries.

    PubMed

    Eerkes, Kevin

    2012-01-01

    There has been a significant increase in the numbers of people playing indoor and beach volleyball since the early 1980s and, consequently, an increase in injuries. Most injuries are related to repetitive jumping and hitting the ball overhead. The ankle is the most commonly injured joint, but the knee, shoulder, low back, and fingers also are vulnerable. The shoulder in particular is subject to extreme torque when hitting and jump serving the ball. Some injuries have a predilection for those playing on sand versus those playing in an indoor court. The clinician caring for volleyball players should be aware of the types of injuries these players sustain and how to help them return to play promptly and appropriately. This article reviews the specific injuries that are most common as a result of participating in the sport of volleyball. PMID:22965348

  13. Rowing Injuries

    PubMed Central

    Hosea, Timothy M.; Hannafin, Jo A.

    2012-01-01

    Context: Rowing is one of the original modern Olympic sports and was one of the most popular spectator sports in the United States. Its popularity has been increasing since the enactment of Title IX. The injury patterns in this sport are unique because of the stress applied during the rowing stroke. Evidence Acquisition: This review summarizes the existing literature describing the biomechanics of the rowing stroke and rowing-related injury patterns. Data were obtained from previously published peer-reviewed literature through a search of the entire PubMed database (up to December, 2011) as well as from textbook chapters and rowing coaching manuals. Results: Rowing injuries are primarily overuse related. The knee, lumbar spine, and ribs are most commonly affected. The injury incidence is directly related to the volume of training and technique. Conclusion: Familiarity of the injury patterns and the biomechanical forces affecting the rowing athlete will aid in prompt diagnosis and appropriate management. PMID:23016093

  14. Skateboarding injuries.

    PubMed

    Fountain, J L; Meyers, M C

    1996-12-01

    Skateboarding has experienced intermittent periods of popularity since the 1960s. Along with this popularity, there have been concomitant increases in numerous types of injuries. Most documented cases occur in boys aged from 10 to 14 years, with injuries ranging from minor cuts and abrasions to multiple fractures and, in some cases, even death. Although head injuries account for approximately 3.5 to 9% of all skateboarding injuries, fractures of both upper and lower extremities account for 50% of all musculoskeletal trauma. Not surprising is the fact that 33% of those injured on skateboards are injured within the first week of skateboarding. Most individuals experience some form of trauma during the initial attempt at skateboarding. Because of the nature of skateboarding, encompassing both high speed and extreme manoeuvres, injuries often occur when the skateboarder collides with an immovable object, falls from the skateboard or is involved in vehicular traffic. Most injuries occur when the skateboard strikes an irregularity in the riding surface, projecting the skateboarder in the direction of travel. Despite traffic legislation, 65% of injured adolescent skateboarders sustain injuries on public roads, on footpaths, and in parking lots. Several organisations have recommended safety guidelines and restrictions based on age and common sense. Use of a helmet, knee and elbow pads, and wrist guards should be required of all skateboarders, as well as some type of formal education. The American Academy of Pediatrics recommends that children under 5 years of age should not be allowed to ride skateboards. At an early age, injuries occur due to several reasons. These include high centre of mass, immature skeletal development, an undeveloped neuromuscular system, and simply poor judgement. Skateboarding injuries are expected to rise with the increasing number of participants, high-tech equipment development and renewed advertising. Although limited preventative measures exist which will totally eradicate skateboarding trauma, some thought to actual restrictions may decrease the incidence and severity of injuries. PMID:8969014

  15. Spinal Cord Injury 101

    MedlinePlus Videos and Cool Tools

    ... Fertility After Spinal Cord Injury Coping with a New Injury Coping with a New Injury Adjusting to Social Life in a Wheelchair ... after an injury? What are the most promising new treatments for spinal cord injuries? What are the ...

  16. Badminton injuries.

    PubMed Central

    Krner, K; Schmidt, S A; Nielsen, A B; Yde, J; Jakobsen, B W; Mller-Madsen, B; Jensen, J

    1990-01-01

    In a one year period, from 1 January 1986 to 31 December 1986, 4303 patients with sports injuries were treated at Aarhus Amtssygehus and Aarhus Kommunehospital. The mean age was 21.6 years (range 7-72 years) and 2830 were men. Two hundred and seventeen badminton injuries occurred in 208 patients (136 men) with a mean age of 29.6 years (range 7-57 years), constituting 4.1 percent of all sport injuries in Aarhus. Joints and ligaments were injured in 58.5 percent of the patients, most frequently located in the lower limb and significantly more often among patients younger than 30 years of age. Muscle injury occurred in 19.8 percent of the patients. This type of injury was significantly more frequent among patients older than 30 years of age. Most injuries were minor. However, 6.8 percent of the patients were hospitalized and 30.9 percent received additional treatment by a physician. As the risk of injury varies with age, attempts to plan training individually and to institute prophylactic measures should be made. PMID:2078802

  17. Badminton injuries.

    PubMed

    Krner, K; Schmidt, S A; Nielsen, A B; Yde, J; Jakobsen, B W; Mller-Madsen, B; Jensen, J

    1990-09-01

    In a one year period, from 1 January 1986 to 31 December 1986, 4303 patients with sports injuries were treated at Aarhus Amtssygehus and Aarhus Kommunehospital. The mean age was 21.6 years (range 7-72 years) and 2830 were men. Two hundred and seventeen badminton injuries occurred in 208 patients (136 men) with a mean age of 29.6 years (range 7-57 years), constituting 4.1 percent of all sport injuries in Aarhus. Joints and ligaments were injured in 58.5 percent of the patients, most frequently located in the lower limb and significantly more often among patients younger than 30 years of age. Muscle injury occurred in 19.8 percent of the patients. This type of injury was significantly more frequent among patients older than 30 years of age. Most injuries were minor. However, 6.8 percent of the patients were hospitalized and 30.9 percent received additional treatment by a physician. As the risk of injury varies with age, attempts to plan training individually and to institute prophylactic measures should be made. PMID:2078802

  18. Propeller injuries.

    PubMed

    Mann, R J

    1976-05-01

    Water skiing, boat racing, skin and scuba diving, and pleasure boat cruising are increasing in popularity. As a result the incidence of injuries secondary to motor propellers is becoming more frequent. In a ten-year period from 1963 to 1973, I collected a total of nine cases. In some amputations were necessary, and in other cases amputations occurred at the time of injury. Problems with bacterial flora occurring in open sea water versus salt water enclosed near docks and fresh lake water are discussed. A review of the orthopedic literature revealed sparse information regarding propeller injuries. PMID:818713

  19. Rowing injuries.

    PubMed

    McNally, Eugene; Wilson, David; Seiler, Stephen

    2005-12-01

    The sport of rowing has gained considerable momentum in recent years. It appeals to many age groups and is an endurance activity with no sudden accelerations or ballistic impact forces. It is associated with several injuries that are so typical that they are easily recognized by the enthusiast and in many cases do not require imaging. These include wrist tenosynovitis, intersection syndrome, and rib fracture. Other injuries may be the result of strenuous training programs or faulty rowing technique and include low back injuries and patellar maltracking. The etiology, biomechanics, imaging, and treatment of rowing-related disorders are discussed. PMID:16315119

  20. Severe injuries in football players. Influencing factors.

    PubMed

    Chomiak, J; Junge, A; Peterson, L; Dvorak, J

    2000-01-01

    The aims of this prospective study were to analyze factors related to the occurrence of severe football injuries in players of different ages (14 to 42 years) and different skill levels (local teams to first league teams). In the Czech Republic, 398 players were followed up for 1 year, during which time they sustained 686 injuries. Of these, 113 (16.5%) were severe injuries. Ninety-seven severe injuries (86%) were able to be documented in detail. Trauma was the cause of 81.5% of the injuries and overuse was the cause of 18.5%. Joint sprains predominated (30%), followed by fractures (16%), muscle strains (15%), ligament ruptures (12%), meniscal tears and contusions (8%), and other injuries. Injuries to the knee were most prevalent (29%), followed by injuries to the ankle (19%) and spine (9%). More injuries occurred during games (59%) than in practice. Twenty-four percent of the injured players had suffered a previous injury of the same body part. Forty-six percent of injuries were caused by contact and 54% involved no body contact. Thirty-one percent of severe injuries were caused by foul play. From these results and the analysis of injuries in specific body parts, the following factors were determined to influence the occurrence of severe injuries: 1) personal factors (intrinsic): age of player, previous injuries, joint instability, abnormality of the spine, poor physical condition, poor football skills, or inadequate treatment and rehabilitation of injuries; 2) environmental factors (extrinsic): subjective exercise overload during practices and games, amount and quality of training, playing field conditions, equipment (wearing of shin guards and taping) and violations of existing rules (foul play). PMID:11032109

  1. Applying Cross-Pin System in Both Femoral and Tibial Fixation in Anterior Cruciate Ligament Reconstruction Using Hamstring Tendons

    PubMed Central

    Qi, Wei; Liu, Yujie; Xue, Jing; Li, Haifeng; Wang, Junliang; Qu, Feng

    2015-01-01

    Use of the RigidFix Cross Pin System (DePuy Mitek, Raynham, MA) is a popular technique for femoral fixation of grafts in anterior cruciate ligament reconstruction (ACLR). However, tibial fixation is still limited to the use of interference screws and post fixation, and few surgeons apply the femoral RigidFix system in tibial fixation. Meanwhile, tunnel enlargement is still a problem that affects the outcome of ACLR with hamstring grafts. We have used the femoral RigidFix system in femoral and tibial fixation. The rod top of the guide frame should be placed under the level of the subchondral bone at the proximal end of the tibial tunnel to ensure that the pins will not be inserted into the joint. The pins are inserted through the center of the lateral tibia. Using our technique, the fixation points of the femur and tibia are close to the anterior cruciate ligament insertions, and full contact of the graft with the tunnel wall can be accomplished. On the basis of our preliminary observations and investigation, we are optimistic about the prospect of performing ACLR using the RigidFix system in femoral and tibial fixation. PMID:26697293

  2. Natural Strain

    NASA Technical Reports Server (NTRS)

    Freed, Alan D.

    1995-01-01

    The purpose of this paper is to present a consistent and thorough development of the strain and strain-rate measures affiliated with Hencky. Natural measures for strain and strain-rate, as I refer to them, are first expressed in terms of of the fundamental body-metric tensors of Lodge. These strain and strain-rate measures are mixed tensor fields. They are mapped from the body to space in both the Eulerian and Lagrangian configurations, and then transformed from general to Cartesian fields. There they are compared with the various strain and strain-rate measures found in the literature. A simple Cartesian description for Hencky strain-rate in the Lagrangian state is obtained.

  3. Use of cervical collar after whiplash injuries.

    PubMed

    Józefiak-Wójtowicz, Anna; Stolarczyk, Artur; Deszczyński, Jarosław Michał; Materek, Magdalena; Pietras, Marta; Bażant, Katarzyna

    2014-01-01

    Whiplash injuries, also known as neck sprains and strains, are currently some of the most common injuries of the cervical spine. Mechanism of injury is still controversial and current treatment methods do not provide satisfactory results. In this article we present QTF classification of related disorders, epidemiological data and treatment methods. We described basic principles of using a soft collar, goals and effects of collar use and potential complications ensuing from immobilization. Authors reviewed publications comparing the effects of collar use with other methods of treatment and physiotherapy following whiplash injury. PMID:25104609

  4. Electrical injury

    MedlinePlus

    ... damage, especially to the heart, muscles, or brain. Electric current can cause injury in three ways: Cardiac arrest ... How long you were in contact with the electricity How the electricity moved through your body Your ...

  5. Spinal injury

    MedlinePlus

    ... Extreme twisting of the middle of the body Landing on the head during a sports injury Fall ... safe until medical help arrives. Call the local emergency number, such as 911. Hold the person's head ...

  6. Knee Injuries

    MedlinePlus

    ... ACL ligament. When used to treat ligament and meniscal tears and other types of serious knee injuries, arthroscopy decreases postoperative pain and recovery time. An orthopedist also can perform open surgery on the knee, which allows him or her ...

  7. Birth Injury

    MedlinePlus

    ... cesarean delivery may be done in certain circumstances. Did You Know... Serious birth injuries are now quite ... are typically not needed. Resources In This Article Did You Know 1 Did You Know... Sidebar 1 ...

  8. Genital injury

    MedlinePlus

    ... It is important to rule out sexual abuse, rape, and assault. The health care provider should ask the girl how the object was placed there. In men and young boys, common causes of genital injury include: Having the ...

  9. Electric injury, Part II: Specific injuries.

    PubMed

    Fish, R M

    2000-01-01

    Electric injury can cause disruption of cardiac rhythm and breathing, burns, fractures, dislocations, rhabdomyolysis, eye and ear injury, oral and gastrointestinal injury, vascular damage, disseminated intravascular coagulation, peripheral and spinal cord injury, and Reflex Sympathetic Dystrophy. Secondary trauma from falls, fires, flying debris, and inhalation injury can complicate the clinical picture. Diagnostic and treatment considerations for electric injuries are described in this article, which is the second part of a three-part series on electric injuries. PMID:10645833

  10. Basketball injuries in a rural area.

    PubMed

    Prebble, T B; Chyou, P H; Wittman, L; McCormick, J; Collins, K; Zoch, T

    1999-11-01

    This study was conducted to determine the frequency and nature of basketball injuries occurring in a rural setting. More than 6000 patients with sports-related injuries presented to a rural emergency department between June 1, 1988 and June 1, 1994. Of these patients, 1189 (19% of the total) were injured playing basketball. A chart abstraction form was utilized to retrospectively review injuries noting demographics, types and sites of injuries, as well as referral and treatment plans. Approximately two-thirds (66.4%) of those injured were males, with most injuries (53%) occurring during school-related activities. Almost four-fifths (78%) of injuries occurred between the ages of 10 and 19. The ankle (33.1%) was the body site most commonly injured, followed in frequency by finger injuries (19.3%), sprains and strains, which accounted for the majority (55%) of injuries. The most common mechanism of injury was recorded in which no contact with other players occurred (37.4%). The vast majority (99%) of injuries were managed as outpatients. The majority of cases (72%) were expected to recover within 2 weeks. Similarities were noted regarding sites of injury and age of distribution of patients when compared to the previous studies. PMID:10638288

  11. Analysis of injuries in taekwondo athletes

    PubMed Central

    Ji, MinJoon

    2016-01-01

    [Purpose] The present study aims to provide fundamental information on injuries in taekwondo by investigating the categories of injuries that occur in taekwondo and determining the locations of these injuries. [Subjects and Methods] The data of 512 taekwondo athletes were collected. The sampling method was convenience sampling along with non-probability sampling extraction methods. Questionnaire forms were used to obtain the data. [Results] The foot, knee, ankle, thigh, and head were most frequently injured while practicing taekwondo, and contusions, strains, and sprains were the main injuries diagnosed. [Conclusion] It is desirable to decrease the possibility of injuries to the lower extremities for extending participation in taekwondo. Other than the lower extremities, injuries of other specific body parts including the head or neck could be important factors limiting the duration of participation. Therefore, it is necessary to cope with these problems before practicing taekwondo. PMID:26957764

  12. Analysis of injuries in taekwondo athletes.

    PubMed

    Ji, MinJoon

    2016-01-01

    [Purpose] The present study aims to provide fundamental information on injuries in taekwondo by investigating the categories of injuries that occur in taekwondo and determining the locations of these injuries. [Subjects and Methods] The data of 512 taekwondo athletes were collected. The sampling method was convenience sampling along with non-probability sampling extraction methods. Questionnaire forms were used to obtain the data. [Results] The foot, knee, ankle, thigh, and head were most frequently injured while practicing taekwondo, and contusions, strains, and sprains were the main injuries diagnosed. [Conclusion] It is desirable to decrease the possibility of injuries to the lower extremities for extending participation in taekwondo. Other than the lower extremities, injuries of other specific body parts including the head or neck could be important factors limiting the duration of participation. Therefore, it is necessary to cope with these problems before practicing taekwondo. PMID:26957764

  13. Cold injuries.

    PubMed

    Long, William B; Edlich, Richard F; Winters, Kathryne L; Britt, L D

    2005-01-01

    Exposure to cold can produce a variety of injuries that occur as a result of man's inability to adapt to cold. These injuries can be divided into localized injury to a body part, systemic hypothermia, or a combination of both. Body temperature may fall as a result of heat loss by radiation, evaporation, conduction, and convection. Hypothermia or systemic cold injury occurs when the core body temperature has decreased to 35 degrees C (95 degrees F) or less. The causes of hypothermia are either primary or secondary. Primary, or accidental, hypothermia occurs in healthy individuals inadequately clothed and exposed to severe cooling. In secondary hypothermia, another illness predisposes the individual to accidental hypothermia. Hypothermia affects multiple organs with symptoms of hypothermia that vary according to the severity of cold injury. The diagnosis of hypothermia is easy if the patient is a mountaineer who is stranded in cold weather. However, it may be more difficult in an elderly patient who has been exposed to a cold environment. In either case, the rectal temperature should be checked with a low-reading thermometer. The general principals of prehospital management are to (1) prevent further heat loss, (2) rewarm the body core temperature in advance of the shell, and (3) avoid precipitating ventricular fibrillation. There are two general techniques of rewarming--passive and active. The mechanisms of peripheral cold injury can be divided into phenomena that affect cells and extracellular fluids (direct effects) and those that disrupt the function of the organized tissue and the integrity of the circulation (indirect effects). Generally, no serious damage is seen until tissue freezing occurs. The mildest form of peripheral cold injury is frostnip. Chilblains represent a more severe form of cold injury than frostnip and occur after exposure to nonfreezing temperatures and damp conditions. Immersion (trench) foot, a disease of the sympathetic nerves and blood vessels in the feet, is observed in shipwreck survivors or in soldiers whose feet have been wet, but not freezing, for long periods. Patients with frostbite frequently present with multisystem injuries (e.g., systemic hypothermia, blunt trauma, substance abuse). The freezing of the corneas has been reported to occur in individuals who keep their eyes open in high wind-chill situations without protective goggles (e.g., snowmobilers, cross-country skiers). PMID:15715518

  14. Lightning injuries.

    PubMed

    O'Keefe Gatewood, Medley; Zane, Richard D

    2004-05-01

    Lightning is persistently one of the leading causes of death caused by environmental or natural disaster. To understand the pathophysiology and treatment of lightning injuries one must first discount the innumerable myths, superstitions, and misconceptions surrounding lightning. The fundamental difference between high voltage electrical injury and lightning is the duration of exposure to current. Reverse triage should be instituted in lightning strike victims because victims in cardiopulmonary arrest might gain the greatest benefit from resuscitation efforts, although there is no good evidence suggesting that lightning strike victims might benefit from longer than usual resuscitation times. Many of the injuries suffered by lightning strike victims are unique to lightning, and long-term sequelae should be anticipated and addressed in the lightning victim. PMID:15163573

  15. Blast Injury

    PubMed Central

    de Candole, C. A.

    1967-01-01

    The shock wave generated by an explosion (“blast wave”) may cause injury in any or all of the following: (1) direct impact on the tissues of variations in environmental pressure; (2) flying glass and other debris set in motion by it; (3) propulsion of the body. Injuries in the first category affect gas-containing organs (ears, lungs and intestines), and acute death is attributed to air forced into the coronary vessels via damaged pulmonary alveoli. It is estimated that overpressure sufficient to cause lung injury may occur up to five miles from a 20-megaton nuclear explosion. The greatest single hazard from blast is, however, flying glass, and serious wounding from this cause is possible up to 12 miles from an explosion of this magnitude. PMID:6015742

  16. Trampoline injuries.

    PubMed

    Esposito, Paul W

    2003-04-01

    As the popularity of trampolines has increased during the past 10 years, so has the number of injuries sustained using them. Whether there is an actual increase in the risk associated with the use of a trampoline for the same number of exposure hours is not known. The marked increase in emergency room visits related to trampoline injuries might reflect only the increased number of trampolines now available for recreational use or the creative manner in which they are being used. The complex factors related to trampolines, their use, and the possible injuries will be discussed. A liberal use of Internet references will be used because this is where much of the advertising and information available to the public regarding trampolines currently is disseminated. PMID:12671484

  17. Impact of limited hamstring flexibility on vertical jump, kicking speed, sprint, and agility in young football players.

    PubMed

    García-Pinillos, F; Ruiz-Ariza, A; Moreno del Castillo, R; Latorre-Román, P Á

    2015-01-01

    This study aims to analyse the impact of limited hamstring flexibility (HF) on specific football skills, such as sprinting and jumping ability, agility, and kicking speed in young football players. Forty-three male football players (aged 14-18) from a semi-professional football academy participated voluntarily in this study. Data about anthropometric measurements, HF (unilateral passive straight-leg raise test: PSLR), vertical jumping ability (countermovement jump: CMJ), sprinting ability (5, 10, 20 m: S5 m, S10 m, S20 m), agility (Balsom agility test: BAT), and kicking speed in terms of ball speed (dominant and non-dominant leg: KSdom and KSnon-dom) were collected. Cluster analysis grouped according to HF, dividing participants into a flexible group (FG, n = 24) and a non-flexible group (NFG, n = 19) in relation to performances on the PSLR test. Despite finding no significant differences between groups in body composition and age, the FG performed better in terms of sprint scores (S5 m: 6.12%, S10 m: 4.09%, S20 m: 3.29%), BAT score (4.11%), CMJ score (10.49%), and scores for KSdom (6.86%) and KSnon-dom (8%) than the NFG. The results suggest that HF is a key factor for performing football-specific skills, such as sprinting, jumping, agility, and kicking in young football players. These results support the rationale that muscle flexibility must be specifically trained in football players beginning at early ages. PMID:25761523

  18. Epidemiology of injuries in Hong Kong elite badminton athletes.

    PubMed

    Yung, Patrick Shu-Hang; Chan, Romy Hing-Kwan; Wong, Fiona Chui-Yan; Cheuk, Phoebe Wai-Ling; Fong, Daniel Tik-Pui

    2007-01-01

    This study retrospectively reviewed the injury epidemiology on 44 Hong Kong elite badminton players in 2003. Team training records were reviewed to retrieve the training and competition hours, while the medical records from the physiotherapy department were reviewed to obtain information regarding injuries. A total of 253 injuries (128 recurrent and 125 new injuries) were recorded, which accounted for an overall incidence rate of 5.04 per 1,000 player hours. Elite senior athletes had a higher incidence rate of recurrent injuries, while elite junior and potential athletes had a higher incidence rate of new injuries. A total of 1,219 visits (4.82 per athlete) to the physiotherapy department were recorded, which cost HK$487,600 (HK$1,928 per injury). Most new injuries were strain (80 injuries), and the most frequently injured body sites were the back (17 injuries), the shoulder (15 injuries), the thigh (15 injuries), and the knee (15 injuries). One-sided exact test showed that a previous injury experience significantly associated with the occurrence of new injury. PMID:17578753

  19. Golf Injuries

    MedlinePlus

    ... Toggle Join Our Team Help Us Spread the Word Get Our Newsletter Donate Blog Skip breadcrumb navigation Preventing Golf Injuries Golf looks like an easy game to play, hitting a stationary object with a club into a relatively wide open space. Well, think again! To become a ...

  20. Patient Injuries?

    PubMed

    2015-01-01

    An injured patient may be the last thing dentists want to think about. However, in reality, patients can be injured during dental treatment or as the result of an incident such as a slip and fall in the office. Treatment-related injuries can run the gamut and include burns, lacerations, swallowed objects and allergic reactions, according to The Dentists Insurance Company. PMID:26638304

  1. A four-season prospective study of muscle strain reoccurrences in a professional football club.

    PubMed

    Carling, Christopher; Le Gall, Franck; Orhant, Emmanuel

    2011-04-01

    The aim of this investigation was to characterise muscle strain reinjuries and examine their impact on playing resources in a professional football club. Muscle strains and reoccurrences were prospectively diagnosed over four seasons in first-team players (n = 46). Altogether, 188 muscle strains were diagnosed with 44 (23.4%) of these classed as reinjuries, leading to an incidence of 1.32 strain reoccurrences per 1,000 hours exposure (95% Confidence Interval [CI], 0.93-1.71). The incidence of recurrent strains was higher in match-play compared with training (4.51, 95% CI, 2.30-6.72 vs 0.94, 95% CI, 0.59-1.29). Altogether, 50.0% of players sustained at least 1 reoccurrence of a muscle strain, leading to approximately 3 days lost and 0.4 matches missed per player per season. The incidence of recurrent strains was highest in centre-forwards (2.15, 95% CI, 1.06-3.24), peaked in May (3.78, 95% CI, 0.47-7.09), and mostly affected the hamstrings (38.6% of all reoccurrences). Mean layoff for nonreoccurrences and recurrences was similar: approximately 7.5 days. These results provide greater insight into the extent of the problem of recurrent muscle strains in professional football. PMID:21480056

  2. Residual Impact of Previous Injury on Musculoskeletal Characteristics in Special Forces Operators

    PubMed Central

    Parr, Jeffrey J.; Clark, Nicholas C.; Abt, John P.; Kresta, Julie Y.; Keenan, Karen A.; Kane, Shawn F.; Lephart, Scott M.

    2015-01-01

    Background Musculoskeletal injuries are a significant burden to United States Army Special Operations Forces. The advanced tactical skill level and physical training required of Army Special Operators highlights the need to optimize musculoskeletal characteristics to reduce the likelihood of suffering a recurrent injury. Purpose To identify the residual impact of previous injury on musculoskeletal characteristics. Study Design Cross-sectional study; Level of evidence, 3. Methods Isokinetic strength of the knee, shoulder, and back and flexibility of the shoulder and hamstrings were assessed as part of a comprehensive human performance protocol, and self-reported musculoskeletal injury history was obtained. Subjects were stratified based on previous history of low back, knee, or shoulder injury, and within-group and between-group comparisons were made for musculoskeletal variables. Results Knee injury analysis showed no significant strength or flexibility differences. Shoulder injury analysis found internal rotation strength of the healthy subjects (H) was significantly higher compared with injured (I) and uninjured (U) limbs of the injured group (H, 60.8 ± 11.5 percent body weight [%BW]; I, 54.5 ± 10.5 %BW; U, 55.5 ± 11.3 %BW) (P = .014 [H vs I] and P = .05 [H vs U]). The external rotation/internal rotation strength ratio was significantly lower in the healthy subjects compared with injured and uninjured limbs of the injured group (H, 0.653 ± 0.122; I, 0.724 ± 0.121; U, 0.724 ± 0.124) (P = .026 [H vs I] and P = .018 [H vs U]). Posterior shoulder tightness was significantly different between the injured and uninjured limb of the injured group (I, 111.6° ± 9.4°; U, 114.4° ± 9.3°; P = .008). The back injury analysis found no significant strength differences between the healthy and injured groups. Conclusion Few physical differences existed between operators with prior knee or back injury. However, operators with a previous history of shoulder injury demonstrated significantly less shoulder strength than uninjured operators as well as decreased shoulder flexibility on the injured side. All operators, regardless of prior injury, must perform the same tasks; therefore, a targeted injury rehabilitation/human performance training specifically focused on internal rotation strength and tightness of the posterior capsule may help reduce the risk for recurrence of injury. Operators presenting with musculoskeletal asymmetries and/or insufficient strength ratios may be predisposed to musculoskeletal injury. Clinical Relevance Specific fitness programs to compensate for deficiencies in strength and flexibility need to be designed that may reduce the risk of injuries in Special Forces Operators. PMID:26740952

  3. Injuries in Norwegian female elite soccer: a prospective one-season cohort study.

    PubMed

    Tegnander, Agnar; Olsen, Odd Egil; Moholdt, Trine Tegdan; Engebretsen, Lars; Bahr, Roald

    2008-02-01

    Female soccer has become increasingly popular during the last two decades. According to the International Football Association (FIFA) there are approximately 40 million registered female soccer players in the world. Three studies in elite soccer have shown an injury incidence during games ranging from 12.6 to 23.3 injuries per 1,000 h. A very high incidence of ACL-injuries ranging from 0.31 to 2.2 per 1,000 game hours has also been shown. We followed the Norwegian female elite series during the 2001 season to estimate the incidence and characteristics of injuries. A total of 181 female soccer players on ten teams were followed during the 2001 elite season in Norway. We recorded baseline data, match and training exposure and injury data as type of injury, location and severity of injury. The mean age of the players was 23 years (range 17-34). A total of 189 injuries were recorded and 19 (10%) of these were overuse injuries; 89 (47%) occurred during games and 100 (53%) during training sessions. The incidence of acute injuries was 23.6 per 1,000 game hours and 3.1 per 1,000 training hours. The majority of the injuries occurred in the lower extremities (81%), but there were also a significant number of head injuries (6.3%). The most common injury type was ankle sprain (17.2%). Half of the injuries were minor, with training or game absence of less than 7 days. Midfielders sustained the most injuries (32.6%) with an incidence of 42.4 per 1,000 game hours. We recorded two ACL-injuries and two PCL-injuries during the season. They all occurred during games, and the incidence was therefore calculated to 0.6 per 1,000 game hours for both injury types. The incidences of injuries reported for female soccer varies considerably, with the highest numbers reported from Germany and the present study. These studies have also the highest incidence of minor injuries registered. The location of the injuries is quite similar compared to other reports, but the number of ankle sprains seems to be higher in our study, whereas the number of knee and thigh injuries is lower. There has been much attention to ACL injuries in team handball and hamstring injuries in soccer in Norway, and this could have influenced the team's pre-season training, resulting in a reduction in the incidence of these injury types. The high number of ankle injuries has to be addressed to see whether this is a result of inadequate rehabilitation routines leading to re-injuries, or other factors. The high number of ACL-injuries in these reports is alarming and needs special attention in the future. PMID:17899007

  4. An integrated approach to change the outcome part I: neuromuscular screening methods to identify high ACL injury risk athletes.

