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Sample records for hamstring strain injuries

  1. Biomechanical response to hamstring muscle strain injury.

    PubMed

    Schache, Anthony G; Wrigley, Tim V; Baker, Richard; Pandy, Marcus G

    2009-02-01

    Hamstring strains are common injuries, the majority of which occur whilst sprinting. An understanding of the biomechanical circumstances that cause the hamstrings to fail during sprinting is required to improve rehabilitation specificity. The aim of this study was to therefore investigate the biomechanics of an acute hamstring strain. Bilateral kinematic and ground reaction force data were captured from a sprinting athlete prior to and immediately following a right hamstring strain. Ten sprinting trials were collected: nine normal (pre-injury) trials and one injury trial. Joint angles, torques and powers as well as hamstring muscle-tendon unit lengths were computed using a three-dimensional biomechanical model. For the pre-injury trials, the right leg compared to the left displayed greater knee extension and hamstring muscle-tendon unit length during terminal swing, an increased vertical ground reaction force peak and loading rate, and an increased peak hip extensor torque and peak hip power generation during initial stance. For the injury trial, significant biomechanical reactions were evident in response to the right hamstring strain, most notably for the right leg during the proceeding swing phase after the onset of the injury. The earliest kinematic deviations in response to the injury were displayed by the trunk and pelvis during right mid-stance. Taking into account neuromuscular latencies and electromechanical delays, the stimulus for the injury must have occurred prior to right foot-strike during the swing phase of the sprinting cycle. It is concluded that hamstring strains during sprinting most likely occur during terminal swing as a consequence of an eccentric contraction.

  2. The role of neuromuscular inhibition in hamstring strain injury recurrence.

    PubMed

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

    2013-06-01

    Hamstring strain injuries are amongst the most common and problematic injuries in a wide range of sports that involve high speed running. The comparatively high rate of hamstring injury recurrence is arguably the most concerning aspect of these injuries. A number of modifiable and nonmodifiable risk factors are proposed to predispose athletes to hamstring strains. Potentially, the persistence of risk factors and the development of maladaptations following injury may explain injury recurrence. Here, the role of neuromuscular inhibition following injury is discussed as a potential mechanism for several maladaptations associated with hamstring re-injury. These maladaptations include eccentric hamstring weakness, selective hamstring atrophy and shifts in the knee flexor torque-joint angle relationship. Current evidence indicates that athletes return to competition after hamstring injury having developed maladaptations that predispose them to further injury. When rehabilitating athletes to return to competition following hamstring strain injury, the role of neuromuscular inhibition in re-injury should be considered.

  3. Hamstring injuries.

    PubMed

    Ropiak, Christopher R; Bosco, Joseph A

    2012-01-01

    Hamstring injuries are a frequent injury in athletes. Proximal injuries are common, ranging from strain to complete tear. Strains are managed nonoperatively, with rest followed by progressive stretching and strengthening. Reinjury is a concern. High grade complete tears are better managed surgically, with reattachment to the injured tendon or ischial tuberosity. Distal hamstring injury is usually associated with other knee injuries, and isolated injury is rare.

  4. Rehabilitation of acute hamstring strain injuries.

    PubMed

    Sherry, Marc A; Johnston, Tyler S; Heiderscheit, Bryan C

    2015-04-01

    Acute hamstring injuries are responsible for significant time loss for athletes. As there are a multitude of injury mechanisms, thorough evaluation is imperative for determining the appropriate plan of care and adequate rehabilitation is required to reduce the risk of recurrent injuries.

  5. 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

  6. Sports related hamstring strains--two cases with different etiologies and injury sites.

    PubMed

    Askling, C; Tengvar, M; Saartok, T; Thorstensson, A

    2000-10-01

    Hamstring strains are common injuries in sports. Knowledge about their etiology and localization is, however, limited. The two cases described here both had acute hamstring strains, but the etiologies were entirely different. The sprinter was injured when running at maximal speed, whereas the hamstring strain in the dancer occurred during slow stretching. Also the anatomical localizations of the injuries clearly differed. Magnetic resonance imaging (MRI) revealed pathological changes in the distal semitendinosus muscle in the sprinter and the proximal tendon of the semimembranosus muscle in the dancer. Subjectively, both athletes severely underestimated the recovery time. These case observations suggest a possible link between etiology and localization of hamstring strains.

  7. 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

  8. 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

  9. Hamstring muscle forces prior to and immediately following an acute sprinting-related muscle strain injury.

    PubMed

    Schache, Anthony G; Kim, Hyung-Joo; Morgan, David L; Pandy, Marcus G

    2010-05-01

    A thorough understanding of the biomechanics of the hamstrings during sprinting is required to optimise injury rehabilitation and prevention strategies. The main aims of this study were to compare hamstrings load across different modes of locomotion as well as before and after an acute sprinting-related muscle strain injury. Bilateral kinematic and ground reaction force data were captured from a single subject whilst walking, jogging and sprinting prior to and immediately following a significant injury involving the right semitendinosis and biceps femoris long head muscles. Experimental data were input into a three-dimensional musculoskeletal model of the body and used, together with optimisation theory, to determine lower-limb muscle forces for each locomotor task. Hamstrings load was found to be greatest during terminal swing for sprinting. The hamstrings contributed the majority of the terminal swing hip extension and knee flexion torques, whilst gluteus maximus contributed most of the stance phase hip extension torque. Gastrocnemius contributed little to the terminal swing knee flexion torque. Peak hamstrings force was also substantially greater during terminal swing compared to stance for sprinting, but not for walking and jogging. Immediately following the muscle strain injury, the hamstrings demonstrated an intolerance to perform an eccentric-type contraction. Whilst peak hamstrings force during terminal swing did not decrease post-injury, both peak hamstrings length and negative work during terminal swing were considerably reduced. These results lend support to the paradigm that the hamstrings are most susceptible to muscle strain injury during the terminal swing phase of sprinting when they are contracting eccentrically.

  10. Effects of Prior Hamstring Strain Injury on Strength, Flexibility, and Running Mechanics

    PubMed Central

    Silder, Amy; Thelen, Darryl G.; Heiderscheit, Bryan C.

    2010-01-01

    Background Previous studies have shown evidence of residual scar tissue at the musculotendon junction following an acute hamstring strain injury, which could influence re-injury risk. The purpose of this study was to investigate whether bilateral differences in strength, neuromuscular patterns, and musculotendon kinematics during sprinting are present in individuals with a history of unilateral hamstring injury, and whether such differences are linked to the presence of scar tissue. Methods Eighteen subjects with a previous hamstring injury (>5 months prior) participated in a magnetic resonance (MR) imaging exam, isokinetic strength testing, and a biomechanical assessment of treadmill sprinting. Bilateral comparisons were made for peak knee flexion torque, angle of peak torque, and hamstrings:quadriceps strength ratio during strength testing, and muscle activations and peak hamstring stretch during sprinting. MR images were used to measure the volumes of the proximal tendon/aponeurois of the biceps femoris, with asymmetries considered indicative of residual scar tissue. Findings A significantly enlarged proximal biceps femoris tendon volume was measured on the side of prior injury. However, no significant differences between the previously injured and uninjured limbs were found in strength measures, peak hamstring stretch, or muscle activation patterns. Further, the degree of asymmetry in tendon volume was not correlated to any of the functional measures. Interpretation The results of this study indicate that injury-induced changes in morphology do not seem discernable from strength measures, running kinematics, or muscle activity patterns. Further research is warranted to ascertain whether residual scarring alters localized musculotendon tissue mechanics in a way that may contribute to the high rates of muscle re-injury that are observed clinically. PMID:20621753

  11. Is there a potential relationship between prior hamstring strain injury and increased risk for future anterior cruciate ligament injury?

    PubMed

    Opar, David A; Serpell, Benjamin G

    2014-02-01

    Hamstring strain injuries (HSIs) are the most prevalent injury in a number of sports, and while anterior cruciate ligament (ACL) injuries are less common, they are far more severe and have long-term implications, such as an increased risk of developing osteoarthritis later in life. Given the high incidence and severity of these injuries, they are key targets of injury preventive programs in elite sport. Evidence has shown that a previous severe knee injury (including ACL injury) increases the risk of HSI; however, whether the functional deficits that occur after HSI result in an increased risk of ACL injury has yet to be considered. In this clinical commentary, we present evidence that suggests that the link between previous HSI and increased risk of ACL injury requires further investigation by drawing parallels between deficits in hamstring function after HSI and in women athletes, who are more prone to ACL injury than men athletes. Comparisons between the neuromuscular function of the male and female hamstring has shown that women display lower hamstring-to-quadriceps strength ratios during isokinetic knee flexion and extension, increased activation of the quadriceps compared with the hamstrings during a stop-jump landing task, a greater time required to reach maximal isokinetic hamstring torque, and lower integrated myoelectrical hamstring activity during a sidestep cutting maneuver. Somewhat similarly, in athletes with a history of HSI, the previously injured limb, compared with the uninjured limb, displays lower eccentric knee flexor strength, a lower hamstrings-to-quadriceps strength ratio, lower voluntary myoelectrical activity during maximal knee flexor eccentric contraction, a lower knee flexor eccentric rate of torque development, and lower voluntary myoelectrical activity during the initial portion of eccentric contraction. Given that the medial and lateral hamstrings have different actions at the knee joint in the coronal plane, which hamstring head is

  12. MR OBSERVATIONS OF LONG-TERM MUSCULOTENDON REMODELING FOLLOWING A HAMSTRING STRAIN INJURY

    PubMed Central

    Silder, Amy; Heiderscheit, Bryan; Thelen, Darryl G.; Enright, Timothy; Tuite, Michael J.

    2009-01-01

    Objective The objective of this study was to use MR imaging to investigate long-term changes in muscle and tendon morphology following a hamstring strain injury. Materials and Methods MR images were obtained from 14 athletes who sustained a clinically diagnosed grade I/II hamstring strain injury between 5-23 months prior as well as five healthy controls. Qualitative bilateral comparisons were used to assess the presence of fatty infiltration and changes in morphology that may have arisen as a result of the previous injury. Hamstring muscle and tendon/scar volumes were quantified in both limbs for the biceps femoris long head (BFLH), biceps femoris short head (BFSH), the proximal semimembranosus tendon (PSMT) and the proximal conjoint biceps femoris and semitendinosus tendon (PBFT). Differences in muscle and tendon volume between limbs were statistically compared between the previously injured and healthy control subjects. Results Increased low-intensity signal was present along the musculotendon junction adjacent to the site of presumed prior injury for 11 of the 14 subjects, suggestive of persistent scar tissue. The thirteen subjects with biceps femoris injuries displayed a significant decrease in BFLH volume (p<0.01), often accompanied by an increase in BFSH volume. Two of these subjects also presented with fatty infiltration within the previously injured BFLH. Conclusion The results of this study provide evidence of long-term musculotendon remodeling following a hamstring strain injury. Additionally, many athletes are likely returning to sport with residual atrophy of the BFLH and/or hypertrophy of the BFSH. It is possible that long-term changes in musculotendon structure following injury alters contraction mechanics during functional movement, such as running, and may contribute to re-injury risk. PMID:18649077

  13. Computed tomography of hamstring muscle strains.

    PubMed

    Garrett, W E; Rich, F R; Nikolaou, P K; Vogler, J B

    1989-10-01

    Acute hamstring muscle strains occurring in ten college athletes were evaluated using computed tomography to identify the location and characteristics of these common injuries. Acute muscle strains appeared as areas of hypodensity within the muscle 1-2 d following injury. This suggests that inflammation and edema are the major component of injury, not bleeding as commonly assumed. Injuries were seen most commonly in the proximal and lateral portions of the hamstring muscle group, particularly in the biceps femoris.

  14. 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

  15. Hamstring strains and tears in the athlete.

    PubMed

    Ali, Kashif; Leland, J Martin

    2012-04-01

    Hamstring injuries continue to be very common for both elite and amateur athletes. Given their high recurrence rate, the ability to treat these injuries effectively is critical to helping athletes return to their previous level of activity without putting them at risk for future injury. Most hamstring strains can be treated with initial pain control and a course of rehabilitation focused on a gradual return to activity. However, an exact, evidence-based rehabilitation protocol has yet to be studied. Although surgery is rare and reserved for complete hamstring ruptures, results show high patient satisfaction and ability to return to play.

  16. Physical principles demonstrate that the biceps femoris muscle relative to the other hamstring muscles exerts the most force: implications for hamstring muscle strain injuries

    PubMed Central

    Dolman, Bronwyn; Verrall, Geoffrey; Reid, Iain

    2014-01-01

    Summary Of the hamstring muscle group the biceps femoris muscle is the most commonly injured muscle in sports requiring interval sprinting. The reason for this observation is unknown. The objective of this study was to calculate the forces of all three hamstring muscles, relative to each other, during a lengthening contraction to assess for any differences that may help explain the biceps femoris predilection for injury during interval sprinting. To calculate the displacement of each individual hamstring muscle previously performed studies on cadaveric anatomical data and hamstring kinematics during sprinting were used. From these displacement calculations for each individual hamstring muscle physical principles were then used to deduce the proportion of force exerted by each individual hamstring muscle during a lengthening muscle contraction. These deductions demonstrate that the biceps femoris muscle is required to exert proportionally more force in a lengthening muscle contraction relative to the semimembranosus and semitendinosus muscles primarily as a consequence of having to lengthen over a greater distance within the same time frame. It is hypothesized that this property maybe a factor in the known observation of the increased susceptibility of the biceps femoris muscle to injury during repeated sprints where recurrent higher force is required. PMID:25506583

  17. 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

  18. Hamstring injuries. Proposed aetiological factors, prevention, and treatment.

    PubMed

    Agre, J C

    1985-01-01

    Injuries to the hamstring muscles can be devastating to the athlete because these injuries frequently heal slowly and have a tendency to recur. It is thought that many of the recurrent injuries to the hamstring musculotendinous unit are the result of inadequate rehabilitation following the initial injury. The severity of hamstring injuries is usually of first or second degree, but occasionally third-degree injuries (complete rupture of the musculotendinous unit) do occur. Most hamstring strain injuries occur while running or sprinting. Several aetiological factors have been proposed as being related to injury of the hamstring musculotendinous unit. They include: poor flexibility, inadequate muscle strength and/or endurance, dyssynergic muscle contraction during running, insufficient warm-up and stretching prior to exercise, awkward running style, and a return to activity before complete rehabilitation following injury. Treatment for hamstring injuries includes rest and immobilisation immediately following injury and then a gradually increasing programme of mobilisation, strengthening, and activity. Permission to return to athletic competition should be withheld until full rehabilitation has been achieved (complete return of muscle strength, endurance, and flexibility in addition to a return of co-ordination and athletic agility). Failure to achieve full rehabilitation will only predispose the athlete to recurrent injury. The best treatment for hamstring injuries is prevention, which should include training to maintain and/or improve strength, flexibility, endurance, co-ordination, and agility.

  19. Factors associated with hamstring injuries. An approach to treatment and preventative measures.

    PubMed

    Worrell, T W

    1994-05-01

    Following hamstring strain, rehabilitation is often prolonged and frustrating for the athlete and for the sports medicine clinician. Though the initial treatment of rest, ice, compression and elevation is accepted for muscle strains, no consensus exists for rehabilitation of hamstring muscle strains. This lack of agreement concerning rehabilitation of hamstring injury represents our lack of understanding of the mechanism of injury and the factors that contribute to hamstring strain. A hamstring rehabilitation model is proposed that is based on our current understanding of the aetiological factors that contribute to hamstring muscle strain. The influence and interaction of hamstring strength, flexibility, warm-up and fatigue are aetiological factors that should be addressed in the rehabilitation and prevention of hamstring strains. The rehabilitation model is, however, not without limitations and speculations. Further research is needed to clarify the etiological factors of hamstring strain and the efficacy of different rehabilitation protocols.

  20. 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 < 0.001) and college-level (OR = 3.55, P = 0.001) athletes to suffer HSI. The 4 × 400-m relay displayed a greater likelihood of HSI compared with the 4 × 100-m relay (OR = 1.77, P = 0.008). High school boys and masters-level athletes are most likely to suffer HSI, and there is higher risk in 400-m events compared with 100-m events.