    PubMed

    Myer, Gregory D; Ford, Kevin R; Brent, Jensen L; Hewett, Timothy E

    2012-08-01

    An important step for treatment of a particular injury etiology is the appropriate application of a treatment targeted to the population at risk. An anterior cruciate ligament (ACL) injury risk algorithm has been defined that employs field-based techniques in lieu of laboratory-based motion analysis systems to identify athletes with high ACL injury risk landing strategies. The resultant field-based assessment techniques, in combination with the developed prediction algorithm, allow for low-cost identification of athletes who may be at increased risk of sustaining ACL injury. The combined simplicity and accuracy of the field-based tool facilitate its use to identify specific factors that may increase risk of injury in female athletes. The purpose of this report is to demonstrate novel algorithmic techniques to accurately capture and analyze measures of knee valgus motion, knee flexion range of motion, body mass, tibia length and quadriceps to hamstrings ratio with video analysis software typically used by coaches, strength and conditioning specialists, and athletic trainers. The field-based measurements and software analyses were used in a prediction algorithm to identify those at potential risk of noncontact ACL injury that may directly benefit from neuromuscular training. PMID:22580976

  5. Adequacy of Semitendinosus Tendon Alone for Anterior Cruciate Ligament Reconstruction Graft and Prediction of Hamstring Graft Size by Evaluating Simple Anthropometric Parameters

    PubMed Central

    Stergios, Papastergiou G.; Georgios, Konstantinidis A.; Konstantinos, Natsis; Efthymia, Papathanasiou; Nikolaos, Koukoulias; Alexandros, Papadopoulos G.

    2012-01-01

    Introduction. Preoperative identification of patients with inadequate hamstring grafts for anterior cruciate ligament reconstruction is still a subject of interest. Purpose. The purpose of this study was to determine whether the semitendinosus tendon length is adequate for four-strand graft harvested by common technique (without bone plug) and whether there is correlation of gracilis and semitendinosus tendon grafts length and diameter of quadrupled graft with anthropometric parameters. Materials and Methods. In this retrospective study, 61 patients (45 males, 16 females) undergoing ACL reconstruction using four-strand hamstring autograft tendons were included. Results. The length of semitendinosus tendon, harvested by the common technique, was in 21% of our cases inadequate in order to be used alone as a four-strand graft especially in females (43%). There was moderate correlation between semitendinosus and gracilis graft diameter and patient's height and weight and fair correlation to BMI. We found no statistically important predictor for graft diameter in female patients. Conclusions. The length of semitendinosus tendon, harvested by common technique, is usually inadequate to be used alone as a four-strand graft especially in females. The most reliable predictor seems to be patient's height in males. In female patients, there is no statistically important predictor. PMID:22900187

  6. Effects of abdominal drawing-in during prone hip extension on the muscle activities of the hamstring, gluteus maximus, and lumbar erector spinae in subjects with lumbar hyperlordosis

    PubMed Central

    Kim, Tae-Woo; Kim, Yong-Wook

    2015-01-01

    [Purpose] The purpose of this study was to compare the effects of an abdominal drawing-in maneuver (ADIM), measured using a pressure bio-feedback unit, on the activities of the hamstring, gluteus maximus, and erector spinae muscles during prone hip extension. [Subjects and Methods] Thirty healthy adult subjects (14 male, 16 female), were recruited. Subjects’ lumbar lordosis and pelvic tilt angles were measured, and based on the results, the subjects were divided into two groups: a hyperlordotic lumbar angle (HLLA) group (n=15) and a normal lordotic lumbar angle (NLLA) group (n=15). The muscle activities of the hamstring and gluteus maximus, and of the erector spinae on the right side of the body, were recorded using surface electromyography. [Results] When performing ADIM with prone hip extension, the muscle activity of the gluteus maximus of the HLLA group significantly improved compared with that the NLLA group. [Conclusion] This study demonstrated that ADIM with prone hip extension was more effective at eliciting gluteus maximus activity in the HLLA group than in the NLLA group. Therefore, ADIM with prone hip extension may be useful for increasing the gluteus maximus activity of individuals with lumbar hyperlordosis. PMID:25729173

  7. Strain Gage

    NASA Technical Reports Server (NTRS)

    1995-01-01

    HITEC Corporation developed a strain gage application for DanteII, a mobile robot developed for NASA. The gage measured bending forces on the robot's legs and warned human controllers when acceptable forces were exceeded. HITEC further developed the technology for strain gage services in creating transducers out of "Indy" racing car suspension pushrods, NASCAR suspension components and components used in motion control.

  8. THE RELATIONSHIP BETWEEN OZONE-INDUCED LUNG INJURY, ANTIOXIDANT COMPENSATION AND UNDERLYING CARDIOVASCULAR DISEASE (CVD).

    EPA Science Inventory

    Increased levels of oxidants and compromised compensatory response are associated with CVD susceptibility. We hypothesized that rat strains demonstrating genetic CVD will have lower levels of antioxidants and greater ozone-induced pulmonary injury relative to healthy strains. Mal...

  9. Neurologic running injuries.

    PubMed

    McKean, Kelly A

    2009-02-01

    Neurologic running injuries account for a small number of running injuries. This may be caused by misdiagnosis or underdiagnosis. Nerve injuries that have been reported in runners include injuries to the interdigital nerves and the tibial, peroneal, and sural nerves. In this article, the etiology, symptoms, diagnosis, and treatment of these injuries are reviewed. Differences between nerve injury and more common musculoskeletal injury have been presented to aid in differential diagnosis. PMID:19084775

  10. Neurologic running injuries.

    PubMed

    McKean, Kelly A

    2008-02-01

    Neurologic running injuries account for a small number of running injuries. This may be caused by misdiagnosis or underdiagnosis. Nerve injuries that have been reported in runners include injuries to the interdigital nerves and the tibial, peroneal, and sural nerves. In this article, the etiology, symptoms, diagnosis, and treatment of these injuries are reviewed. Differences between nerve injury and more common musculoskeletal injury have been presented to aid in differential diagnosis. PMID:18295096

  11. High knee abduction moments are common risk factors for patellofemoral pain (PFP) and anterior cruciate ligament (ACL) injury in girls: Is PFP itself a predictor for subsequent ACL injury?

    PubMed Central

    Myer, Gregory D; Ford, Kevin R; Di Stasi, Stephanie L; Foss, Kim D Barber; Micheli, Lyle J; Hewett, Timothy E

    2014-01-01

    Background Identifying risk factors for knee pain and anterior cruciate ligament (ACL) injury can be an important step in the injury prevention cycle. Objective We evaluated two unique prospective cohorts with similar populations and methodologies to compare the incidence rates and risk factors associated with patellofemoral pain (PFP) and ACL injury. Methods The ‘PFP cohort’ consisted of 240 middle and high school female athletes. They were evaluated by a physician and underwent anthropometric assessment, strength testing and three-dimensional landing biomechanical analyses prior to their basketball season. 145 of these athletes met inclusion for surveillance of incident (new) PFP by certified athletic trainers during their competitive season. The ‘ACL cohort’ included 205 high school female volleyball, soccer and basketball athletes who underwent the same anthropometric, strength and biomechanical assessment prior to their competitive season and were subsequently followed up for incidence of ACL injury. A one-way analysis of variance was used to evaluate potential group (incident PFP vs ACL injured) differences in anthropometrics, strength and landing biomechanics. Knee abduction moment (KAM) cut-scores that provided the maximal sensitivity and specificity for prediction of PFP or ACL injury risk were also compared between the cohorts. Results KAM during landing above 15.4 Nm was associated with a 6.8% risk to develop PFP compared to a 2.9% risk if below the PFP risk threshold in our sample. Likewise, a KAM above 25.3 Nm was associated with a 6.8% risk for subsequent ACL injury compared to a 0.4% risk if below the established ACL risk threshold. The ACL-injured athletes initiated landing with a greater knee abduction angle and a reduced hamstrings-to-quadriceps strength ratio relative to the incident PFP group. Also, when comparing across cohorts, the athletes who suffered ACL injury also had lower hamstring/quadriceps ratio than the players in the PFP sample (p<0.05). Conclusions In adolescent girls aged 13.3 years, >15 Nm of knee abduction load during landing is associated with greater likelihood of developing PFP. Also, in girls aged 16.1 years who land with >25 Nm of knee abduction load during landing are at increased risk for both PFP and ACL injury. PMID:24687011

  12. Influence of Extrinsic Risk Factors on National Football League Injury Rates

    PubMed Central

    Lawrence, David W.; Comper, Paul; Hutchison, Michael G.

    2016-01-01

    Background: The risk of injury associated with American football is significant, with recent reports indicating that football has one of the highest rates of all-cause injury, including concussion, of all major sports. There are limited studies examining risk factors for injuries in the National Football League (NFL). Purpose: To identify risk factors for NFL concussions and musculoskeletal injuries. Study Design: Case-control study; Level of evidence, 3. Methods: Injury report data were collected prospectively for each week over the 2012-2013 and 2013-2014 regular seasons for all 32 teams. Poisson regression models were used to identify the relationship between predetermined variables and the risk of the 5 most frequent injuries (knee, ankle, hamstring, shoulder, and concussion). Results: A total of 480 games or 960 team games (TGs) from the 2012-2013 and 2013-2014 regular seasons were included in this study. A trend to an increasing risk of concussion and TG ankle injury with decreasing mean game-day temperature was observed. The risk of TG concussion (incidence rate ratio [IRR], 2.16; 95% CI, 1.35-3.45; P = .001) and TG ankle injury (IRR, 1.48; 95% CI, 1.10-1.98; P = .01) was significantly greater for TGs played at a mean game-day temperature of ≤9.7°C (≤49.5°F) compared with a mean game-day temperature of ≥21.0°C (≥69.8°F). The risk of TG shoulder injury was significantly increased for TGs played on grass surfaces (IRR, 1.36; 95% CI, 1.02-1.81; P = .038) compared with synthetic surfaces. The risk of TG injury was not associated with time in season, altitude, time zone change prior to game, or distance traveled to a game. Conclusion: This study evaluated extrinsic risk factors for injury in the NFL. A hazardous association was identified for risk of concussion and ankle injury with colder game-day temperature. Further research should be conducted to substantiate this relationship and its potential implication for injury prevention initiatives. PMID:27088102

  13. Nine year longitudinal retrospective study of Taekwondo injuries.

    PubMed

    Kazemi, Mohsen; Chudolinski, Artur; Turgeon, Matt; Simon, Aaron; Ho, Eric; Coombe, Lianne

    2009-12-01

    This retrospective longitudinal study aims to describe reported Taekwondo injuries and to examine associations between competitor experience level, age and gender, and the type, location, and mechanism of injury sustained. Additionally, we examined whether recent rule changes concerning increased point value of head shots in adult Taekwondo competition had affected injury incidence.This study was a summation of 9 years of data of competition injury reports, which included 904 injury reports spanning 58 individual competitions. The data was collected on standardized injury reports at time of injury during competition. Care was provided to the athletes, but the type of care provided was not included in the study. Participants included athletes injured during competition who sought care by the health care team, and for whom an injury report was filled out. The data analysis was performed at the Canadian Memorial Chiropractic College.The three most common locations of presenting injury were the head (19%), foot (16%), and thigh (9%). The most common mechanism of presenting injury was found to be a defensive kick (44%), followed by an offensive kick (35%). The most commonly diagnosed injuries were contusions (36%), sprains (19%), and strains (15%). Coloured belts had a higher incidence of contusions, while black belts sustained more joint irritation injuries. Black belts were more likely to suffer multiple injuries. Colored belts suffered more injuries while receiving a kick, while black belts had a larger influence of past history of injury. We found no significant difference in location or type of injury when comparing pre versus post rule change. The most common locations of injury are head, foot, and thigh respectively, and are areas for concern when considering preventative measures. Colour belt competitors are more likely to sustain contusions, which the authors believe is due to more aggressive tactics and lack of control. Those more likely to be injured tend to be younger than 18 years. Recent rule changes have no significant effect on head injuries. PMID:20037692

  14. Bilateral simultaneous anterior cruciate ligament injury: a case report and national survey of orthopedic surgeon management preference.

    PubMed

    Saadat, Ehsan; Curry, Emily J; Li, Xinning; Matzkin, Elizabeth G

    2014-10-27

    Unilateral anterior cruciate ligament (ACL) tear is a common injury seen by sports medicine orthopedic surgeons. However, a bilateral simultaneous ACL injury is extremely rare and has been reported only three times in the literature. We present a young female skier with simultaneous bilateral ACL tears that were managed with staged ACL reconstruction. We then conducted a nationwide survey (United States) to determine the prevalence of simultaneous bilateral ACL tear and preferred management strategies by sports medicine orthopedic surgeons. Sports medicine fellowship directors were contacted and asked to send an 8-item survey to colleagues (sports medicine fellowship trained surgeons) asking about overall number of ACL reconstructions performed, number of bilateral simultaneous ACL injuries seen and optimal management strategies of such an injury. Out of 43 responses, only 22 (51.2%) surgeons had seen a bilateral simultaneous ACL injury. Of these, 16 (76.2%) preferred staged reconstruction. Graft choice was mixed between autograft and allograft, but a large majority preferred either patellar tendon autograft (58%) or hamstring autograft (41%) were the most common choice. Staged reconstruction is the treatment of choice by surgeons surveyed in our study. PMID:25568728

  15. Return to Play After Soleus Muscle Injuries

    PubMed Central

    Pedret, Carles; Rodas, Gil; Balius, Ramon; Capdevila, Lluis; Bossy, Mireia; Vernooij, Robin W.M.; Alomar, Xavier

    2015-01-01

    Background Soleus muscle injuries are common in different sports disciplines. The time required for recovery is often difficult to predict, and reinjury is common. The length of recovery time might be influenced by different variables, such as the involved part of the muscle. Hypothesis Injuries in the central aponeurosis have a worse prognosis than injuries of the lateral or medial aponeurosis as well as myofascial injuries. Study Design Case series; Level of evidence, 4. Methods A total of 61 high-level or professional athletes from several sports disciplines (soccer, tennis, track and field, basketball, triathlon, and field hockey) were reviewed prospectively to determine the recovery time for soleus muscle injuries. Clinical and magnetic resonance imaging evaluation was performed on 44 soleus muscle injuries. The association between the different characteristics of the 5 typical muscle sites, including the anterior and posterior myofascial and the lateral, central, and medial aponeurosis disruption, as well as the injury recovery time, were determined. Recovery time was correlated with age, sport, extent of edema, volume, cross-sectional area, and retraction extension or gap. Results Of the 44 patients with muscle injuries who were analyzed, there were 32 (72.7%) strains affecting the myotendinous junction (MT) and 12 (23.7%) strains of the myofascial junction. There were 13 injuries involving the myotendinous medial (MTM), 7 affecting the MT central (MTC), 12 the MT lateral (MTL), 8 the myofascial anterior (MFA), and 4 the myofascial posterior (MFP). The median recovery time (±SD) for all injuries was 29.1 ± 18.8 days. There were no statistically significant differences between the myotendinous and myofascial injuries regarding recovery time. The site with the worst prognosis was the MTC aponeurosis, with a mean recovery time of 44.3 ± 23.0 days. The site with the best prognosis was the MTL, with a mean recovery time of 19.2 ± 13.5 days (P < .05). There was a statistically significant correlation between recovery time and age (P < .001) and between recovery time and the extent of retraction (P < .05). Conclusion Wide variation exists among the different types of soleus injuries and the corresponding recovery time for return to the same level of competitive sports. Injuries in the central aponeurosis have a significantly longer recovery time than do injuries in the lateral and medial aponeurosis and myofascial sites. PMID:26674181

  16. Nerve Injuries in Athletes.

    ERIC Educational Resources Information Center

    Collins, Kathryn; And Others

    1988-01-01

    Over a two-year period this study evaluated the condition of 65 athletes with nerve injuries. These injuries represent the spectrum of nerve injuries likely to be encountered in sports medicine clinics. (Author/MT)

  17. Traumatic Brain Injury (TBI)

    MedlinePlus

    ... head injury) or by an object penetrating the skull (called a penetrating injury). Some TBIs result in ... to) several types of injury to the brain: Skull fracture occurs when the skull cracks. Pieces of ...

  18. Eye Injuries at Work

    MedlinePlus

    ... Bureau of Labor Statistics, more than 20,000 workplace eye injuries happen each year. Injuries on the job often ... Occupational Safety and Health Administration (OSHA) reports that workplace eye injuries cost an estimated $300 million a year in ...

  19. Traumatic Brain Injury

    MedlinePlus

    ... Submit Search The CDC Injury Prevention & Control: Traumatic Brain Injury & Concussion Note: Javascript is disabled or is not ... please visit this page: About CDC.gov . Traumatic Brain Injury & Concussion Basic Information Get the Facts Signs and ...

  20. Traumatic Brain Injury

    MedlinePlus

    Traumatic brain injury (TBI) happens when a bump, blow, jolt, or other head injury causes damage to the brain. Every year, millions of people in the U.S. suffer brain injuries. More than half are bad enough that ...

  1. Traumatic Brain Injury

    MedlinePlus

    ... Center PTACs Workspaces Log-in Search for: Traumatic Brain Injury A legacy resource from NICHCY Disability Fact ... in her. Back to top What is Traumatic Brain Injury? A traumatic brain injury (TBI) is an ...

  2. Wounds and Injuries

    MedlinePlus

    An injury is damage to your body. It is a general term that refers to harm caused by accidents, ... millions of people injure themselves every year. These injuries range from minor to life-threatening. Injuries can ...

  3. Spinal injury - resources

    MedlinePlus

    Resources - spinal injury ... The following organizations are good resources for information on spinal injury : National Institute of Neurological Disorders and Stroke -- www.ninds.nih.gov The National Spinal Cord Injury ...

  4. Head injury. Second edition

    SciTech Connect

    Cooper, P.R.

    1987-01-01

    This book contains 22 chapters. Some of the chapter titles are: Radiographic Evaluation; Epidemiology of Head Injury; Emergency Care and Initial Evaluation; Skull Fracture and Traumatic Cerebrospinal Fluid Fistulas; Mild Head Injury; and Injuries of the Cranial Nerves.

  5. Work-related injuries in drywall installation.

    PubMed

    Lipscomb, H J; Dement, J M; Gaal, J S; Cameron, W; McDougall, V

    2000-10-01

    Administrative data sources were used to describe the work-related injuries of drywall carpenters, to calculate rates of occurrence, and to explore high risk sub-groups. Health insurance eligibility files were used to identify a cohort of active union carpenters affiliated with a union local whose predominant work involved drywall installation in the state of Washington. These files contained the hours worked by each individual for each month between January 1989 and December 1995, providing person-hours at risk as a union carpenter. The Washington Department of Labor and Industries (L&I) provided records of workers' compensation claims filed by these individuals. Over seven years 1773 drywall carpenters filed 2567 workers' compensation claims representing an overall rate of 53.3 per 200,000 hours worked. These claims were filed by 1046 different individuals, or 59.0 percent of the cohort. Claims resulting in paid lost time from work were filed at a rate of 12.5 per 200,000 hours worked (n = 609) by 445 (25.1%) different individuals. The most common mechanisms of injury involved being struck (38.3%), overexertion (28.1%), and falls (13.2%). Struck by injuries most commonly involved cuts to the upper extremity. Overexertion injuries were most commonly described as sprains or strains involving the back. Sheetrock was associated with over 40 percent of these injuries. Falls most commonly involved injuries to the knee followed by the back and multiple injuries. Struck by injuries decreased steadily with increasing age and increasing time in the union. There was a steady increase in the rate of falls with increasing age. Overexertion injuries were responsible for the greatest proportion of costs for medical care, permanent impairment, and paid lost days. The high rates of overexertion injuries among these workers is consistent with known ergonomic stresses on drywall jobs. However, these workers are also at high risk of acute traumatic injuries. PMID:11036730

  6. The application of musculoskeletal modeling to investigate gender bias in non-contact ACL injury rate during single-leg landings.

    PubMed

    Ali, Nicholas; Andersen, Michael Skipper; Rasmussen, John; Robertson, D Gordon E; Rouhi, Gholamreza

    2014-01-01

    The central tenet of this study was to develop, validate and apply various individualised 3D musculoskeletal models of the human body for application to single-leg landings over increasing vertical heights and horizontal distances. While contributing to an understanding of whether gender differences explain the higher rate of non-contact anterior cruciate ligament (ACL) injuries among females, this study also correlated various musculoskeletal variables significantly impacted by gender, height and/or distance and their interactions with two ACL injury-risk predictor variables; peak vertical ground reaction force (VGRF) and peak proximal tibia anterior shear force (PTASF). Kinematic, kinetic and electromyography data of three male and three female subjects were measured. Results revealed no significant gender differences in the musculoskeletal variables tested except peak VGRF (p = 0.039) and hip axial compressive force (p = 0.032). The quadriceps and the gastrocnemius muscle forces had significant correlations with peak PTASF (r = 0.85, p < 0.05 and r = - 0.88, p < 0.05, respectively). Furthermore, hamstring muscle force was significantly correlated with peak VGRF (r = - 0.90, p < 0.05). The ankle flexion angle was significantly correlated with peak PTASF (r = - 0.82, p < 0.05). Our findings indicate that compared to males, females did not exhibit significantly different muscle forces, or ankle, knee and hip flexion angles during single-leg landings that would explain the gender bias in non-contact ACL injury rate. Our results also suggest that higher quadriceps muscle force increases the risk, while higher hamstring and gastrocnemius muscle forces as well as ankle flexion angle reduce the risk of non-contact ACL injury. PMID:23387967

  7. ROLLER‐MASSAGER APPLICATION TO THE HAMSTRINGS INCREASES SIT‐AND‐REACH RANGE OF MOTION WITHIN FIVE TO TEN SECONDS WITHOUT PERFORMANCE IMPAIRMENTS

    PubMed Central

    Sullivan, Kathleen M.; Silvey, Dustin B.J.; Button, Duane C.

    2013-01-01

    Background: Foam rollers are used to mimic myofascial release techniques and have been used by therapists, athletes, and the general public alike to increase range of motion (ROM) and alleviate pressure points. The roller‐massager was designed to serve a similar purpose but is a more portable device that uses the upper body rather than body mass to provide the rolling force. Objectives/Purpose: A roller massager was used in this study to examine the acute effects on lower extremity ROM and subsequent muscle length performance. Methods: Seven male and ten female volunteers took part in 4 trials of hamstrings roller‐massager rolling (1 set – 5 seconds, 1 set – 10 seconds, 2 sets – 5 seconds, and 2 sets – 10 seconds) at a constant pressure (13 kgs) and a constant rate (120 bpm). A group of 9 participants (three male, six female) also performed a control testing session with no rolling intervention. A sit and reach test for ROM, along with a maximal voluntary contraction (MVC) force and muscle activation of the hamstrings were measured before and after each session of rolling. Results: A main effect for testing time (p<0.0001) illustrated that the use of the roller‐massager resulted in a 4.3% increase in ROM. There was a trend (p=0.069) for 10s of rolling duration to increase ROM more than 5s rolling duration. There were no significant changes in MVC force or MVC EMG activity after the rolling intervention. Conclusions: The use of the roller‐massager had no significant effect on muscle strength, and can provide statistically significant increases in ROM, particularly when used for a longer duration. PMID:23772339

  8. The effects of multiple daily applications of ice to the hamstrings on biochemical measures, signs, and symptoms associated with exercise-induced muscle damage.