  1. Evaluation and management of hamstring injuries.

    PubMed

    Ahmad, Christopher S; Redler, Lauren H; Ciccotti, Michael G; Maffulli, Nicola; Longo, Umile Giuseppe; Bradley, James

    2013-12-01

    Muscle injuries are the most common injuries in sports, with hamstring injuries accounting for 29% of all injuries in athletes. These injuries lead to prolonged impairment and have a reinjury risk of 12% to 31%. They range from mild muscle damage without loss of structural integrity to complete muscle tearing with fiber disruption. Novel MRI scores are increasingly being used and allow a more precise prediction of return to sport. In this article, the authors review the history, mechanisms of injury, and classification systems for hamstring injuries as well as present the latest evidence related to the management of hamstring injuries, including intramuscular and both proximal and distal insertional injuries. Indications for surgical treatment of certain proximal and distal avulsions, biological augmentation to the nonoperative treatment of midsubstance injuries, and advances in risk reduction and injury prevention are discussed.

  2. Hamstring strains in athletes: diagnosis and treatment.

    PubMed

    Clanton, T O; Coupe, K J

    1998-01-01

    Hamstring strains are among the most common injuries (and reinjuries) in athletes. Studies combining electromyography with gait analysis have elucidated the timing of activity of the three muscles of the hamstring group; they function during the early-stance phase for knee support, during the late-stance phase for propulsion, and during midswing to control the momentum of the leg. Muscle injury, whether partial or complete, occurs at the myotendinous junction, where force is concentrated. The healing response begins with inflammation, associated edema, and localized hemorrhage. After an initial period of reduced tension, the healing muscle regains strength rapidly as long as reinjury does not occur. Although the use of anti-inflammatory medication is a keystone of treatment, a certain degree of inflammation is necessary for removing necrotic muscle fibers and rescaffolding to allow optimal recovery. The protocol of rest, ice, compression, and elevation is still the preferred first-aid approach. After a brief period of immobilization (usually less than 1 week for even the most severe strain), mobilization is begun to properly align the regenerating muscle fibers and limit the extent of connective tissue fibrosis. Concurrent pain-free stretching and strengthening exercises (beginning with isometrics and progressing to isotonics and isokinetics) are essential to regain flexibility and prevent further injury and inflammation. Readiness for return to competition can be assessed by isokinetic testing to confirm that muscle-strength imbalances have been corrected, the hamstring-quadriceps ratio is 50% to 60%, and the strength of the injured leg has been restored to within 10% of that of the unaffected leg. The only indication for surgery is a complete rupture at or near the origin from the ischial tuberosity or distally at its insertion (either soft-tissue avulsion with a large defect or bone avulsion with displacement by 2 cm).

  3. Evidence based prevention of hamstring injuries in sport.

    PubMed

    Petersen, J; Hölmich, P

    2005-06-01

    A common soft tissue injury in sports involving sprinting and jumping is the hamstring strain. A major problem with hamstring strains is the high incidence of reinjury. Muscle injuries can be classified as direct or indirect and are typically grouped into three categories according to severity. A number of potential risk factors have been proposed for hamstring strains. Only a few are evidence based and some are mainly based on theoretical assumptions. There is a lack of clinical research on the effectiveness of rehabilitation programmes for hamstring strains. Although the initial treatment of rest, ice, compression, and elevation is accepted for muscle strains, no consensus exists for their rehabilitation. Not much evidence based research has been carried out on prevention of hamstring strain. To our knowledge only two prospective studies have so far been published. As the injuries are common in football and other sports involving sprinting and jumping, there is a need for further research preferably in the form of randomised controlled trials.

  4. 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

  5. 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.

  6. Hamstring muscle strain treated by mobilizing the sacroiliac joint.

    PubMed

    Cibulka, M T; Rose, S J; Delitto, A; Sinacore, D R

    1986-08-01

    The purpose of this study was to compare the effectiveness of two types of treatment of hamstring muscle strains. Twenty patients with hamstring muscle strains were assigned randomly to an Experimental Group (n = 10) or a Control Group (n = 10). Peak torque production of the quadriceps femoris and hamstring muscles and hamstring muscle length were measured before and after treatment. The hamstring muscles of the Experimental and Control groups were treated with moist heat followed by passive stretching. The Experimental Group also received manipulation of the sacroiliac joint. The change in hamstring muscle peak torque was significantly greater for the Experimental Group than for the Control Group (p less than .005). No significant differences existed between the two groups in either quadriceps femoris muscle peak torque or hamstring muscle length. The results of this study suggest a relationship between sacroiliac joint dysfunction and hamstring muscle strain.

  7. Anatomy and physiology of hamstring injury.

    PubMed

    Kumazaki, T; Ehara, Y; Sakai, T

    2012-12-01

    The hamstring muscles were analyzed anatomically and physiologically to clarify the specific reasons for the incidence of muscle strain of the hamstrings. For the anatomical study, hamstring muscles of 13 embalmed cadavers were dissected. For the physiological study, the knee flexor torque and surface electromyographic (EMG) signals were measured during isometric contraction of hamstring muscles in 10 healthy adults. The biceps femoris muscle long head (BF-L) and semimembranosus muscle (SM) had hemi-pennate architecture and their fiber length per total muscle length (FL/TML) was smaller than that of semtendinosus muscle (ST) and biceps femoris muscle short head (BF-S) with other architecture. The decrease of total muscle length per fiber length (ΔTML/FL) was larger in BF-L and SM than in ST and BF-S. The EMG activities at 0° of knee angle were at maximal compared with other knee angles and were of similar level in BF-L, in SM and in ST, whereas they were considerably smaller in BF-S. The EMG at 0° of knee angle activity per physiological cross-sectional area (PCSA) was about 1.6 times greater in BF-L than in SM. These results indicate the highest risk of muscle strain was in BF-L followed by SM.

  8. Hamstring exercises for track and field athletes: injury and exercise biomechanics, and possible implications for exercise selection and primary prevention.

    PubMed

    Malliaropoulos, Nikos; Mendiguchia, Jurdan; Pehlivanidis, Hercules; Papadopoulou, Sofia; Valle, Xavier; Malliaras, Peter; Maffulli, Nicola

    2012-09-01

    Hamstring strain injuries are the most prevalent muscle injuries in track and field (TF). These injuries often cause prolonged symptoms and a high risk of re-injury. Strengthening of the hamstring muscles has been recommended for injury prevention. The authors review the possible role of eccentric training in TF hamstring injury prevention and introduce exercise classification criteria to guide clinicians in designing strengthening programmes adapted to TF. The principles exposed may serve as a foundation for future development and application of new eccentric programmes to decrease the high incidence of this type of injury in other sports.

  9. Hamstring muscle strain recurrence and strength performance disorders.

    PubMed

    Croisier, Jean-Louis; Forthomme, Bénédicte; Namurois, Marie-Hélène; Vanderthommen, Marc; Crielaard, Jean-Michel

    2002-01-01

    We determined the frequency of strength disorders in 26 athletes with a history of hamstring muscle injury and recurrent strains and discomfort. We also assessed the effectiveness of rehabilitation to correct muscle performance. After concentric and eccentric isokinetic assessment, 18 athletes were found to have strength deficits, as determined by statistically selected cutoffs of peak torque, bilateral differences, and the flexors/quadriceps ratio. The discriminating character of the eccentric trial was demonstrated, combining a preferential eccentric peak torque deficit and a significant reduction of the mixed eccentric flexors/concentric quadriceps ratio. The athletes with muscle imbalances followed a rehabilitation program individually adapted from their strength profile. Treatment length was from 10 to 30 sessions and resulted in isokinetic parameter normalization in 17 of 18 subjects. Isokinetically corrected subjects were observed for 12 months after return to athletics. None sustained a clinically diagnosed hamstring muscle reinjury. Subjective intensity of pain and discomfort were significantly reduced, and they all returned to their prior level of competition. These results demonstrate that persistent muscle strength abnormalities may give rise to recurrent hamstring injuries and discomfort. An individualized rehabilitation program emphasizing eccentric training based on specific deficits contributes to a decrease in symptoms on return to sports.

  10. The relationship between previous hamstring injury and the concentric isokinetic knee muscle strength of irish gaelic footballers

    PubMed Central

    O'Sullivan, Kieran; O'Ceallaigh, Brian; O'Connell, Kevin; Shafat, Amir

    2008-01-01

    Background Hamstring injury is one of the most common injuries affecting gaelic footballers, similar to other field sports. Research in other sports on whether residual hamstring weakness is present after hamstring injury is inconsistent, and no study has examined this factor in irish gaelic footballers. The aim of this study was to examine whether significant knee muscle weakness is present in male Irish gaelic footballers who have returned to full activity after hamstring injury. Methods The concentric isokinetic knee flexion and extension strength of 44 members of a university gaelic football team was assessed at 60, 180 and 300 degrees per second using a Contrex dynamometer. Results Fifteen players (34%) reported a history of hamstring strain, with 68% of injuries affecting the dominant (kicking) limb. The hamstrings were significantly stronger (p < 0.05) on the dominant limb in all uninjured subjects. The previously injured limbs had a significantly lower (p < 0.05) hamstrings to quadriceps (HQ) strength ratio than all other non-injured limbs, but neither their hamstrings nor quadriceps were significantly weaker (p > 0.05) using this comparison. The previously unilaterally injured hamstrings were significantly weaker (p < 0.05) than uninjured limbs however, when matched for dominance. The hamstring to opposite hamstring (H:oppH) strength ratio of the previously injured players was also found to be significantly lower (p < 0.05) than that of the uninjured players. Conclusion Hamstring muscle weakness was observed in male Irish gaelic footballers with a history of hamstring injury. This weakness is most evident when comparisons are made to multiple control populations, both within and between subjects. The increased strength of the dominant limb should be considered as a potential confounding variable in future trials. The study design does not allow interpretation of whether these changes in strength were present before or after injury. PMID:18325107

  11. The correlation between the imaging characteristics of hamstring injury and time required before returning to sports: a literature review.

    PubMed

    Svensson, Kjell; Alricsson, Marie; Eckerman, Mattias; Magounakis, Theofilos; Werner, Suzanne

    2016-06-01

    Injuries to the hamstring muscles are common in athletes. Track and field, Australian football, American football and soccer are examples of sports where hamstring injuries are the most common. The purpose of this study was to investigate whether there is a correlation between a hamstring injury prognosis and its characteristics of imaging parameters. The literature search was performed in the databases PubMed and CINAHL, and eleven articles were included. Seven out of the 11 articles showed a correlation between the size of the hamstring injury and length of time required before returning to sports. Different authors have reported contrasting results about length of time required before returning to sports due to location of injury within specific muscle. Majority of the articles found hamstring strain correlated to an extended amount of time required before returning to sports. PMID:27419106

  12. The correlation between the imaging characteristics of hamstring injury and time required before returning to sports: a literature review

    PubMed Central

    Svensson, Kjell; Alricsson, Marie; Eckerman, Mattias; Magounakis, Theofilos; Werner, Suzanne

    2016-01-01

    Injuries to the hamstring muscles are common in athletes. Track and field, Australian football, American football and soccer are examples of sports where hamstring injuries are the most common. The purpose of this study was to investigate whether there is a correlation between a hamstring injury prognosis and its characteristics of imaging parameters. The literature search was performed in the databases PubMed and CINAHL, and eleven articles were included. Seven out of the 11 articles showed a correlation between the size of the hamstring injury and length of time required before returning to sports. Different authors have reported contrasting results about length of time required before returning to sports due to location of injury within specific muscle. Majority of the articles found hamstring strain correlated to an extended amount of time required before returning to sports. PMID:27419106

  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. Knee flexor strength and bicep femoris electromyographical activity is lower in previously strained hamstrings.

    PubMed

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

    2013-06-01

    The aim of this study was to determine if athletes with a history of hamstring strain injury display lower levels of surface EMG (sEMG) activity and median power frequency in the previously injured hamstring muscle during maximal voluntary contractions. Recreational athletes were recruited, 13 with a history of unilateral hamstring strain injury and 15 without prior injury. All athletes undertook isokinetic dynamometry testing of the knee flexors and sEMG assessment of the biceps femoris long head (BF) and medial hamstrings (MHs) during concentric and eccentric contractions at ±180 and ±60°s(-1). The knee flexors on the previously injured limb were weaker at all contraction speeds compared to the uninjured limb (+180°s(-1)p=0.0036; +60°s(-1)p=0.0013; -60°s(-1)p=0.0007; -180°s(-1)p=0.0007) whilst sEMG activity was only lower in the BF during eccentric contractions (-60°s(-1)p=0.0025; -180°s(-1)p=0.0003). There were no between limb differences in MH sEMG activity or median power frequency from either BF or MH in the injured group. The uninjured group showed no between limb differences in any of the tested variables. Secondary analysis comparing the between limb difference in the injured and the uninjured groups, confirmed that previously injured hamstrings were mostly weaker (+180°s(-1)p=0.2208; +60°s(-1)p=0.0379; -60°(-1)p=0.0312; -180°s(-1)p=0.0110) and that deficits in sEMG were confined to the BF during eccentric contractions (-60°s(-1)p=0.0542; -180°s(-1)p=0.0473). Previously injured hamstrings were weaker and BF sEMG activity was lower than the contralateral uninjured hamstring. This has implications for hamstring strain injury prevention and rehabilitation which should consider altered neural function following hamstring strain injury.

  16. Prevention of hamstring strains in elite soccer: an intervention study.

    PubMed

    Arnason, A; Andersen, T E; Holme, I; Engebretsen, L; Bahr, R

    2008-02-01

    The purpose was to test the effect of eccentric strength training and flexibility training on the incidence of hamstring strains in soccer. Hamstring strains and player exposure were registered prospectively during four consecutive soccer seasons (1999-2002) for 17-30 elite soccer teams from Iceland and Norway. The first two seasons were used as baseline, while intervention programs consisting of warm-up stretching, flexibility and/or eccentric strength training were introduced during the 2001 and 2002 seasons. During the intervention seasons, 48% of the teams selected to use the intervention programs. There was no difference in the incidence of hamstring strains between teams that used the flexibility training program and those who did not [relative risk (RR)=1.53, P=0.22], nor was there a difference compared with the baseline data (RR=0.89, P=0.75). The incidence of hamstring strains was lower in teams who used the eccentric training program compared with teams that did not use the program (RR=0.43, P=0.01), as well as compared with baseline data for the same intervention teams (RR=0.42, P=0.009). Eccentric strength training with Nordic hamstring lowers combined with warm-up stretching appears to reduce the risk of hamstring strains, while no effect was detected from flexibility training alone. These results should be verified in randomized clinical trials.

  17. Asymmetry after hamstring injury in English Premier League: issue resolved, or perhaps not?

    PubMed

    Barreira, P; Drust, B; Robinson, M A; Vanrenterghem, J

    2015-06-01

    Hamstring injuries constitute one of the most concerning injuries in English Premier League football, due to its high primary incidence but also its recurrence. Functional methods assessing hamstring function during high-risk performance tasks such as sprinting are vital to identify potential risk factors. The purpose of this study was to assess horizontal force deficits during maximum sprint running on a non-motorized treadmill in football players with previous history of hamstring strains as a pre-season risk-assessment in a club setting. 17 male football players from one Premier League Club were divided into 2 groups, experimental (n=6, age=24.5±2.3 years) and control (n=11, age=21.3±1.2 years), according to history of previous hamstring injury. Participants performed a protocol including a 10-s maximum sprint on a non-motorized treadmill. Force deficits during acceleration phase and steady state phases of the sprint were assessed between limbs and between groups. The main outcome measures were horizontal and vertical peak forces during the acceleration phase or steady state. There were no significant differences in peak forces between previously injured and non-injured limbs, or between groups, challenging the ideas around functional force deficits in sprint running as a diagnostic measure of hamstring re-injury risk.