    PubMed

    Oakley, Elizabeth T; Pardeiro, Rafael B; Powell, Joseph W; Millar, Audrey L

    2013-10-01

    There is inconclusive evidence for the effectiveness of cryotherapy for the treatment of exercised-induced muscle damage (EIMD). Small sample sizes and treatment applications that did not correspond to evidence-based practice are limitations in previous studies that may have contributed to these equivocal findings. The purpose of this study was to examine the effectiveness of daily multiple applications of ice on EIMD throughout the 72-hour recovery period, an icing protocol that more closely resembles current clinical practice. Thirty-three subjects were assigned to either the cryotherapy group (n = 23) or control group (n = 10). The EIMD was induced through repeated isokinetic eccentric contractions of the right hamstring muscle group. The experimental group received ice immediately after induction of EIMD and continued to ice thrice a day for 20 minutes throughout the 72 hours; the control group received no intervention. Isometric torque, hamstring length, pain, and biochemical markers (creatine kinase [CK], alanine aminotransferase, and aspartate aminotransferase [AST]) were assessed at baseline, 24, 48, and 72 hours. Both groups demonstrated a significant change (p < 0.05) in all dependent variables compared with that at baseline, but there was no difference between groups except for pain. The cryotherapy group had significantly (p = 0.048) less pain (3.0 ± 2.1 cm) compared with the control (5.35 ± 2.5 cm) at 48 hours. Although not statistically significant, the cryotherapy group had a greater range of motion and lower CK and AST means at 72 hours compared with that of the control group. Repeated applications of ice can decrease the pain associated with EIMD significantly at 48 hours post EIMD. Although the results may not be unique, the methodology in this study was distinctive in that we used a larger sample size and an icing protocol similar to current recommended treatment practice. PMID:23364294

  9. Descriptive Epidemiology of Musculoskeletal Injuries in Naval Special Warfare Sea, Air, and Land Operators.

    PubMed

    Lovalekar, Mita; Abt, John P; Sell, Timothy C; Wood, Dallas E; Lephart, Scott M

    2016-01-01

    The purpose of this analysis was to describe medical chart reviewed musculoskeletal injuries among Naval Special Warfare Sea, Air, and Land Operators. 210 Operators volunteered (age: 28.1 ± 6.0 years, height: 1.8 ± 0.1 m, weight: 85.4 ± 9.3 kg). Musculoskeletal injury data were extracted from subjects' medical charts, and injuries that occurred during 1 year were described. Anatomic location of injury, cause of injury, activity when injury occurred, and injury type were described. The frequency of injuries was 0.025 per Operator per month. Most injuries involved the upper extremity (38.1% of injuries). Frequent anatomic sublocations for injuries were the shoulder (23.8%) and lumbopelvic region of the spine (12.7%). Lifting was the cause of 7.9% of injuries. Subjects were participating in training when 38.1% of injuries occurred and recreational activity/sports when 12.7% of injuries occurred. Frequent injury types were strain (20.6%), pain/spasm/ache (19.0%), fracture (11.1%), and sprain (11.1%). The results of this analysis underscore the need to investigate the risk factors, especially of upper extremity and physical activity related injuries, in this population of Operators. There is a scope for development of a focused, customized injury prevention program, targeting the unique injury profile of this population. PMID:26741478

  10. Boxing, Wrestling, and Martial Arts Related Injuries Treated in Emergency Departments in the United States, 2002-2005

    PubMed Central

    Pappas, Evangelos

    2007-01-01

    The incidence of injury in combat sports has not been adequately reported although it is important to identify the nature and frequency of injuries prior to the implementation of prevention programs. This study compared injury rates treated in Hospital Emergency Departments between different combat sports of boxing, wrestling, and martial arts. A secondary objective described anatomic region and diagnosis of these injuries. Data were obtained on all boxing, wrestling, and martial arts-related injuries that were in the National Electronic Injury Surveillance System database and resulted in Emergency Department visits between 2002 and 2005. Pearson’s chi-square statistics were calculated to compare injury rates for each activity accounting for complex sample design. Martial arts had lower injury rates compared to boxing and wrestling for all diagnoses (p<0.001). Boxing had lower injury rates compared to wrestling for strains/sprains and dislocations. Boxing and wrestling had similar injury rates for concussions. Injury prevention efforts should consider the distribution of injuries and concentrate on preventing strains/sprains in wrestling, concussions in boxing and wrestling, and fractures for all three activities. The findings of the present study do not provide evidence that combat sports have alarmingly high rates of injuries resulting in emergency department visits. Key points Martial arts have lower emergency department injury rates compared to boxing and wrestling. Wrestling has higher strains/sprains and dislocation injury rates compared to boxing. Combat sports do not appear to have higher injury rates compared to non-combat sports. PMID:24198705

  11. Alterations in body composition and spasticity following subtetanic neuromuscular electrical stimulation training in spinal cord injury.

    PubMed

    Carty, Amanda; McCormack, Kirsty; Coughlan, Garret F; Crowe, Louis; Caulfield, Brian

    2013-01-01

    The objective of this prospective cohort study was to investigate alterations in body composition variables and spasticity following subtetanic neuromuscular electrical stimulation (NMES) training in an adult population with spinal cord injury (SCI). Fourteen sedentary adults with SCI (thoracic [T]4-T11; American Spinal Injury Association Impairment Scale A/B; time since injury: 10.17 +/- 11.17 yr) were recruited from the National SCI database. Four adhesive electrodes (175 cm2 each) were placed bilaterally on the proximal and distal quadriceps and hamstrings muscle groups and subtetanic contractions were elicited using a handheld NMES device. Lean body mass (LBM) and other body composition variables were measured using dual-energy X-ray absorptiometry. Spasticity was measured using the Spinal Cord Assessment Tool for Spastic Reflexes (SCATs) and visual analog scales. Verbal and written feedback was obtained to subjectively evaluate spasticity. LBM and spasticity measurements were taken before and after an 8 wk NMES training program in order to assess change. A statistically significant increase in lower-limb LBM, i.e., muscle tissue (p > 0.001), and a reduction in SCATs (p < 0.001) score, indicating reduced spasticity, was observed. Subjective responses were positive. Improvements in body composition and SCATs scores indicate that subtetanic NMES training elicits favorable responses and may have important clinical implications for an SCI population. PMID:23761000

  12. Platelet-rich plasma for muscle injuries: game over or time out?

    PubMed

    Mosca, Michael J; Rodeo, Scott A

    2015-06-01

    Muscle injuries are common and may be associated with impaired functional capacity, especially among athletes. The results of healing with conventional therapy including rest, ice, compression, and elevation (RICE) are often inadequate, generating substantial interest in the potential for emerging technologies such as platelet-rich plasma (PRP) to enhance the process of soft-tissue healing and to decrease time to recovery. In vitro studies and animal research have suggested that PRP may have benefits associated with the increased release of cytokines and growth factors resulting from supraphysiological concentrations of platelets that facilitate muscle repair, regeneration, and remodeling. Despite the promise of basic science, there is a paucity of clinical data to support the theoretical benefits of PRP. The only double-blind controlled clinical trial was recently reported and showed no benefit of PRP in the time to resume sports activity among athletes with hamstring muscle injury. This review examines the current evidence and the theoretical framework for PRP and muscle healing. Scientific gaps and technological barriers are discussed that must be addressed if the potential promise of PRP as a therapeutic modality for muscle injury is to be realized. PMID:25715983

  13. Football injuries during the 2014 FIFA World Cup

    PubMed Central

    Junge, Astrid; Dvořák, Jiri

    2015-01-01

    Background FIFA has surveyed match injuries in its tournaments since 1998. Aim To analyse the incidence and characteristics of match injuries incurred during the 2014 FIFA World Cup in comparison to previous FIFA World Cups. Methods The chief physicians of the participating teams reported all newly incurred injuries of their players after the match on a standardised report form. 124 (97%) forms were returned. Results A total of 104 injuries were reported, equivalent to an incidence of 1.68 injuries per match (95% CI 1.36 to 2.00). 64 (63.4%) injuries were caused by contact with another player. Thigh (26; 25%) and head (19; 18%) were the most frequently injured body parts. The most frequent diagnosis was thigh strain (n=18). Five concussions and three fractures to the head were reported. While most thigh strains (15/17; 88.2%) occurred without contact, almost all head injuries (18/19; 94.7%) were caused by contact. 0.97 injuries per match (95% CI 0.72 to 1.22) were expected to result in absence from training or match. Eight injuries were classified as severe. The incidence of match injuries in the 2014 FIFA World Cup was significantly lower than the average of the four preceding FIFA World Cups, both for all injuries (2.34; 95% CI 2.15 to 2.53) and time-loss injuries (1.51; 95% CI 1.37 to 1.65). Conclusions The overall incidence of injury during the FIFA World Cups decreased from 2002 to 2014 by 37%. A detailed analysis of the injury mechanism is recommended to further improve prevention strategies. PMID:25878077

  14. Correlation between injury pattern and Finite Element analysis in biomechanical reconstructions of Traumatic Brain Injuries.

    PubMed

    Fahlstedt, Madelen; Depreitere, Bart; Halldin, Peter; Vander Sloten, Jos; Kleiven, Svein

    2015-05-01

    At present, Finite Element (FE) analyses are often used as a tool to better understand the mechanisms of head injury. Previously, these models have been compared to cadaver experiments, with the next step under development being accident reconstructions. Thus far, the main focus has been on deriving an injury threshold and little effort has been put into correlating the documented injury location with the response displayed by the FE model. Therefore, the purpose of this study was to introduce a novel image correlation method that compares the response of the FE model with medical images. The injuries shown on the medical images were compared to the strain pattern in the FE model and evaluated by two indices; the Overlap Index (OI) and the Location Index (LI). As the name suggests, OI measures the area which indicates both injury in the medical images and high strain values in the FE images. LI evaluates the difference in center of mass in the medical and FE images. A perfect match would give an OI and LI equal to 1. This method was applied to three bicycle accident reconstructions. The reconstructions gave an average OI between 0.01 and 0.19 for the three cases and between 0.39 and 0.88 for LI. Performing injury reconstructions are a challenge as the information from the accidents often is uncertain. The suggested method evaluates the response in an objective way which can be used in future injury reconstruction studies. PMID:25817473

  15. Lower extremity injury criteria for evaluating military vehicle occupant injury in underbelly blast events.

    PubMed

    McKay, Brian J; Bir, Cynthia A

    2009-11-01

    Anti-vehicular (AV) landmines and improvised explosive devices (IED) have accounted for more than half of the United States military hostile casualties and wounded in Operation Iraqi Freedom (OIF) (Department of Defense Personnel & Procurement Statistics, 2009). The lower extremity is the predominantly injured body region following an AV mine or IED blast accounting for 26 percent of all combat injuries in OIF (Owens et al., 2007). Detonations occurring under the vehicle transmit high amplitude and short duration axial loads onto the foot-ankle-tibia region of the occupant causing injuries to the lower leg. The current effort was initiated to develop lower extremity injury criteria for occupants involved in underbelly blast impacts. Eighteen lower extremity post mortem human specimens (PMHS) were instrumented with an implantable load cell and strain gages and impacted at one of three incrementally severe AV axial loading conditions. Twelve of the 18 PMHS specimens sustained fractures of the calcaneus, talus, fibula and/or tibia. The initiation of skeletal injury was precisely detected by strain gages and corresponded with local peak axial tibia force. Survival analysis identified peak axial tibia force and impactor velocity as the two best predictors of incapacitating injury. A tibia axial force of 5,931 N and impactor velocity of 10.8 m/s corresponds with a 50 percent risk of an incapacitating injury. The criteria may be utilized to predict the probability of lower extremity incapacitating injury in underbelly blast impacts. PMID:20058557

  16. Injury and Treatment Characteristics of Sport-Specific Injuries Sustained in Interscholastic Athletics

    PubMed Central

    Lam, Kenneth C.; Snyder Valier, Alison R.; Valovich McLeod, Tamara C.

    2015-01-01

    Background: The inclusion of clinical practice factors, beyond epidemiologic data, may help guide medical coverage and care decisions. Hypothesis: Trends in injury and treatment characteristics of sport-specific injuries sustained by secondary school athletes will differ based on sport. Study Design: Retrospective analysis of electronic patient records. Level of evidence: Level 4. Methods: Participants consisted of 3302 boys and 2293 girls who were diagnosed with a sport-related injury or condition during the study years. Injury (sport, body part, diagnosis via ICD-9 codes) and treatment (type, amount, and duration of care) characteristics were grouped by sport and reported using summary statistics. Results: Most injuries and treatments occurred in football, girls’ soccer, basketball, volleyball, and track and field. Sprain or strain of the ankle, knee, and thigh/hip/groin and concussion were the most commonly documented injuries across sports. The injury pattern for boys’ wrestling differed from other sports and included sprain or strain of the elbow and neck and general medical skin conditions. The most frequently reported service was athletic training evaluation/reevaluation treatment, followed by hot/cold pack, therapeutic exercise, manual therapy techniques, electrical stimulation, and strapping of lower extremity joints. Most sports required 4 to 5 services per injury. With the exception of boys’ soccer and girls’ softball, duration of care ranged from 10 to 14 days. Girls’ soccer and girls’ and boys’ track and field reported the longest durations of care. Conclusion: Injury and treatment characteristics are generally comparable across sports, suggesting that secondary school athletic trainers may diagnose and treat similar injuries regardless of sport. Clinical Relevance: Subtle sport trends, including skin conditions associated with boys’ wrestling and longer duration of care for girls’ soccer, are important to note when discussing appropriate medical coverage and care. PMID:25553215

  17. Strains and Sprains

    MedlinePlus

    ... Kids For Parents MORE ON THIS TOPIC Sports Medicine Center A to Z: Sprain, Wrist A to Z: Sprain, Knee Preventing Children's Sports Injuries Computer-Related Repetitive Stress Injuries Knee Injuries Broken Bones, ...

  18. Beyond the fireground: injuries in the fire service.

    PubMed

    Poplin, Gerald S; Harris, Robin B; Pollack, Keshia M; Peate, Wayne F; Burgess, Jefferey L

    2012-08-01

    Background Although firefighting and emergency medical services are high-risk professions, few studies have identified the aetiology of injury in the fire service beyond the fireground. Methods Data were collected for work-related injuries in a medium-sized metropolitan fire department. In a descriptive study, the factors explored included the nature of injury, agent, mechanism, body location, environment, abbreviated injury scale (AIS), functional capacity index (FCI) and lost time status. Results From 2004 to 2009, the annual injury incidence rate averaged 17.7 per 100 employees. One-third of all injuries (32.9%) resulted from physical exercise activities, while patient transport, training drills and fireground operations resulted in 16.9%, 11.1% and 10.2% of injuries, respectively. For all job operations, sprains and strains were the most prevalent type of injury (40.2-85.2%), followed by contusions and lacerations (7.7-26.1%). The third most common injury was related to the conventional hazards of the individual job operation. Most injuries (n=862, 95.6%) were minor in severity, while 4.3% of injuries were classified as having some impedance of normal function (FCI 3). Moderate injuries (AIS 2) were infrequent, but comprised a greater proportion of fireground injuries (8.7%) than the other activities (1.0-4.1%); however, lost time injuries were more frequent for patient transport (46.1%) than other operations (22.0-29.1%). Conclusions Physical exercise, patient transport and training activities were responsible for a greater percentage of injuries than fireground operations. Focused efforts to improve the characterisation of risks during these more diverse set of work processes should help guide the development of salient strategies for injury prevention. PMID:22117024

  19. Injuries in students of three different dance techniques.

    PubMed

    Echegoyen, Soledad; Acuña, Eugenia; Rodríguez, Cristina

    2010-06-01

    As with any athlete, the dancer has a high risk for injury. Most studies carried out relate to classical and modern dance; however, there is a lack of reports on injuries involving other dance techniques. This study is an attempt to determine the differences in the incidence, the exposure-related rates, and the kind of injuries in three different dance techniques. A prospective study about dance injuries was carried out between 2004 and 2007 on students of modern, Mexican folkloric, and Spanish dance at the Escuela Nacional de Danza. A total of 1,168 injuries were registered in 444 students; the injury rate was 4 injuries/student for modern dance and 2 injuries/student for Mexican folkloric and Spanish dance. The rate per training hours was 4 for modern, 1.8 for Mexican folkloric, and 1.5 injuries/1,000 hr of training for Spanish dance. The lower extremity is the most frequent structure injured (70.47%), and overuse injuries comprised 29% of the total. The most frequent injuries were strain, sprain, back pain, and patellofemoral pain. This study has a consistent medical diagnosis of the injuries and is the first attempt in Mexico to compare the incidence of injuries in different dance techniques. To decrease the frequency of student injury, it is important to incorporate prevention programs into dance program curricula. More studies are necessary to define causes and mechanisms of injury, as well as an analysis of training methodology, to decrease the incidence of the muscle imbalances resulting in injury. PMID:20795335

  20. Head Injuries in Children

    ERIC Educational Resources Information Center

    Pennington, Nicole

    2010-01-01

    School nurses play a crucial role in injury prevention and initial treatment when injuries occur at school. The role of school nurses includes being knowledgeable about the management of head injuries, including assessment and initial treatment. The school nurse must be familiar with the outcomes of a head injury and know when further evaluation…

  1. Rugby injury survey 1979.

    PubMed

    Inglis, G S; Stewart, I D

    1981-11-11

    In a prospective study 1085 rugby players and their injuries were recorded in the 1979 playing season. The age, grade, position, fitness and ground conditions did not affect the injury pattern. The majority of injuries were insignificant requiring no hospital follow up. The tackle accounted for 44 percent of all injuries. Set play does not contribute significantly to the number of injuries. The head and neck was the most frequently involved site, followed by the lower limbs. Foul play was implicated in 15 percent of all injuries. More stringent refereeing and coaching of the tackle could aid in reducing the number and severity of rugby injuries. PMID:6950267

  2. Traumatic brain injury using mouse models.

    PubMed

    Zhang, Yi Ping; Cai, Jun; Shields, Lisa B E; Liu, Naikui; Xu, Xiao-Ming; Shields, Christopher B

    2014-08-01

    The use of mouse models in traumatic brain injury (TBI) has several advantages compared to other animal models including low cost of breeding, easy maintenance, and innovative technology to create genetically modified strains. Studies using knockout and transgenic mice demonstrating functional gain or loss of molecules provide insight into basic mechanisms of TBI. Mouse models provide powerful tools to screen for putative therapeutic targets in TBI. This article reviews currently available mouse models that replicate several clinical features of TBI such as closed head injuries (CHI), penetrating head injuries, and a combination of both. CHI may be caused by direct trauma creating cerebral concussion or contusion. Sudden acceleration-deceleration injuries of the head without direct trauma may also cause intracranial injury by the transmission of shock waves to the brain. Recapitulation of temporary cavities that are induced by high-velocity penetrating objects in the mouse brain are difficult to produce, but slow brain penetration injuries in mice are reviewed. Synergistic damaging effects on the brain following systemic complications are also described. Advantages and disadvantages of CHI mouse models induced by weight drop, fluid percussion, and controlled cortical impact injuries are compared. Differences in the anatomy, biomechanics, and behavioral evaluations between mice and humans are discussed. Although the use of mouse models for TBI research is promising, further development of these techniques is warranted. PMID:24493632

  3. Posttraumatic mossy fiber sprouting is related to the degree of cortical damage in three mouse strains

    PubMed Central

    Hunt, Robert F.; Haselhorst, Laura A.; Schoch, Kathleen M.; Bach, Eva C.; Rios-Pilier, Jennifer; Scheff, Stephen W.; Saatman, Kathryn E.; Smith, Bret N.

    2011-01-01

    Summary Controlled cortical impact injury was used to examine relationships between focal posttraumatic cortical damage and mossy fiber sprouting (MFS) in the dentate gyrus in three mouse strains. Posttraumatic MFS was more robust when cortical injury impinged upon the hippocampus, versus contusions restricted to neocortex, and was qualitatively similar among CD-1, C57BL/6, and FVB/N background strains. Impact parameters influencing injury severity may be critical in reproducing epilepsy-related changes in neurotrauma models. PMID:22047981

  4. Low-back injuries in a heavy industry. I. Worker and workplace factors.

    PubMed

    Clemmer, D I; Mohr, D L; Mercer, D J

    1991-07-01

    The costs and circumstances of low-back strains, low-back impact injuries, and non-low-back injuries among field employees of an offshore petroleum drilling company, 1979-1985, were compared. The objectives were to identify worker and workplace factors associated with low-back injuries, to identify factors differentially associated with lost-time injuries, and to formulate recommendations for the control of low-back injuries. Low-back-impact injuries resulted largely from falls. Efforts to prevent falls would have a potential to reduce other serious consequences as well as back injuries. Workers performing the heaviest physical labor were at highest risk of low-back strains. Based on activities precipitating the injury, modifications of work site, equipment, and procedures to help reduce low-back strains are recommended. Only job was a predictor of whether a low-back strain was likely to be associated with lost time. Even this association was lacking for low-back impact injuries. Cost control by preventing the small proportion of high cost injuries may not be feasible. Rather, subsets of low-back injuries defined, for example, by work site or activity can suggest options for intervention. PMID:1833829

  5. Randomized prospective study of ACL reconstruction with interference screw fixation in patellar tendon autografts versus femoral metal plate suspension and tibial post fixation in hamstring tendon autografts: 5-year clinical and radiological follow-up results.

    PubMed

    Harilainen, Arsi; Linko, Eric; Sandelin, Jerker

    2006-06-01

    Patellar tendon graft has been the most frequently used material in anterior cruciate ligament (ACL) reconstruction, but the hamstring tendons have been increasingly used as well; however, which graft is to be preferred is not adequately supported by existing clinical studies. In this prospective randomized clinical trial, the study hypothesis was that the hamstring tendons are equally good graft material as the patellar tendon in ACL reconstruction. Ninety-nine patients with laxity due to a torn ACL underwent arthroscopically assisted reconstruction with graft randomization according to their birth year to either patellar tendon with metal interference screw fixation or double looped semitendinosus and gracilis tendons with fixation similar to the Endobutton technique using a titanium metal plate suspension proximally and screw-washer postdistally. Excluding preoperative Lysholm knee score, there were no significant differences between the two groups in the preoperative and operative data. A standard rehabilitation regimen was used for all the patients, including immediate postoperative mobilization without a knee brace, protected weight bearing for 2 weeks, and return to full activity at 6-12 months postoperatively. Forty patients in the patellar tendon group and 39 patients in the hamstring tendon group were available for clinical evaluation at median 5 years after surgery (ranges 3 years 11 months-6 years 7 months). The results revealed no statistically significant differences with respect to clinical and instrumented laxity testing, isokinetic muscle torque measurements, International Knee Documentation Committee ratings, Lysholm (knee score), Tegner (activity level) and Kujala patellofemoral knee scores. There was an enlargement of the drill tunnels, statistically more in the hamstring tendon group, but no increase from 2 to 5 years in either group. Narrowing of the joint spaces (IKDC measurement method) from 2 to 5 years postoperatively was seen in both the groups, however, without difference between the two groups. PMID:16552549

  6. Correlation of Shoulder and Elbow Injuries with Muscle Tightness, Core Stability, and Balance by Longitudinal Measurements in Junior High School Baseball Players

    PubMed Central

    Endo, Yasuhiro; Sakamoto, Masaaki

    2014-01-01

    [Purpose] The present study longitudinally investigated injury occurrences and the risk factors for muscle tightness, core stability, and dynamic standing balance among junior high school student baseball players. [Subjects] Thirty-nine male students, belonging to baseball clubs at 2 junior high schools, participated in this study. [Methods] Study measurements were obtained twice, once in the early stage of the baseball season (March) and once at the end of the season (July). All subjects underwent muscle tightness testing, the Star Excursion Balance Test (SEBT), and trunk endurance testing during each measurement session. [Results] Fifteen players experienced episodes of elbow or shoulder pain while throwing. Players in the pain group demonstrated a significant increase in the tightness of their shoulder internal rotators, axis-leg quadriceps, and axis-leg hamstrings. There was no clear evidence of differences of changes in core stability and dynamic standing balance between the groups. [Conclusion] The results of this study suggest that lower extremity muscle tightness early in a season and the subsequent decline in the flexibility of the axis-leg quadriceps and hamstrings during the season may be due to an increased upper extremity load while throwing, thus producing shoulder and elbow pain. PMID:24926133

  7. Correlation of shoulder and elbow injuries with muscle tightness, core stability, and balance by longitudinal measurements in junior high school baseball players.

    PubMed

    Endo, Yasuhiro; Sakamoto, Masaaki

    2014-05-01

    [Purpose] The present study longitudinally investigated injury occurrences and the risk factors for muscle tightness, core stability, and dynamic standing balance among junior high school student baseball players. [Subjects] Thirty-nine male students, belonging to baseball clubs at 2 junior high schools, participated in this study. [Methods] Study measurements were obtained twice, once in the early stage of the baseball season (March) and once at the end of the season (July). All subjects underwent muscle tightness testing, the Star Excursion Balance Test (SEBT), and trunk endurance testing during each measurement session. [Results] Fifteen players experienced episodes of elbow or shoulder pain while throwing. Players in the pain group demonstrated a significant increase in the tightness of their shoulder internal rotators, axis-leg quadriceps, and axis-leg hamstrings. There was no clear evidence of differences of changes in core stability and dynamic standing balance between the groups. [Conclusion] The results of this study suggest that lower extremity muscle tightness early in a season and the subsequent decline in the flexibility of the axis-leg quadriceps and hamstrings during the season may be due to an increased upper extremity load while throwing, thus producing shoulder and elbow pain. PMID:24926133

  8. Outcomes of a Home Cycling Program Using Functional Electrical Stimulation or Passive Motion for Children With Spinal Cord Injury: A Case Series

    PubMed Central

    Johnston, Therese E; Smith, Brian T; Oladeji, Oluwabunmi; Betz, Randal R; Lauer, Richard T

    2008-01-01

    Background/Objective: Children with spinal cord injury (SCI) are at risk for musculoskeletal and cardiovascular complications. Stationary cycling using functional electrical stimulation (FES) or passive motion has been suggested to address these complications. The purpose of this case series is to report the outcomes of a 6-month at-home cycling program for 4 children with SCI. Methods: Two children cycled with FES and 2 cycled passively at home for 1 hour, 3 times per week. Outcome Measures: Data collected included bone mineral density of the left femoral neck, distal femur, and proximal tibia; quadriceps and hamstring muscle volume; stimulated quadriceps and hamstring muscle strength; a fasting lipid profile; and heart rate and oxygen consumption during incremental upper extremity ergometry testing. Results: The 2 children cycling with FES and 1 child cycling passively exhibited improved bone mineral density, muscle volume, stimulated quadriceps strength, and lower resting heart rate. For the second child cycling passively, few changes were realized. Overall, the lipid results were inconsistent, with some positive and some negative changes seen. Conclusions: This case series suggests that cycling with or without FES may have positive health benefits and was a practical home exercise option for these children with SCI. PMID:18581671

  9. The nature and circumstances of tackle injuries in rugby union.

    PubMed

    Wilson, B D; Quarrie, K L; Milburn, P D; Chalmers, D J

    1999-06-01

    This study describes the nature and circumstances of injury occurring in rugby union tackles (33% of 569 injury events) using data from the Rugby Injury and Performance Project (RIPP) and provides supplementary information on the nature of tackles involving injury from analysis of videotape of tackle injury events. The most common tackle injuries in the RIPP data were sprains/strains (41%) followed by haematomas/bruising (26%). The most frequently injured body sites were the head/neck/face (22%) and the knee (17%). The ball carrier and tackler were injured in tackles in similar proportions in both RIPP and New Zealand Rugby Football Union (NZRFU) video tackle incidents. Both players were most often in motion in the tackle at the time of injury with approximately 70% of injuries occurring when the injured player was running or diving/falling to the ground. Tackle injury was most often caused by impact with another player rather than impact with the ground. The use of protective padding may reduce the risk of impact injury. The majority of tackle injuries were associated with stopping tackles to the trunk which were from the front (63%), rather than from the side or behind. Thus consideration should be given to coaching strategies or to rule changes which reduce the likelihood or prohibit front-on tackles. PMID:10476979

  10. A Possible Role for Integrin Signaling in Diffuse Axonal Injury

    PubMed Central

    Kerscher, Lucas; Franck, Christian; Goss, Josue A.; Alford, Patrick W.; Parker, Kevin Kit

    2011-01-01

    Over the past decade, investigators have attempted to establish the pathophysiological mechanisms by which non-penetrating injuries damage the brain. Several studies have implicated either membrane poration or ion channel dysfunction pursuant to neuronal cell death as the primary mechanism of injury. We hypothesized that traumatic stimulation of integrins may be an important etiological contributor to mild Traumatic Brain Injury. In order to study the effects of forces at the cellular level, we utilized two hierarchical, in vitro systems to mimic traumatic injury to rat cortical neurons: a high velocity stretcher and a magnetic tweezer system. In one system, we controlled focal adhesion formation in neurons cultured on a stretchable substrate loaded with an abrupt, one dimensional strain. With the second system, we used magnetic tweezers to directly simulate the abrupt injury forces endured by a focal adhesion on the neurite. Both systems revealed variations in the rate and nature of neuronal injury as a function of focal adhesion density and direct integrin stimulation without membrane poration. Pharmacological inhibition of calpains did not mitigate the injury yet the inhibition of Rho-kinase immediately after injury reduced axonal injury. These data suggest that integrin-mediated activation of Rho may be a contributor to the diffuse axonal injury reported in mild Traumatic Brain Injury. PMID:21799943

  11. Robust human body model injury prediction in simulated side impact crashes.

    PubMed

    Golman, Adam J; Danelson, Kerry A; Stitzel, Joel D

    2016-05-01

    This study developed a parametric methodology to robustly predict occupant injuries sustained in real-world crashes using a finite element (FE) human body model (HBM). One hundred and twenty near-side impact motor vehicle crashes were simulated over a range of parameters using a Toyota RAV4 (bullet vehicle), Ford Taurus (struck vehicle) FE models and a validated human body model (HBM) Total HUman Model for Safety (THUMS). Three bullet vehicle crash parameters (speed, location and angle) and two occupant parameters (seat position and age) were varied using a Latin hypercube design of Experiments. Four injury metrics (head injury criterion, half deflection, thoracic trauma index and pelvic force) were used to calculate injury risk. Rib fracture prediction and lung strain metrics were also analysed. As hypothesized, bullet speed had the greatest effect on each injury measure. Injury risk was reduced when bullet location was further from the B-pillar or when the bullet angle was more oblique. Age had strong correlation to rib fractures frequency and lung strain severity. The injuries from a real-world crash were predicted using two different methods by (1) subsampling the injury predictors from the 12 best crush profile matching simulations and (2) using regression models. Both injury prediction methods successfully predicted the case occupant's low risk for pelvic injury, high risk for thoracic injury, rib fractures and high lung strains with tight confidence intervals. This parametric methodology was successfully used to explore crash parameter interactions and to robustly predict real-world injuries. PMID:26158552

  12. Injury profile among elite male youth soccer players in a Swedish first league

    PubMed Central

    Nilsson, Tania; Östenberg, Anna Hafsteinsson; Alricsson, Marie

    2016-01-01

    This study investigated the injury profile among elite male youth soccer players in a Swedish first league during two seasons. The present cohort study is based on data collected during the 2013–2014 seasons. In total, 43 young elite male soccer players, aged 15 to 19 yr, were prospectively followed regarding injuries, time of exposure, injury location, type of injury, and injury severity. The overall incidence of injury in the present study was estimated to 6.8 injuries per 1,000 exposure hours and 15.5 and 5.6 injuries per 1,000 hr for matches and training, respectively. The single most common injury subtype was muscle strain (53%). The hip and groin were the most common locations for injuries. Thirty-one percent of the injuries were classified as severe injury and caused >28 days absence from training and match play. Both the injury incidence and the number of serious injury seems to be relatively high in youth elite players according to this study. Although the injury incidence seems to be slightly lower than in adult elite players the injuries seem to be more traumatic in youth elite players. PMID:27162769

  13. Bodygraphic Injury Surveillance System

    NASA Astrophysics Data System (ADS)

    Tsuboi, Toshiki; Kitamura, Koji; Nishida, Yoshihumi; Motomura, Yoichi; Takano, Tachio; Yamanaka, Tatsuhiro; Mizoguchi, Hiroshi

    This paper proposes a new technology,``a bodygraphic injury surveillance system (BISS)'' that not only accumulates accident situation data but also represents injury data based on a human body coordinate system in a standardized and multilayered way. Standardized and multilayered representation of injury enables accumulation, retrieval, sharing, statistical analysis, and modeling causalities of injury across different fields such as medicine, engineering, and industry. To confirm the effectiveness of the developed system, the authors collected 3,685 children's injury data in cooperation with a hospital. As new analyses based on the developed BISS, this paper shows bodygraphically statistical analysis and childhood injury modeling using the developed BISS and Bayesian network technology.