  18. Days to Return to Participation After a Hamstrings Strain Among American Collegiate Soccer Players

    PubMed Central

    Cross, Kevin M.; Saliba, Susan A.; Conaway, Mark; Gurka, Kelly K.; Hertel, Jay

    2015-01-01

    Context Among US collegiate soccer players, the incidence rate and the event characteristics of hamstrings strains differ between sexes, but comparisons in the return-to-participation (RTP) time have not been reported. Objective To compare the RTP time between male and female collegiate soccer players and analyze the influence of event characteristics on the RTP time for each sex. Design Descriptive epidemiology study. Setting Data were collected from collegiate teams that voluntarily participated in the National Collegiate Athletic Association Injury Surveillance System. Patients or Other Participants Collegiate soccer athletes who sustained 507 hamstrings strains (306 men, 201 women) during the 2004 through 2009 fall seasons. Main Outcome Measure(s) Nonparametric statistics were used to evaluate RTP time differences between sexes and among categories of each event characteristic (ie, time of season, practice or competition, player position). Negative binomial regression was used to model the RTP time for each sex. All analyses were performed separately for first-time and recurrent strains. Results We found no differences in the RTP time between sexes for first-time (median: men = 7.0 days, women = 6.0 days; P = .07) or recurrent (median: men = 11 days, women = 5.5 days; P = .06) hamstrings strains. For male players with first-time strains, RTP time was increased when the strain occurred during competition or the in-season/postseason and varied depending on the division of play. Among female players with first-time strains, we found no differences in RTP time within characteristics. For male players with recurrent hamstrings strains, the RTP time was longer when the injury occurred during the in-season/postseason. Among female players with recurrent strains, RTP time was longer for forwards than for midfielders or defenders. Conclusions Although we found no differences in the RTP time after hamstrings strains in male and female collegiate soccer players, each sex

  19. Prediction of hamstring injury in professional soccer players by isokinetic measurements

    PubMed Central

    Dauty, Marc; Menu, Pierre; Fouasson-Chailloux, Alban; Ferréol, Sophie; Dubois, Charles

    2016-01-01

    Summary Objectives previous studies investigating the ability of isokinetic strength ratios to predict hamstring injuries in soccer players have reported conflicting results. Hypothesis to determine if isokinetic ratios are able to predict hamstring injury occurring during the season in professional soccer players. Study Design case-control study; Level of evidence: 3. Methods from 2001 to 2011, 350 isokinetic tests were performed in 136 professional soccer players at the beginning of the soccer season. Fifty-seven players suffered hamstring injury during the season that followed the isokinetic tests. These players were compared with the 79 uninjured players. The bilateral concentric ratio (hamstring-to-hamstring), ipsilateral concentric ratio (hamstring-to-quadriceps), and mixed ratio (eccentric/concentric hamstring-to-quadriceps) were studied. The predictive ability of each ratio was established based on the likelihood ratio and post-test probability. Results the mixed ratio (30 eccentric/240 concentric hamstring-to-quadriceps) <0.8, ipsilateral ratio (180 concentric hamstring-to-quadriceps) <0.47, and bilateral ratio (60 concentric hamstring-to-hamstring) <0.85 were the most predictive of hamstring injury. The ipsilateral ratio <0.47 allowed prediction of the severity of the hamstring injury, and was also influenced by the length of time since administration of the isokinetic tests. Conclusion isokinetic ratios are useful for predicting the likelihood of hamstring injury in professional soccer players during the competitive season. PMID:27331039

  20. Hamstring pain and muscle strains following anterior cruciate ligament reconstruction: a prospective, randomized trial comparing hamstring graft harvest techniques.

    PubMed

    D'Alessandro, Peter; Wake, Giulia; Annear, Peter

    2013-04-01

    There is limited information in the literature regarding hamstring pain and muscle strains in patients following anterior cruciate ligament (ACL) reconstruction using hamstring autograft. We sought to investigate whether dividing hamstring tendons distal to the musculotendinous junction rather than forcefully stripping tendons away from the muscle belly during graft harvest resulted in a lower incidence of hamstring pain, muscle strains, and leg flexion strength deficit following commencement of sport-specific training postoperatively. Patients were randomized to either the "Cut" or "Push" groups of hamstring tendon harvesting. All other operative techniques were uniform. A total of 34 (cut = 20, push = 14) patients had a mean follow-up of 30 months, and assessments were conducted by a blinded single practitioner. A customized hamstring strain questionnaire and visual analogue pain score provided information for the study's primary focus: evaluation of postoperative hamstring pain and muscle strains. Leg flexion strength was also measured and a full knee assessment was conducted. The Cincinnati sports activity rating scale (SARS) was used to account for varying degrees of sporting participation and intensity since reconstruction. The "Cut" group's mean visual analogue score was 10.05 mm, significantly lower than the "Push" group (24.66 mm, p = 0.0398). The Cut group also recorded a significant reduction in the incidence of hamstring strains following ACL reconstruction (5/20 patients 25%) compared with the Push group (7/14 patients 50%, p = 0.045). There was no difference in leg flexion strength between the groups. Of the patients who reported hamstring strains, there was no significant difference in the mean Cincinnati SARS between the groups, nor any difference in overall knee function. The incidence of hamstring pain and muscle strains was significantly reduced in patients receiving the "cut" technique of harvesting hamstring tendons in ACL reconstruction

  1. 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

  2. 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

  3. Hamstring Injuries in Major and Minor League Baseball

    PubMed Central

    Zachazewski, James; Silvers, Holly J.; Li, Bernard; Snyder-Mackler, Lynn; Insler, Stephanie; Ahmad, Christopher S.; Mandelbaum, Bert R.

    2016-01-01

    Objectives: The purpose of this study is to test the efficacy of a hamstring injury prevention program designed to address the high incidence of acute and chronic hamstring injuries and re-injuries that occur in the sport of professional baseball. Methods: This was a prospective cluster cohort study assessing the efficacy of an injury prevention intervention designed to address hamstring injury in rookie and professional baseball players participating in Minor and Major League Baseball (N = 213). Each athlete was asked to participate and consented (Johns Hopkins Internal Review Board, Baltimore, Maryland). Those athletes who agreed to participate completed a questionnaire detailing their hamstring injury history. The hamstring injury prevention program was disseminated to each medical staff (team physician, certified athletic trainer and strength and conditioning coach) and they were instructed on how to implement the program. Weekly individual compliance with the program and injury data was collected. At the end of the season, the data were analyzed for program compliance and hamstring (HS) injury rates (both acute and reoccurrence) compared to the control data in the MLB HITS database. All data were stripped of individual and team identifiers prior to analysis. Results: For the major and minor league intervention study, one Major and Minor League organization served as the intervention (INT) team, which encompassed Rookie League, Fall Ball, Class A, AA, AAA and major league rosters (6 total teams). A total of 213 athletes consented to participate: Minor League: N = 173 players and Majors League: N = 40. Weekly compliance, injury incidence and time loss due to injury was compared to the HITS database (age, skill matched control group). The average weighted utilization of the injury prevention program was 25.30 utilizations for the uninjured group compared to 13.53 in the injured group (p=0.09). In the majors, there were 2 HS injuries in the INT vs. 79 in the CON

  4. Conceptual framework for strengthening exercises to prevent hamstring strains.

    PubMed

    Guex, Kenny; Millet, Grégoire P

    2013-12-01

    High-speed running accounts for the majority of hamstring strains in many sports. The terminal swing phase is believed to be the most hazardous as the hamstrings are undergoing an active lengthening contraction in a long muscle length position. Prevention-based strength training mainly focuses on eccentric exercises. However, it appears crucial to integrate other parameters than the contraction type. Therefore, the aim of this study is to present a conceptual framework based on six key parameters (contraction type, load, range of motion, angular velocity, uni-/bilateral exercises, kinetic chain) for the hamstring's strength exercise for strain prevention. Based on the biomechanical parameters of sprinting, it is proposed to use high-load eccentric contractions. The movement should be performed at a slow to moderate angular velocity and focused at the knee joint, while the hip is kept in a large flexion position in order to reach a greater elongation stress of the hamstrings than in the terminal swing phase. In this way, we believe that, during sprinting, athletes would be better trained to brake the knee extension effectively in the whole range of motion without overstretch of the hamstrings. Finally, based on its functional application, unilateral open kinetic chain should be preferred. PMID:24062275

  5. Conceptual framework for strengthening exercises to prevent hamstring strains.

    PubMed

    Guex, Kenny; Millet, Grégoire P

    2013-12-01

    High-speed running accounts for the majority of hamstring strains in many sports. The terminal swing phase is believed to be the most hazardous as the hamstrings are undergoing an active lengthening contraction in a long muscle length position. Prevention-based strength training mainly focuses on eccentric exercises. However, it appears crucial to integrate other parameters than the contraction type. Therefore, the aim of this study is to present a conceptual framework based on six key parameters (contraction type, load, range of motion, angular velocity, uni-/bilateral exercises, kinetic chain) for the hamstring's strength exercise for strain prevention. Based on the biomechanical parameters of sprinting, it is proposed to use high-load eccentric contractions. The movement should be performed at a slow to moderate angular velocity and focused at the knee joint, while the hip is kept in a large flexion position in order to reach a greater elongation stress of the hamstrings than in the terminal swing phase. In this way, we believe that, during sprinting, athletes would be better trained to brake the knee extension effectively in the whole range of motion without overstretch of the hamstrings. Finally, based on its functional application, unilateral open kinetic chain should be preferred.

  6. How Joint Torques Affect Hamstring Injury Risk in Sprinting Swing–Stance Transition

    PubMed Central

    SUN, YULIANG; WEI, SHUTAO; ZHONG, YUNJIAN; FU, WEIJIE; LI, LI; LIU, YU

    2015-01-01

    ABSTRACT Purpose The potential mechanisms of hamstring strain injuries in athletes are not well understood. The study, therefore, was aimed at understanding hamstring mechanics by studying loading conditions during maximum-effort overground sprinting. Methods Three-dimensional kinematics and ground reaction force data were collected from eight elite male sprinters sprinting at their maximum effort. Maximal isometric torques of the hip and knee were also collected. Data from the sprinting gait cycle were analyzed via an intersegmental dynamics approach, and the different joint torque components were calculated. Results During the initial stance phase, the ground reaction force passed anteriorly to the knee and hip, producing an extension torque at the knee and a flexion torque at the hip joint. Thus, the active muscle torque functioned to produce flexion torque at the knee and extension torque at the hip. The maximal muscle torque at the knee joint was 1.4 times the maximal isometric knee flexion torque. During the late swing phase, the muscle torque counterbalanced the motion-dependent torque and acted to flex the knee joint and extend the hip joint. The loading conditions on the hamstring muscles were similar to those of the initial stance phase. Conclusions During both the initial stance and late swing phases, the large passive torques at both the knee and hip joints acted to lengthen the hamstring muscles. The active muscle torques generated mainly by the hamstrings functioned to counteract those passive effects. As a result, during sprinting or high-speed locomotion, the hamstring muscles may be more susceptible to high risk of strain injury during these two phases. PMID:24911288

  7. Risk factors for hamstring injuries in male soccer players: a systematic review of prospective studies.

    PubMed

    van Beijsterveldt, A M C; van de Port, I G L; Vereijken, A J; Backx, F J G

    2013-06-01

    Hamstring injuries are common injuries in soccer players. In view of the high incidence and the serious consequences, identifying risk factors related to hamstring injuries is essential. The aim of this systematic review was therefore to identify risk factors for hamstring injuries in male adult soccer players. PubMed, Embase/Medline, Cumulative Index to Nursing and Allied Health Literature, and SPORTDiscus were systematically searched, and prospective studies investigating risk factors for hamstring injuries in adult male soccer players were included. The methodological quality of the included articles was assessed using a standardized set of predefined criteria. Seven of the 11 studies identified, involving a total of 1775 players and 344 hamstring injuries, met the inclusion criteria. All but one of the included studies met at least five of nine methodological criteria, causing them to be qualified as 'high quality'. The included studies used univariate as well as multivariate analyses to identify risk factors for hamstring injury. The results from the multivariate analyses suggest that previous hamstring injury is most strongly related to hamstring injury. Conflicting evidence is found for age and hamstring length or flexibility as risk factors for the occurrence of hamstring injuries.

  8. 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

  9. Muscle strain injuries.

    PubMed

    Garrett, W E

    1996-01-01

    One of the most common injuries seen in the office of the practicing physician is the muscle strain. Until recently, little data were available on the basic science and clinical application of this basic science for the treatment and prevention of muscle strains. Studies in the last 10 years represent action taken on the direction of investigation into muscle strain injuries from the laboratory and clinical fronts. Findings from the laboratory indicate that certain muscles are susceptible to strain injury (muscles that cross multiple joints or have complex architecture). These muscles have a strain threshold for both passive and active injury. Strain injury is not the result of muscle contraction alone, rather, strains are the result of excessive stretch or stretch while the muscle is being activated. When the muscle tears, the damage is localized very near the muscle-tendon junction. After injury, the muscle is weaker and at risk for further injury. The force output of the muscle returns over the following days as the muscle undertakes a predictable progression toward tissue healing. Current imaging studies have been used clinically to document the site of injury to the muscle-tendon junction. The commonly injured muscles have been described and include the hamstring, the rectus femoris, gastrocnemius, and adductor longus muscles. Injuries inconsistent with involvement of a single muscle-tendon junction proved to be at tendinous origins rather than within the muscle belly. Important information has also been provided regarding injuries with poor prognosis, which are potentially repairable surgically, including injuries to the rectus femoris muscle, the hamstring origin, and the abdominal wall. Data important to the management of common muscle injuries have been published. The risks of reinjury have been documented. The early efficacy and potential for long-term risks of nonsteroidal antiinflammatory agents have been shown. New data can also be applied to the field

  10. The influence of prior hamstring injury on lengthening muscle tissue mechanics.

    PubMed

    Silder, Amy; Reeder, Scott B; Thelen, Darryl G

    2010-08-26

    Hamstring strain injuries often occur near the proximal musculotendon junction (MTJ) of the biceps femoris. Post-injury remodeling can involve scar tissue formation, which may alter contraction mechanics and influence re-injury risk. The purpose of this study was to assess the affect of prior hamstring strain injury on muscle tissue displacements and strains during active lengthening contractions. Eleven healthy and eight subjects with prior biceps femoris injuries were tested. All previously injured subjects had since returned to sport and exhibited evidence of residual scarring along the proximal aponeurosis. Subjects performed cyclic knee flexion-extension on an MRI-compatible device using elastic and inertial loads, which induced active shortening and lengthening contractions, respectively. CINE phase-contrast imaging was used to measure tissue velocities within the biceps femoris during these tasks. Numerical integration of the velocity information was used to estimate two-dimensional tissue displacement and strain fields during muscle lengthening. The largest tissue motion was observed along the distal MTJ, with the active lengthening muscle exhibiting significantly greater and more homogeneous tissue displacements. First principal strain magnitudes were largest along the proximal MTJ for both loading conditions. The previously injured subjects exhibited less tissue motion and significantly greater strains near the proximal MTJ. We conclude that localized regions of high tissue strains during active lengthening contractions may predispose the proximal biceps femoris to injury. Furthermore, post-injury remodeling may alter the in-series stiffness seen by muscle tissue and contribute to the relatively larger localized tissue strains near the proximal MTJ, as was observed in this study.

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

    PubMed

    Brukner, Peter; Connell, David

    2016-02-01

    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'.

  12. 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

  13. The management of hamstring injury--Part 1: Issues in diagnosis.

    PubMed

    Hoskins, Wayne; Pollard, Henry

    2005-05-01

    Hamstring injuries are the most prevalent muscle injury in sports involving rapid acceleration and maximum speed running. Injury typically occurs in an acute manner through an eccentric mechanism at the terminal stages of the swing phase of gait. Biceps femoris is most commonly injured. Re-injury rates are high and management is a challenge given the complex multi-factorial aetiology. The high rates of hamstring injury and re-injury may result from a lack of high-quality research into the aetiological factors underlying injury. Re-injury may also result from inaccuracy in diagnosis that results from the potential multi-factorial causes of these conditions. Inaccuracy in diagnosis could lead to multiple potential diagnoses that may result in the implementation of variable management protocols. Whilst potentially useful, such variability may also lead to the implementation of sub-optimal management strategies. Previous hamstring injury is the most recognized risk factor for injury, which indicates that future research should be directed at preventative measures. Much anecdotal and indirect evidence exists to suggest that several non-local factors contribute to injury, which may be addressed through the application of manual therapy. However, this connection has been neglected in previous research and literature. This paper will explore and speculate on this potential connection and offer some new contributive factors for hamstring injury management. This first paper of a two part series on hamstring injury will explore diagnostic issues relevant to hamstring injury and the second will investigate various established and speculative management approaches.

  14. Strength Measurements in Acute Hamstring Injuries: Intertester Reliability and Prognostic Value of Handheld Dynamometry.

    PubMed

    Reurink, Gustaaf; Goudswaard, Gert Jan; Moen, Maarten H; Tol, Johannes L; Verhaar, Jan A N; Weir, Adam

    2016-08-01

    Study Design Cohort study, repeated measures. Background Although hamstring strength measurements are used for assessing prognosis and monitoring recovery after hamstring injury, their actual clinical relevance has not been established. Handheld dynamometry (HHD) is a commonly used method of measuring muscle strength. The reliability of HHD has not been determined in athletes with acute hamstring injuries. Objectives To determine the intertester reliability and the prognostic value of hamstring HHD strength measurement in acute hamstring injuries. Methods We measured knee flexion strength with HHD in 75 athletes at 2 visits, at baseline (within 5 days of hamstring injury) and follow-up (5 to 7 days after the baseline measurement). We assessed isometric hamstring strength in 15° and 90° of knee flexion. Reliability analysis testing was performed by 2 testers independently at the follow-up visit. We recorded the time needed to return to play (RTP) up to 6 months following baseline. Results The intraclass correlation coefficients of the strength measurements in injured hamstrings were between 0.75 and 0.83. There was a statistically significant but weak correlation between the time to RTP and the strength deficit at 15° of knee flexion measured at baseline (Spearman r = 0.25, P = .045) and at the follow-up visit (Spearman r = 0.26, P = .034). Up to 7% of the variance in time to RTP is explained by this strength deficit. None of the other strength variables were significantly correlated with time to RTP. Conclusion Hamstring strength can be reliably measured with HHD in athletes with acute hamstring injuries. The prognostic value of strength measurements is limited, as there is only a weak association between the time to RTP and hamstring strength deficit after acute injury. Level of Evidence Prognosis, level 4. J Orthop Sports Phys Ther 2016;46(8):689-696. Epub 12 May 2016. doi:10.2519/jospt.2016.6363.

  15. Preventive Effects of Eccentric Training on Acute Hamstring Muscle Injury in Professional Baseball

    PubMed Central

    Seagrave, Richard A.; Perez, Luis; McQueeney, Sean; Toby, E. Bruce; Key, Vincent; Nelson, Joshua D.

    2014-01-01

    Background: Hamstring injuries are the second most common injury causing missed days in professional baseball field players. Recent studies have shown the preventive benefit of eccentric conditioning on the hamstring muscle group in injury prevention. Specifically, Nordic-type exercises have been shown to decrease the incidence of acute hamstring injuries in professional athletes. Purpose: This was a prospective study performed in coordination with a single Major League Baseball (MLB) organization (major and minor league teams) that targeted the effects of Nordic exercises on the incidence of acute hamstring injuries in the professional-level baseball player. Study Design: Prospective cohort study; Level of evidence, 2. Methods: The daily workouts of 283 professional baseball players throughout all levels of a single MLB organization were prospectively recorded. The intervention group participated in the Nordic exercise program and was compared with a randomly selected control group of professional athletes within the organization not participating in the exercise program. The incidence of hamstring injuries in both groups was compared, and the total number of days missed due to injury was compared with the 2 previous seasons. Results: There were 10 hamstring injuries that occurred during the 2012 season among the 283 professional athletes that required removal from play. There were no injuries that occurred in the intervention group (n = 65, 0.00%; P = .0381). The number needed to treat (NNT) to prevent 1 hamstring injury was 11.3. The average repetitions per week of the injured group were assessed at multiple time points (2, 4, 6, and total weeks) prior to injury. There were significantly fewer repetitions per week performed in the injured group at all time points compared with overall average repetitions per week in the noninjured group (P = .0459, .0127, .0164, and .0299, respectively). After beginning the Nordic exercise program, there were 136 total days

  16. Hamstring Strength and Morphology Progression after Return to Sport from Injury

    PubMed Central

    Sanfilippo, Jennifer; Silder, Amy; Sherry, Marc A; Tuite, Michael J; Heiderscheit, Bryan C

    2012-01-01

    Hamstring strain re-injury rates can reach 30% within the initial two weeks following return to sport (RTS). Incomplete recovery of strength may be a contributing factor. However, relative strength of the injured and unaffected limbs at RTS is currently unknown. PURPOSE: Characterize hamstring strength and morphology at the time of RTS and six months later. METHODS: Twenty-five athletes that experienced an acute hamstring strain injury participated, following completion of a controlled rehabilitation program. Bilateral isokinetic strength testing and magnetic resonance imaging (MRI) were performed at RTS and 6-months later. Strength (knee flexion peak torque, work, angle of peak torque) and MRI (muscle and tendon volumes) measures were compared between limbs and over time using repeated measures ANOVA. RESULTS: The injured limb showed a peak torque deficit of 9.6% compared to the uninjured limb at RTS (60°/s, p<0.001), but not 6-months following. The knee flexion angle of peak torque decreased over time for both limbs (60°/s, p<0.001). MRI revealed that 20.4% of the muscle cross-sectional area showed signs of edema at RTS with full resolution by the 6-month follow-up. Tendon volume of the injured limb tended to increase over time (p=0.108), while muscle volume decreased 4–5% in both limbs (p<0.001). CONCLUSION: Residual edema and deficits in isokinetic knee flexion strength were present at RTS, but resolved during the subsequent six months. This occurred despite MRI evidence of scar tissue formation (increased tendon volume) and muscle atrophy, suggesting that neuromuscular factors may contribute to the return of strength. PMID:23059864

  17. An anatomical study of the proximal hamstring muscle complex to elucidate muscle strains in this region.

    PubMed

    Battermann, N; Appell, H-J; Dargel, J; Koebke, J

    2011-03-01

    Muscle strain injuries are common in sports, and a high incidence is reported for the hamstring muscles, especially in the proximal region, where the long head of the biceps femoris muscle is most frequently affected. To look for some architectural peculiarities, which would make this muscle vulnerable, 101 legs of embalmed human cadavers were dissected and descriptively examined, morphometric data were obtained in the proximal region, and slices of plastinated specimens were microscopically examined. The 3 muscles composing the proximal hamstring complex are partly twisted around each other and possess common fibrous adhesions. Biceps femoris (BF) and semitendinosus (ST) muscles form a common head, to which the ST contributes the majority of fascicles extending 9 cm down from the ischiac tuberosity, thereby attaching to the common tendon at a remarkable pennation angle. The first BF fascicles origin from the common tendon only at 6 cm distance from the ischiac tuberosity. It is concluded that the high incidence of proximal BF strains may be a misinterpretation due to insufficient imaging and the complex architecture. It is suggested that the pennation angle at which the ST inserts to the common tendon makes this muscle especially vulnerable for strains during forced eccentric contractions.

  18. TREATMENT OF HAMSTRING STRAIN IN A COLLEGIATE POLE‐VAULTER INTEGRATING DRY NEEDLING WITH AN ECCENTRIC TRAINING PROGRAM: A RESIDENT'S CASE REPORT

    PubMed Central

    Westrick, Richard B.; Zylstra, Edo; Johnson, Michael R.

    2013-01-01

    Background: Hamstring strain injuries are among the most common injuries seen in sports. Management is made difficult by the high recurrence rates. Typical time to return to sport varies but can be prolonged with recurrence. Eccentric strength deficits remain post‐injury, contributing to reinjury. Eccentric training has shown to be an effective method at prevention of hamstring injury in multiple systematic reviews and prospective RCTs but limited prospective rehabilitation literature. Functional dry needling is a technique that has been reported to be beneficial in the management of pain and dysfunction after muscle strains, but there is limited published literature on its effects on rehabilitation or recurrence of injury. Purpose: The purpose of this case report is to present the management and outcomes of a patient with hamstring strain, treated with functional dry needling and eccentric exercise. Case Description: The subject was an 18‐year‐old collegiate pole‐vaulter who presented to physical therapy with an acute hamstring strain and history of multiple strains on uninvolved extremity. He was treated in Physical Therapy three times per week for 3 weeks with progressive eccentric training and 3 sessions of functional dry needling. Outcomes: By day 12, his eccentric strength on the involved extremity was greater than the uninvolved extremity and he reported clinically meaningful improvement in outcome scores. By Day 20, he was able to return to full sports participation without pain or lingering strength deficits. Discussion: The patient in this case report was able to return to sport within 20 days and without recurrence. He demonstrated significant decreases in pain and dysfunction with dry needling. He had greater strength on the injured extremity compared to contra‐lateral previously injured extremity. Conclusions: This case illustrates the use of functional dry needling and eccentric exercise leading to a favorable outcome in a patient with

  19. 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

  20. 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.

  1. 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

    2016-01-01

    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 (F(H0)), 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 F(H0) (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 F(H0) (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 (F(H0)) (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

  2. Platelet-rich plasma in the treatment of acute hamstring injuries in professional football players

    PubMed Central

    ZANON, GIACOMO; COMBI, FRANCO; COMBI, ALBERTO; PERTICARINI, LORIS; SAMMARCHI, LUIGI; BENAZZO, FRANCESCO

    2016-01-01

    Purpose muscle injuries have a high incidence in professional football and are responsible for the largest number of days lost from competition. Several in vitro studies have confirmed the positive role of platelet-rich plasma (PRP) in accelerating recovery and in promoting muscle regeneration, and not fibrosis, in the healing process. This study examines the results of intralesional administration of PRP in the treatment of primary hamstring injuries sustained by players belonging to a major league football club. Methods twenty-five hamstring injuries (grade 2 according to MRI classification) sustained by professional football players during a 31-months observation period were treated with PRP and analyzed. Sport participation absence (SPA), in days, was considered to correspond to the healing time, and we also considered the re-injury rate, and tissue healing on MRI. The mean follow-up was 36.6 months (range 22–42). Results there were no adverse events. The mean SPA for the treated muscle injuries was 36.76±19.02 days. The re-injury rate was 12%. Tissue healing, evaluated on MRI, was characterized by the presence of excellent repair tissue and a small scar. Conclusions this study confirmed the safety of PRP in treating hamstring lesions in a large series of professional football players. PRP-treated lesions did not heal more quickly than untreated lesions described in the literature, but they showed a smaller scar and excellent repair tissue. Level of evidence Level IV, therapeutic case series. PMID:27386443

  3. Unstable Surface Improves Quadriceps:Hamstring Co-contraction for Anterior Cruciate Ligament Injury Prevention Strategies

    PubMed Central

    Shultz, Rebecca; Silder, Amy; Malone, Maria; Braun, Hillary Jane; Dragoo, Jason Logan

    2015-01-01

    Background: Increasing quadriceps:hamstring muscular co-contraction at the knee may reduce the risk of anterior cruciate ligament (ACL) injury. The purpose of this investigation was to examine muscle activation in the quadriceps and hamstrings and peak kinematics of the knee, hip, and trunk when performing a single-leg drop (SLD) on to a Bosu ball (unstable surface) compared with on to the floor (stable surface). Hypotheses: (1) The SLD on an unstable surface would lower the quadriceps to hamstrings electromyographic (EMG) activation ratio (Q:H EMG activation ratio) compared with being performed on the floor. (2) Lower Q:H EMG activation ratio would be caused by a relative increase in hamstring activation, with no significant change in quadriceps activation. Study Design: Controlled laboratory study. Methods: Thirty-nine Division I National Collegiate Athletic Association (NCAA) female athletes performed 3 SLDs per leg onto a Bosu ball and onto the floor. Muscle activity of the vastus lateralis and lateral hamstrings were used to estimate peak quadriceps and hamstring activation, along with the Q:H EMG activation ratio. Kinematic measures at the knee, hip, and trunk were also estimated. Differences between landings were assessed using a 2-level analysis of variance (limb and surface). Results: The maximum Q:H EMG activation ratio was significantly reduced when athletes performed an SLD onto the Bosu ball (20%, P < 0.001) compared with the floor. Peak hamstring activity was higher when athletes landed on a Bosu ball (18% higher, P = 0.029) compared with when they landed on the floor. Conclusion: Compared with landing on the floor (a stable surface), landing on a Bosu ball (unstable surface) changed the athlete’s co-contraction at the knee and increased hamstring activity. However, landing on a Bosu ball also decreased the athlete’s knee flexion, which was an undesired effect. Clinical Relevance: These findings highlight the potential utility of unstable surfaces

  4. The accuracy of MRI in predicting recovery and recurrence of acute grade one hamstring muscle strains within the same season in Australian Rules football players.

    PubMed

    Gibbs, N J; Cross, T M; Cameron, M; Houang, M T

    2004-06-01

    The purpose of this study was to use MRI to classify acute grade one hamstring muscle strains in Australian Rules footballers to determine if it was accurate in predicting the recovery time for each injury and also able to predict those that would recur within the same season. A prospective study was performed over five years at a professional Australian Football League club. Thirty-one acute grade one hamstring injuries underwent MRI examination within 24-72 hours following the injury. Each injury underwent the same rehabilitation programme. The rehabilitation interval (RI) was the time in days for the player to resume full team training. Fourteen (45%) of the injuries were normal on MRI. Seventeen (55%) were abnormal with a hyperintense T2 lesion on the axial fat suppressed views. The MRI negative group had a significantly faster RI (6.6 days) compared with the MRI positive group (20.2 days). Both the length and cross sectional area (CSA) of the MRI positive lesions were measured. The length of the lesion had a stronger correlation coefficient with the RI (0.84) than did the CSA (0.76). Six of the 17 MRI positive strains recurred with no correlation found between the lesion's length or CSA, or the RI. None of the 14 MRI negative injuries recurred. The study confirms that MRI can aid in the investigation of acute grade one hamstring muscle strains in predicting recovery time. However the size of the initial strain or the RI do not seem to be reliable indicators in predicting those strains that might recur.

  5. 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

  6. 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

  7. A pilot randomised controlled trial of eccentric exercise to prevent hamstring injuries in community-level Australian Football.

    PubMed

    Gabbe, B J; Branson, R; Bennell, K L

    2006-05-01

    Hamstring injuries are the most common injury sustained by Australian Football players. Eccentric training has been proposed as a potential preventative strategy. This pilot randomised controlled trial (RCT) evaluated the effectiveness of a pre-season eccentric training program for preventing hamstring injuries at the community level of Australian Football. Seven amateur clubs (n=220 players) were recruited. Players were randomised within clubs to the intervention (eccentric exercise) or control (stretching) groups and randomisation was stratified according to previous history of hamstring injury. Five exercise sessions were completed over a 12-week period, three during the pre-season and two during the first 6 weeks of the season. Compliance was recorded and players were monitored for the season to collect injury and participation data. There was no difference between the control (n=106) or intervention (n=114) groups with respect to baseline characteristics. Only 46.8% of all players completed at least two program sessions. Compliance was poorest for the intervention group. Intention-to-treat analysis suggested that players in the intervention group were not at reduced risk of hamstring injury (RR 1.2, 95% CI: 0.5, 2.8). When only control and intervention group players who participated in at least the first two sessions were analysed, 4.0% of intervention and 13.2% of control group players sustained a hamstring injury (RR 0.3, 95% CI: 0.1, 1.4; p=0.098). The findings suggest that a simple program of eccentric exercise could reduce the incidence of hamstring injuries in Australian Football but widespread implementation of this program is not likely because of poor compliance.

  8. ‘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

  9. 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

  10. Relationship between hamstring strains and leg muscle strength. A follow-up study of collegiate track and field athletes.

    PubMed

    Yamamoto, T

    1993-06-01

    The purpose of the present study was to assess the relationship between hamstring strains and leg muscle strength. The bilateral isometric extensions and flexion maximum voluntary contraction (MVC) of knee and hip were measured among 64 collegiate track and field athletes (128 legs). The values of MVC per body-weight, flexion to extension ratio and bilateral legs imbalance index were calculated as the parameters for the investigation. The follow-up research was performed within the following two years. Among the 64 subjects (128 legs): 26 subjects (31 legs), 24.2 percent had suffered from hamstring strains. Then, the subjects were divided into injured (31 legs) and uninjured (97 legs) groups respectively. The parameters of the lower extremities measured at the beginning were compared for the two groups. The different rates of the hip flexion and knee extension of bilateral legs of the injured group were significantly higher than those of the uninjured group (p < 0.05). In the injured group, the value of MVC per body-weight of the knee flexor and the flexion-extension ratio were significantly lower than in the uninjured group (p < 0.05). In conclusion, the imbalance of the bilateral legs, the hamstring strength and the ratio of the flexor to extensor were shown to be parameters related to the occurrence of hamstring strains.