  14. Muscle morphometric effect of anterior cruciate ligament injury measured by computed tomography: aspects on using non-injured leg as control

    PubMed Central

    2013-01-01

    Background Anterior cruciate ligament (ACL) tears are common, functionally disabling, and predispose to subsequent injuries and early onset of osteoarthritis in the knee. Injuries result in muscular atrophy and impaired muscular activation. To optimize surgical methods and rehabilitation strategies, knowledge of the effects of ACL injuries on muscles size and function is needed. Asymmetry due to limb dominance implies that the effect of ACL-injury might be different in right-sided and left-sided injuries which, should be taken in account when evaluating the effect of an injury. Evaluation of the effects of injuries is usually made with the contralateral leg as control. The aim of this study is to describe the effect of ACL-injuries on thigh muscle size and also to analyze feasibility of using contralateral limb as control. Methods Sixty-two patients scheduled to undergo ACL reconstruction were examined with computed tomography (CT). Muscle cross sectional area (CSA) was recorded for quadriceps, hamstrings, gracilis and sartorius 15 cm above the knee joint. Comparisons were made between the injured and non-injured side and between individuals separated by gender and side of injury. Comparisons were also made for patients with or without concomitant meniscal tear, for patients differing in time between injury and examinations and for patients with different level of physical activity after the injury. Results Quadriceps CSA was 5% smaller on the injured side. There was an indication that the muscles of the right thigh were generally bigger than those of the left thigh. The difference between the injured and the non-injured side was larger for right-sided injuries than for left-sided. There was also a greater difference in semimembranosus for women than for men. There were no differences related to meniscal injury, time since injury or physical activity. Conclusion The use of contralateral leg for evaluating the effect of ACL-injury is often the only available alternative but our study indicates that the difference in CSA between injured and non-injured side does not necessarily reflect the true degree of atrophy, as there are side differences both in muscle size in general and in the effect of an ACL-injury on muscle size. PMID:23628130

  15. Histopathological findings, phenotyping of inflammatory cells, and expression of markers of nitritative injury in joint tissue samples from calves after vaccination and intraarticular challenge with Mycoplasma bovis strain 1067

    PubMed Central

    2014-01-01

    Background The pathogenesis of caseonecrotic lesions developing in lungs and joints of calves infected with Mycoplasma bovis is not clear and attempts to prevent M. bovis-induced disease by vaccines have been largely unsuccessful. In this investigation, joint samples from 4 calves, i.e. 2 vaccinated and 2 non-vaccinated, of a vaccination experiment with intraarticular challenge were examined. The aim was to characterize the histopathological findings, the phenotypes of inflammatory cells, the expression of class II major histocompatibility complex (MHC class II) molecules, and the expression of markers for nitritative stress, i.e. inducible nitric oxide synthase (iNOS) and nitrotyrosine (NT), in synovial membrane samples from these calves. Furthermore, the samples were examined for M. bovis antigens including variable surface protein (Vsp) antigens and M. bovis organisms by cultivation techniques. Results The inoculated joints of all 4 calves had caseonecrotic and inflammatory lesions. Necrotic foci were demarcated by phagocytic cells, i.e. macrophages and neutrophilic granulocytes, and by T and B lymphocytes. The presence of M. bovis antigens in necrotic tissue lesions was associated with expression of iNOS and NT by macrophages. Only single macrophages demarcating the necrotic foci were positive for MHC class II. Microbiological results revealed that M. bovis had spread to approximately 27% of the non-inoculated joints. Differences in extent or severity between the lesions in samples from vaccinated and non-vaccinated animals were not seen. Conclusions The results suggest that nitritative injury, as in pneumonic lung tissue of M. bovis-infected calves, is involved in the development of caseonecrotic joint lesions. Only single macrophages were positive for MHC class II indicating down-regulation of antigen-presenting mechanisms possibly caused by local production of iNOS and NO by infiltrating macrophages. PMID:25162202

  16. Thermal injury of Yersinia enterocolitica.

    PubMed Central

    Restaino, L; Jeter, W S; Hill, W M

    1980-01-01

    Procedures were developed to evaluate thermal injury to three strains of Yersinia enterocolitica (serotypes 0:3, 0:8, and 0:17). Serotype 0:17 (atypical strain) was more sensitive to bile salts no. 3 (BS) and to sublethal heat treatment than the typical strains, 0:3 and 0:8. When the 0:3, 0:8, and 0:17 serotypes were thermally stressed in 0.1 M PO4 buffer, pH 7.0, at 47 degrees C for 70, 60, and 12 min, respectively, greater than 99% of the total viable cell population was injured. Injury was determined by the ability of cells to form colonies on brain heart infusion (BHI) agar, but not on Trypticase soy agar (TSA) plus 0.6% BS for serotypes 0:3 and 0:8 and TSA plus 0.16% BS for 0:17. Heat injury of serotype 0:17 cells for 15 min in 0.1 M PO4 buffer caused an approximate 1,000-fold reduction in cell numbers on selective media as compared with cells heated in pork infusion (PI), BHI broth, and 10% nonfat dry milk (NFDM). The extended lag and resuscitation period in BHI broth was 2.5 times greater for 0:17 cells injured in 0.1 M PO4 than for cells injured in BHI or PI. The rate and extent of repair of Y. enterocolitica 0:17 cells in three recovery media were directly related to the heating menstruum used for injury. The use of metabolic inhibitors demonstrated that ribonucleic acid synthesis was required for repair, whereas deoxyribonucleic, cell wall, and protein synthesis were not necessary for recovery of 0:17 cells injured in 0.1 M PO4 buffer, BHI, or PI. Inhibition of respiration by 2,4-dinitrophenol slowed repair only for 0:17 cells injured in 0.1 M PO4 buffer, not for cells injured in PI or BHI. PMID:6160814

  17. Injuries Among Italian DanceSport Athletes: A Questionnaire Survey.

    PubMed

    Pellicciari, Leonardo; Piscitelli, Daniele; De Vita, Marilena; D'Ingianna, Lucia; Bacciu, Serenella; Perno, Giacomo; Lunetta, Laura; Rosulescu, Eugenia; Cerri, Cesare G; Foti, Calogero

    2016-03-01

    During training and competition, athletic dancers perform complex artistic movements that can lead to stress on the musculoskeletal system, making them subject to high risk of injury. The purpose of this study was to evaluate the prevalence, location, and nature of musculoskeletal injuries among dancesport athletes and to identify potential risk factors for injury. This cross-sectional study was performed at several national dancesport meetings in Italy. All 168 dancesport athletes who participated at the meetings were invited to complete a questionnaire related to injuries they may have suffered during the previous year; other information collected included demographic data (age, sex, height, weight), dance participation (discipline, categories), training (training duration, years since starting to dance), and injury (location, etiology). Of the 168 dancers, 153 completed the questionnaire. Of the 102 injuries reported, 73 athletes (47.7%) reported at least 1 injury. The locations of the injuries were the lower limbs (n=75, 73.5%), upper limbs (8, 7.8%), and spine (19, 18.7%). Significant differences were found in the injury location (p<0.01) as well as the nature of the injury (p<0.01). No significant differences were found between injured and non-injured athletes in demographic data, dance participation, and training variables (p>0.05). The results indicate that about half of the dancers reported at least 1 injury, with these being located particularly in the lower limbs and predominantly strain and sprain injuries. To reduce the prevalence of injuries, a prevention program may be indicated, with future research needed to identify appropriate strategies to prevent injuries. PMID:26966959

  18. Posterior cruciate ligament (PCL) injury

    MedlinePlus

    Cruciate ligament injury - posterior; PCL injury; Knee injury - posterior cruciate ligament (PCL); Hyperextended knee ... physical examination to check for signs of PCL injury. This includes moving the knee joint in various ...

  19. Descriptive Epidemiology of Collegiate Women's Soccer Injuries: National Collegiate Athletic Association Injury Surveillance System, 1988–1989 Through 2002–2003

    PubMed Central

    Dick, Randall; Putukian, Margot; Agel, Julie; Evans, Todd A; Marshall, Stephen W

    2007-01-01

    Objective: To review 15 years of National Collegiate Athletic Association (NCAA) injury surveillance data for women's soccer and identify potential areas for injury prevention initiatives. Background: The number of NCAA schools sponsoring women's soccer has grown tremendously, from 271 in 1988– 1989 to 879 schools in 2002–2003. During that time, the NCAA Injury Surveillance System has collected game and practice injury data for women's soccer across all 3 NCAA divisions. Main Results: The rate of injury was more than 3 times higher in games than in practices (16.44 versus 5.23 injuries per 1000 athlete-exposures, rate ratio = 3.2, 95% confidence interval = 3.1, 3.4, P < .01), and preseason practices had an injury rate that was more than 3 times greater than the rate for in-season practices (9.52 versus 2.91 injuries per 1000 athlete-exposures, rate ratio = 3.3, 95% confidence interval = 3.1, 3.5, P < .01). Approximately 70% of all game and practice injuries affected the lower extremities. Ankle ligament sprains (18.3%), knee internal derangements (15.9%), concussions (8.6%), and leg contusions (8.3%) accounted for a substantial portion of game injuries. Upper leg muscle-tendon strains (21.3%), ankle ligament sprains (15.3%), knee internal derangements (7.7%), and pelvis and hip muscle strains (7.6%) represented most of the practice injuries. Injuries were categorized as attributable to player contact, “other contact” (eg, contact with the ball, ground, or other object), or no contact. Player-to-player contact accounted for more than half of all game injuries (approximately 54%) but less than 20% of all practice injuries. The majority of practice injuries involved noncontact injury mechanisms. Knee internal derangements, ankle ligament sprains, and concussions were the leading game injuries that resulted in 10 or more days of time lost as a result of injury. Recommendations: Ankle ligament sprains, knee internal derangements, and concussions are common injuries in women's soccer. Research efforts have focused on knee injuries and concussions in soccer, and further epidemiologic data are needed to determine if preventive strategies will help to alter the incidence of these injuries. Furthermore, the specific nature of the player contact leading to concussions and lower extremity injuries should be investigated. Preventive efforts should continue to focus on reducing knee injuries, ankle injuries, and concussions in women collegiate soccer players. PMID:17710177

  20. Injury Profile in Women Shotokan Karate Championships in Iran (2004-2005)

    PubMed Central

    Halabchi, Farzin; Ziaee, Vahid; Lotfian, Sarah

    2007-01-01

    The aims of this paper were to record injury rates among Iranian women competitive Shotokan karate athletes and propose possible predisposing factors. A prospective recording of the injuries resulting from all matches in 6 consecutive women national Shotokan Karate Championships in all age groups in Iran (season 2004-2005) was performed. Data recorded included demographic characteristics (Age and Weight), athletic background (rank, years of experience, time spent training and previous injuries), type, location and reason for the injury, and the result of the match. Results indicate 186 recorded injuries from a total of 1139 bouts involving 1019 athletes, therefore there were 0.163 injury per bout [C.I. 95%: 0.142-0.184] and 183 injuries per 1000 athletes [C.I. 95%: 159-205]. Injuries were most commonly located in the head and neck (55.4%) followed by the lower limb (21%), upper limb (12.9%) and trunk (10.8%). Punches (48. 4%) were associated with more injuries than kicks (33.3%). The injuries consisted of muscle strain and contusion (81, 43.6%), hematoma and epistaxis (49, 26.3%), lacerations and abrasions (28, 15. 1%), concussion (13, 7%), tooth avulsion or subluxation (3, 1.6%), joint dislocation (3, 1.6%) and fractures (3, 1.6%). In conclusion, as the majority of injuries are minor, and severe or longstanding injuries are uncommon, it can be argued that shotokan karate is a relatively safe for females, despite its image as a combat sport, where ostensibly the aim appears to injure your opponent. Further research is needed to evaluate the effective strategies to minimize the risk of injuries. Key points 186 injuries were recorded during women competitions. Incidence rates of 0.163 injury per bout and 183 injuries per 1000 athletes were calculated. The injuries were most commonly located in the head and neck. Muscle strain and contusion, hematoma and epistaxis constitute the majority of injuries. PMID:24198704

  1. Head Injuries in Soccer.

    ERIC Educational Resources Information Center

    Fields, Karl B.

    1989-01-01

    This article reviews the medical literature on head injuries in soccer and concludes that protective headgear to reduce these injuries may not be as effective as rule changes and other measures, such as padding goal posts. (IAH)

  2. Bicycle-related injuries.

    PubMed

    Thompson, M J; Rivara, F P

    2001-05-15

    Bicycle riding is a popular form of recreation among persons of all ages, and related injuries cause significant morbidity and mortality. Most injuries occur in males and are associated with riding at high speed; most serious injuries and fatalities result from collisions with motor vehicles. Although superficial soft tissue injuries and musculoskeletal trauma are the most common injuries, head injuries are responsible for most fatalities and long-term disabilities. Overuse injuries may contribute to a variety of musculoskeletal complaints, compression neuropathies, perineal and genital complaints. Physicians treating such patients should consider medical factors, as well as suggest adjusting various components of the bicycle, such as the seat height and handlebars. Encouraging bicycle riders to wear helmets is key to preventing injuries; protective clothing and equipment, and general safety advice also may offer some protection. PMID:11388717

  3. Football injuries: current concepts.

    PubMed

    Olson, David E; Sikka, Robby Singh; Hamilton, Abigail; Krohn, Austin

    2011-01-01

    Football is one of the most popular sports in the United States and is the leading cause of sports-related injury. A large focus in recent years has been on concussions, sudden cardiac death, and heat illness, all thought to be largely preventable health issues in the young athlete. Injury prevention through better understanding of injury mechanisms, education, proper equipment, and practice techniques and preseason screening may aid in reducing the number of injuries. Proper management of on-field injuries and health emergencies can reduce the morbidity associated with these injuries and may lead to faster return to play and reduced risk of future injury. This article reviews current concepts surrounding frequently seen football-related injuries. PMID:23531977

  4. Preventing Knee Injuries

    MedlinePlus

    ... lateral meniscus on the outside of the knee. Meniscal tears usually result from a forceful injury and often accompany ligament tears such as ACL tears. These injuries usually require surgery. In addition, some children are born with an ...

  5. [Occupational eye injuries].

    PubMed

    Bakholdt, V T; Illum, D

    1990-03-26

    Occupational eye injuries are common. The authors found that these constituted 2.5% of all the injuries treated in the Central Hospital in Esbjerg during the period 1.8.1987-31.12.1987. A total of 224 patients were included in the investigation. Of these, 145 had not employed any form of protection of the eyes when the injury occurred. This was mandatory where 34% were concerned and not mandatory for 66%. Occupational eye injuries resulted in 0-4 days of sick-leave and young men were particularly affected. Metal workers were most exposed and unskilled workers employed with grinding and welding. Forty-five patients had sustained more than two occupational eye injuries within the past year. Twenty-one of these had not notified any of the injuries, 11 had notified some of the injuries and 13 had notified all of the injuries. Approximately 80% had received instruction about employment of protective measures. PMID:2321309

  6. Facial Injuries and Disorders

    MedlinePlus

    Face injuries and disorders can cause pain and affect how you look. In severe cases, they can affect sight, ... your nose, cheekbone and jaw, are common facial injuries. Certain diseases also lead to facial disorders. For ...

  7. Arm Injuries and Disorders

    MedlinePlus

    ... of muscles, joints, tendons and other connective tissue. Injuries to any of these parts of the arm ... a fall or an accident. Types of arm injuries include Tendinitis and bursitis Sprains Dislocations Broken bones ...

  8. Hand Injuries and Disorders

    MedlinePlus

    ... the wrist, often making your fingers feel numb Injuries that result in fractures, ruptured ligaments and dislocations ... deformity Tendinitis - irritation of the tendons Disorders and injuries of your fingers and thumb

  9. Rotator Cuff Injuries

    MedlinePlus

    ... cuff are common. They include tendinitis, bursitis, and injuries such as tears. Rotator cuff tendons can become ... cuff depends on age, health, how severe the injury is, and how long you've had the ...

  10. Brachial Plexus Injuries

    MedlinePlus

    ... Diversity Find People About NINDS NINDS Brachial Plexus Injuries Information Page Synonym(s): Erb's Palsy Table of Contents ( ... done? Clinical Trials Organizations What are Brachial Plexus Injuries? The brachial plexus is a network of nerves ...

  11. Brachial Plexus Injuries

    MedlinePlus

    ... to the shoulder, arm, and hand. Brachial plexus injuries are caused by damage to those nerves. Symptoms ... sensation in the arm or hand Brachial plexus injuries can occur as a result of shoulder trauma, ...

  12. Eye Injuries (For Parents)

    MedlinePlus

    ... Caring for Your Child All About Food Allergies Eye Injuries KidsHealth > For Parents > Eye Injuries Print A ... sand, dirt, and other foreign bodies on the eye surface) Wash your hands thoroughly before touching the ...

  13. Injury - kidney and ureter

    MedlinePlus

    ... injury Removing the entire kidney ( nephrectomy ), draining the space around the kidney, or stopping the bleeding via ... BA. Acute kidney injury. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 24th ed. Philadelphia, PA: ...

  14. Injury surveillance at a national multi-sport event.

    PubMed

    Cunningham, C; Cunningham, S

    1996-06-01

    The 1994 Australian Universities Games represents a multi-sport event which featured 5106 participants competing in nineteen sports. Injury surveillance was conducted by means of the injury Surveillance Form, which recorded time, mechanism, site, type and severity of injury, as well as initial treatment and referral patterns. Over six days of competition, 1177 presentations with injury were recorded, sustained by 994 athletes or 19.5% of all participating athletes. Tae kwon do and hockey were the sports with the greatest incidence of injury. Haematomas, muscle strains and ligament sprains were the most common injuries, with contact and overuse the most common mechanisms of injury. Mild injuries dominated and severe injuries were uncommon. 75% of injuries were initially assessed and treated by a nurse, first aid officer or sports trainer; 15% by a physiotherapist and 10% by a doctor. The authors' recommendation is that such a team of medical staff should be an integral part of any large sporting event, whether participants are professionals or amateurs. Additionally, they need to be supported by facilities and services such as central clinics, a nearby x-ray centre, a nearby hospital and an ambulance/first aid transport network. PMID:8836476

  15. Smoke inhalation injury

    NASA Astrophysics Data System (ADS)

    Birky, M.

    The cause of death by fires was studied. The present results and information are, however, not enough to reduce loss of life or inhalation injury. The magnitude and type of inhalation injury for civilians and firefighters represents the most inadequately defined human element of accidental fires. Little information is available on compounds other than carbon monoxide, which are responsible for respiration injury or toxicological syndrome. Effective treatment methods for inhalation victims and studies on fatalities, inhalation injury and animals are suggested.

  16. Incidence of football injuries and complaints in different age groups and skill-level groups.

    PubMed

    Peterson, L; Junge, A; Chomiak, J; Graf-Baumann, T; Dvorak, J

    2000-01-01

    In this study, the incidence of football injuries and complaints as related to different age groups and skill levels was studied over the period of 1 year. All injuries and complaints as well as the amount of time players spent in training and games were recorded. All injured players were examined weekly by physicians, and all injuries were assessed according to the International Classification of Diseases (ICD-10), which describes them in terms of injury type and location, the treatment required, and the duration of subsequent performance limitations. A total of 264 players of different age groups and skill levels was observed for 1 year. Five hundred fifty-eight injuries were documented. Two hundred sixteen players had one or more injuries. Only 48 players (18%) had no injury. The average number of injuries per player per year was 2.1. Injuries were classified as mild (52%), moderate (33%), or severe (15%). Almost 50% of all injuries were contact injuries; half of all the contact injuries were associated with foul play. The majority of injuries were strains and sprains involving the ankle, knee, and lumbar spine. Nearly all players (91%) suffered from complaints related to football. Only 23 players reported no injuries and no complaints. Prevention programs, fair play, and continuing education in techniques and skills may reduce the incidence of injuries over time. PMID:11032108

  17. Pediatric update #7. The orthopaedic manifestations of head injury in children.

    PubMed

    Blasier, D; Letts, R M

    1989-03-01

    The incidence of significant head injury has been estimated at 220/100,000 children. Over 90% of these will recover with little residual disability. The purpose of this study is to re-examine the small but significant percentage of head injured children with permanent total body involvement to identify patterns of deformity and temporal sequences and to develop preventive treatment regimens. Sixteen head injured children with residual spastic quadriplegia were examined. All exhibited musculoskeletal abnormalities. Hip adduction contractures were most common leading to hip subluxation in eight children, followed by pes equinus, scoliosis, pelvic obliquity, and knee flexion contracture. The average time to onset of permanent foot deformity was 11 months after head injury, for scoliosis an average of 22 months postinjury, and for hip subluxation an average of 31 months postinjury. Hamstring contractures occurred later, at an average of 37 months, but caused the most interference with good seating. The physical problems of the head injured child have some similarities to those of the child with cerebral palsy, but with distinct differences. An aggressive surgical approach to prevention and treatment of fixed deformity in these children is recommended at an early stage with postoperative orthotic management and stable seating in abduction. PMID:2710583

  18. Double-bundle medial patellofemoral ligament reconstruction with hamstring tendon autograft and mediolateral patellar tunnel fixation: a meta-analysis of outcomes and complications.

    PubMed

    Singhal, R; Rogers, S; Charalambous, C P

    2013-07-01

    Medial patellofemoral ligament (MPFL) reconstruction is used to treat patellar instability and recurrent patellar dislocation. Anatomical studies have found the MPFL to be a double-bundle structure. We carried out a meta-analysis of studies reporting outcomes of patellofemoral reconstruction using hamstring tendon autograft in a double-bundle configuration and patellar fixation via mediolateral patellar tunnels. A literature search was undertaken with no language restriction in various databases from their year of inception to July 2012. The primary outcome examined was the post-operative Kujala score. We identified 320 MPFL reconstructions in nine relevant articles. The combined mean post-operative Kujala score was 92.02 (standard error (se) 1.4, p = 0.001) using a fixed effects model and 89.45 (se 37.9, p = 0.02) using random effect modelling. The reported rate of complications with MPFL reconstruction was 12.5% (40 of 320) with stiffness of the knee being the most common. High-quality evidence in assessing double-bundle MPFL reconstruction is lacking. The current literature consists of a mixture of prospective and retrospective case series. High-quality randomised trials evaluating this procedure are still awaited. PMID:23814240

  19. Lightning injury: a review.

    PubMed

    Ritenour, Amber E; Morton, Melinda J; McManus, John G; Barillo, David J; Cancio, Leopoldo C

    2008-08-01

    Lightning is an uncommon but potentially devastating cause of injury in patients presenting to burn centers. These injuries feature unusual symptoms, high mortality, and significant long-term morbidity. This paper will review the epidemiology, physics, clinical presentation, management principles, and prevention of lightning injuries. PMID:18395987

  20. "Floating shoulder" injuries.

    PubMed

    Heng, Kenneth

    2016-12-01

    "Floating shoulder" is a rare injury complex resulting from high-energy blunt force trauma to the shoulder, resulting in scapulothoracic dissociation. It is commonly associated with catastrophic neurovascular injury. Two cases of motorcyclists with floating shoulder injuries are described. PMID:26961729

  1. Injuries in badminton.

    PubMed

    Jrgensen, U; Winge, S

    1990-07-01

    Though badminton is one of the most widely played sports in the world, it has received little sports medical interest. Based on the few existing studies on injuries in badminton, compared to other sports it is of relatively low risk and dominated by overuse injuries. The injury duration is relatively long, but only a few working days are lost. Anatomically, most injuries are localised to the foot and ankle. The single most frequent injuries are Achilles tendinitis and tennis elbow. Rupture of the Achilles tendon is a rare injury, which is typically seen in older recreational players. When the time of exposure is taken into account men are found to have a higher injury risk than women, and recreational players a higher injury risk than elite players. In contrast to most other sports the relative injury risk is higher during training than in competition. Based on suggested causes of injury and injury mechanisms, together with the known injury pattern in badminton the following preventive matters are suggested: (a) changes in the badminton shoe, towards a higher heel, with shock absorption and a stiffer anatomically fitting heel counter; (b) adjustment of the friction between the individual shoe-soles and playing surfaces; and (c) specific badminton training including stretching and strengthening of the triceps surae and the muscles involved in the internal and external rotation of the shoulder and elbow during the badminton strokes. PMID:2197700

  2. Assessment of Ankle Injuries

    ERIC Educational Resources Information Center

    Mai, Nicholas; Cooper, Leslie

    2009-01-01

    School nurses are faced with the challenge of identifying and treating ankle injuries in the school setting. There is little information guiding the assessment and treatment of these children when an injury occurs. It is essential for school nurses to understand ankle anatomy, pathophysiology of the acute ankle injury, general and orthopedic…

  3. Spinal Cord Injuries

    MedlinePlus

    ... your body and your brain. A spinal cord injury disrupts the signals. Spinal cord injuries usually begin with a blow that fractures or ... bone disks that make up your spine. Most injuries don't cut through your spinal cord. Instead, ...

  4. Injuries from break dancing.

    PubMed

    Norman, R A; Grodin, M A

    1984-10-01

    Break dancing is a popular contemporary activity that has important medical implications. Some dancers have complained of lower back pain and difficulty in bending over-the "breakdance back syndrome." Break dancing injuries are often comparable to the orthopedic injuries that occur in unsupervised athletic activities. Careful screening, instruction, supervision and training of break dancers will help prevent injuries. PMID:6238511

  5. Injuries in Elite Men’s Lacrosse

    PubMed Central

    Webb, Mark; Davis, Caroline; Westacott, Daniel; Webb, Robin; Price, Jessica

    2014-01-01

    Background: There are limited data on injuries sustained during men’s lacrosse. As the sport gains popularity, practitioners will be more likely to treat lacrosse players. Purpose: To analyze data from the 2010 World Lacrosse Championships. Study Design: Descriptive epidemiology study. Methods: This was a prospective observational study of injuries reported during the 2010 World Lacrosse Championships. An injury surveillance questionnaire was completed, and data were categorized into body part injured, diagnosis, mechanism, and time of injury. Results: Over 9 days, 667 players from 29 countries competed in 105 games. A total of 150 injuries were sustained by 129 individuals aged 16 to 46 years. Five times more injuries occurred during games than in training (69.3% [n = 104] vs 13.3% [n = 20]; rate ratio [95% CI] = 5.2 [4.9-5.5]), resulting in 39.5 injuries per 1000 hours played. The most frequent mechanism was contact (53.3%; n = 80), including direct impact with another player (30%; n = 45), with a stick (16.7%; n = 25), or with a ball (5.3%; n = 8). Change of direction and/or speed were the most common noncontact mechanisms (27.3%; n = 41). The most frequently reported injuries were contusions (32.0%; n = 48), sprains (22.7%; n = 34), and strains (22.7%; n = 34). The lower limb was the most injured body part (50.7%; n = 76) compared with the upper limb (23.3%; n = 35; rate ratio [95% CI] = 2.2 [2.1-2.3]). The ankle was the most injured joint (14.0%; n = 21), followed by the shoulder (10.0%; n = 15). Conclusion: As participation expands, health professionals may become more responsible for treating lacrosse players. Players are susceptible to a range of injuries. Familiarity with the common injury patterns could help treatment and prevention. Despite differences in rules during international competition, this study corroborates reports from North America. Clinical Relevance: The epidemiology of men’s lacrosse injuries needs to be documented and understood to effectively prevent injuries. The 2014 World Championships are to be held in Denver, Colorado (July 10-19, 2014), and it is important that practitioners treating players are aware of the differences in the international game. Publication of these data will allow for those planning lacrosse tournaments to do so more effectively. PMID:26535349

  6. Extravehicular mobility unit training and astronaut injuries

    NASA Technical Reports Server (NTRS)

    Strauss, Samuel; Krog, Ralph L.; Feiveson, Alan H.

    2005-01-01

    BACKGROUND: Astronaut spacewalk training can result in a variety of symptom complaints and possible injuries. This study quantified and characterized signs, symptoms, and injuries resulting from extravehicular activity spacesuit training at NASA's Neutral Buoyancy Laboratory, Johnson Space Center, Houston, TX, immersion facility. METHODS: We identified the frequency and incidence of symptoms by location, mechanisms of injury, and effective countermeasures. Recommendations were made to improve injury prevention, astronaut training, test preparation, and training hardware. At the end of each test, a questionnaire was completed documenting signs and symptoms, mechanisms of injury, and countermeasures. RESULTS: Of the 770 tests, there were 190 in which suit symptoms were reported (24.6%). There were a total of 352 reported suit symptom comments. Of those symptoms, 166 were in the hands (47.16%), 73 were in the shoulders (20.7%), and 40 were in the feet (11.4%). Others ranged from 6.0% to 0.28%, respectively, from the legs, arms, neck, trunk, groin, and head. Causal mechanisms for the hands included moisture and hard glove contacts resulting in fingernail injuries; in the shoulders, hard contact with suit components and strain mechanisms; and in the feet, hard boot contact. The severity of symptoms was highest in the shoulders, hands, and feet. CONCLUSIONS: Most signs and symptoms were mild, self-limited, of brief duration, and were well controlled by available countermeasures. Some represented the potential for significant injury with consequences affecting astronaut health and performance. Correction of extravehicular activity training-related injuries requires a multidisciplinary approach to improve prevention, medical intervention, astronaut training, test planning, and suit engineering.

  7. Open extensor tendon injuries.

    PubMed

    Amirtharajah, Mohana; Lattanza, Lisa

    2015-02-01

    The extensor tendons in the dorsum of the hand lie relatively superficially, making open injuries to the extensor mechanism a common source of morbidity. These injuries can range from simple clean lacerations to complex open injuries associated with severe skin and soft tissue loss. Although many advances in the treatment of tendon injuries focused on the flexor tendon, the extensor tendon has begun to receive more attention in recent literature. Knowledge of modern repair techniques and rehabilitation protocols may improve patient outcomes. This Current Concepts article summarizes the treatment of open extensor tendon injuries with a focus on the recent literature. PMID:25557773

  8. The Effects of Injury Preventive Warm-Up Programs on Knee Strength Ratio in Young Male Professional Soccer Players

    PubMed Central

    Daneshjoo, Abdolhamid; Mokhtar, Abdul Halim; Rahnama, Nader; Yusof, Ashril

    2012-01-01

    Purpose We aimed to investigate the effect of FIFA 11+ (11+) and HarmoKnee injury preventive warm-up programs on conventional strength ratio (CSR), dynamic control ratio (DCR) and fast/slow speed ratio (FSR) in young male professional soccer players. These ratios are related to the risk of injury to the knee in soccer players. Methods Thirty-six players were divided into 3 groups; FIFA 11+, HarmoKnee and control (n = 12 per group). These exercises were performed 3 times per week for 2 months (24 sessions). The CSR, DCR and FSR were measured before and after the intervention. Results After training, the CSR and DCR of knee muscles in both groups were found to be lower than the published normal values (0.61, 0.72, and 0.78 during 60°.s−1, 180°.s−1 and 300°.s−1, respectively). The CSR (60°.s−1) increased by 8% and FSR in the quadriceps of the non-dominant leg by 8% in the 11+. Meanwhile, the DCR in the dominant and non-dominant legs were reduced by 40% and 30% respectively in the 11+. The CSR (60°.s−1) in the non-dominant leg showed significant differences between the 11+, HarmoKnee and control groups (p = 0.02). As for the DCR analysis between groups, there were significant differences in the non-dominant leg between both programs with the control group (p = 0.04). For FSR no significant changes were found between groups. Conclusions It can be concluded that the 11+ improved CSR and FSR, but the HarmoKnee program did not demonstrate improvement. We suggest adding more training elements to the HarmoKnee program that aimed to enhance hamstring strength (CSR, DCR and FSR). Professional soccer players have higher predisposition of getting knee injuries because hamstring to quadriceps ratio were found to be lower than the average values. It seems that the 11+ have potentials to improve CSR and FSR as well as prevent knee injuries in soccer players. PMID:23226553

  9. High temperature strain gage apparent strain compensation

    NASA Technical Reports Server (NTRS)

    Holmes, Harlan K.; Moore, T. C., Sr.

    1992-01-01

    Once an installed strain gage is connected to a strain indicating device and the instrument is balanced, a subsequent change in temperature of the gage installation will generally produce a resistance change in the gage. This purely temperature-induced resistance will be registered by the indicating device as a strain and is referred to as 'apparent strain' to distinguish it from strain due to applied stress. One desirable technique for apparent strain compensation is to employ two identical gages with identical mounting procedures which are connected with a 'half bridge' configuration where gages see the same thermal environment but only one experiences a mechanical strain input. Their connection in adjacent arms of the bridge will then balance the thermally induced apparent strains and, in principle, only the mechanical strain remains. Two approaches that implement this technique are discussed.

  10. Biomechanical strain of goldsmiths.

    PubMed

    Cândido, Paula Emanuela Fernandes; Teixeira, Juliana Vieira Schmidt; Moro, Antônio Renato Pereira; Gontijo, Leila Amaral

    2012-01-01

    The work of the goldsmiths consists in the manufacture of jewelry. The piece, be it an earring, bracelet or necklace, is hand-assembled. This task requires precision, skill, kindness and patience. In this work, we make use of tools such as cuticle clippers and rounded tip, beads or precious stones and also pieces of metal. This type of activity requires a biomechanical stress of hands and wrists. In order to quantify the biomechanical stress, we performed a case study to measure the movements performed by an assembly of pieces of jewelry. As method for research, filming was done during assembly of parts to a paste, using a Nikon digital camera, for 1 (one) hour. The film was edited by Kinovea software, and the task was divided into cycles, each cycle corresponds to a complete object. In one cycle, there are four two movements of supination and pronation movements of the forearm. The cycle lasts approximately sixteen seconds, totaling 1800 cycles in eight hours. Despite the effort required of the wrists, the activity shows no complaints from the employees, but this fact does not mischaracterizes the ability of employees to acquire repetitive strain injuries and work-related musculoskeletal disorders. PMID:22317096

  11. Biomechanical strain of goldsmiths.

    TOXLINE Toxicology Bibliographic Information

    Cândido PE; Teixeira JV; Moro AR; Gontijo LA

    2012-01-01

    The work of the goldsmiths consists in the manufacture of jewelry. The piece, be it an earring, bracelet or necklace, is hand-assembled. This task requires precision, skill, kindness and patience. In this work, we make use of tools such as cuticle clippers and rounded tip, beads or precious stones and also pieces of metal. This type of activity requires a biomechanical stress of hands and wrists. In order to quantify the biomechanical stress, we performed a case study to measure the movements performed by an assembly of pieces of jewelry. As method for research, filming was done during assembly of parts to a paste, using a Nikon digital camera, for 1 (one) hour. The film was edited by Kinovea software, and the task was divided into cycles, each cycle corresponds to a complete object. In one cycle, there are four two movements of supination and pronation movements of the forearm. The cycle lasts approximately sixteen seconds, totaling 1800 cycles in eight hours. Despite the effort required of the wrists, the activity shows no complaints from the employees, but this fact does not mischaracterizes the ability of employees to acquire repetitive strain injuries and work-related musculoskeletal disorders.

  12. Biological maturity and injury in elite youth football.

    PubMed

    Le Gall, F; Carling, C; Reilly, T

    2007-10-01

    The purpose of the present study was to investigate injury according to biological maturity in elite under-14 youth football players based at the National Football Institute, France. Over 10 seasons, injury incidence, severity and distribution were compared in 233 players classed according to individual biological maturity determined by skeletal age into three cohorts as early, normal and late maturers.A non-significant higher injury incidence was found in early and normal maturers compared with late maturers. In contrast, the latter group sustained a significantly higher incidence of major injuries compared with early maturers (0.3 vs 0.6 vs 0.9, P=0.039). A significantly higher incidence of osteochrondoses was reported in normal and late maturers (0.3 vs 0.7 vs 0.9, P=0.014), whereas tendinopathy incidence was greater in early and normal maturers (0.06 vs 0.08 vs 0.02, P=0.033). Early maturers incurred the highest incidence of groin strains and re-injuries (P<0.05). There was no significant difference between groups in the seasonal disposition of injury.Biological maturity status did not significantly affect overall injury incidence in elite French youth football players, although there were differences between maturity groups when patterns of injury location, type, severity and re-injury were analyzed. PMID:17076832

  13. Development of brain injury criteria (BrIC).

    PubMed

    Takhounts, Erik G; Craig, Matthew J; Moorhouse, Kevin; McFadden, Joe; Hasija, Vikas

    2013-11-01

    Rotational motion of the head as a mechanism for brain injury was proposed back in the 1940s. Since then a multitude of research studies by various institutions were conducted to confirm/reject this hypothesis. Most of the studies were conducted on animals and concluded that rotational kinematics experienced by the animal's head may cause axonal deformations large enough to induce their functional deficit. Other studies utilized physical and mathematical models of human and animal heads to derive brain injury criteria based on deformation/pressure histories computed from their models. This study differs from the previous research in the following ways: first, it uses two different detailed mathematical models of human head (SIMon and GHBMC), each validated against various human brain response datasets; then establishes physical (strain and stress based) injury criteria for various types of brain injury based on scaled animal injury data; and finally, uses Anthropomorphic Test Devices (ATDs) (Hybrid III 50th Male, Hybrid III 5th Female, THOR 50th Male, ES-2re, SID-IIs, WorldSID 50th Male, and WorldSID 5th Female) test data (NCAP, pendulum, and frontal offset tests) to establish a kinematically based brain injury criterion (BrIC) for all ATDs. Similar procedures were applied to college football data where thousands of head impacts were recorded using a six degrees of freedom (6 DOF) instrumented helmet system. Since animal injury data used in derivation of BrIC were predominantly for diffuse axonal injury (DAI) type, which is currently an AIS 4+ injury, cumulative strain damage measure (CSDM) and maximum principal strain (MPS) were used to derive risk curves for AIS 4+ anatomic brain injuries. The AIS 1+, 2+, 3+, and 5+ risk curves for CSDM and MPS were then computed using the ratios between corresponding risk curves for head injury criterion (HIC) at a 50% risk. The risk curves for BrIC were then obtained from CSDM and MPS risk curves using the linear relationship between CSDM - BrIC and MPS - BrIC respectively. AIS 3+, 4+ and 5+ field risk of anatomic brain injuries was also estimated using the National Automotive Sampling System - Crashworthiness Data System (NASS-CDS) database for crash conditions similar to the frontal NCAP and side impact conditions that the ATDs were tested in. This was done to assess the risk curve ratios derived from HIC risk curves. The results of the study indicated that: (1) the two available human head models - SIMon and GHBMC - were found to be highly correlated when CSDMs and max principal strains were compared; (2) BrIC correlates best to both - CSDM and MPS, and rotational velocity (not rotational acceleration) is the mechanism for brain injuries; and (3) the critical values for angular velocity are directionally dependent, and are independent of the ATD used for measuring them. The newly developed brain injury criterion is a complement to the existing HIC, which is based on translational accelerations. Together, the two criteria may be able to capture most brain injuries and skull fractures occurring in automotive or any other impact environment. One of the main limitations for any brain injury criterion, including BrIC, is the lack of human injury data to validate the criteria against, although some approximation for AIS 2+ injury is given based on the angular velocities calculated at 50% probability of concussion in college football players instrumented with 5 DOF helmet system. Despite the limitations, a new kinematic rotational brain injury criterion - BrIC - may offer a way to capture brain injuries in situations when using translational accelerations based HIC alone may not be sufficient. PMID:24435734

  14. Exploring the formation of an employee injury team.

    PubMed

    Klingel, P

    1997-01-01

    In May 1994, it was noted that lost work days due to employee injuries were out of control at MedCenter Hospital in Marion, OH. An employee injury team was commissioned by the continuous quality improvement steering committee to investigate and make recommendations to reduce lost workdays. An analysis of the situation required a data search that revealed several patterns and trends. This information was then examined and a decision was made to institute a "Back Care: Train the Trainer" program to reduce the major cause of employee injuries--back sprains and strains. The concept of teamwork is defined and the developmental process of a team is explored. PMID:10174388

  15. Geobacteraceae strains and methods

    SciTech Connect

    Lovley, Derek R.; Nevin, Kelly P.; Yi, Hana

    2015-07-07

    Embodiments of the present invention provide a method of producing genetically modified strains of electricigenic microbes that are specifically adapted for the production of electrical current in microbial fuel cells, as well as strains produced by such methods and fuel cells using such strains. In preferred embodiments, the present invention provides genetically modified strains of Geobacter sulfurreducens and methods of using such strains.

  16. Sonography of Sports Injuries of the Hip

    PubMed Central

    Dawes, Aaron R. L.; Seidenberg, Peter H.

    2014-01-01

    Context: Sports-related injuries of the hip are a common complaint of both competitive and recreational athletes of all ages. The anatomic and biomechanical complexity of the hip region often cause diagnostic uncertainty for the clinicians evaluating these injuries. Therefore, obtaining additional diagnostic information is often crucial for providing injured athletes with a prompt and accurate diagnosis so they can return to activity as soon as possible. Musculoskeletal ultrasound is becoming increasingly important in evaluating and treating sports-related injuries of the hip. Evidence Acquisition: The PubMed database was searched in May of 2013 for English-language articles pertaining to sonography of sports injuries of the hip using the following keywords in various combinations: musculoskeletal, ultrasound, hip, hip sonography, and sports. Study Design: Clinical review. Level of Evidence: Level 4. Results: Musculoskeletal ultrasound is currently being used for both diagnosis and treatment in a wide range of acute and chronic conditions affecting the hip, including tendinosis, tendon/muscle strains, ligamentous sprains, enthesopathies, growth plate injuries, fractures, bursitis, effusions, synovitis, labral tears, and snapping hip. Therapeutically, it is used to guide injections, aspirations, and biopsies. Conclusion: Musculoskeletal ultrasound use is expanding and will likely continue to do so as more clinicians realize its capabilities. Characteristics, including accessibility, portability, noninvasiveness, dynamic examination, power Doppler examination, and low cost highlight the potential of ultrasound. PMID:25364486

  17. Therapeutic vaccination for closed head injury.

    PubMed

    Kipnis, Jonathan; Nevo, Uri; Panikashvili, David; Alexandrovich, Alexander; Yoles, Eti; Akselrod, Solange; Shohami, Esther; Schwartz, Michal

    2003-06-01

    Closed head injury often has a devastating outcome, partly because the insult, like other injuries to the central nervous system (CNS), triggers self-destructive processes. During studies of the response to other CNS insults, it was unexpectedly discovered that the immune system, if well controlled, provides protection against self-destructive activities. Here we show that in mice with closed head injury, the immune system plays a key role in the spontaneous recovery. Strain-related differences were observed in the ability to harness a T cell-dependent protective mechanism against the effects of the injury. We further show that the trauma-induced deficit could be reduced, both functionally and anatomically, by post-traumatic vaccination with Cop-1, a synthetic copolymer used to treat patients with multiple sclerosis and found (using a different treatment protocol) to effectively counteract the loss of neurons caused by axonal injury or glutamate-induced toxicity. We suggest that a compound such as Cop-1 can be safely developed as a therapeutic vaccine to boost the body's immune repair mechanisms, thereby providing multifactorial protection against the consequences of brain trauma. PMID:12906740

  18. Imaging of American football injuries in children.

    PubMed

    Podberesky, Daniel J; Unsell, Bryan J; Anton, Christopher G

    2009-12-01

    It is estimated that 3.2 million children ages 6 to 14 years participated in organized youth football in the United States in 2007. Approximately 240,000 children play football in the nation's largest youth football organization, with tackle divisions starting at age 5 years. The number of children playing unsupervised football is much higher, and the overall number of children participating in American football is increasing. Sports are the leading cause of injury-related emergency room visits for teenagers, and football is a leading precipitating athletic activity for these visits. Football is also the most hazardous organized sports in the United States. Though most pediatric football-related injuries are minor, such as abrasions, sprains, and strains of the extremities, football accounts for more major and catastrophic injuries than any other sport. Given football's popularity with children in the United States, combined with the high rate of injury associated with participation in this activity, radiologists should be familiar with the imaging features and injury patterns seen in this patient population. PMID:19774374

  19. Mechanical Injury Induces Brain Endothelial-Derived Microvesicle Release: Implications for Cerebral Vascular Injury during Traumatic Brain Injury.

    PubMed

    Andrews, Allison M; Lutton, Evan M; Merkel, Steven F; Razmpour, Roshanak; Ramirez, Servio H

    2016-01-01

    It is well established that the endothelium responds to mechanical forces induced by changes in shear stress and strain. However, our understanding of vascular remodeling following traumatic brain injury (TBI) remains incomplete. Recently published studies have revealed that lung and umbilical endothelial cells produce extracellular microvesicles (eMVs), such as microparticles, in response to changes in mechanical forces (blood flow and mechanical injury). Yet, to date, no studies have shown whether brain endothelial cells produce eMVs following TBI. The brain endothelium is highly specialized and forms the blood-brain barrier (BBB), which regulates diffusion and transport of solutes into the brain. This specialization is largely due to the presence of tight junction proteins (TJPs) between neighboring endothelial cells. Following TBI, a breakdown in tight junction complexes at the BBB leads to increased permeability, which greatly contributes to the secondary phase of injury. We have therefore tested the hypothesis that brain endothelium responds to mechanical injury, by producing eMVs that contain brain endothelial proteins, specifically TJPs. In our study, primary human adult brain microvascular endothelial cells (BMVEC) were subjected to rapid mechanical injury to simulate the abrupt endothelial disruption that can occur in the primary injury phase of TBI. eMVs were isolated from the media following injury at 2, 6, 24, and 48 h. Western blot analysis of eMVs demonstrated a time-dependent increase in TJP occludin, PECAM-1 and ICAM-1 following mechanical injury. In addition, activation of ARF6, a small GTPase linked to extracellular vesicle production, was increased after injury. To confirm these results in vivo, mice were subjected to sham surgery or TBI and blood plasma was collected 24 h post-injury. Isolation and analysis of eMVs from blood plasma using cryo-EM and flow cytometry revealed elevated levels of vesicles containing occludin following brain trauma. These results indicate that following TBI, the cerebral endothelium undergoes vascular remodeling through shedding of eMVs containing TJPs and endothelial markers. The detection of this shedding potentially allows for a novel methodology for real-time monitoring of cerebral vascular health (remodeling), BBB status and neuroinflammation following a TBI event. PMID:26973460

  20. Mechanical Injury Induces Brain Endothelial-Derived Microvesicle Release: Implications for Cerebral Vascular Injury during Traumatic Brain Injury

    PubMed Central

    Andrews, Allison M.; Lutton, Evan M.; Merkel, Steven F.; Razmpour, Roshanak; Ramirez, Servio H.

    2016-01-01

    It is well established that the endothelium responds to mechanical forces induced by changes in shear stress and strain. However, our understanding of vascular remodeling following traumatic brain injury (TBI) remains incomplete. Recently published studies have revealed that lung and umbilical endothelial cells produce extracellular microvesicles (eMVs), such as microparticles, in response to changes in mechanical forces (blood flow and mechanical injury). Yet, to date, no studies have shown whether brain endothelial cells produce eMVs following TBI. The brain endothelium is highly specialized and forms the blood-brain barrier (BBB), which regulates diffusion and transport of solutes into the brain. This specialization is largely due to the presence of tight junction proteins (TJPs) between neighboring endothelial cells. Following TBI, a breakdown in tight junction complexes at the BBB leads to increased permeability, which greatly contributes to the secondary phase of injury. We have therefore tested the hypothesis that brain endothelium responds to mechanical injury, by producing eMVs that contain brain endothelial proteins, specifically TJPs. In our study, primary human adult brain microvascular endothelial cells (BMVEC) were subjected to rapid mechanical injury to simulate the abrupt endothelial disruption that can occur in the primary injury phase of TBI. eMVs were isolated from the media following injury at 2, 6, 24, and 48 h. Western blot analysis of eMVs demonstrated a time-dependent increase in TJP occludin, PECAM-1 and ICAM-1 following mechanical injury. In addition, activation of ARF6, a small GTPase linked to extracellular vesicle production, was increased after injury. To confirm these results in vivo, mice were subjected to sham surgery or TBI and blood plasma was collected 24 h post-injury. Isolation and analysis of eMVs from blood plasma using cryo-EM and flow cytometry revealed elevated levels of vesicles containing occludin following brain trauma. These results indicate that following TBI, the cerebral endothelium undergoes vascular remodeling through shedding of eMVs containing TJPs and endothelial markers. The detection of this shedding potentially allows for a novel methodology for real-time monitoring of cerebral vascular health (remodeling), BBB status and neuroinflammation following a TBI event. PMID:26973460

  1. Perioperative Organ Injury

    PubMed Central

    Bartels, Karsten; Karhausen, Jörn; Clambey, Eric T.; Grenz, Almut; Eltzschig, Holger K.

    2014-01-01

    In spite of the fact that a surgical procedure may have been performed for the appropriate indication and in a technically perfect manner, patients are threatened by perioperative organ injury. For example, stroke, myocardial infarction, acute respiratory distress syndrome, acute kidney injury, or acute gut injury are among the most common causes for morbidity and mortality in surgical patients. In the present review, we discuss the pathogenesis of perioperative organ injury, and provide select examples for novel treatment concepts that have emerged over the past decade. Indeed, we believe that research to provide mechanistic insight into acute organ injury and to identify novel therapeutic approaches for the prevention or treatment of perioperative organ injury represents the most important opportunity to improve outcomes of anesthesia and surgery. PMID:24126264

  2. Distal biceps tendon injuries--current treatment options.

    PubMed

    Quach, Tony; Jazayeri, Reza; Sherman, Orrin H; Rosen, Jeffrey E

    2010-01-01

    Three percent of all biceps tendon ruptures occur at the distal aspect, where the tendon inserts into the radial tuberosity. Distal bicep tendon ruptures typically occur in middle-aged males after an eccentric extension load is applied to the elbow. Patients usually complain of a sudden, sharp, and painful tearing sensation in the antecubital region, with a palpable defect. The biceps squeeze and hook tests are specific maneuvers by which to diagnose distal biceps ruptures on physical examination. Magnetic resonance imaging (MRI) or ultrasound maybe be helpful to distinguish between partial and complete tears. Anatomic studies suggest there are two distinct insertions for the short and long heads of the distal biceps. The short head may be a more powerful flexor, and the long head may be a more powerful supinator. Nonoperative treatment typically results in loss of flexion and supination strength and endurance. Early anatomic re-attachment is the goal. Surgical approaches include one- or two-incision techniques, and tendon fixation methods include the use of suture anchors, bone tunnels, an endobutton, or biotenodesis screws. Biomechanical studies have shown that endobuttons have higher load-to-failure strengths, compared to the other fixation methods. However, clinical studies have demonstrated that patients do well regardless of surgical approach or fixation method. Possible complications include nerve injuries, heterotopic ossification, postoperative fracture, tendon rerupture, complex regional pain syndrome, and wound infection. Partial ruptures are significantly less common and initially can be treated conservatively. Chronic tears are more difficult to treat because of possible tendon retraction and poor tissue quality. Tendon grafts using semitendinosus, fascia lata, hamstring, Achilles (calcaneal), or flexor carpi radialis have been successfully used for length restoration in these cases. PMID:20632985

  3. Muscle strain (image)

    MedlinePlus

    A muscle strain is the stretching or tearing of muscle fibers. A muscle strain can be caused by sports, exercise, a ... something that is too heavy. Symptoms of a muscle strain include pain, tightness, swelling, tenderness, and the ...

  4. Injuries from hovercraft racing.

    PubMed

    Cattermole, H R

    1997-01-01

    A 31-year-old man presented with a potentially serious neck injury following a racing hovercraft accident. Previous reports of hovercrafting injuries could not be found, and a review of the sport's own records was undertaken. This shows there to be a wide range of injuries sustained from the sport, although most of them are minor. However, there are some worrying trends, and further studies are being undertaking in order to improve the sport's safety record. PMID:9196622

  5. [Injuries in handball players].