  11. Effects of a low volume injury prevention program on the hamstring torque angle relationship.

    PubMed

    Naclerio, Fernando; Faigenbaum, Avery D; Larumbe, Eneko; Goss-Sampson, Mark; Perez-Bilbao, Txomin; Jimenez, Alfonso; Beedie, Chris

    2013-01-01

    The effects of a 4-week lower body injury prevention program on knee muscle torque-angle relationship were examined in soccer players. Twenty men were randomly allocated to either a control (n = 10) or training group (n = 10). The training group underwent three training sessions per week, comprising 3 sets of 8 repetitions of one open-chain exercise (Nordic curl) and two closed-chain exercises-forward lunges on a Bosu balance trainer and eccentric single leg dead lifts. Maximal peak knee flexion torque was measured at 35°, 45°, 60°, 80°, 90°, and 100° pre- and post-intervention. Significant improvements were observed only at 80° (p = .001; d = .94) along with a nonsignificant trend at 35° (p = .081; d = .43). As these modifications might protect athletes against muscle and joint injuries, the use of both stable-open and unstable-closed kinetic chain exercises emphasizing eccentric hamstring and knee stabilization actions should be integrated into injury prevention programs in team sports athletes. PMID:23777380

  12. Repetitive strain injury.

    PubMed

    Al-Otaibi, S T

    2001-05-01

    Repetitive strain injury is a group of musculoskeletal disorders affecting muscles, tendons, nerves and blood vessels. These disorders could be attributed to occupational causes; however non-occupational causes should be excluded. The management of these cases required a multidisciplinary team approach.

  13. 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.

  14. Strain on the gastrocnemii and hamstrings affecting standing balance on an inclined plane in spastic cerebral palsy. A study using a geometric model.

    PubMed

    Suzuki, N; Mita, K; Watakabe, M; Akataki, K; Okagawa, T; Kimizuka, M

    1998-01-01

    The purpose of this study was to use an non-invasive method to determine whether strain on the gastrocnemii and hamstrings influences postural balance in spastic cerebral palsy (CP). Changes in alignment during standing posture with subjects positioned on a platform that was gradually inclined were measured in 10 normal children and 11 children with CP. The changes in postural alignment were plotted and geometric models used to determine the lines where the gastrocnemii and hamstrings were maximally stretched. In this way the relationship between postural alignment and the amount of strain on the gastrocnemii and hamstrings was investigated. On the inclined platform, which caused ankle joints to become dorsiflexed as the inclination angle increased, the gastrocnemii began to be strained and the hip joints began to be flexed (trunk bent forward) at the same time. In the children with CP, the gastrocnemii were more strained by smaller degrees of inclination. Furthermore, there was one child with CP whose hamstrings were also strained on the inclined platform. We confirmed that postural balance was affected by strain on the gastrocnemii and hamstrings.

  15. Anterior Cruciate Ligament Injury: Compensation during Gait using Hamstring Muscle Activity

    PubMed Central

    Catalfamo, Paola Formento; Aguiar, Gerardo; Curi, Jorge; Braidot, Ariel

    2010-01-01

    Previous research has shown that an increase in hamstring activation may compensate for anterior tibial transalation (ATT) in patients with anterior cruciate ligament deficient knee (ACLd); however, the effects of this compensation still remain unclear. The goals of this study were to quantify the activation of the hamstring muscles needed to compensate the ATT in ACLd knee during the complete gait cycle and to evaluate the effect of this compensation on quadriceps activation and joint contact forces. A two dimensional model of the knee was used, which included the tibiofemoral and patellofemoral joints, knee ligaments, the medial capsule and two muscles units. Simulations were conducted to determine the ATT in healthy and ACLd knee and the hamstring activation needed to correct the abnormal ATT to normal levels (100% compensation) and to 50% compensation. Then, the quadriceps activation and the joint contact forces were calculated. Results showed that 100% compensation would require hamstring and quadriceps activations larger than their maximum isometric force, and would generate an increment in the peak contact force at the tibiofemoral (115%) and patellofemoral (48%) joint with respect to the healthy knee. On the other hand, 50% compensation would require less force generated by the muscles (less than 0.85 of maximum isometric force) and smaller contact forces (peak tibiofemoral contact force increased 23% and peak patellofemoral contact force decreased 7.5% with respect to the healthy knee). Total compensation of ATT by means of increased hamstring activity is possible; however, partial compensation represents a less deleterious strategy. PMID:20721326

  16. Electromechanical delay of the hamstrings during eccentric muscle actions in males and females: Implications for non-contact ACL injuries.

    PubMed

    De Ste Croix, Mark B A; ElNagar, Youssif O; Iga, John; James, David; Ayala, Francisco

    2015-12-01

    Sex differences in neuromuscular functioning has been proposed as one of the factors behind an increased relative risk of non-contact anterior cruciate ligament (ACL) injury in females. The aim of this study was to explore sex differences in electromechanical delay (EMD) of the hamstring muscles during eccentric muscle actions and during a range of movement velocities. This study recruited 110 participants (55 males, 55 females) and electromyography of the semitendinosus, semimembranosus and biceps femoris was determined during eccentric actions at 60, 120 and 240°/s. No significant sex differences were observed irrespective of muscle examined or movement velocity. Irrespective of sex EMD significantly increased with increasing movement velocity (P < 0.01). There was no significant difference in the EMD of the 3 muscles examined. Our findings suggest that during eccentric actions of the hamstrings that there are no sex differences, irrespective of movement velocity. This would suggest that other factors are probably responsible for the increased relative risk of non-contact ACL injury in females compared to males. PMID:26522999

  17. 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

  18. 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

    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(-1) by 16% (p < 0.001) and at 240° · s(-1) by 10% (p < 0.01), in eccentric at 30° · s(-1) by 20% (p < 0.001) and at 120° · s(-1) 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(-1) by 6% (p ≤ 0.05) and at 120° · s(-1) 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

  19. 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

    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(-1) by 16% (p < 0.001) and at 240° · s(-1) by 10% (p < 0.01), in eccentric at 30° · s(-1) by 20% (p < 0.001) and at 120° · s(-1) 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(-1) by 6% (p ≤ 0.05) and at 120° · s(-1) 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.

  20. Chronic occupational repetitive strain injury.

    PubMed Central

    O'Neil, B. A.; Forsythe, M. E.; Stanish, W. D.

    2001-01-01

    OBJECTIVE: To review common repetitive strain injuries (RSIs) that occur in the workplace, emphasizing diagnosis, treatment, and etiology of these conditions. QUALITY OF EVIDENCE: A MEDLINE search from January 1966 to June 1999 focused on articles published since 1990 because RSIs are relatively new diagnoses. MeSH headings that were explored using the thesaurus included "cumulative trauma disorder," "overuse injury," and "repetitive strain injury." The search was limited to English articles only, and preference was given to randomized controlled trials. MAIN MESSAGE: Repetitive strain injuries result from repeated stress to the body's soft tissue structures including muscles, tendons, and nerves. They often occur in patients who perform repetitive movements either in their jobs or in extracurricular activities. Common RSIs include tendon-related disorders, such as rotator cuff tendonitis, and peripheral nerve entrapment disorders, such as carpal tunnel syndrome. A careful history and physical examination often lead to the diagnosis, but newer imaging techniques, such as magnetic resonance imaging and ultrasound, can help in refractory cases. Conservative management with medication, physiotherapy, or bracing is the mainstay of treatment. Surgery is reserved for cases that do not respond to treatment. CONCLUSION: Repetitive strain injury is common; primary care physicians must establish a diagnosis and, more importantly, its relationship to occupation. Treatment can be offered by family physicians who refer to specialists for cases refractory to conservative management. PMID:11228032

  1. Progression of mechanical properties during on-field sprint running after returning to sports from a hamstring muscle injury in soccer players.

    PubMed

    Mendiguchia, J; Samozino, P; Martinez-Ruiz, E; Brughelli, M; Schmikli, S; Morin, J-B; Mendez-Villanueva, A

    2014-07-01

    The objectives of this study were to examine the consequences of an acute hamstring injury on performance and mechanical properties of sprint-running at the time of returning to sports and after the subsequent ~2 months of regular soccer training after return. 28 semi-professional male soccer players, 14 with a recent history of unilateral hamstring injury and 14 without prior injury, participated in the study. All players performed two 50-m maximal sprints when cleared to return to play (Test 1), and 11 injured players performed the same sprint test about 2 months after returning to play (Test 2). Sprint performance (i. e., speed) was measured via a radar gun and used to derive linear horizontal force-velocity relationships from which the following variables obtained: theoretical maximal velocity (V(0)), horizontal force (F(H0)) and horizontal power (Pmax). Upon returning to sports the injured players were moderately slower compared to the uninjured players. F H0 and Pmax were also substantially lower in the injured players. At Test 2, the injured players showed a very likely increase in F(H0) and Pmax concomitant with improvements in early acceleration performance. Practitioners should consider assessing and training horizontal force production during sprint running after acute hamstring injuries in soccer players before they return to sports.

  2. 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

  3. A descriptive study of a manual therapy intervention within a randomised controlled trial for hamstring and lower limb injury prevention

    PubMed Central

    2010-01-01

    Background There is little literature describing the use of manual therapy performed on athletes. It was our purpose to document the usage of a sports chiropractic manual therapy intervention within a RCT by identifying the type, amount, frequency, location and reason for treatment provided. This information is useful for the uptake of the intervention into clinical settings and to allow clinicians to better understand a role that sports chiropractors offer. Methods All treatment rendered to 29 semi-elite Australian Rules footballers in the sports chiropractic intervention group of an 8 month RCT investigating hamstring and lower-limb injury prevention was recorded. Treatment was pragmatically and individually determined and could consist of high-velocity, low-amplitude (HVLA) manipulation, mobilization and/or supporting soft tissue therapies. Descriptive statistics recorded the treatment rendered for symptomatic or asymptomatic benefit, delivered to joint or soft tissue structures and categorized into body regions. For the joint therapy, it was recorded whether treatment consisted of HVLA manipulation, HVLA manipulation and mobilization, or mobilization only. Breakdown of the HVLA technique was performed. Results A total of 487 treatments were provided (mean 16.8 consultations/player) with 64% of treatment for asymptomatic benefit (73% joint therapies, 57% soft tissue therapies). Treatment was delivered to approximately 4 soft tissue and 4 joint regions each consultation. The most common asymptomatic regions treated with joint therapies were thoracic (22%), knee (20%), hip (19%), sacroiliac joint (13%) and lumbar (11%). For soft tissue therapies it was gluteal (22%), hip flexor (14%), knee (12%) and lumbar (11%). The most common symptomatic regions treated with joint therapies were lumbar (25%), thoracic (15%) and hip (14%). For soft tissue therapies it was gluteal (22%), lumbar (15%) and posterior thigh (8%). Of the joint therapy, 56% was HVLA manipulation only

  4. Distal tears of the hamstring muscles: review of the literature and our results of surgical treatment

    PubMed Central

    Lempainen, Lasse; Sarimo, Janne; Mattila, Kimmo; Heikkilä, Jouni; Orava, Sakari

    2007-01-01

    Background Hamstring strains are among the most frequent injuries in sports, especially in events requiring sprinting and running. Distal tears of the hamstring muscles requiring surgical treatment are scarcely reported in the literature. Objective To evaluate the results of surgical treatment for distal hamstring tears. Design A case series of 18 operatively treated distal hamstring muscle tears combined with a review of previously published cases in the English literature. Retrospective study; level of evidence 4. Setting Mehiläinen Sports Trauma Research Center, Mehiläinen Hospital and Sports Clinic, Turku, Finland. Patients Between 1992 and 2005, a total of 18 athletes with a distal hamstring tear were operated at our centre. Main outcome measurements At follow‐up, the patients were asked about possible symptoms (pain, weakness, stiffness) and their return to the pre‐injury level of sport. Results The final results were rated excellent in 13 cases, good in 1 case, fair in 3 cases and poor in 1 case. 14 of the 18 patients were able to return to their former level of sport after an average of 4 months (range 2–6 months). Conclusions Surgical treatment seems to be beneficial in distal hamstring tears in selected cases. PMID:17138628

  5. 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

  6. 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

  7. Hamstring strain - aftercare

    MedlinePlus

    ... bone. You will likely be referred to a sports medicine or bone (orthopedic) doctor. You may need surgery. ... by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, ...

  8. Overview of thigh injuries in dance.

    PubMed

    Deleget, Alison

    2010-01-01

    Thigh injuries include musculotendinous strains of the quadriceps, hamstrings, adductors, iliotibial band (ITB), and bony injuries to the shaft of the femur. There is scant information in the literature regarding thigh injuries in dance, which appear to range from 5% to 16% of total injury incidence. Hamstring strains and ITB syndrome are the most commonly reported thigh injuries. Hamstring injuries occur most frequently during slow stretching when the dancer's hip is flexed and knee extended. Uniquely in dancers, adductor injury occurs concurrently with hamstring injuries in approximately one-third of cases. Snapping of the ITB at the lateral hip and knee may result from imbalance of thigh muscle strength and flexibility. To date no quadriceps strain injuries or stress injuries to the shaft of the femur have been reported in the dance medicine literature. As dancers notoriously underestimate time needed to return to dance, it can be suggested that early return to work is a contributing factor to chronic injury. Further research is needed regarding the incidence and nature of injury to the thigh among dancers. PMID:21067687

  9. Overview of thigh injuries in dance.

    PubMed

    Deleget, Alison

    2010-01-01

    Thigh injuries include musculotendinous strains of the quadriceps, hamstrings, adductors, iliotibial band (ITB), and bony injuries to the shaft of the femur. There is scant information in the literature regarding thigh injuries in dance, which appear to range from 5% to 16% of total injury incidence. Hamstring strains and ITB syndrome are the most commonly reported thigh injuries. Hamstring injuries occur most frequently during slow stretching when the dancer's hip is flexed and knee extended. Uniquely in dancers, adductor injury occurs concurrently with hamstring injuries in approximately one-third of cases. Snapping of the ITB at the lateral hip and knee may result from imbalance of thigh muscle strength and flexibility. To date no quadriceps strain injuries or stress injuries to the shaft of the femur have been reported in the dance medicine literature. As dancers notoriously underestimate time needed to return to dance, it can be suggested that early return to work is a contributing factor to chronic injury. Further research is needed regarding the incidence and nature of injury to the thigh among dancers.

  10. Conservative treatment for repetitive strain injury.

    PubMed

    Konijnenberg, H S; de Wilde, N S; Gerritsen, A A; van Tulder, M W; de Vet, H C

    2001-10-01

    Various conservative treatment options for repetitive strain injury are widely used, despite questionable evidence of their effectiveness. This systematic review evaluates the effectiveness of these treatment options for relieving symptoms of repetitive strain injury and improving activities of daily living. Searches in Medline and Embase, with additional reference checking resulted in 15 eligible trials for this review. Methodological quality was assessed, and data-extraction was performed. With the use of a "best-evidence synthesis", no strong evidence was found for the effectiveness of any of the treatment options. There is limited evidence that multidisciplinary rehabilitation, ergonomic intervention measures, exercises, and spinal manipulation combined with soft tissue therapy are effective in providing symptom relief or improving activities of daily living. There is conflicting evidence for the effectiveness of behavioral therapy. In conclusion, little is known about the effectiveness of conservative treatment options for repetitive strain injury. To establish strong evidence, more high-quality trials are needed.

  11. Repetitive strain injury: causes, treatment and prevention.

    PubMed

    Shuttleworth, Ann

    Repetitive strain injury (RSI) has become increasingly prevalent with the growth of computer-based and automated occupations. While environmental factors such as work stations and repetitive tasks are primary causes, a number of secondary causes can increase a person's risk of RSI. Various treatments provide relief but the rate of recovery varies widely. Prevention involves adopting a range of measures that will also promote recovery in those with RSI.

  12. 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

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

    PubMed

    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

  14. Effects of forward trunk lean on hamstring muscle kinematics during sprinting.

    PubMed

    Higashihara, Ayako; Nagano, Yasuharu; Takahashi, Kazumasa; Fukubayashi, Toru

    2015-01-01

    This study aimed to investigate the effects of forward trunk lean on hamstring muscle kinematics during sprinting. Eight male sprinters performed maximal-effort sprints in two trunk positions: forward lean and upright. A three-dimensional musculoskeletal model was used to compute the musculotendon lengths and velocity of the biceps femoris long head, semitendinosus, and semimembranosus muscles during the sprinting gait cycle. The musculotendon lengths of all the three hamstring muscles at foot strike and toe-off were significantly greater during the forward trunk lean sprint than during the upright trunk sprint. In addition, a positive peak musculotendon lengthening velocity was observed in the biceps femoris long head and semimembranosus muscles during the late stance phase, and musculotendon lengths at that instant were significantly greater during the forward trunk lean sprint than during the upright trunk sprint. The present study provides significant evidence that a potential for hamstring muscle strain injury involving forward trunk lean sprinting would exist during the stance phase. The results also indicate that the biceps femoris long head and semimembranosus muscles are stretched during forward trunk lean sprinting while contracting eccentrically in the late stance phase; thus, the elongation load on these muscles could be increased.

  15. Repetitive strain injuries: has the Australian epidemic burnt out?

    PubMed

    Awerbuch, M

    2004-07-01

    In the 1980s Australia experienced an epidemic of medically certified claims for non-specific arm symptoms described as repetitive strain injury. Although a number of factors were mooted as causal of the epidemic, no single factor emerged as a compelling putative candidate. The present paper discusses the results of research which was published only after the epidemic had waned. It provides possible insights into the rise and fall of repetitive strain injury.

  16. 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

  17. 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

  18. Quadriceps and hamstrings prelanding myoelectric activity during landing from different heights among male and female athletes.

    PubMed

    de Britto, Morgana Alves; Carpes, Felipe P; Koutras, Georgios; Pappas, Evangelos

    2014-08-01

    ACL tear is a major concern among athletes, coaches and sports scientists. More than taking the athlete away from training and competition, ACL tear is a risk factor for early-onset of knee osteoarthritis, and, therefore addressing strategies to avoid such injury is pertinent not only for competitive athletes, but for all physically active subjects. Imbalances in the prelanding myoelectric activity of the hamstrings and quadriceps muscles have been linked to ACL injuries. We investigated the effect of landing from different heights on prelanding myoelectric activity of the hamstrings and quadriceps muscles in recreational athletes. Thirty recreational athletes (15 male and 15 female) performed three bilateral drop jumps from two different heights; 20cm and 40cm while myoelectric activity of the vastus medialis, rectus femoris, biceps femoris and medial hamstrings were collected. When increasing the height of drop landing tasks prelanding normalized myoelectric activity of the quadriceps was increased by 15-20% but no significant changes were found for the hamstrings. Female athletes exhibited higher activity of the medial hamstrings compared to their male counterparts. We concluded that increasing the height of drop landing tasks is associated with increased myoelectric activity of the quadriceps but not the hamstrings in recreational athletes. These differences in muscle activity may be related to increased risk for ACL injury when the height is increased. Female athletes demonstrated higher recruitment of the medial hamstrings.

  19. Strain and rate-dependent neuronal injury in a 3D in vitro compression model of traumatic brain injury

    PubMed Central

    Bar-Kochba, Eyal; Scimone, Mark T.; Estrada, Jonathan B.; Franck, Christian

    2016-01-01

    In the United States over 1.7 million cases of traumatic brain injury are reported yearly, but predictive correlation of cellular injury to impact tissue strain is still lacking, particularly for neuronal injury resulting from compression. Given the prevalence of compressive deformations in most blunt head trauma, this information is critically important for the development of future mitigation and diagnosis strategies. Using a 3D in vitro neuronal compression model, we investigated the role of impact strain and strain rate on neuronal lifetime, viability, and pathomorphology. We find that strain magnitude and rate have profound, yet distinctively different effects on the injury pathology. While strain magnitude affects the time of neuronal death, strain rate influences the pathomorphology and extent of population injury. Cellular injury is not initiated through localized deformation of the cytoskeleton but rather driven by excess strain on the entire cell. Furthermore we find that, mechanoporation, one of the key pathological trigger mechanisms in stretch and shear neuronal injuries, was not observed under compression. PMID:27480807

  20. Strain and rate-dependent neuronal injury in a 3D in vitro compression model of traumatic brain injury.

    PubMed

    Bar-Kochba, Eyal; Scimone, Mark T; Estrada, Jonathan B; Franck, Christian

    2016-01-01

    In the United States over 1.7 million cases of traumatic brain injury are reported yearly, but predictive correlation of cellular injury to impact tissue strain is still lacking, particularly for neuronal injury resulting from compression. Given the prevalence of compressive deformations in most blunt head trauma, this information is critically important for the development of future mitigation and diagnosis strategies. Using a 3D in vitro neuronal compression model, we investigated the role of impact strain and strain rate on neuronal lifetime, viability, and pathomorphology. We find that strain magnitude and rate have profound, yet distinctively different effects on the injury pathology. While strain magnitude affects the time of neuronal death, strain rate influences the pathomorphology and extent of population injury. Cellular injury is not initiated through localized deformation of the cytoskeleton but rather driven by excess strain on the entire cell. Furthermore we find that, mechanoporation, one of the key pathological trigger mechanisms in stretch and shear neuronal injuries, was not observed under compression. PMID:27480807

  1. Strain and rate-dependent neuronal injury in a 3D in vitro compression model of traumatic brain injury

    NASA Astrophysics Data System (ADS)

    Bar-Kochba, Eyal; Scimone, Mark T.; Estrada, Jonathan B.; Franck, Christian

    2016-08-01

    In the United States over 1.7 million cases of traumatic brain injury are reported yearly, but predictive correlation of cellular injury to impact tissue strain is still lacking, particularly for neuronal injury resulting from compression. Given the prevalence of compressive deformations in most blunt head trauma, this information is critically important for the development of future mitigation and diagnosis strategies. Using a 3D in vitro neuronal compression model, we investigated the role of impact strain and strain rate on neuronal lifetime, viability, and pathomorphology. We find that strain magnitude and rate have profound, yet distinctively different effects on the injury pathology. While strain magnitude affects the time of neuronal death, strain rate influences the pathomorphology and extent of population injury. Cellular injury is not initiated through localized deformation of the cytoskeleton but rather driven by excess strain on the entire cell. Furthermore we find that, mechanoporation, one of the key pathological trigger mechanisms in stretch and shear neuronal injuries, was not observed under compression.

  2. 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.

  3. 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

  4. [Repetitive strain injuries. Forearm pain caused by tissue responses to repetitive strain].

    PubMed

    Sorgatz, H

    2002-10-01

    According to the National Research Council, painful work-related upper limb disorders are caused by different pathophysiological mechanisms, one of which is repetitive strain injury (RSI). Forearm pain, tenderness, and paresthesias are thought to result from a continual risk of exceeding limits of "cumulative trauma load tolerance" (CTLT, cf. NRC 2001) in soft tissue by thousands of high-frequency, repetitive movements. On the other hand, repetitive painful stimulations also produce neuroplastic changes in the spinal and supraspinal nociceptive systems. Thus, repetitive motor and nociceptive impulses become part of the same motor programs, which are also responsible for high-frequency movements and tissue damage. In this way RSI pain may be felt as a task-related response, even after all injuries are completely healed. Consequences of this neuroplastic CTLT model for RSI prevention and therapy are discussed.

  5. Impaired endothelial function and blood flow in repetitive strain injury.

    PubMed

    Brunnekreef, J; Brunnekreef, J J; Benda, N; Benda, N M M; Schreuder, T; Schreuder, T H A; Hopman, M; Hopman, M T E; Thijssen, D; Thijssen, D H J

    2012-10-01

    Repetitive Strain Injury (RSI) is a disabling upper extremity overuse injury that may be associated with pathophysiological changes in the vasculature. In this study we investigated whether RSI is associated with endothelial dysfunction and impaired exercise-induced blood flow in the affected forearm. 10 patients with RSI (age, 40.2 ± 10.3; BMI, 23.8 ± 3.3) and 10 gender- and age-matched control subjects (age, 38.0 ± 12.4; BMI, 22.7 ± 3.4) participated in this study. Brachial artery blood flow was measured at rest and during 3-min periods of isometric handgrip exercise at 15%, 30% and 45% of the individual maximal voluntary contraction. Brachial artery endothelial function was assessed as the flow mediated dilation (FMD), by measuring brachial artery diameter and velocity before and after 5-min ischemic occlusion. We found a lower exercise-induced brachial artery blood flow in patients with RSI than in controls (p=0.04). Brachial artery FMD was significantly lower in patients with RSI than in controls (p<0.01), whilst a lower FMD was also found in patient with unilateral RSI when comparing the affected arm with the non-affected arm (p=0.04). Our results suggest that patients with RSI have an attenuated exercise-induced blood flow and an impaired endothelial function in the affected arm. These findings importantly improve our understanding of the pathophysiological mechanism of RSI.

  6. 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

  7. Comparison of hamstring neuromechanical properties between healthy males and females and the influence of musculotendinous stiffness.

    PubMed

    Blackburn, J Troy; Bell, David R; Norcross, Marc F; Hudson, Jeff D; Engstrom, Lauren A

    2009-10-01

    The hamstrings limit anterior cruciate ligament (ACL) loading, and neuromuscular control of these muscles is crucial for dynamic knee joint stability. Sex differences in electromechanical delay (EMD) and rate of force production (RFP) have been reported previously, and attributed to differences in musculotendinous stiffness (MTS). These characteristics define the neuromechanical response to joint perturbation, and sex differences in these characteristics may contribute to the greater female ACL injury risk. However, it is unclear if these differences exist in the hamstrings, and the relationship between MTS and neuromechanical function has not been assessed directly. Hamstring MTS, EMD, the time required to produce 50% peak force (Time50%), and RFP were assessed in 20 males and 20 females with no history of ACL injury. EMD did not differ significantly across sex (p=0.788). However, MTS (p<0.001) and RFP (p=0.003) were greater in males, Time50% (p=0.013) was shorter in males, and Time50% was negatively correlated with MTS (r=-0.332, p=0.039). These results suggest that neuromechanical hamstring function in females may limit dynamic knee joint stability, potentially contributing to the greater female ACL injury risk. However, future research is necessary to determine the direct influences of MTS and neuromechanical function on dynamic knee joint stability and ACL injury risk.

  8. Athletes attending a sports injury clinic--a review.

    PubMed

    Devereaux, M D; Lachmann, S M

    1983-12-01

    In a prospective study over the two years 1981-1982, there were 1186 separate sporting injuries treated at a Sports Injury Clinic. Just over 75% of patients were aged between 16 and 25 years old, while 80% were male. Football, Rugby, Running, Squash and Rowing contributed over 70% of these injuries. The commonest injuries were to the lower limb and lumbar region. In 43% of knee injuries there was strain of the collateral ligaments, while another 26% had patello-femoral pain. Short distance running was associated with an increase in shin splints, tibial stress fractures and hamstring injuries. Long distance running was associated with an increase in ankle and foot injuries. Sports Injury Clinics can benefit the injured athlete and there appears to be a need for their development in major hospitals.

  9. Individual Muscle use in Hamstring Exercises by Soccer Players Assessed using Functional MRI.

    PubMed

    Fernandez-Gonzalo, R; Tesch, P A; Linnehan, R M; Kreider, R B; Di Salvo, V; Suarez-Arrones, L; Alomar, X; Mendez-Villanueva, A; Rodas, G

    2016-06-01

    This study used functional magnetic resonance imaging (fMRI) to compare individual muscle use in exercises aimed at preventing hamstring injuries. Thirty-six professional soccer players were randomized into 4 groups, each performing either Nordic hamstring, flywheel leg curl, Russian belt or conic-pulley exercise. MRIs were performed before and immediately after a bout of 4 sets of 8 repetitions. Pre-post exercise differences in contrast shift (T2) were analyzed for the long (BFLh) and short head (BFSh) of biceps femoris, semitendinosus (ST), semimembranosus (SM) and gracilis (GR) muscles. Flywheel leg curl increased (P<0.001) T2 of GR (95%), ST (65%), BFSh (51%) and BFLh (14%). After the Nordic hamstring, GR (39%), ST (16%) and BFSh (14%) showed increased T2 (P<0.001). Russian belt and conic-pulley exercise produced subtle (P<0.02) T2 increases of ST (9 and 6%, respectively) and BFLh (7 and 6%, respectively). Russian belt increased T2 of SM (7%). Among exercises examined, flywheel leg curl showed the most substantial hamstring and GR muscle use. However, no single exercise executed was able to increase T2 of all hamstring and synergist muscles analyzed. It is therefore suggested that multiple exercises must be carried out to bring in, and fully activate all knee flexors and hip extensors. PMID:27116347

  10. 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 = 21.3±2.0 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 α 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

  11. 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

  12. Hamstrings Stiffness and Landing Biomechanics Linked to Anterior Cruciate Ligament Loading

    PubMed Central

    Blackburn, J. Troy; Norcross, Marc F.; Cannon, Lindsey N.; Zinder, Steven M.

    2013-01-01

    Context: Greater hamstrings stiffness is associated with less anterior tibial translation during controlled perturbations. However, it is unclear how hamstrings stiffness influences anterior cruciate ligament (ACL) loading mechanisms during dynamic tasks. Objective: To evaluate the influence of hamstrings stiffness on landing biomechanics related to ACL injury. Design: Cross-sectional study. Setting: Research laboratory. Patients or Other Participants: A total of 36 healthy, physically active volunteers (18 men, 18 women; age = 23 ± 3 years, height = 1.8 ± 0.1 m, mass = 73.1 ± 16.6 kg). Intervention(s): Hamstrings stiffness was quantified via the damped oscillatory technique. Three-dimensional lower extremity kinematics and kinetics were captured during a double-legged jump-landing task via a 3-dimensional motion-capture system interfaced with a force plate. Landing biomechanics were compared between groups displaying high and low hamstrings stiffness via independent-samples t tests. Main Outcome Measure(s): Hamstrings stiffness was normalized to body mass (N/m·kg−1). Peak knee-flexion and -valgus angles, vertical and posterior ground reaction forces, anterior tibial shear force, internal knee-extension and -varus moments, and knee-flexion angles at the instants of each peak kinetic variable were identified during the landing task. Forces were normalized to body weight, whereas moments were normalized to the product of weight and height. Results: Internal knee-varus moment was 3.6 times smaller in the high-stiffness group (t22 = 2.221, P = .02). A trend in the data also indicated that peak anterior tibial shear force was 1.1 times smaller in the high-stiffness group (t22 = 1.537, P = .07). The high-stiffness group also demonstrated greater knee flexion at the instants of peak anterior tibial shear force and internal knee-extension and -varus moments (t22 range = 1.729–2.224, P < .05). Conclusions: Greater hamstrings stiffness was associated with landing

  13. Factors involved in strain-induced injury in skeletal muscles and outcomes of prolonged exposures.

    PubMed

    Stauber, William T

    2004-02-01

    Repetitive motion disorders can involve lengthening of skeletal muscles to perform braking actions to decelerate limbs under load often resulting in muscle strains and injury. Injury is a loss of isometric force (weakness) requiring days to recover. The capacity of skeletal muscle to tolerate repeated strains is dependent on multiple factors including individual variation. The most important factors producing muscle strain injury are the magnitude of the resisting force (peak-stretch force) and the number of strains. Other factors such as muscle length and fiber type contribute to the susceptibility to injury as well, but to a lesser degree. Strain injury can also lead to inflammation and pain. Chronic exposure to repeated strains can result in fibrosis that is not completely reversed after months of rest. Long rest times appear to be the only factor reported to prevent inflammation in rats following repeated strain injury. Further understanding of the mechanism for prevention of histopathologic changes by long rest times should provide a rationale for prevention of negative outcomes.

  14. 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

  15. 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

  16. [Repetitive strain injury (RSI): occurrence, etiology, therapy and prevention].

    PubMed

    Bongers, P M; de Vet, H C W; Blatter, B M

    2002-10-19

    In the Netherlands, work related upper-limb disorders are called Repetitive Strain Injuries (RSI). RSI is not a diagnosis but a catch-all term for symptoms and signs located in the neck, upper back, shoulder, arm, elbow, hand, wrist and fingers. These symptoms may include pain, stiffness, tingling, clumsiness, loss of co-ordination, loss of strength, skin discoloration and temperature differences. Each year, 8% of working Dutch citizens take time off work due to RSI symptoms. Although the number of people claiming disability benefit due to RSI is limited, this figure has risen consecutively over the last three years. There is consensus that repetitive work at a high frequency and possibly accompanied by exertion of force is accompanied by RSI symptoms. There are indications of a relation between visual display unit use and these symptoms. However, these relations have not been established in a longitudinal study of adequate quality. High perceived job stress and a high workload are thought to be related to RSI, and women report more symptoms than men. There is insufficient information available on the role of different coping styles, perfectionism and dealing with symptoms. There is little information on the underlying mechanisms in the development of RSI, the diagnostics, therapy and prevention. In view of the lack of clear diagnostic criteria, suggestions have been made for a standardised description of the symptoms involved in the syndrome. A multidisciplinary treatment is likely to have the most effect. In terms of prevention, an integrated approach aimed at improving the working posture, reduction of static load and job stress and at individual factors is assumed to be the most effective.