    PubMed

    Fagerli, U M; Lereim, I; Sahlin, Y

    1990-02-10

    The study involves 421 patients who had suffered injury while playing handball. It describes mechanism and trauma, the injuries and their consequences, and data on training and technical conditions. 2/3 of the injured were female and one half belonged to the younger age-classes. The incidence of injury was highest among senior players. Distortion was the most frequent type of injury, followed by contusions and fractures. Half of the injuries were to the upper limbs, but the most frequent single injury was injury to the ankle joint. Many fractures were seen in fingers, forearm, hand and ribs. Wounds occurred most frequently to the face. The most serious injuries were ruptures of the ligaments in the knee joint. Protective equipment, such as braces, was seldom used. A small minority of the players were given adequate first aid. Important measures to prevent injury include better basic training, better technical training conditions, good first aid, and some changes in the rules of competition. PMID:2309195

  6. Spinal injuries in sports.

    PubMed

    Boden, Barry P; Jarvis, Christopher G

    2008-02-01

    Athletic competition has long been a known source of spinal injuries. Approximately 8.7% of all new cases of spinal cord injuries in the United States are related to sports activities. The sports activities that have the highest risk of catastrophic spinal injuries are football, ice hockey, wrestling, diving, skiing, snowboarding, rugby, and cheerleading. Axial compression forces to the top of the head can lead to cervical fracture and quadriplegia in any sport. It is critical for any medical personnel responsible for athletes in team sports to have a plan for stabilization and transfer of an athlete who sustains a cervical spine injury. PMID:18295084

  7. Spinal injuries in sports.

    PubMed

    Boden, Barry P; Jarvis, Christopher G

    2009-02-01

    Athletic competition has long been a known source of spinal injuries. Approximately 8.7% of all new cases of spinal cord injuries in the United States are related to sports activities. The sports activities that have the highest risk of catastrophic spinal injuries are football, ice hockey, wrestling, diving, skiing, snowboarding, rugby, and cheerleading. Axial compression forces to the top of the head can lead to cervical fracture and quadriplegia in any sport. It is critical for any medical personnel responsible for athletes in team sports to have a plan for stabilization and transfer of an athlete who sustains a cervical spine injury. PMID:19084763

  8. Blunt Cardiac Injury.

    PubMed

    Marcolini, Evie G; Keegan, Joshua

    2015-08-01

    Blunt cardiac injury encompasses multiple different injuries, including contusion, chamber rupture, and acute valvular disorders. Blunt cardiac injury is common and may cause significant morbidity and mortality; a high index of suspicion is needed for accurate diagnosis. Diagnostic work-up should always include electrocardiogram and cardiac enzymes, and may include echocardiography if specific disorders (ie, tamponade or valvular disorders) are suspected. Patients with myocardial contusion should be observed for 24 to 48 hours for arrhythmias. Many other significant forms of blunt cardiac injury require surgical intervention. PMID:26226863

  9. Imaging of Physeal Injury

    PubMed Central

    Jawetz, Shari T.; Shah, Parina H.; Potter, Hollis G.

    2015-01-01

    Context: As the intensity of youth participation in athletic activities continues to rise, the number of overuse injuries has also increased. A subset of overuse injuries involves the physis, which is extremely susceptible to injury. This paper aims to review the utility of the various imaging modalities in the diagnosis and management of physeal injuries in the skeletally immature population. Evidence Acquisition: A search for the keywords pediatric, physis, growth plate, x-ray, computed tomography, magnetic resonance imaging, and overuse injury was performed using the PubMed database. No limits were set for the years of publication. Articles were reviewed for relevance with an emphasis on the imaging of growth plate injuries. Study Design: Retrospective literature review. Level of Evidence: Level 4. Results: Three major imaging modalities (radiographs, computed tomography, and magnetic resonance imaging) complement each other in the evaluation of pediatric patients with overuse injuries. However, magnetic resonance imaging is the only modality that offers direct visualization of the physis, and it also offers the best soft tissue contrast for evaluating the other periarticular structures for concomitant injury. Conclusion: Imaging has an important role in the diagnosis of physeal injuries, and the information it provides has a tremendous impact on the subsequent management of these patients. PMID:25984260

  10. MUSCLE INJURIES IN ATHLETES

    PubMed Central

    Barroso, Guilherme Campos; Thiele, Edilson Schwansee

    2015-01-01

    This article had the aim of demonstrating the physiology, diagnosis and treatment of muscle injuries, focusing on athletes and their demands and expectations. Muscle injuries are among the most common complaints in orthopedic practice, occurring both among athletes and among non-athletes. These injuries present a challenge for specialists, due to the slow recovery, during which time athletes are unable to take part in training and competitions, and due to frequent sequelae and recurrences of the injuries. Most muscle injuries (between 10% and 55% of all injuries) occur during sports activities. The muscles most commonly affected are the ischiotibial, quadriceps and gastrocnemius. These muscles go across two joints and are more subject to acceleration and deceleration forces. The treatment for muscle injuries varies from conservative treatment to surgery. New procedures are being used, like the hyperbaric chamber and the use of growth factors. However, there is still a high rate of injury recurrence. Muscle injury continues to be a topic of much controversy. New treatments are being researched and developed, but prevention through muscle strengthening, stretching exercises and muscle balance continues to be the best “treatment”. PMID:27027021

  11. Midfoot and Forefoot Injuries.

    PubMed

    Gorbachova, Tetyana

    2015-08-01

    Sports injuries of the midfoot and forefoot encompass a spectrum of osseous and soft tissue trauma. Magnetic resonance imaging serves as a primary or important supplementary diagnostic modality in evaluation of various injuries, most important of which include Lisfranc complex injury, stress fractures, and injury to the first metatarsophalangeal joint, aka "turf toe." Current technical advances in magnetic resonance and improved knowledge of regional anatomy enable thorough evaluation of the complex anatomic structures of the foot and facilitate accurate diagnosis in the setting of trauma. PMID:26244619

  12. Lightning and thermal injuries.

    PubMed

    Sanford, Arthur; Gamelli, Richard L

    2014-01-01

    Electrical burns are classified as either high voltage (1000 volts and higher) or low voltage (<1000 volts). The typical injury with a high-voltage electrical contact is one where subcutaneous fat, muscles, and even bones are injured. Lower voltages may have lesser injuries. The electrical current has the potential to injure via three mechanisms: injury caused by current flow, an arc injury as the current passes from source to an object, and a flame injury caused by ignition of material in the local environment. Different tissues also have different resistance to the conduction of electricity. Voltage, current (amperage), type of current (alternating or direct), path of current flow across the body, duration of contact, and individual susceptibility all determine what final injury will occur. Devitalized tissue must be evaluated and debrided. Ocular cataracts may develop over time following electrical injury. Lightning strikes may conduct millions of volts of electricity, yet the effects can range from minimal cutaneous injuries to significant injury comparable to a high-voltage industrial accident. Lightning strikes commonly result in cardiorespiratory arrest, for which CPR is effective when begun promptly. Neurologic complications from electrical and lightning injuries are highly variable and may present early or late (up to 2 years) after the injury. The prognosis for electricity-related neurologic injuries is generally better than for other types of traumatic causes, suggesting a conservative approach with serial neurologic examinations after an initial CT scan to rule out correctable causes. One of the most common complications of electrical injury is a cardiac dysrhythmia. Because of the potential for large volumes of muscle loss and the release of myoglobin, the presence of heme pigments in the urine must be evaluated promptly. Presence of these products of breakdown of myoglobin and hemoglobin puts the injured at risk for acute renal failure and must be treated. The exact mechanism of nerve injury has not been explained, but both direct injury by electrical current overload or a vascular cause receive the most attention. Because electrical injuries carry both externally visible cutaneous injuries and possible hidden musculoskeletal damage, conventional burn resuscitation formulas based on body surface area injured may not provide enough fluid to maintain urine output. Damaged muscle resulting in swelling within the investing fascia of an extremity may result in compartment syndromes, requiring further attention. If myoglobin has been detected in the urine, treatment is aggressive volume resuscitation and possibly alkalinization of the urine or mannitol is given IV push to minimize pigment precipitation in the renal tubules. Approximately 15% of electrical burn victims also sustain traumatic injuries. This is because of falls from height or being thrown against an object. The tetanic contractions that result from exposure to electrical injury cause imbalance in flexor versus extensor muscles, with the flexor groups being stronger. Not only is the victim unable to release from the electrical contact, but they are at risk for fracture of bones from this prolonged muscular contracture. Neurologic and psychological symptoms were the most common sequelae of electrical and lightning injuries. Many of these symptoms are nonspecific, and they often do not appear until several months after the injury. A full neurologic examination must be performed on admission, documenting initial presentation and at any change in symptoms. Electrical injuries can have devastating consequences. Prevention of electrical injuries is clearly the preferable strategy for treatment. PMID:24365365

  13. Overview of injuries in the young athlete.

    PubMed

    Adirim, Terry A; Cheng, Tina L

    2003-01-01

    It is estimated that 30 million children in the US participate in organised sports programmes. As more and more children participate in sports and recreational activities, there has been an increase in acute and overuse injuries. Emergency department visits are highest among the school-age to young adult population. Over one-third of school-age children will sustain an injury severe enough to be treated by a doctor or nurse. The yearly costs have been estimated to be as high as 1.8 billion US dollars. There are physical and physiological differences between children and adults that may cause children to be more vulnerable to injury. Factors that contribute to this difference in vulnerability include: children have a larger surface area to mass ratio, children have larger heads proportionately, children may be too small for protective equipment, growing cartilage may be more vulnerable to stresses and children may not have the complex motor skills needed for certain sports until after puberty. The most commonly injured areas of the body include the ankle and knee followed by the hand, wrist, elbow, shin and calf, head, neck and clavicle. Contusions and strains are the most common injuries sustained by young athletes. In early adolescence, apophysitis or strains at the apophyses are common. The most common sites are at the knee (Osgood-Schlatter disease), at the heel (Sever's disease) and at the elbow (Little League Elbow). Non-traumatic knee pain is one of the most common complaints in the young athlete. Patellar Femoral Pain Syndrome (PFPS) has a constellation of causes that include overuse, poor tracking of the patellar, malalignment problems of the legs and foot problems, such as pes planus. In the child, hip pathology can present as knee pain so a careful hip exam is important in the child presenting with an insidious onset of knee pain. Other common injuries in young athletes discussed include anterior cruciate ligament injuries, ankle sprains and ankle fractures. Prevention of sports and recreation-related injuries is the ideal. There are six potential ways to prevent injuries in general: (i) the pre-season physical examination; (ii) medical coverage at sporting events; (iii) proper coaching; (iv) adequate hydration; (v) proper officiating; and (vi) proper equipment and field/surface playing conditions. PMID:12477379

  14. INJURIES OF THE FINGERS AND HANDS—A Review of Cases from the Standpoint of Compensation

    PubMed Central

    Barritt, J. L.

    1955-01-01

    Review of records in cases of injury to the hand that come before the California Industrial Accident Commission indicate that: 1. Primary closure at a suitable level in finger amputations is often preferable to plastic repair. 2. Complications incident to plastic repair in minor injuries frequently increase disability and cost to employer. 3. Tendon injury resulting from strain is a frequently overlooked cause of disability. PMID:13260933

  15. Lateral collateral ligament (LCL) injury

    MedlinePlus

    LCL injury; Knee injury - lateral collateral ligament (LCL) ... ligament helps keep the outer side of the knee joint stable. ... by pressure or an injury that pushes the knee joint from the inside, which results in stress ...

  16. Injuries and injury prevention during foot marching.

    PubMed

    Knapik, Joseph J

    2014-01-01

    Since the beginning of recorded history, Soldiers have carried arms and equipment on their bodies. More recently, loads have substantially increased, driven by improvements in weapons technology and personal protection. As Soldier loads increase, there are increases in energy cost, altered gait mechanics, increased stress on the musculoskeletal system, and more rapid fatigue, factors that may increase the risk of injury. Common injuries and symptoms experienced by Soldiers on load-carriage missions include foot blisters, metatarsalgia, knee problems, and back problems. This article discusses these problems, providing diagnoses, injury mechanisms, and preventive measures. In general, lighter loads, improving load distribution, using appropriate physical training, selecting proper equipment, and using specific prevention techniques will facilitate load carriage and provide Special Operations Forces with a higher probability of mission success. PMID:25399383

  17. Incidence and Descriptive Epidemiology of Injuries to College Ultimate Players

    PubMed Central

    Swedler, David I.; Nuwer, Jamie M.; Nazarov, Anna; Huo, Samantha C.; Malevanchik, Lev

    2015-01-01

    Context: The burden of injuries to college ultimate players has never been fully described. Objective: To quantify the injury rate in ultimate players and describe the diagnoses, anatomic locations, and mechanisms of injuries. Design: Descriptive epidemiology study. Setting: College ultimate teams in the United States during the 2012 season. Main Outcome Measure(s): Initial injury rate per 1000 athlete-exposures. Results: The initial injury rate in college ultimate players was 12.64 per 1000 athlete-exposures; the rate did not differ between men and women (P = .5). Bivariate analysis indicated that injuries occurred twice as often during games as during practices, men were more likely than women to be injured when laying out for the disc, and men were more likely to incur strains and sprains than women. Conclusions: Injury patterns to college ultimate players were similar to those for athletes in other National Collegiate Athletic Association sports. This is the first study to systematically describe injuries to ultimate players. PMID:25384003

  18. Greater arch injuries.

    PubMed

    Shivanna, Deepak; Manjunath, Dayanand; Amaravathi, Rajkumar

    2014-12-01

    Dislocations and fracture dislocations of carpal bones are uncommon injuries which invariably poses challenges in the management. Perilunate fracture dislocations are the combination of ligamentous and osseous injury that involve the "greater arc" of the perilunate associated instability. Despite their severity, these injuries often go unrecognized in the emergency department leading to delayed diagnosis and treatment. A Prospective study was done from June 2008 to December 2013 in 15 cases of complex wrist injuries which included of greater arch injuries, perilunate fracture dislocation and one dorsal dislocation of Scaphoid. 10 cases of perilunate fracture dislocation underwent open reduction and internal fixation with Herbert screw and k-wire, 4 cases of greater arch injury underwent closed reduction and kwire fixation and one case of neglected dorsal dislocation underwent proximal row carpectomy. One patient had Sudecks osteodystrophy 1 had Scaphoid nonunion and 6 had median nerve compression. Overall outcome according to Mayo wrist score was 53 % excellent, 33 % good and 14 % fair. Greater arch injuries are difficult to treat because injuries to many ligaments are involved and failure to recognize early leads to persistent pain, disability and early onset of arthritis. Prompt recognition requires CT scan and MRI. Management requires reduction and multiple K-Wiring according to merits of the case. PMID:25414554

  19. Healing of Genital Injuries

    ERIC Educational Resources Information Center

    Berkowitz, Carol D.

    2011-01-01

    Child sexual abuse as well as accidental trauma may cause acute injuries in the anogenital area. Most data on residual findings following genital trauma come from longitudinal studies of children who have been sexually assaulted, undergone surgical procedures, or experienced accidental trauma. Like injuries in other part parts of the body, such

  20. Nail Bed Injuries

    MedlinePlus

    ... Injuries Hand Fracture See More... Español Quistes sinoviales Síndrome del túnel carpiano Artritis de la base del pulgar Dedo en ... Injuries Hand Fracture See More... Español Quistes sinoviales Síndrome del túnel carpiano Artritis de la base del pulgar Dedo en ...

  1. Flexor Tendon Injuries

    MedlinePlus

    ... Injuries Hand Fracture See More... Español Quistes sinoviales Síndrome del túnel carpiano Artritis de la base del pulgar Dedo en ... Injuries Hand Fracture See More... Español Quistes sinoviales Síndrome del túnel carpiano Artritis de la base del pulgar Dedo en ...

  2. Extensor Tendon Injuries

    MedlinePlus

    ... Injuries Hand Fracture See More... Español Quistes sinoviales Síndrome del túnel carpiano Artritis de la base del pulgar Dedo en ... Injuries Hand Fracture See More... Español Quistes sinoviales Síndrome del túnel carpiano Artritis de la base del pulgar Dedo en ...

  3. Management of Tracheobronchial Injuries

    PubMed Central

    Altinok, Tamer; Can, Atilla

    2014-01-01

    Tracheobronchial injury is one of cases which are relatively uncommon, but must be suspected to make the diagnosis and managed immediately. In such a case, primary initial goals are to stabilize the airway and localize the injury and then determine its extend. These can be possible mostly with flexible bronchoscopy conducted by a surgeon who can repair the injury. Most of the penetrating injuries occur in the cervical region. On the other hand, most of the blunt injuries occur in the distal trachea and right main bronchus and they can be best approached by right posterolateral thoracotomy. The selection of the manner and time of approaching depends on the existence and severity of additional injuries. Most of the injuries can be restored by deploying simple techniques such as individual sutures, while some of them requires complex reconstruction techniques. Apart from paying attention to the pulmonary toilet, follow-up is crucial for determination of anastomotic technique or stenosis. Conservative treatment may be considered an option with a high probability of success in patients meeting the criteria, especially in patients with iatrogenic tracheobronchial injury. PMID:25610327

  4. Peroneal Tendon Injuries

    MedlinePlus

    ... peroneal tendons is to stabilize the foot and ankle and protect them from sprains. Causes and Symptoms of Peroneal Tendon Injuries Peroneal tendon injuries may be acute (occurring suddenly) or chronic (developing over a period of time). They most commonly occur in individuals who participate ...

  5. Mild Traumatic Brain Injury

    MedlinePlus

    ... SafeHelpline 877-995-5247 89 reads Home Topics Post-Traumatic Stress Physical Injury Families & Friendships Military Sexual Trauma Depression ... Support Physical Injury Resilience Post Deployment Social Support Post-Traumatic Stress Resilience Satisfaction with Life Sexual Truama Sleep Spirituality ...

  6. Injuries in Preschool Classrooms

    ERIC Educational Resources Information Center

    Obeng, Cecilia

    2009-01-01

    Purpose: The primary purpose of this paper is to examine the kinds of injuries that preschool teachers working in Indiana, USA, believed to be the most common in their preschool (3-6 year olds) classrooms, the causes of such injuries, and the most important precautions they take to prevent them. Also examined are the measures the teachers take

  7. Preventing Eye Injuries

    MedlinePlus

    ... yard work, cleaning and cooking. More than a third (34.2 percent) of injuries in the home occurred in living areas such as the kitchen, bedroom, bathroom, living or family room. More than 40 percent of eye injuries every year are related to sports or ...

  8. Healing of Genital Injuries

    ERIC Educational Resources Information Center

    Berkowitz, Carol D.

    2011-01-01

    Child sexual abuse as well as accidental trauma may cause acute injuries in the anogenital area. Most data on residual findings following genital trauma come from longitudinal studies of children who have been sexually assaulted, undergone surgical procedures, or experienced accidental trauma. Like injuries in other part parts of the body, such…

  9. FIREARM INJURY SURVEILLANCE STUDY

    EPA Science Inventory

    The National Center for Injury Prevention and Control (NCIPC), within the Centers for Disease Control and Prevention, established an interagency agreement with CPSC to begin collecting data on nonfatal firearm-related injuries to monitor the incidence and characteristics of perso...

  10. Spinal Cord Injury Map

    MedlinePlus

    ... Short List Government Programs Family and Caregiver Support Financial Help Active Lifestyle Advocacy Employment and Education Adaptive Technology Recent Medical Research Good Things to Read Spinal Cord Injury Facts and Figures Model System Rehab Hospitals Pediatric Spinal Cord Injury Sex and ...

  11. Injuries in Preschool Classrooms

    ERIC Educational Resources Information Center

    Obeng, Cecilia

    2009-01-01

    Purpose: The primary purpose of this paper is to examine the kinds of injuries that preschool teachers working in Indiana, USA, believed to be the most common in their preschool (3-6 year olds) classrooms, the causes of such injuries, and the most important precautions they take to prevent them. Also examined are the measures the teachers take…

  12. DISCUSSION ON SPINAL INJURIES

    PubMed Central

    1928-01-01

    (1).Varieties of spinal injuries, the three groups of common usage: fractures, dislocations, fracture-dislocations. Shall not refer in detail to fractures of the spinous or transverse processes. (2) Mechanics of injury to vertebr. Two variables: (1) the nature of the bones; (2) the qualities of the force. Spinal injury usually caused by indirect violence. (3) The different results of injuries applied to the head; may break skull, failing that, the neck. Atlas fracture. Difference in qualities of the force causing atlas fracture and low cervical dislocation. (4) The compound nature of the vertebral body. The two columns, anterior, spongy; posterior, compact. The nature of wedge-compression of the vertebral body. Variations in the shape of the wedge. Reasons. Occur at all levels, including cervical spine. (5) Frequency of injury at different levels of vertebral column. Localization of injury. The two places of the graph of injury. The cervical at C. 5. Reason. The thoracic-lumbar peak at T. 12, L. 1 industrial. Is there a third peak at C. 2? (6) The effects of violent flexion of the spine: cervical flexion causes luxation at C. 5 or so. Extension causes fracture of odontoid. Violent flexion and extension therefore cause injury at very different levels. Thoracic region, why is there no peak of injury at T.6, 7? Lumbar region. (7) Displacement of fragments. Continuation of violence after the essential injury has been effected. Kmmell's disease, no inflammatory process involved. (8) Injury to the intervertebral discs, essential for displacement. Imperfect rupture a cause for difficulty in reducing luxations. The worst cases those in which it is most easily done, but most of these have cord damage. (9) Spinal injury from minimal violence. Examples of trivial cases, diving, brushing hair and so forth. Vertebral displacement in disease a much more serious thing. (10) Curious stability of many cervical luxations. Reasons. Locking of the inferior zygaphophyses. (11) Injury to nervous elements left principally to other speakers. Cord compression very rare. Immediate and irremediable damage. Root injuries. Falling mortality of modern statistics due to better diagnosis. (12) Primary operation for fractures of spine relegated to oblivion. Rarity of indications for open operation. Reduction the best treatment. ImagesFig. 5Fig. 6 PMID:19986314

  13. [Traumatic lung injury].

    PubMed

    Hara, Hidenori; Yoshimura, Hirokuni

    2004-07-01

    Pulmonary injuries include a wide variety of clinical conditions. Most patients with blunt chest trauma can be managed with conservative treatment. Only about 10 to 15% of patients with severe chest injuries require major thoracotomy. Management of pulmonary contusion, pulmonary laceration, pneumothorax or hemothorax by oxygen inhalation, respirator assist and chest drainage can usually result in complete recovery. However, pulmonary injuries sometimes lapse into fatal condition if they are improperly treated. Open thoracotomy is required in cases with persistent massive air leakage or massive bleeding with the use of chest drainage. It is crucial to evaluate the extent and severity of the injuries based on chest X-ray and computed tomography (CT) findings for the proper initial treatment in patients with pulmonary injuries. PMID:15362557

  14. Waterskiing-related injuries.

    PubMed

    Hummel, G; Gainor, B J

    1982-01-01

    Twenty-six cases of waterskiing-related injuries, including four deaths, were studied and the case histories classified into four categories. Injury was caused by a fall into unobstructed water, by boat propeller blades, by collisions with obstacles or a boat, and by the tow rope. Injuries sustained in falls were comparable to trauma seen in vigorous contact sports. Boat propeller blades inflicted devastating battlefield-type wounds, and collisions produced trauma similar to that seen in motor vehicle accidents. The shearing action of an accelerating tow rope imparted trauma unique to this sporting activity. There is limited recognition of the potential for serious injury that attends this recreational sport, and it is concluded that the prevention of injury depends on the nuclear trio of participants: boat operator, operator, observer, and skier. PMID:7125042

  15. Motorboat propeller injuries.

    PubMed

    Mendez-Fernandez, M A

    1998-08-01

    It is estimated that approximately 25% of the population of the United States participates in recreational boating activities in a given year. These activities result in 7,000 reported accidents, 60% of which result in injuries. Of these injuries, 19% are fatal (11.3% of accidents). Eighteen percent of these fatalities are caused by propellers (2% of accidents). The death toll from boating accidents ranks second among deaths in all modes of transportation. Open motorboats are involved in half of the fatalities recorded. Propeller injuries have an overall fatality rate of 15% to 17%, and a similar rate of major amputations. Experience with nine propeller injuries treated from 1990 to 1996 is presented. The mechanism of production, some technical aspects of propellers, as well as literature on the subject are reviewed. Three patients are described, demonstrating the severity of these injuries, their sequelae, and the challenges they represent. PMID:9718142

  16. [Chest Wall Injury].

    PubMed

    Tanahashi, Masayuki; Niwa, Hiroshi

    2015-07-01

    The thoracic wall protects the heart, great vessels, lungs, trachea, and bronchus, which are organs important for maintaining respiration/circulation, against external forces. Therefore, injury of the thoracic wall may necessitate emergency treatment. Such injury primarily consists of rib and sternal fractures. In particular, fractures of 2 or more consecutive ribs with each rib being fractured at 2 or more sites and serial rib fracture with sternal fracture lead to reverse thoracic movement involving contraction on inhalation and expansion on expiration. Such thoracic injury is termed flail chest. Injury of the thoracic wall, such as flail chest, markedly influences the prognosis. Therefore, it is necessary to promptly evaluate the general condition, involving respiratory/circulatory kinetics, confirm the presence or absence of concomitant injury, such as bruises of the lungs/heart, and accurately select therapeutic strategies, including artificial respiration and surgical intervention. PMID:26197917

  17. Acute badminton injuries.

    PubMed

    Fahlstrm, M; Bjrnstig, U; Lorentzon, R

    1998-06-01

    During 1990-1994, 1.2% of all sports injuries that required emergency care at the University Hospital of Ume were caused by badminton. In 90.7% of the cases the patients described themselves as recreational players or beginners. There were 51.3% minor injuries (AIS 1) and 48.7% moderate injuries (AIS 2). The lower extremities were affected in 92.3% of the cases. Achilles tendon ruptures (34.6%) and ankle sprains and fractures (29.5%) were the most frequent. By the time of the follow-up (10-69 months), 52.6% of the players still had symptoms from the injuries and 39.5% had not been able to return to playing badminton. Our data indicate the importance of adequate treatment and rehabilitation after acute badminton injuries. PMID:9659674

  18. Mole gun injury.

    PubMed

    Pistré, V; Rezzouk, J

    2013-09-01

    A mole gun is a weapon, which is used to trap and kill moles. This report provides an overview of the state of knowledge of mole gun injuries, comparable to blast injuries caused by fireworks, explosive or gunshot. Over a 2-year period, the authors reported their experience with ten hand injuries caused by mole gun. Radial side of the hand was often concerned, particularly the thumb. The authors explain their choices in the management of such lesions. Surgery was performed primarily and a large debridement currently seemed to offer the best outcome for the patient. Blast, crush, burns and lacerations may explain the higher rate of amputation to the digits. A long period of physiotherapy, specifically of the hand, was needed before the patient could return to work. This ballistic hand trauma encountered by surgeons requires knowledge and understanding of these injuries. It should be in accordance with firearms law because of severe injuries encountered and possible lethal wounds. PMID:23746826

  19. Injuries among amateur runners☆

    PubMed Central

    de Araujo, Mariana Korbage; Baeza, Ricardo Maletta; Zalada, Sandro Ricardo Benites; Alves, Pedro Benzam Rodrigues; de Mattos, Carlos Augusto

    2015-01-01

    Objectives To determine the frequency and severity of injuries that affect amateur runners. Methods This study was conducted by means of a questionnaire applied to 204 amateur runners. Individuals who were under the age of 18 years and those who were unpracticed runners were excluded. The data gathered comprised the number, type, site and degree of severity of the injuries and the individuals’ age and sex. Results It was observed that male athletes predominated. The mean age was 32.6 ± 9.3 years with a range from 18 to 68 years, and the injuries were classified as mild, keeping the athlete away from practicing running for fewer than eight days. Sprains, blisters and abrasions were the most frequent injuries, located most often on the lower limbs and predominantly on the feet. Conclusion In practicing running, sprains, blisters and abrasions occur frequently, but are mild injuries. They mostly affect the lower limbs. PMID:26535199

  20. Characterisation of human diaphragm at high strain rate loading.

    PubMed

    Gaur, Piyush; Chawla, Anoop; Verma, Khyati; Mukherjee, Sudipto; Lalvani, Sanjeev; Malhotra, Rajesh; Mayer, Christian

    2016-07-01

    Motor vehicle crashes (MVC׳s) commonly results in life threating thoracic and abdominal injuries. Finite element models are becoming an important tool in analyzing automotive related injuries to soft tissues. Establishment of accurate material models including tissue tolerance limits is critical for accurate injury evaluation. The diaphragm is the most important skeletal muscle for respiration having a bi-domed structure, separating the thoracic cavity from abdominal cavity. Traumatic rupture of the diaphragm is a potentially serious injury which presents in different forms depending upon the mechanisms of the causative trauma. A major step to gain insight into the mechanism of traumatic rupture of diaphragm is to understand the high rate failure properties of diaphragm tissue. Thus, the main objective of this study was to estimate the mechanical and failure properties of human diaphragm at strain rates associated with blunt thoracic and abdominal trauma. A total of 23 uniaxial tensile tests were performed at various strain rates ranging from 0.001-200s(-1) in order to characterize the mechanical and failure properties on human diaphragm tissue. Each specimen was tested to failure at one of the four strain rates (0.001s(-1), 65s(-1), and 130s(-1), 190s(-1)) to investigate the effects of strain rate dependency. High speed video and markers placed on the grippers were used to measure the gripper to gripper displacement. Engineering stresses reported in the study is calculated from the ratio of force measured and initial cross sectional area whereas engineering strain is calculated from the ratio of the elongation to the undeformed length (gauge length) of the specimen.The results of this study showed that the diaphragm tissues is rate dependent with higher strain rate tests giving higher failure stress and higher failure strains. The failure stress for all tests ranged from 1.17MPa to 4.1MPa and failure strain ranged from 12.15% to 24.62%. PMID:27062242

  1. Prevention of youth injuries.

    PubMed Central

    Laraque, D.; Barlow, B.; Durkin, M.

    1999-01-01

    There are four categories of causes responsible for the majority of injuries in youth 10-19 years of age: 1) motor vehicle traffic; 2) violence (intra-familial, extra-familial, self, pregnancy-related); 3) recreational; and 4) occupational. This article presents data from the National Center for Health Statistics mortality data and the National Pediatric Trauma Registry morbidity data. Nationwide, the pediatric injury death rate is highest among adolescents 15-19 years of age. Motor vehicle-related deaths account for 41% and firearm-related deaths account for 36% of injury deaths in this age group. For youths aged 10-14 years, motor vehicle-related deaths account for 38% and; firearm-related deaths account for 26% of injury deaths. For both age groups, occupant motor vehicle-related deaths account for the majority of deaths and underscore the need for seat belt use. Using theoretical principles based on the Haddon matrix and a knowledge of adolescent development, proposed interventions to decrease injuries and deaths related to motor vehicles and firearms include graduated licensing, occupant restraint, speed limits, conflict resolution, and gun control. Occupational injuries, particularly injury associated with agricultural production, account for an estimated 100,000 injuries per year. Preventive strategies include OSHA regulations imposing standards for protective devices and further study for guidelines for adolescent work in agriculture. Injuries related to recreation include drowning and sports injuries. Preventive strategies may include proper supervision and risk reduction with respect to use of alcohol/drugs. The data presented support the use of primary prevention to achieve the most effective, safe community interventions targeting adolescents. PMID:10599188

  2. Descriptive Epidemiology of Collegiate Women's Basketball Injuries: National Collegiate Athletic Association Injury Surveillance System, 1988–1989 Through 2003–2004

    PubMed Central

    Agel, Julie; Olson, David E; Dick, Randall; Arendt, Elizabeth A; Marshall, Stephen W; Sikka, Robby S

    2007-01-01

    Objective: To review 16 years of National Collegiate Athletic Association (NCAA) injury surveillance data for women's basketball and to identify potential areas for injury prevention initiatives. Background: The number of colleges participating in women's college basketball has grown over the past 25 years. The Injury Surveillance System (ISS) has enabled the NCAA to collect and report injury trends over an extended period of time. This has allowed certified athletic trainers and coaches to be more informed regarding injuries and to adjust training regimens to reduce the risk of injury. It also has encouraged administrators to make rule changes that attempt to reduce the risk of injury. Main Results: From 1988–1989 through 2003–2004, 12.4% of schools across Divisions I, II, and III that sponsor varsity women's basketball programs participated in annual ISS data collection. Game and practice injury rates exhibited significant decreases over the study period. The rate of injury in a game situation was almost 2 times higher than in a practice (7.68 versus 3.99 injuries per 1000 athlete-exposures, rate ratio = 1.9, 95% confidence interval = 1.9, 2.0). Preseason-practice injury rates were more than twice as high as regular-season practice injury rates (6.75 versus 2.84 injuries per 1000 athlete-exposures, rate ratio = 2.4, 95% confidence interval = 2.2, 2.4). More than 60% of all game and practice injuries were to the lower extremity, with the most common game injuries being ankle ligament sprains, knee injuries (internal derangements and patellar conditions), and concussions. In practices, ankle ligament sprains, knee injuries (internal derangements and patellar conditions), upper leg muscle-tendon strains, and concussions were the most common injuries. Recommendations: Appropriate preseason conditioning and an emphasis on proper training may reduce the risk of injury and can optimize performance. As both player size and the speed of the women's game continue to increase, basketball's evolution from a finesse sport to a high-risk contact sport also will continue. The rates of concussions and other high-energy trauma injuries likely will increase. The NCAA ISS is an excellent tool for identifying new risk factors that may affect injury rates and for developing consistent injury definitions in order to improve the research and provide a source of clinically relevant data. PMID:17710168

  3. Program Calibrates Strain Gauges

    NASA Technical Reports Server (NTRS)

    Okazaki, Gary D.

    1991-01-01

    Program dramatically reduces personnel and time requirements for acceptance tests of hardware. Data-acquisition system reads output from Wheatstone full-bridge strain-gauge circuit and calculates strain by use of shunt calibration technique. Program nearly instantaneously tabulates and plots strain data against load-cell outputs. Modified to acquire strain data for other specimens wherever full-bridge strain-gauge circuits used. Written in HP BASIC.

  4. Superlattice strain gage

    DOEpatents

    Noel, Bruce W. (Espanola, NM); Smith, Darryl L. (Los Alamos, NM); Sinha, Dipen N. (Los Alamos, NM)

    1990-01-01

    A strain gage comprising a strained-layer superlattice crystal exhibiting piezoelectric properties is described. A substrate upon which such a strained-layer superlattice crystal has been deposited is attached to an element to be monitored for strain. A light source is focused on the superlattice crystal and the light reflected from, passed through, or emitted from the crystal is gathered and compared with previously obtained optical property data to determine the strain in the element.

  5. Superlattice strain gage

    DOEpatents

    Noel, B.W.; Smith, D.L.; Sinha, D.N.

    1988-06-28

    A strain gage comprising a strained-layer superlattice crystal exhibiting piezoelectric properties is described. A substrate upon which such a strained-layer superlattice crystal has been deposited is attached to an element to be monitored for strain. A light source is focused on the superlattice crystal and the light reflected from, passed through, or emitted from the crystal is gathered and compared with previously obtained optical property data to determine the strain in the element. 8 figs.

  6. Sport injuries in adolescents

    PubMed Central

    Habelt, Susanne; Hasler, Carol Claudius; Steinbrück, Klaus; Majewski, Martin

    2011-01-01

    In spite of the wide range of injuries in adolescents during sports activities, there are only a few studies investigating the type and frequency of sport injuries in puberty. However, this information may help to prevent, diagnose and treat sports injuries among teens. 4468 injuries in adolescent patients were treated over a ten year period of time: 66,97% were boys and 32.88% girls. The most frequent sports injuries were football (31.13%) followed by handball (8.89%) and sports during school (8.77%). The lower extremity was involved in 68.71% of the cases. Knee problems were seen in 29.79% of the patients; 2.57% spine and 1.99% head injuries. Injuries consisted primarily of distortions (35.34%) and ligament tears (18.76%); 9,00% of all injuries were fractures. We found more skin wounds (6:1) and fractures (7:2) in male patients compared to females. The risk of ligament tears was highest during skiing. Three of four ski injuries led to knee problems. Spine injuries were observed most often during horse riding (1:6). Head injuries were seen in bicycle accidents (1:3). Head injuries were seen in male patients much more often then in female patients (21:1). Fractures were noted during football (1:9), skiing (1:9), inline (2:3), and during school sports (1:11). Many adolescents participate in various sports. Notwithstanding the methodological problems with epidemiological data, there is no doubt about the large number of athletes sustain musculoskeletal injuries, sometimes serious. In most instances, the accident does not happened during professional sports and training. Therefore, school teachers and low league trainer play an important role preventing further accidence based on knowledge of individual risk patterns of different sports. It is imperative to provide preventive medical check-ups, to monitor the sport-specific needs for each individual sports, to observe the training skills as well as physical fitness needed and to evaluation coaches education. PMID:22355484

  7. Sport injuries in adolescents.

    PubMed

    Habelt, Susanne; Hasler, Carol Claudius; Steinbrück, Klaus; Majewski, Martin

    2011-09-01

    In spite of the wide range of injuries in adolescents during sports activities, there are only a few studies investigating the type and frequency of sport injuries in puberty. However, this information may help to prevent, diagnose and treat sports injuries among teens. 4468 injuries in adolescent patients were treated over a ten year period of time: 66,97% were boys and 32.88% girls. The most frequent sports injuries were football (31.13%) followed by handball (8.89%) and sports during school (8.77%). The lower extremity was involved in 68.71% of the cases. Knee problems were seen in 29.79% of the patients; 2.57% spine and 1.99% head injuries. Injuries consisted primarily of distortions (35.34%) and ligament tears (18.76%); 9,00% of all injuries were fractures. We found more skin wounds (6:1) and fractures (7:2) in male patients compared to females. The risk of ligament tears was highest during skiing. Three of four ski injuries led to knee problems. Spine injuries were observed most often during horse riding (1:6). Head injuries were seen in bicycle accidents (1:3). Head injuries were seen in male patients much more often then in female patients (21:1). Fractures were noted during football (1:9), skiing (1:9), inline (2:3), and during school sports (1:11). Many adolescents participate in various sports. Notwithstanding the methodological problems with epidemiological data, there is no doubt about the large number of athletes sustain musculoskeletal injuries, sometimes serious. In most instances, the accident does not happened during professional sports and training. Therefore, school teachers and low league trainer play an important role preventing further accidence based on knowledge of individual risk patterns of different sports.It is imperative to provide preventive medical check-ups, to monitor the sport-specific needs for each individual sports, to observe the training skills as well as physical fitness needed and to evaluation coaches education. PMID:22355484

  8. Cerebral Vascular Injury in Traumatic Brain Injury.

    PubMed

    Kenney, Kimbra; Amyot, Franck; Haber, Margalit; Pronger, Angela; Bogoslovsky, Tanya; Moore, Carol; Diaz-Arrastia, Ramon

    2016-01-01

    Traumatic cerebral vascular injury (TCVI) is a very frequent, if not universal, feature after traumatic brain injury (TBI). It is likely responsible, at least in part, for functional deficits and TBI-related chronic disability. Because there are multiple pharmacologic and non-pharmacologic therapies that promote vascular health, TCVI is an attractive target for therapeutic intervention after TBI. The cerebral microvasculature is a component of the neurovascular unit (NVU) coupling neuronal metabolism with local cerebral blood flow. The NVU participates in the pathogenesis of TBI, either directly from physical trauma or as part of the cascade of secondary injury that occurs after TBI. Pathologically, there is extensive cerebral microvascular injury in humans and experimental animal, identified with either conventional light microscopy or ultrastructural examination. It is seen in acute and chronic TBI, and even described in chronic traumatic encephalopathy (CTE). Non-invasive, physiologic measures of cerebral microvascular function show dysfunction after TBI in humans and experimental animal models of TBI. These include imaging sequences (MRI-ASL), Transcranial Doppler (TCD), and Near InfraRed Spectroscopy (NIRS). Understanding the pathophysiology of TCVI, a relatively under-studied component of TBI, has promise for the development of novel therapies for TBI. PMID:26048614

  9. Sports injuries and adolescent athletes.

    PubMed

    Axe, M J; Newcomb, W A; Warner, D

    1991-06-01

    A one-year study was undertaken investigating adolescent sports injury experiences at a major sports clinic in the state of Delaware. A total of 619 athletes sustained 870 injuries, for an overall injury rate of 1.4 injuries per athlete. The largest number of injuries was recorded in football (40.2 percent), followed by boys' soccer, wrestling, baseball and girls' basketball. Severity of injury was measured by the number of days lost per injury. Cheerleading had the highest average days lost per injury (28.8), followed by girls' basketball, wrestling, boys' cross-country and girls' tennis. Inflammation, fractures and dislocations comprised 50.6 percent of all the injuries, while 50.5 percent of the injuries were located in the knee, thigh, and shoulder. Twenty-seven of the 870 injuries required surgery. PMID:1874345

  10. From the Horse Worker's Mouth: A Detailed Account of Injuries Experienced by Latino Horse Workers.

    PubMed

    Swanberg, Jennifer E; Clouser, Jessica Miller; Bush, Ashley; Westneat, Susan

    2016-06-01

    Horse breeding farms are hazardous. Yet, little is known about the injuries of Latino horse workers. This study assesses Latino horse workers' injury prevalence, describes their injuries, and analyzes differences between injuries receiving medical versus those receiving first aid care. Data were gathered from 225 Latino thoroughbred workers via a community-based purposive sampling strategy. Questions included injury experiences in the past year and details about each person's two most severe injuries. Univariate and bivariate analyses were conducted. Nearly half of workers experienced an injury in the past year, often involving a horse. Bruises and sprains/strains were most common, as were injuries to upper/lower appendages. Head/face injuries more often resulted in medical care. The injury burden in this Latino worker population is high. Personal protective equipment (PPE) and training is advised due to the high prevalence of horse-related injuries. Future research should investigate aspects of the work environment that may influence injury risk. PMID:26458955

  11. Bone Tunnel Diameter Measured with CT after Anterior Cruciate Ligament Reconstruction Using Double-Bundle Auto-Hamstring Tendons: Clinical Implications

    PubMed Central

    Yoon, Soo Jeong; Bae, So Young; Wang, Joon Ho

    2015-01-01

    Objective To evaluate the correlation between bone tunnel diameter after anterior cruciate ligament (ACL) reconstruction measured by computed tomography (CT) using multiplanar reconstruction (MPR) and stability or clinical scores. Materials and Methods Forty-seven patients (41 men and 6 women, mean age: 34 years) who had undergone ACL reconstruction with the double bundle technique using auto-hamstring graft and had subsequently received CT scans immediately after the surgery (T1: range, 1-4 days, mean, 2.5 days) and at a later time (T2: range, 297-644 days, mean, 410.4 days) were enrolled in this study. The diameter of each tunnel (two femoral and two tibial) at both T1 and T2 were independently measured using MPR technique by two radiologists. Stability and clinical scores were evaluated with a KT-2000 arthrometer, International Knee Documentation Committee objective scores, and the Lysholm score. Statistical analysis of the correlation between the diameter at T2 or the interval diameter change ratio ([T2 - T1] / T1) and clinical scores or stability was investigated. Results The tibial bone tunnels for the anteromedial bundles were significantly widened at T2 compared with T1 (observer 1, 0.578 mm to 0.698 mm, p value of < 0.001; observer 2, 0.581 mm to 0.707 mm, p value of < 0.001). There was no significant correlation between the diameter at T2 and stability or clinical scores and between the interval change ratio ([T2 - T1] / T1) and stability or clinical scores (corrected p values for all were 1.0). Intraobserver agreement for measurements was excellent (> 0.8) for both observers. Interobserver agreement for measurement was excellent (> 0.8) except for the most distal portion of the femoral bone tunnel for anterior medial bundle in immediate postoperative CT, which showed moderate agreement (concordance correlation coefficient = 0.6311). Conclusion Neither the diameter nor its change ratio during interval follow-up is correlated with stability or clinical scores. PMID:26576121

  12. Validity of hamstring muscle length assessment during the sit-and-reach test using an inclinometer to measure hip joint angle.

    PubMed

    Youdas, James W; Krause, David A; Hollman, John H

    2008-01-01

    The aim of this study was twofold: (i) to describe the criterion-related validity of the sit-and-reach test (SRT) using a hand-held inclinometer when assessing hamstring muscle length (HML) when HML is recorded in degrees of hip joint angle (HJA); and (ii) to describe the effect of gender and age on HML in healthy adults during the performance of a SRT. We examined 212 healthy subjects (106 men and 106 women) whose ages ranged from 20 to 79 years. The Pearson-product moment correlation coefficient (r) described the relationship between HJA at the end-point of the SRT and the criterion, supine passive straight-leg raise (PSLR). We conducted a 6 x 2 analysis of variance, where age was stratified on 6 levels of 10-year increments (20-29, 30-39, 40-49, 50-59, 60-69, and 70-79 years of age) and gender was stratified on 2 levels (men and women). There was a statistically significant correlation (r = 0.59, P < 0.01) between performance on the SRT as measured by HJA and the supine PSLR, but the SRT only accounted for 35% of the variability in the PSLR. SRT performance in men (mean +/- SD, 80 +/- 9 degrees) was significantly less (P < 0.001) than in women (mean +/- SD, 92 +/- 10 degrees). Subjects in the 60- to 69- and 70- to 79-year age groups had significantly less (P < 0.05) HJA than those in the 20- to 29-, 30- to 39-, and 40- to 49-year age groups. Using an inclinometer to measure HJA during the SRT is not a valid method for assessing HML in men and women who can independently assume a long-sitting position on a hard surface. Clinicians should recognize there are differences in HML between men and women, and that men and women between 20 to 49 years of age have more HML than their counterparts between ages 60 to 79 years. PMID:18296990

  13. Strains at the myotendinous junction predicted by a micromechanical model

    PubMed Central

    Sharafi, Bahar; Ames, Elizabeth G.; Holmes, Jeffrey W.; Blemker, Silvia S.

    2011-01-01

    The goal of this work was to create a finite element micromechanical model of the myotendinous junction (MTJ) to examine how the structure and mechanics of the MTJ affect the local micro-scale strains experienced by muscle fibers. We validated the model through comparisons with histological longitudinal sections of muscles fixed in slack and stretched positions. The model predicted deformations of the A-bands within the fiber near the MTJ that were similar to those measured from the histological sections. We then used the model to predict the dependence of local fiber strains on activation and the mechanical properties of the endomysium. The model predicted that peak micro-scale strains increase with activation and as the compliance of the endomysium decreases. Analysis of the models revealed that, in passive stretch, local fiber strains are governed by the difference of the mechanical properties between the fibers and the endomysium. In active stretch, strain distributions are governed by the difference in cross-sectional area along the length of the tapered region of the fiber near the MTJ. The endomysium provides passive resistance that balances the active forces and prevents the tapered region of the fiber from undergoing excessive strain. These model predictions lead to the following hypotheses: (i) the increased likelihood of injury during active lengthening of muscle fibers may be due to the increase in peak strain with activation and (ii) endomysium may play a role in protecting fibers from injury by reducing the strains within the fiber at the MTJ. PMID:21945569

  14. Phase-Dependent Modulation of Percutaneously Elicited Multisegmental Muscle Responses After Spinal Cord Injury

    PubMed Central

    Dy, Christine J.; Gerasimenko, Yury P.; Edgerton, V. Reggie; Dyhre-Poulsen, Poul; Courtine, Grégoire

    2010-01-01

    Phase-dependent modulation of monosynaptic reflexes has been reported for several muscles of the lower limb of uninjured rats and humans. To assess whether this step-phase-dependent modulation can be mediated at the level of the human spinal cord, we compared the modulation of responses evoked simultaneously in multiple motor pools in clinically complete spinal cord injury (SCI) compared with noninjured (NI) individuals. We induced multisegmental responses of the soleus, medial gastrocnemius, tibialis anterior, medial hamstring, and vastus lateralis muscles in response to percutaneous spinal cord stimulation over the Th11–Th12 vertebrae during standing and stepping on a treadmill. Individuals with SCI stepped on a treadmill with partial body-weight support and manual assistance of leg movements. The NI group demonstrated phase-dependent modulation of evoked potentials in all recorded muscles with the modulation of the response amplitude corresponding with changes in EMG amplitude in the same muscle. The SCI group demonstrated more variation in the pattern of modulation across the step cycle and same individuals in the SCI group could display responses with a magnitude as great as that of modulation observed in the NI group. The relationship between modulation and EMG activity during the step cycle varied from noncorrelated to highly correlated patterns. These findings demonstrate that the human lumbosacral spinal cord can phase-dependently modulate motor neuron excitability in the absence of functional supraspinal influence, although with much less consistency than that in NI individuals. PMID:20357075

  15. Penetrating cardiac injuries.

    PubMed

    Mittal, V; McAleese, P; Young, S; Cohen, M

    1999-05-01

    Our objective was to determine the influence of several clinical factors on the survival of patients with penetrating wounds to the heart. A retrospective review of 80 consecutive penetrating cardiac injuries treated in a Level II urban trauma center from 1980 through 1994 were examined. Thirty-six patients (45%) had gunshot wounds (including 1 shotgun wound), and 44 (55%) had stab wounds. Intervention consisted of emergency room (ER) or operating room thoracotomy. We measured the effect of several clinical factors on morbidity and patient survival. Survival rate was 17 of 36 (47%) in gunshot injuries and 35 of 44 (80%) in stab injuries, with an overall survival rate of 52 of 80 patients (65%). The average age was 24 years (range, 9-53), and there were 3 female patients. Twelve patients (15%) had multiple cardiac injuries, and 63 (79%) had other associated injuries. Fourteen patients (17%) presented with no blood pressure, and 55 (69%) were hypotensive on admission. ER thoracotomy was performed on 7 of 52 survivors (13%) and 24 of 28 nonsurvivors (86%). Survival after ER thoracotomy was 7 of 31 patients (22%). A selective approach is recommended, because ER thoracotomy has a limited role in penetrating cardiac injury. A high index of suspicion, prompt resuscitation, and immediate definitive surgical management resulted in a high survival rate for these frequently lethal injuries. PMID:10231214

  16. [Monteggia injuries in childhood].

    PubMed

    Angermann, P; Lutz, M; Zimmermann, R; Reinhart, C; Gabl, M; Pechlaner, S

    2000-07-01

    The Monteggia-fracture dislocation is a characteristic combined injury of the forearm with fracture of the ulna and dislocation of the head of the radius. Monteggia- and equivalent injuries are rare. In the present study, we attempt to clarify the concept of therapy and observe the influence of this injury on the growth of the forearm bones. Between 1977 and 1996, 27 patients (three to thirteen years) with a Monteggia or a Monteggia-equivalent injury were treated. We present clinical and radiological long-term results of 20 patients, two to 21 years following the injury. Group I includes 12 patients with a classic Monteggia injury, five patients were treated conservatively, seven patients surgically. Ten patients were free of pain and had no loss of motion. In one patient there was a loss of pronation following an accompanying injury of the distal radius. Primary paresis of the radial nerve has a good prognosis. One patient presents a persisting dislocation of the radius head with a loss of flexion in the elbow joint, and a secondary persisting paraesthesia of the median nerve. Group II includes eight patients with a Monteggia-equivalent injury; all of them were treated surgically. The results in this group showed more loss of motion in elbow function, forearm rotation, and dislocation of the axis in the elbow joint. Monteggia and Monteggia-equivalent injuries in childhood have good functional results if correct reduction of the fracture of the ulna and the head of the radius is performed. If this is not possible conservatively, patients need open reduction and internal fixation. PMID:11036547

  17. Rodeo roping thumb injuries.

    PubMed

    Morgan, R F; Nichter, L S; Friedman, H I; McCue, F C

    1984-03-01

    Three men with thumb injuries sustained during rodeo roping competition have been treated recently. Two of the thumbs were amputated, and the third was partially avulsed. The mechanism of injury was identical in all three cases. The thumbs were entwined between the rope and saddle horn while reducing the slack in the rope and then subjected to shearing and crushing forces as tension was placed on the rope. These injuries emphasize the importance of keeping the thumb upward and clear of the rope to avoid entrapment between the rope and saddle horn. PMID:6715819

  18. Gasoline immersion injury

    SciTech Connect

    Simpson, L.A.; Cruse, C.W.

    1981-01-01

    Chemical burns and pulmonary complications are the most common problems encountered in the patient immersed in gasoline. Our patient demonstrated a 46-percent total-body-surface area, partial-thickness chemical burn. Although he did not develop bronchitis or pneumonitis, he did display persistent atelectasis, laryngeal edema, and subsequent upper airway obstruction. This had not previously been reported in gasoline inhalation injuries. Hydrocarbon hepatitis secondary to the vascular endothelial damage is apparently a reversible lesion with no reported long-term sequelae. Gasoline immersion injuries may be a series multisystem injury and require the burn surgeon to take a multisystem approach to its diagnosis and treatment.

  19. Critical Illness Brain Injury.

    PubMed

    Girard, Timothy D; Dittus, Robert S; Ely, E Wesley

    2016-01-14

    A growing body of literature has shown that survivors of critical illness often struggle with cognitive impairment that persists months to years after hospital discharge. We describe the epidemiology of this form of cognitive impairment-which we refer to as critical illness brain injury-and review the history and maturation of the investigation of this previously unrecognized, yet common problem. We then review the characteristics of critical illness brain injury, which can vary in severity and typically affects multiple domains of cognition. Finally, we examine known risk factors for critical illness brain injury and, based on these data, suggest approaches to patient management. PMID:26768245

  20. Epidemiology of paediatric injury.

    PubMed Central

    Mazurek, A J

    1994-01-01

    Thousands of young lives are lost every year as a result of accidents, and trauma remains the number one cause of paediatric death. There is a pattern and regularity to children's injury: boys are more often victims than the girls, most injuries occur during the summer months, the pedestrian child has usually been the victim of a road traffic accident (RTA) and, in 75% of these cases, has suffered head injury. The research into paediatric trauma is still very young. For instance, socio-economic and ethnic factors play a significant role in the statistics of accidental death. In order to take effective preventative measures more factors must be determined. PMID:7921561

  1. Fast pitch softball injuries.

    PubMed

    Meyers, M C; Brown, B R; Bloom, J A

    2001-01-01

    The popularity of fast pitch softball in the US and throughout the world is well documented. Along with this popularity, there has been a concomitant increase in the number of injuries. Nearly 52% of cases qualify as major disabling injuries requiring 3 weeks or more of treatment and 2% require surgery. Interestingly, 75% of injuries occur during away games and approximately 31% of traumas occur during nonpositional and conditioning drills. Injuries range from contusions and tendinitis to ligamentous disorders and fractures. Although head and neck traumas account for 4 to 12% of cases, upper extremity traumas account for 23 to 47% of all injuries and up to 19% of cases involve the knee. Approximately 34 to 42% of injuries occur when the athlete collides with another individual or object. Other factors involved include the quality of playing surface, athlete's age and experience level, and the excessive physical demands associated with the sport. Nearly 24% of injuries involve base running and are due to poor judgement, sliding technique, current stationary base design, unorthodox joint and extremity position during ground impact and catching of cleats. The increasing prevalence of overtraining syndrome among athletes has been attributed to an unclear definition of an optimal training zone, poor communication between player and coach, and the limited ability of bone and connective tissue to quickly respond to match the demands of the sport. This has led routinely to arm, shoulder and lumbar instability, chronic nonsteroidal anti-inflammatory drug (NSAID) use and time loss injuries in 45% of pitching staff during a single season. Specific attention to a safer playing environment, coaching and player education, and sport-specific training and conditioning would reduce the risk, rate and severity of fast pitch traumas. Padding of walls, backstops, rails and dugout areas, as well as minimising use of indoor facilities, is suggested to decrease the number of collision injuries. Coaches should be cognisant of overtraining, vary day-to-day training routines to decrease repetitive musculoskeletal stress, focus on motor skills with equal emphasis on speed and efficiency of movement, and use drills that reinforce sport-specific, decision making processes to minimise mental mistakes. Conditioning programs that emphasise a combination of power, acceleration, flexibility, technical skill, functional capacity and injury prevention are recommended. Due to the limited body of knowledge presently available on this sport, a greater focus on injury surveillance would provide a clearer picture of injury causation and effective management procedures, leading toward safer participation and successful player development. PMID:11219502

  2. Skateboard and scooter injuries.

    PubMed

    2002-03-01

    Skateboard-related injuries account for an estimated 50 000 emergency department visits and 1500 hospitalizations among children and adolescents in the United States each year. Nonpowered scooter-related injuries accounted for an estimated 9400 emergency department visits between January and August 2000, and 90% of these patients were children younger than 15 years. Many such injuries can be avoided if children and youth do not ride in traffic, if proper protective gear is worn, and if, in the absence of close adult supervision, skateboards and scooters are not used by children younger than 10 and 8 years, respectively. PMID:11875157

  3. [Skateboard injuries (author's transl)].