  17. Relationship between muscle volume and muscle torque of the hamstrings after anterior cruciate ligament reconstruction.

    PubMed

    Konishi, Yu; Fukubayashi, Toru

    2010-01-01

    The muscle torque per unit volume of the hamstrings on the injured and uninjured sides in patients with ACL reconstruction were compared with participants with no history of knee injury to examine whether a similar mechanism leading to quadriceps weakness exists in the hamstrings of these patients. The study population consisted of 18 and 52 patients at hamstring volume was measured on MRI. To identify the muscle torque per unit volume, the peak torque of knee flexion was divided by the hamstring volume. Most muscle torque per unit volume indexes were not significantly different between the patients at hamstrings of the patients. The results of this study indicated that the mechanism of muscle weakness of the hamstrings after reconstruction was different from that of the quadriceps, although the precise mechanism remains to be determined.

  18. 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…

  19. Abdominal wall injuries: rectus abdominis strains, oblique strains, rectus sheath hematoma.

    PubMed

    Johnson, Rob

    2006-04-01

    Abdominal wall injuries are reported to be less common than actually perceived by sports medicine practitioners. National Collegiate Athletic Association injury statistics for 2004-2005 cite a high of 0.71 abdominal muscle injuries per 1000 player-hours in wrestling competition to a low of 0.01 injuries per 1000 player-hours in autumn football practices. British professional soccer clubs reported an incidence of "torso" injuries of up to 7% of all injuries over the course of several seasons. Injury definition is most likely the explanation for this discrepancy. The abdominal wall muscles (rectus abdominis, external and internal obliques, and transverse abdominis) are injured by direct blows to the abdomen or by sudden or repetitive trunk movement, either rotation or flexion/extension. With the exception of the rare rectus sheath hematoma that does not self-tamponade, the treatment for these problems is nonoperative with symptoms guiding rehabilitation and return to play decisions.

  20. Biomarkers affected by impact velocity and maximum strain of cartilage during injury.

    PubMed

    Waters, Nicole Poythress; Stoker, Aaron M; Carson, William L; Pfeiffer, Ferris M; Cook, James L

    2014-09-22

    Osteoarthritis is one of the most common, debilitating, musculoskeletal diseases; 12% associated with traumatic injury resulting in post-traumatic osteoarthritis (PTOA). Our objective was to develop a single impact model with cartilage "injury level" defined in terms of controlled combinations of strain rate to a maximum strain (both independent of cartilage load resistance) to study their sensitivity to articular cartilage cell viability and potential PTOA biomarkers. A servo-hydraulic test machine was used to measure canine humeral head cartilage explant thickness under repeatable pressure, then subject it (except sham and controls) to a single impact having controlled constant velocity V=1 or 100mm/s (strain rate 1.82 or 182/s) to maximum strain ε=10%, 30%, or 50%. Thereafter, explants were cultured in media for twelve days, with media changed at day 1, 2, 3, 6, 9, 12. Explant thickness was measured at day 0 (pre-injury), 6 and 12 (post-injury). Cell viability, and tissue collagen and glycosaminoglycan (GAG) were analyzed immediately post-injury and day 12. Culture media were tested for biomarkers: GAG, collagen II, chondroitin sulfate-846, nitric oxide, and prostaglandin E2 (PGE2). Detrimental effects on cell viability, and release of GAG and PGE2 to the media were primarily strain-dependent, (PGE2 being more prolonged and sensitive at lower strains). The cartilage injury model appears to be useful (possibly superior) for investigating the relationship between impact severity of injury and the onset of PTOA, specifically for discovery of biomarkers to evaluate the risk of developing clinical PTOA, and to compare effective treatments for arthritis prevention. PMID:25005436

  1. Incidence of injury in elite Gaelic footballers.

    PubMed

    Newell, M; Grant, S; Henry, A; Newell, J

    2006-10-01

    The purpose of this study was to undertake a comprehensive prospective epidemiological study of injuries sustained by elite Gaelic Football players over one season. The pattern of injury is strikingly similar across all teams with 47% of all injuries occurring in the final quarter of games and training. Injuries to the lower limb, particularly the hamstrings muscles accounted for the majority of injuries. 65% of players were unable to participate fully in Gaelic Football activity for between one and three weeks as a result of injury. The high incidence of injury especially hamstrings injuries in the latter stages of training and games warrants further investigation.

  2. 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

  3. Activation and aponeurosis morphology affect in vivo muscle tissue strains near the myotendinous junction.

    PubMed

    Fiorentino, Niccolo M; Epstein, Frederick H; Blemker, Silvia S

    2012-02-23

    Hamstring strain injury is one of the most common injuries in athletes, particularly for sports that involve high speed running. The aims of this study were to determine whether muscle activation and internal morphology influence in vivo muscle behavior and strain injury susceptibility. We measured tissue displacement and strains in the hamstring muscle injured most often, the biceps femoris long head muscle (BFLH), using cine DENSE dynamic magnetic resonance imaging. Strain measurements were used to test whether strain magnitudes are (i) larger during active lengthening than during passive lengthening and (ii) larger for subjects with a relatively narrow proximal aponeurosis than a wide proximal aponeurosis. Displacement color maps showed higher tissue displacement with increasing lateral distance from the proximal aponeurosis for both active lengthening and passive lengthening, and higher tissue displacement for active lengthening than passive lengthening. First principal strain magnitudes were averaged in a 1cm region near the myotendinous junction, where injury is most frequently observed. It was found that strains are significantly larger during active lengthening (0.19 SD 0.09) than passive lengthening (0.13 SD 0.06) (p<0.05), which suggests that elevated localized strains may be a mechanism for increased injury risk during active as opposed to passive lengthening. First principal strains were higher for subjects with a relatively narrow aponeurosis width (0.26 SD 0.15) than wide (0.14 SD 0.04) (p<0.05). This result suggests that athletes who have BFLH muscles with narrow proximal aponeuroses may have an increased risk for BFLH strain injuries.

  4. Isokinetic Hamstrings: Quadriceps Ratios in Intercollegiate Athletes.

    ERIC Educational Resources Information Center

    Rosene, John M.; Fogarty, Tracey D.; Mahaffey, Brian L.

    2001-01-01

    Compared the differences in the concentric hamstrings to quadriceps (H:Q) ratio among athletes in different sports at three velocities. Measurement of H:Q ratio of both knees among male and female college athletes indicated that the H:Q ratio increased as velocity increased. No differences existed for the H:Q ratio for sport or side of body. (SM)

  5. Epidemiology of injuries in the Australian Football League, seasons 1997–2000

    PubMed Central

    Orchard, J; Seward, H

    2002-01-01

    Objective: To describe the epidemiology of injuries in the Australian Football League (AFL) over four seasons. Methods: An injury was defined as "any physical or medical condition that caused a player to miss a match in the regular season." The rationale for this definition was to eliminate a previously noted tendency of team recorders to interpret injury definitions subjectively. Administrative records of injury payments to players who did not play matches determined the occurrence of an injury. Results: The seasonal incidence of new injuries was 39 per club (of 40 players) per season (of 22 matches). The match injury incidence for AFL games was 25.7 injuries per 1000 player hours. The injury prevalence (percentage of players missing through injury in an average week) was 16%. The recurrence rate of injuries was 17%. The most common and prevalent injury was hamstring strain (six injuries per club per season, resulting in 21 missed matches per club per season), followed in prevalence by anterior cruciate ligament and groin injuries. Conclusions: The injury definition of this study does not produce incidence rates that are complete for all minor injuries. However, the determination of an injury is made by a single entity in exactly the same manner for all teams, which overcomes a significant methodological flaw present in other multiteam injury surveillance systems. PMID:11867491

  6. MRI-Based Regional Muscle Use during Hamstring Strengthening Exercises in Elite Soccer Players.

    PubMed

    Mendez-Villanueva, Alberto; Suarez-Arrones, Luis; Rodas, Gil; Fernandez-Gonzalo, Rodrigo; Tesch, Per; Linnehan, Richard; Kreider, Richard; Di Salvo, Valter

    2016-01-01

    The present study examined site-specific hamstring muscles use with functional magnetic resonance imaging (MRI) in elite soccer players during strength training. Thirty-six players were randomized into four groups, each performing either Nordic hamstring, flywheel leg-curl, Russian belt or the hip-extension conic-pulley exercise. The transverse relaxation time (T2) shift from pre- to post-MRI were calculated for the biceps femoris long (BFl) and short (BFs) heads, semitendinosus (ST) and semimembranosus (SM) muscles at proximal, middle and distal areas of the muscle length. T2 values increased substantially after flywheel leg-curl in all regions of the BFl (from 9±8 to 16±8%), BFs (41±6-71±11%), and ST (60±1-69±7%). Nordic hamstring induced a substantial T2 increase in all regions of the BFs (13±8-16±5%) and ST (15±7-17±5%). T2 values after the Russian belt deadlift substantially increased in all regions of the BFl (6±4-7±5%), ST (8±3-11±2%), SM (6±4-10±4%), and proximal and distal regions of BFs (6±6-8±5%). T2 values substantially increased after hip-extension conic-pulley only in proximal and middle regions of BFl (11±5-7±5%) and ST (7±3-12±4%). The relevance of such MRI-based inter- and intra-muscle use in designing more effective resistance training for improving hamstring function and preventing hamstring injuries in elite soccer players should be explored with more mechanistic studies. PMID:27583444

  7. MRI-Based Regional Muscle Use during Hamstring Strengthening Exercises in Elite Soccer Players.

    PubMed

    Mendez-Villanueva, Alberto; Suarez-Arrones, Luis; Rodas, Gil; Fernandez-Gonzalo, Rodrigo; Tesch, Per; Linnehan, Richard; Kreider, Richard; Di Salvo, Valter

    2016-01-01

    The present study examined site-specific hamstring muscles use with functional magnetic resonance imaging (MRI) in elite soccer players during strength training. Thirty-six players were randomized into four groups, each performing either Nordic hamstring, flywheel leg-curl, Russian belt or the hip-extension conic-pulley exercise. The transverse relaxation time (T2) shift from pre- to post-MRI were calculated for the biceps femoris long (BFl) and short (BFs) heads, semitendinosus (ST) and semimembranosus (SM) muscles at proximal, middle and distal areas of the muscle length. T2 values increased substantially after flywheel leg-curl in all regions of the BFl (from 9±8 to 16±8%), BFs (41±6-71±11%), and ST (60±1-69±7%). Nordic hamstring induced a substantial T2 increase in all regions of the BFs (13±8-16±5%) and ST (15±7-17±5%). T2 values after the Russian belt deadlift substantially increased in all regions of the BFl (6±4-7±5%), ST (8±3-11±2%), SM (6±4-10±4%), and proximal and distal regions of BFs (6±6-8±5%). T2 values substantially increased after hip-extension conic-pulley only in proximal and middle regions of BFl (11±5-7±5%) and ST (7±3-12±4%). The relevance of such MRI-based inter- and intra-muscle use in designing more effective resistance training for improving hamstring function and preventing hamstring injuries in elite soccer players should be explored with more mechanistic studies.

  8. Fatigue affects peak joint torque angle in hamstrings but not in quadriceps.

    PubMed

    Coratella, Giuseppe; Bellin, Giuseppe; Beato, Marco; Schena, Federico

    2015-01-01

    Primary aim of this study was to investigate peak joint torque angle (i.e. the angle of peak torque) changes recorded during an isokinetic test before and after a fatiguing soccer match simulation. Secondarily we want to investigate functional Hecc:Qconc and conventional Hconc:Qconc ratio changes due to fatigue. Before and after a standardised soccer match simulation, twenty-two healthy male amateur soccer players performed maximal isokinetic strength tests both for hamstrings and for quadriceps muscles at 1.05 rad · s(‒1), 3.14 rad · s(‒1) and 5.24 rad · s(‒1). Peak joint torque angle, peak torque and both functional Hecc:Qconc and conventional Hconc:Qconc ratios were examined. Both dominant and non-dominant limbs were tested. Peak joint torque angle significantly increased only in knee flexors. Both eccentric and concentric contractions resulted in such increment, which occurred in both limbs. No changes were found in quadriceps peak joint torque angle. Participants experienced a significant decrease in torque both in hamstrings and in quadriceps. Functional Hecc:Qconc ratio was lower only in dominant limb at higher velocities, while Hconc:Qconc did not change. This study showed after specific fatiguing task changes in hamstrings only torque/angle relationship. Hamstrings injury risk could depend on altered torque when knee is close to extension, coupled with a greater peak torque decrement compared to quadriceps. These results suggest the use eccentric based training to prevent hamstrings shift towards shorter length.

  9. MRI-Based Regional Muscle Use during Hamstring Strengthening Exercises in Elite Soccer Players

    PubMed Central

    Mendez-Villanueva, Alberto; Suarez-Arrones, Luis; Rodas, Gil; Fernandez-Gonzalo, Rodrigo; Tesch, Per; Linnehan, Richard; Kreider, Richard; Di Salvo, Valter

    2016-01-01

    The present study examined site-specific hamstring muscles use with functional magnetic resonance imaging (MRI) in elite soccer players during strength training. Thirty-six players were randomized into four groups, each performing either Nordic hamstring, flywheel leg-curl, Russian belt or the hip-extension conic-pulley exercise. The transverse relaxation time (T2) shift from pre- to post-MRI were calculated for the biceps femoris long (BFl) and short (BFs) heads, semitendinosus (ST) and semimembranosus (SM) muscles at proximal, middle and distal areas of the muscle length. T2 values increased substantially after flywheel leg-curl in all regions of the BFl (from 9±8 to 16±8%), BFs (41±6–71±11%), and ST (60±1–69±7%). Nordic hamstring induced a substantial T2 increase in all regions of the BFs (13±8–16±5%) and ST (15±7–17±5%). T2 values after the Russian belt deadlift substantially increased in all regions of the BFl (6±4–7±5%), ST (8±3–11±2%), SM (6±4–10±4%), and proximal and distal regions of BFs (6±6–8±5%). T2 values substantially increased after hip-extension conic-pulley only in proximal and middle regions of BFl (11±5–7±5%) and ST (7±3–12±4%). The relevance of such MRI-based inter- and intra-muscle use in designing more effective resistance training for improving hamstring function and preventing hamstring injuries in elite soccer players should be explored with more mechanistic studies. PMID:27583444

  10. Graft Diameter matters in Hamstring ACL reconstruction

    PubMed Central

    Clatworthy, Mark

    2016-01-01

    Objective: Recently techniques have been developed to increase graft diameter in hamstring ACL reconstruction with the hope to decrease graft failure. To date there is limited evidence to show that a smaller graft diameter results in a higher ACL failure rate. Method: The factors for failure in 1480 consecutive single surgeon hamstring ACL reconstructions were evaluated prospectively. Patients were followed for 2-15 years. A multivariate analysis was performed which looked at graft size, age, sex, time to surgery, meniscal integrity, meniscal repair and ACL graft placement to determine whether graft diameter matters in determining the failure of hamstring ACL reconstruction. Results: Graft diameters ranged from 6-10 mm. The mean graft diameter for all patients was 7.75 mm. 83 ACL reconstructions failed. The mean size of graft failures was 7.55 mm ACL reconstructions that failed had a significantly smaller hamstring graft diameter p=0.001. The Hazard Ratio for a smaller diameter graft is 0.517 p=<0.0001. For every 1 mm decrease in graft diameter there is a 48.3% higher chance of failure. The multivariate analysis showed a hazard ratio of 0.543 p=0.002. For every 1 mm decrease in graft diameter there is a 45.7% higher chance of failure. Conclusion: Smaller diameter hamstring grafts do have a higher failure rate. Grafts ≤ 7.5 mm had twice the failure rate of grafts ≥8 mm using a multivariate analysis for every 1 mm decrease in graft diameter there is a 45.7% higher chance of failure.

  11. 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...