    PubMed

    Strz, H; Rosemeyer, B

    1979-04-01

    Following the introduction of skateboards into Germany in 1976 an increasing number of accidents and injuries have been noted, affecting mainly children 10 to 14 years of age. The causes were lack of experience and the careless use of the boards on public streets. More than 30% of injuries were fractures mainly affecting the upper limb. Because of the frequent involvement of the epiphyseal plates the post-accidental growth may be seriously disturbed. Severe and sometimes fatal head or abdominal injuries have been reported, mainly after collision with cars. PMID:107438

  4. Acute lung injury: functional genomics and genetic susceptibility.

    PubMed

    Leikauf, George D; McDowell, Susan A; Wesselkamper, Scott C; Hardie, William D; Leikauf, John E; Korfhagen, Thomas R; Prows, Daniel R

    2002-03-01

    Initiated by numerous factors, acute lung injury is marked by epithelial and endothelial cell perturbation and inflammatory cell influx that leads to surfactant disruption, pulmonary edema, and atelectasis. This syndrome has been associated with a myriad of mediators including cytokines, oxidants, and growth factors. To better understand gene-environmental interactions controlling this complex process, the sensitivity of inbred mouse strains was investigated following acute lung injury that was induced by fine nickel sulfate aerosol. Measuring survival time, protein and neutrophil concentrations in BAL fluid, lung wet-to-dry weight ratio, and histology, we found that these responses varied between inbred mouse strains and that susceptibility is heritable. To assess the progression of acute lung injury, the temporal expression of genes and expressed sequence tags was assessed by complementary DNA microarray analysis. Enhanced expression was noted in genes that were associated with oxidative stress, antiprotease function, and extracellular matrix repair. In contrast, expression levels of surfactant proteins (SPs) and Clara cell secretory protein (ie, transcripts that are constitutively expressed in the lung) decreased markedly. Genome-wide analysis was performed with offspring derived from a sensitive and resistant strain (C57BL/6xA F(1) backcrossed with susceptible A strain). Significant linkage was identified for a locus on chromosome 6 (proposed as Aliq4), a region that we had identified previously following ozone-induced acute lung injury. Two suggestive linkages were identified on chromosomes 1 and 12. Using haplotype analysis to estimate the combined effect of these regions (along with putative modifying loci on chromosomes 9 and 16), we found that five loci interact to account for the differences in survival time of the parental strains. Candidate genes contained in Aliq4 include SP-B, aquaporin 1, and transforming growth factor-alpha. Thus, the functional genomic approaches of large gene set expression (complementary DNA microarray) and genome-wide analyses continue to provide novel insights into the genetic susceptibility of lung injury. PMID:11893692

  5. Labrum and rotator cuff injuries in the throwing athlete.

    PubMed

    Menge, Travis J; Byram, Ian R; Boykin, Robert E; Bushnell, Brandon D

    2015-02-01

    The large amount of force imparted across the shoulder during the act of throwing makes the glenohumeral joint highly susceptible to injury in the athlete performing overhead throwing motions. The bony incongruity of the shoulder enables greater range of motion than any other joint in the body, but it also results in significant strain on the surrounding soft tissues during the throwing motion. Throwers can present with acute injuries, but more commonly they suffer from chronic overuse conditions resulting from repetitive overload. Proper management requires early recognition with treatment directed toward the athlete's safe return to sports. Failure to institute an appropriate management strategy may result in significant complications, including prolonged disability, progression of symptoms, and further injury. We discuss the functional anatomy, pathophysiology, clinical presentation, evaluation, and treatment of common injuries of the glenoid labrum and rotator cuff in the overhead throwing athlete. PMID:25599876

  6. Prevention and Control of Injuries.

    ERIC Educational Resources Information Center

    Tuchfarber, Barbara S.; Zins, Joseph E.; Jason, Leonard A.

    Childhood injury continues to be a major public health crisis in the United States, with a large percentage of injuries being preventable and controllable. This chapter provides information related to understanding child and youth injury. Studies have shown that injuries affect identifiable high-risk groups. Such host factors that put children at…

  7. Soda pop vending machine injuries.

    PubMed

    Cosio, M Q

    1988-11-11

    Fifteen male patients, 15 to 24 years of age, sustained injuries after rocking soda machines. The machines fell onto the victims, resulting in a variety of injuries. Three were killed. The remaining 12 required hospitalization for their injuries. Unless changes are made to safeguard these machines, people will continue to suffer severe and possibly fatal injuries from what are largely preventable accidents. PMID:3184337

  8. DARPA challenge: developing new technologies for brain and spinal injuries

    NASA Astrophysics Data System (ADS)

    Macedonia, Christian; Zamisch, Monica; Judy, Jack; Ling, Geoffrey

    2012-06-01

    The repair of traumatic injuries to the central nervous system remains among the most challenging and exciting frontiers in medicine. In both traumatic brain injury and spinal cord injuries, the ultimate goals are to minimize damage and foster recovery. Numerous DARPA initiatives are in progress to meet these goals. The PREventing Violent Explosive Neurologic Trauma program focuses on the characterization of non-penetrating brain injuries resulting from explosive blast, devising predictive models and test platforms, and creating strategies for mitigation and treatment. To this end, animal models of blast induced brain injury are being established, including swine and non-human primates. Assessment of brain injury in blast injured humans will provide invaluable information on brain injury associated motor and cognitive dysfunctions. The Blast Gauge effort provided a device to measure warfighter's blast exposures which will contribute to diagnosing the level of brain injury. The program Cavitation as a Damage Mechanism for Traumatic Brain Injury from Explosive Blast developed mathematical models that predict stresses, strains, and cavitation induced from blast exposures, and is devising mitigation technologies to eliminate injuries resulting from cavitation. The Revolutionizing Prosthetics program is developing an avant-garde prosthetic arm that responds to direct neural control and provides sensory feedback through electrical stimulation. The Reliable Neural-Interface Technology effort will devise technologies to optimally extract information from the nervous system to control next generation prosthetic devices with high fidelity. The emerging knowledge and technologies arising from these DARPA programs will significantly improve the treatment of brain and spinal cord injured patients.

  9. Occupational injuries in a poor inner-city population.

    PubMed

    Frumkin, H; Williamson, M; Magid, D; Holmes, J H; Grisso, J A

    1995-12-01

    This study aims to characterize occupational injuries in a defined poor inner-city population in terms of demographic features, types, and circumstances of injuries, and medical and financial consequences. It is a case series drawn from a larger population-based injury registry in emergency departments that serve 17 poor census tracts in Philadelphia. Of 335 patients from the study area who had been treated at the emergency departments under study for occupational injuries, 107 could be contacted by telephone 2 to 3 years after their injuries. Interviews sought information on the patients, their employment, their injuries, and the consequences. Respondents were almost all African-American, approximately 50% male, and had a median age of 32. Approximately one third were employed in the health care industry, one fourth in the service sector (including conventional service firms, restaurants, and hotels), and the remainder in construction, retail and wholesale trade, education, transportation, and manufacturing. Major causes of injuries included overexertion, contact with sharp objects, and falls. Major types on injuries included sprain/strains and lacerations. Approximately half the respondents had missed more than 3 days of work, with 15% missing more than 1 month. Almost 40% of respondents reported persistent health problems after their injuries. Only about one quarter had received workers' compensation. We conclude that poor and minority workers are at risk of a wide range of occupational injuries, which may result in considerable lost work time and have serious medical and economic consequences. More, attention to the workplace risks of these relatively marginalized workers and more vigorous preventive interventions are needed. PMID:8749743

  10. Miniature biaxial strain transducer

    NASA Technical Reports Server (NTRS)

    Hoffman, I. S. (Inventor)

    1976-01-01

    A reusable miniature strain transducer for use in the measurement of static or quasi-static, high level, biaxial strain on the surface of test specimens or structures was studied. Two cantilever arms, constructed by machining the material to appropriate flexibility, are self-aligning and constitute the transducing elements of the device. Used in conjunction with strain gages, the device enables testing beyond normal gage limits for high strains and number of load cycles. The device does not require conversion computations since the electrical output of the strain gages is directly proportional to the strain measured.

  11. Evaluating Pregnant Occupant Restraints: The Effect of Local Uterine Compression on the Risk of Fetal Injury

    PubMed Central

    Duma, Stefan M.; Moorcroft, David M.; Stitzel, Joel D.; Duma, Greg G.

    2004-01-01

    In order to develop effective restraint systems for the pregnant occupant, injury criteria for determining fetal injury risk must be developed. This study presents computer simulations of a 30 week pregnant occupant that illustrate the importance of local uterine compression on the risk of fetal injury. Frontal impact simulations with a range of velocities and belt positions were used to identify the best correlation between local uterine compression and peak strain measured at the uterine-placental interface. It is suggested that future pregnant dummy development and specifically pregnant injury criteria should be based on local uterine compression relative to the placental attachment location. PMID:15319120

  12. Direct catastrophic injury in sports.

    PubMed

    Boden, Barry P

    2005-11-01

    Catastrophic sports injuries are rare but tragic events. Direct (traumatic) catastrophic injury results from participating in the skills of a sport, such as a collision in football. Football is associated with the greatest number of direct catastrophic injuries for all major team sports in the United States. Pole vaulting, gymnastics, ice hockey, and football have the highest incidence of direct catastrophic injuries for sports in which males participate. In most sports, the rate of catastrophic injury is higher at the collegiate than at the high school level. Cheerleading is associated with the highest number of direct catastrophic injuries for all sports in which females participate. Indirect (nontraumatic) injury is caused by systemic failure as a result of exertion while participating in a sport. Cardiovascular conditions, heat illness, exertional hyponatremia, and dehydration can cause indirect catastrophic injury. Understanding the common mechanisms of injury and prevention strategies for direct catastrophic injuries is critical in caring for athletes. PMID:16272269

  13. Photobiomodulation on sports injuries

    NASA Astrophysics Data System (ADS)

    Liu, Xiao-Guang; Liu, Timon C.; Jiao, Jian-Ling; Li, Cheng-Zhang; Xu, Xiao-Yang

    2003-12-01

    Sports injuries healing has long been an important field in sports medicine. The stimulatory effects of Low intensity laser (LIL) irradiation have been investigated in several medical fields, such as cultured cell response, wound healing, hormonal or neural stimulation, pain relief and others. The aim of this study was to evaluate whether LIL irradiation can accelerate sports injuries healing. Some experimental and clinical studies have shown the laser stimulation effects on soft tissues and cartilage, however, controversy still exists regarding the role of LIL when used as a therapeutic device. Summarizing the data of cell studies and animal experiments and clinic trials by using the biological information model of photobiomodulation, we conclude that LIL irradiation is a valuable treatment for superficial and localized sports injuries and that the injuries healing effects of the therapy depend on the dosage of LIL irradiation.

  14. [Traumatic brain injury].

    PubMed

    Hackenberg, K; Unterberg, A

    2016-02-01

    Since traumatic brain injury is the most common cause of long-term disability and death among young adults, it represents an enormous socio-economic and healthcare burden. As a consequence of the primary lesion, a perifocal brain edema develops causing an elevation of the intracranial pressure due to the limited intracranial space. This entails a reduction of the cerebral perfusion pressure and the cerebral blood flow. A cerebral perfusion deficit below the threshold for ischemia leads to further ischemic lesions and to a progression of the contusion. As the irreversible primary lesion can only be inhibited by primary prevention, the therapy of traumatic brain injury focuses on the secondary injuries. The treatment consists of surgical therapy evacuating the space-occupying intracranial lesion and conservative intensive medical care. Due to the complex pathophysiology the therapy of traumatic brain injury should be rapidly performed in a neurosurgical unit. PMID:26810405

  15. Preventing Children's Sports Injuries

    MedlinePlus

    ... in first aid and CPR, and the coach's philosophy should promote players' well-being. A coach with ... nearest hospital emergency department. For overuse injuries , the philosophy is similar. If your child complains of pain, ...

  16. Injury reduction at Fermilab

    SciTech Connect

    Griffing, Bill; /Fermilab

    2005-06-01

    In a recent DOE Program Review, Fermilab's director presented results of the laboratory's effort to reduce the injury rate over the last decade. The results, shown in the figure below, reveal a consistent and dramatic downward trend in OSHA recordable injuries at Fermilab. The High Energy Physics Program Office has asked Fermilab to report in detail on how the laboratory has achieved the reduction. In fact, the reduction in the injury rate reflects a change in safety culture at Fermilab, which has evolved slowly over this period, due to a series of events, both planned and unplanned. This paper attempts to describe those significant events and analyze how each of them has shaped the safety culture that, in turn, has reduced the rate of injury at Fermilab to its current value.

  17. Genital injuries in adults.

    PubMed

    White, Catherine

    2013-02-01

    The examination of the rape victim should focus on the therapeutic, forensic and psychological needs of the individual patient. One aspect will be an examination for ano-genital injuries. From a medical perspective, they tend to be minor and require little in the way of treatment. They must be considered when assessing the risk of blood-borne viruses and the need for prophylaxis. From a forensic perspective, an understanding of genital injury rates, type of injury, site and healing may assist the clinician to interpret the findings in the context of the allegations that have been made. There are many myths and misunderstandings about ano-genital injuries and rape. The clinician has a duty to dispel these. PMID:23219384

  18. Head injury - first aid

    MedlinePlus

    ... For a moderate to severe head injury, CALL 911 RIGHT AWAY. Get medical help right away if ... Call 911 right away if: There is severe head or face bleeding. The person is confused, tired, or unconscious. ...

  19. Spine Injuries and Disorders

    MedlinePlus

    ... damage the vertebrae and surrounding tissue. They include Infections Injuries Tumors Conditions, such as ankylosing spondylitis and scoliosis Bone changes that come with age, such as spinal stenosis and herniated disks Spinal diseases often cause ...

  20. [Highway craniocerebral injuries].

    PubMed

    Romodanov, A P; Pedachenko, G A

    1984-01-01

    The work analyses the specific features of the clinical picture, diagnosis, and treatment of craniocerebral injury because of 7 car accidents (225 patients) and in common accidents of everyday life (210 patients). Craniocerebral injury in car accidents is very severe (high incidence of massive and multiple contusions of the brain, fractures of the skull bones, intracranial hematomas) and is often combined with injury to the viscera and bones. Thorough clinical and neurological examination, x-ray of the skull, echoencephalography, cerebral angiography, and trephination of the skull help to disclose and identify exactly the character of the cerebral damage. The therapeutic complex in craniocerebral injury because of car accidents includes measures of intensive therapy and, if indicated, surgical intervention. Traumatism occurring as the result of car accidents is characterized by coarser cerebral functional defects and graver invalidism of patients in contrast to accidents of everyday life. PMID:6464616

  1. Finger joint injuries.

    PubMed

    Prucz, Roni B; Friedrich, Jeffrey B

    2015-01-01

    Finger joint dislocations and collateral ligament tears are common athletic hand injuries. Treatment of the athlete requires a focus on safe return to play and maximizing function. Certain dislocations, such as proximal interphalangeal and distal interphalangeal volar dislocations, may be associated with tendon injuries and must be treated accordingly. Treatment of other dislocations is ultimately determined by postreduction stability, with many dislocations amenable to nonoperative treatment (ie, immobilization followed by rehabilitation). Protective splinting does not necessarily preclude athletic participation. Minor bone involvement typically does not affect the treatment plan, but significant articular surface involvement may necessitate surgical repair or stabilization. Percutaneous and internal fixation are the mainstays of surgical treatment. Treatment options that do not minimize recovery or allow the patient to return to protected play, such as external fixation, are generally avoided during the season of play. Undertreated joint injuries and unrecognized ligament injuries can result in long term disability. PMID:25455398

  2. Survey of laser injury

    NASA Astrophysics Data System (ADS)

    Johnson, Thomas E.; Dunn, J. C., II; Roach, William P.

    2002-06-01

    Laser use is pervasive and steadily expanding both in the private sector and the Department of Defense (DoD). For more than 20 years, Rockwell Laser Industries, the U.S. Army, and the Food and Drug Administration's Center for Devices and Radiological Health have separately collected data on injuries occurring during, or resultant from, the use of lasers. However, data from these sources is incomplete and has not recently undergone a thorough compiling, statistical analysis, review and summarization. It is our belief that in order to evaluate current related medical surveillance, safety and training procedures, this data needs such an examination. Persons maintaining these databases were contacted and any available data on laser injury was collected. The data was analyzed and examined for pertinent similarities and differences among a wide range of parameters. We summarize these findings in this paper and also comment on the injuries, current safety measures and injury reporting protocols associated with laser use.

  3. Spinal Cord Injury

    MedlinePlus

    ... Dramatically Improves Function After Spinal Cord Injury in Rats May 2004 press release on an experimental treatment ... NINDS). Signaling Molecule Improves Nerve Cell Regeneration in Rats August 2002 news summary on a signaling molecule ...

  4. Head Injury Prevention Tips

    MedlinePlus

    ... injuries Buy and use helmets or protective head gear approved by the American Society for Testing and ... bear a sticker stating this. Helmets and head gear come in many sizes and styles for many ...

  5. Facial Sports Injuries

    MedlinePlus

    ... injuries are preventable by wearing the proper protective gear, and your attitude toward safety can make a ... move the victim, or remove helmets or protective gear. Do not give food, drink or medication until ...

  6. What Are Sports Injuries?

    MedlinePlus

    ... can result from poor training practices or improper gear. Some people get injured when they are not ... reduce your risk of “overuse” injuries. Use safety gear. Know your body’s limits. Build up your exercise ...

  7. Traumatic Brain Injury

    MedlinePlus

    ... disabilities include problems with cognition (thinking, memory, and reasoning), sensory processing (sight, hearing, touch, taste, and smell), ... org/ NIH Patient Recruitment for Traumatic Brain Injury Clinical Trials At NIH Clinical Center Throughout the U.S. ...

  8. Eye Injuries in Sports

    MedlinePlus

    ... and severity of eye injuries. Only 3-mm polycarbonate lenses should be used in protective sports eyewear. ... lenses are available in plain and prescription forms. Polycarbonate lenses are impact resistant. They also are the ...

  9. Brain injury - discharge

    MedlinePlus

    ... 5, 2014. Chuang K, Stroud, NL, Zafonte R. Rehabilitation of patients with traumatic brain injury. In: Winn HR, ed. Youman's Neurological Surgery . 6th ed. Philadelphia, PA: Elsevier Saunders; 2011: ...

  10. Biomarkers of Lung Injury

    EPA Science Inventory

    Unlike the hepatic, cardiovascular, nervous, or excretory organ systems, where there .ls a strong contribution of host factors or extracellular biochemical milieu in causing organ damage, the causes of lung injuries and subsequent diseases are primarily from direct environmental ...

  11. Injury and disability in matched men's and women's intercollegiate sports.

    PubMed Central

    Lanese, R R; Strauss, R H; Leizman, D J; Rotondi, A M

    1990-01-01

    Eight matched men's and women's intercollegiate varsity teams were studied prospectively for one academic year to determine the incidence of athletic injury and resulting disability. Sports in which both men and women participated in a comparable manner were chosen: basketball, fencing, gymnastics, swimming, tennis, indoor track, outdoor track, and volleyball. Men (232) and women (150) were injured at comparable rates, 42 percent versus 39 percent. When adjusted for exposure time, seven of the eight sports continued to show similar injury rates. Women gymnasts, however, experienced .82 injuries per 100 person-hours of exposure as compared to .21 injuries for the men (p = .0001). Disability was greater in women gymnasts, 7.44 days per 100 person-hours versus 1.15 days for men (p = .0004). Percent of season lost to injury was also greater for women gymnasts. Types and sites of injury were similar for men and women, with sprains and strains accounting for over half of all injuries. We found no evidence for gender differences in matched sports except for gymnastics, in which technically diverse events may have accounted for the differences observed. PMID:2240330

  12. Injury and disability in matched men's and women's intercollegiate sports.

    PubMed

    Lanese, R R; Strauss, R H; Leizman, D J; Rotondi, A M

    1990-12-01

    Eight matched men's and women's intercollegiate varsity teams were studied prospectively for one academic year to determine the incidence of athletic injury and resulting disability. Sports in which both men and women participated in a comparable manner were chosen: basketball, fencing, gymnastics, swimming, tennis, indoor track, outdoor track, and volleyball. Men (232) and women (150) were injured at comparable rates, 42 percent versus 39 percent. When adjusted for exposure time, seven of the eight sports continued to show similar injury rates. Women gymnasts, however, experienced .82 injuries per 100 person-hours of exposure as compared to .21 injuries for the men (p = .0001). Disability was greater in women gymnasts, 7.44 days per 100 person-hours versus 1.15 days for men (p = .0004). Percent of season lost to injury was also greater for women gymnasts. Types and sites of injury were similar for men and women, with sprains and strains accounting for over half of all injuries. We found no evidence for gender differences in matched sports except for gymnastics, in which technically diverse events may have accounted for the differences observed. PMID:2240330

  13. Low back injury.

    PubMed

    Hainline, B

    1995-01-01

    Low back injuries occur commonly in tennis, but the pathophysiologic, biomechanical, and clinical characteristics are not well defined. Tennis players may be at an increased risk of lumbar disc pathology from rotational and hyperextension shearing effects. Treatment of low back injury at present is empiric, but sport-specific lumbar stabilization and unloading of the lumbar disc should be developed. Prospective longitudinal research protocols are needed to study the lumbar spine in tennis players. PMID:7712553

  14. Frailty and Injury Causation

    PubMed Central

    Ryb, Gabriel E; Dischinger, Patricia C; Burch, Cynthia A; Kerns, Timothy J; Kufera, Joseph; Andersen, Daniel

    2012-01-01

    Purpose: The current study will attempt to elucidate whether frailty has a role in motor vehicle crash injury causation. Methods: The association between frailty and injury was studied among Crash Injury Research Engineering Network (CIREN) cases. The baseline “physical functioning” (PF) score of the SF-36 was used as a marker of frailty (i.e., PF score <75). Frailty associations with ISS and occupant, vehicular and crash factors were explored. Frailty association with delta V was analyzed among injured (i.e., brain, rib, or femur) belted occupants in frontal crashes to establish whether frailty confers a different risk of each particular injury. Results: Frailty occurred in 13.7 % of the cohort (n=1,747). Median (q1-q3) ISS was 14.0 (10–22) among the frail and 17.0 (10–24) among the non frail (p=0.40). Frailty was significantly associated with advanced age, male gender, the presence of co-morbidities, extreme BMIs, frontal and near-side crashes and delta V < 45 km/h. Seat belt use and ISS<16 were not associated with frailty. Multiple linear regressions, adjusting for age, gender and BMI revealed a negative association between frailty and log delta V (coefficient −0.188, p=0.04) among those with rib fractures but not among those with brain injuries or femur fractures. Conclusion: PF score, a marker of frailty, is associated with similar ISS and lower delta V and is independently linked to lower delta V thresholds for some injuries (i.e. rib fractures) but not for others (i.e. brain injuries and femur fractures). These associations suggest a potential role of frailty in injury causation. PMID:23169127

  15. 1. Avoiding back injury.

    PubMed

    Randall, Sara

    2014-12-01

    This article looks at healthcare professionals, in particular midwives, and considers how to maintain back health and prevent injury through principles of good practice. Knowledge of back pain, mindfulness in working conditions and modifications of current practice will reduce the risk of repetitive injury, and present management options in the short- and long term. Considerations on improving the 'working lifestyle' rather than quick fixes are ultimately the long-term goal. PMID:25597130

  16. Hysteria following brain injury.

    PubMed Central

    Eames, P

    1992-01-01

    Of 167 patients referred to a unit treating severe behaviour disorders after brain injury, 54 showed clinical features closely resembling those of gross hysteria as described by Charcot. Close correlation was found with very diffuse insults (hypoxia and hypoglycaemia), but not with severity of injury or with family or personal history of hysterical or other psychiatric disorder. The findings may have implications for the understanding of the nature of hysteria. PMID:1469401

  17. Pars Injuries in Athletes.

    PubMed

    Oren, Jonathan; Gallina, Jason

    2016-03-01

    Pars injuries are common causes of low back pain in adolescent athletes. Workup traditionally has included lumbar radiographs with oblique views and single-photon emission computed tomography (SPECT). However, recent literature has demonstrated the accuracy of MRI as a diagnostic modality. Acute injuries may be amenable to bracing with the goal of a healed lesion. Most cases of spondylolysis will result in asymptomatic non-union, though pars repair is an option for symptomatic pars defects without spondylolisthesis. PMID:26977552

  18. Traumatic injuries to athletes.

    PubMed

    Sigurdsson, Asgeir; Bourguignon, Cecilia

    2015-01-01

    The timeliness of treatment after dental trauma is crucial to successful tooth preservation. This article focuses on the emergency treatment of common forms of dental trauma in athletes, both at the site of the injury and at the dental office. When dental injuries happen to young patients, saving the tooth is an absolute priority, because few long-term replacement solutions can be performed in a growing child. Preserving pulpal vitality of immature teeth is essential to allow continued root development. PMID:26545271

  19. Catastrophic spine injuries in sports.

    PubMed

    Boden, Barry P; Prior, Chris

    2005-02-01

    Catastrophic spine injuries in sports are rare but tragic events. The sports with the highest risk of catastrophic spinal injuries are football, ice hockey, wrestling, diving, skiing and snowboarding, rugby, cheerleading, and baseball. A common mechanism of injury for all at-risk sports is an axial compression force to the top of the head with the neck slightly flexed. We review common mechanisms of injury and prevention strategies for spine injuries in the at-risk sports. PMID:15659279

  20. Electrical and lightning injuries.

    PubMed

    Maghsoudi, Hemmat; Adyani, Yosef; Ahmadian, Nahid

    2007-01-01

    The aim of this study was to explore the mechanisms, complications, morbidity, and mortality associated with electrical injuries. Of 5053 acute burn admissions during a 5-year period, 202 patients (4%) had electrical burn injuries. Their mean age was 27.5 years (range, 3-71 years). Ninety-eight percent were male, and the extent of burn ranged from 1% to 70% TBSA (mean, 10.5 +/- 10.7% TBSA). High-voltage electricity caused 54% of the electrical injuries. Forty-two percent were caused by low-voltage currents and 4% by lightning. A total of 217 surgical procedures were performed on 202 patients Fifteen patients (7.4%) required amputation. All patients who had abnormal electrocardiograms underwent cardiac monitoring. Four had cardiac complications. Mean hospital stay was 13.9 +/- 14.6 days (range, 1-90). Four patients (2%) died. Electrical burn injuries continue to be a serious problem of modern society. Climbing power poles is the most common mechanism for high-voltage injury. Special consideration is required to prevent this type of injury in our region. PMID:17351442