  12. Relating Histopathology and Mechanical Strain in Experimental Contusion Spinal Cord Injury in a Rat Model

    PubMed Central

    Liu, Jie; Yung, Andrew; Cripton, Peter; Kozlowski, Piotr; Tetzlaff, Wolfram; Oxland, Thomas

    2016-01-01

    Abstract During traumatic spinal cord injury (SCI), the spinal cord is subject to external displacements that result in damage of neural tissues. These displacements produce complex internal deformations, or strains, of the spinal cord parenchyma. The aim of this study is to determine a relationship between these internal strains during SCI and primary damage to spinal cord gray matter (GM) in an in vivo rat contusion model. Using magnetic resonance imaging and novel image registration methods, we measured three-dimensional (3D) mechanical strain in in vivo rat cervical spinal cord (n = 12) during an imposed contusion injury. We then assessed expression of the neuronal transcription factor, neuronal nuclei (NeuN), in ventral horns of GM (at the epicenter of injury as well as at intervals cranially and caudally), immediately post-injury. We found that minimum principal strain was most strongly correlated with loss of NeuN stain across all animals (R2 = 0.19), but varied in strength between individual animals (R2 = 0.06–0.52). Craniocaudal distribution of anatomical damage was similar to measured strain distribution. A Monte Carlo simulation was used to assess strain field error, and minimum principal strain (which ranged from 8% to 36% in GM ventral horns) exhibited a standard deviation of 2.6% attributed to the simulated error. This study is the first to measure 3D deformation of the spinal cord and relate it to patterns of ensuing tissue damage in an in vivo model. It provides a platform on which to build future studies addressing the tolerance of spinal cord tissue to mechanical deformation. PMID:26729511

  13. Relating Histopathology and Mechanical Strain in Experimental Contusion Spinal Cord Injury in a Rat Model.

    PubMed

    Bhatnagar, Tim; Liu, Jie; Yung, Andrew; Cripton, Peter; Kozlowski, Piotr; Tetzlaff, Wolfram; Oxland, Thomas

    2016-09-15

    During traumatic spinal cord injury (SCI), the spinal cord is subject to external displacements that result in damage of neural tissues. These displacements produce complex internal deformations, or strains, of the spinal cord parenchyma. The aim of this study is to determine a relationship between these internal strains during SCI and primary damage to spinal cord gray matter (GM) in an in vivo rat contusion model. Using magnetic resonance imaging and novel image registration methods, we measured three-dimensional (3D) mechanical strain in in vivo rat cervical spinal cord (n = 12) during an imposed contusion injury. We then assessed expression of the neuronal transcription factor, neuronal nuclei (NeuN), in ventral horns of GM (at the epicenter of injury as well as at intervals cranially and caudally), immediately post-injury. We found that minimum principal strain was most strongly correlated with loss of NeuN stain across all animals (R(2) = 0.19), but varied in strength between individual animals (R(2) = 0.06-0.52). Craniocaudal distribution of anatomical damage was similar to measured strain distribution. A Monte Carlo simulation was used to assess strain field error, and minimum principal strain (which ranged from 8% to 36% in GM ventral horns) exhibited a standard deviation of 2.6% attributed to the simulated error. This study is the first to measure 3D deformation of the spinal cord and relate it to patterns of ensuing tissue damage in an in vivo model. It provides a platform on which to build future studies addressing the tolerance of spinal cord tissue to mechanical deformation.

  14. 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

  15. In vivo imaging of rapid deformation and strain in an animal model of traumatic brain injury*

    PubMed Central

    Bayly, Philip V.; Black, Erin E.; Pedersen, Rachel C.; Leister, Elizabeth P.; Genin, Guy M.

    2005-01-01

    In traumatic brain injury (TBI) rapid deformation of brain tissue leads to axonal injury and cell death. In vivo quantification of such fast deformations is extremely difficult, but important for understanding the mechanisms of degeneration post-trauma and for development of numerical models of injury biomechanics. In this paper, strain fields in the brain of the perinatal rat were estimated from data obtained in vivo during rapid indentation. Tagged magnetic resonance (MR) images were obtained with high spatial (0.2 mm) and temporal (3.9 ms) resolution by gated image acquisition during and after impact. Impacts were repeated either 64 or 128 times to obtain images of horizontal and vertical tag lines in coronal and sagittal planes. Strain fields were estimated by harmonic phase (HARP) analysis of the tagged images. The original MR data was filtered and Fourier-transformed to obtain HARP images, following a method originally developed by Osman et al. (IEEE Trans. Med. Imaging 19(3) (2000) 186). The displacements of material points were estimated from intersections of HARP contours and used to generate estimates of the deformation gradient and Lagrangian strain tensors. Maximum principal Lagrangian strains of >0.20 at strain rates >40/s were observed during indentations of 2 mm depth and 21 ms duration. PMID:16549098

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

    PubMed

    Fiorentino, Niccolo M; Blemker, Silvia S

    2014-10-17

    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.

  17. The effects of the Bowen technique on hamstring flexibility over time: a randomised controlled trial.

    PubMed

    Marr, Michelle; Baker, Julian; Lambon, Nicky; Perry, Jo

    2011-07-01

    The hamstring muscles are regularly implicated in recurrent injuries, movement dysfunction and low back pain. Links between limited flexibility and development of neuromusculoskeletal symptoms are frequently reported. The Bowen Technique is used to treat many conditions including lack of flexibility. The study set out to investigate the effect of the Bowen Technique on hamstring flexibility over time. An assessor-blind, prospective, randomised controlled trial was performed on 120 asymptomatic volunteers. Participants were randomly allocated into a control group or Bowen group. Three flexibility measurements occurred over one week, using an active knee extension test. The intervention group received a single Bowen treatment. A repeated measures univariate analysis of variance, across both groups for the three time periods, revealed significant within-subject and between-subject differences for the Bowen group. Continuing increases in flexibility levels were observed over one week. No significant change over time was noted for the control group.

  18. 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 ...

  19. The 5-Strand Hamstring Graft in Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Lee, Rushyuan Jay; Ganley, Theodore J.

    2014-01-01

    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

  20. Effects of crushed ice and wetted ice on hamstring flexibility.

    PubMed

    Larsen, Chelsea C; Troiano, Jean M; Ramirez, Rebecca J; Miller, Michael G; Holcomb, William R

    2015-02-01

    Flexibility, which is the ability to move freely through a full range of motion (ROM), is desired to enhance the performance and decrease the likelihood of muscle injury. There are different techniques used to increase ROM and cryotherapy techniques to facilitation flexibility gains. However, the combination of stretching and type of cryotherapy agents are still confounding. The purpose was to determine which type of cryotherapy, crushed or wetted ice, would produce the greatest gains in hamstring ROM when followed by proprioceptive neuromuscular facilitation (PNF) stretching. Fifteen healthy subjects underwent 3 treatment conditions: crushed ice bag (crushed ice), wetted ice bag (wetted ice), and no ice bag (no ice). Subject's hamstring ROM was measured at baseline, then again after a 20-minute cryotherapy treatment session. Subjects were then stretched using a slow-reversal-hold-relax PNF technique followed by a final ROM measurement. A repeated measures analysis of variance showed significant differences between cryotherapy and measurement conditions. Post hoc testing indicated that no ice (75.49 ± 12.19° C) was significantly different from wetted ice (81.73 ± 10.34° C) and crushed ice (81.62 ± 13.19° C) at the end of the treatment session, and that no ice (85.27 ± 13.83° C) was significantly different than wetted ice (89.44 ± 11.31° C) and crushed ice (89.16 ± 13.78° C) after the stretching session. However, there were no differences between wetted ice and crushed ice. Results indicate that strength and conditioning specialists can increase ROM with both forms of ice in combination with PNF stretching more so than when using no ice at all. PMID:24378663

  1. Effects of crushed ice and wetted ice on hamstring flexibility.

    PubMed

    Larsen, Chelsea C; Troiano, Jean M; Ramirez, Rebecca J; Miller, Michael G; Holcomb, William R

    2015-02-01

    Flexibility, which is the ability to move freely through a full range of motion (ROM), is desired to enhance the performance and decrease the likelihood of muscle injury. There are different techniques used to increase ROM and cryotherapy techniques to facilitation flexibility gains. However, the combination of stretching and type of cryotherapy agents are still confounding. The purpose was to determine which type of cryotherapy, crushed or wetted ice, would produce the greatest gains in hamstring ROM when followed by proprioceptive neuromuscular facilitation (PNF) stretching. Fifteen healthy subjects underwent 3 treatment conditions: crushed ice bag (crushed ice), wetted ice bag (wetted ice), and no ice bag (no ice). Subject's hamstring ROM was measured at baseline, then again after a 20-minute cryotherapy treatment session. Subjects were then stretched using a slow-reversal-hold-relax PNF technique followed by a final ROM measurement. A repeated measures analysis of variance showed significant differences between cryotherapy and measurement conditions. Post hoc testing indicated that no ice (75.49 ± 12.19° C) was significantly different from wetted ice (81.73 ± 10.34° C) and crushed ice (81.62 ± 13.19° C) at the end of the treatment session, and that no ice (85.27 ± 13.83° C) was significantly different than wetted ice (89.44 ± 11.31° C) and crushed ice (89.16 ± 13.78° C) after the stretching session. However, there were no differences between wetted ice and crushed ice. Results indicate that strength and conditioning specialists can increase ROM with both forms of ice in combination with PNF stretching more so than when using no ice at all.

  2. Hamstrings stretch reflex in human spasticity

    PubMed Central

    Burke, David; Gillies, J. D.; Lance, James W.

    1971-01-01

    In 16 patients with spastic paralysis the hamstrings stretch reflex was found to increase as the velocity of stretch increased, and generally to subside after movement ceased. These effects are attributable to the dynamic property of the primary spindle ending. The stretch reflex commonly appeared in only the last third of the stretching movement and was maximal as the knee became fully extended. This is consistent with the static properties of the primary and secondary spindle endings, and accounts for the absence of the clasp-knife phenomenon in the spastic hamstrings. The difference in the nature of the stretch reflex in spastic flexor and extensor muscles is best explained by the differential reflex effects of group II afferent fibres which facilitate flexor motoneurones and inhibit extensor motoneurones. PMID:4255176

  3. Endoscopic proximal hamstring repair and ischial bursectomy.

    PubMed

    Dierckman, Brian D; Guanche, Carlos A

    2012-12-01

    With the significant increase in use of the arthroscope around the hip have come several less invasive techniques to manage pathologies around this joint. This technical note with a video details one such technique that allows for the endoscopic management of proximal hamstring tears and chronic ischial bursitis, which until now have been managed exclusively with much larger open approaches. This procedure allows for complete exposure of the posterior aspect of the hip in a safe, minimally invasive fashion. PMID:23766996

  4. 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

  5. Anterior Cruciate Ligament Reconstruction With Autologous Hamstring

    PubMed Central

    Grawe, Brian M.; Williams, Phillip N.; Burge, Alissa; Voigt, Marcia; Altchek, David W.; Hannafin, Jo A.; Allen, Answorth A.

    2016-01-01

    Background: Recent clinical investigations have identified inadequate autograft hamstring graft diameter (<8 mm) to be predictive of failure after reconstruction of the anterior cruciate ligament (ACL). Purpose/Hypothesis: The objective of this study was to determine the utility of preoperative magnetic resonance imaging (MRI) variables of the hamstring tendons for the prediction of graft diameter at the time of surgery. The hypothesis was that cross-sectional area (CSA) of the hamstring tendon measured on MRI could accurately predict graft diameter, and threshold measurements could be established to predict graft diameter at the time of surgery. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: A total of 84 consecutive skeletally mature patients prospectively enrolled in our ACL reconstruction patient registry were identified for study purposes. Patients were included if they underwent an MRI of the affected knee at our institution prior to ACL reconstruction with hamstring (HT) autograft. Graft preparation was performed via a standard quadrupled hamstring technique after harvesting both the gracilis and semitendinosus (4-GST). The smallest diameter end of the HT autograft was then utilized for measurement analysis. Total CSA was calculated for both hamstring tendons using the “region of interest tool” on the corresponding proton density–weighted axial image of the knee at the widest condylar dimension. Three independent reviewers measured the MRI scans so that intra- and interrater reliability of the measurements could be determined. A trend analysis was then undertaken to establish correlations between the MRI CSA and graft diameter. Predictive analysis was then performed to establish threshold MRI measurement values for specific graft diameters and determine whether any patient-specific factors would affect graft diameter (age, sex, and body mass index). Results: Mean patient age at the time of surgery was 36 years (range, 11

  6. Neck strain in car occupants: injury status after 6 months and crash-related factors.

    PubMed

    Ryan, G A; Taylor, G W; Moore, V M; Dolinis, J

    1994-10-01

    In this study, 29 individuals who sustained a neck strain as a result of a car crash were drawn from a group of physiotherapy and general practices and were followed up after 6 months. The aim was to examine relationships between the state of the neck injury at the time of follow up and crash-related factors, notably crash severity and occupant awareness. Crash severity was assessed by measurement of damage to the involved vehicles, while 6-month injury status was established through physical examinations and interviews. No statistically significant associations between crash severity and 6-month injury status were found, but subjects who were unaware of the impending collision had a greatly increased likelihood of experiencing persisting symptoms of and/or signs of neck strain, compared with those who were aware (odds ratio = 15.0; 95 per cent confidence limits: 1.8, 178). While the role of crash severity in the production and duration of neck strains remains unclear, awareness appears to have a strong protective influence and may prove to be a useful prognostic indicator in clinical settings.

  7. Sensory dysfunction associated with repetitive strain injuries of tendinitis and focal hand dystonia: a comparative study.

    PubMed

    Byl, N; Wilson, F; Merzenich, M; Melnick, M; Scott, P; Oakes, A; McKenzie, A

    1996-04-01

    Repetitive strain injuries are reaching epidemic levels among workers who perform heavy schedules of rapid alternating movements (eg., computer programmers, data entry workers) or repetitive, sustained, coordinated movements (eg., editors, writers, salespeople). The purpose of this study was to determine if patients with repetitive strain injury demonstrated degraded sensory motor performance with their hands. Sixty age-matched adults were recruited, with 15 each assigned to a healthy adult control group, a healthy musician control group, a tendinitis group, or a focal dystonia group. Four sensory motor subtests from the Sensory Integration and Praxis Test were given to the subjects according to a standardized protocol. Using multiple one-factor analyses of variance in the parametric or nonparametric mode followed by post hoc pairwise testing, no significant differences were found between the healthy controls and the musician controls. On the test of kinesthesia, using the left hand, subjects with tendinitis performed significantly worse than controls and subjects with focal dystonia. Compared with controls, subjects with focal dystonia did significantly worse on graphesthesia and manual form perception (part 1 and part 2). Subjects with focal dystonia also did significantly worse than subjects with tendinitis when using the left hand on graphesthesia and manual form perception (part 2). When treating patients with repetitive strain injury, discriminative sensory motor skills must be carefully assessed and may need to be addressed as part of an effective treatment program.

  8. 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

  9. Musculoskeletal injuries and pain in dancers: a systematic review update.

    PubMed

    Jacobs, Craig L; Hincapié, Cesar A; Cassidy, J David

    2012-01-01

    The objective of this study was to assemble and synthesize the best available literature from 2004 to 2008 on musculoskeletal injury and pain in dancers. MEDLINE and CINAHL were the primary sources of data. Indexed terms such as dance, dancer, dancing, athletic injuries, occupational injuries, sprains and strains, musculoskeletal diseases, bone density, menstruation disturbances, and eating disorders were used to search the databases. Citations were screened for relevance using a priori criteria, and relevant studies were critically reviewed for scientific merit by the best-evidence synthesis method. After screening, 19 articles were found to be scientifically admissible. Data from accepted studies were abstracted into evidence tables relating to: prevalence and associated factors; incidence and risk factors; intervention; and injury characteristics and prognosis of musculoskeletal injury and pain in dancers. Principal findings included: a high prevalence and incidence of lower extremity, hip and back injuries; preliminary evidence that psychosocial and psychological issues such as stress and coping strategies affect injury frequency and duration; history of a previous lateral ankle sprain is associated with an increased risk of ankle sprain in the contralateral ankle in dance students; fatigue may play a role in ACL injury in dancers; acute hamstring strains in dancers affect tendon more than muscle tissue, often resulting in prolonged absence from dance. It is concluded that, while there are positive developments in the literature on the epidemiology, diagnosis, prognosis, treatment, and prevention of MSK injuries and pain in dancers, much room for improvement remains. Suggestions for future research are offered.

  10. 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.

  11. 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

  12. 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

  13. 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

  14. Reconstruction of anterior cruciate ligament and anterolateral ligament using interlinked hamstrings - technical note.

    PubMed

    Ferreira, Marcio de Castro; Zidan, Flavio Ferreira; Miduati, Francini Belluci; Fortuna, Caio Cesar; Mizutani, Bruno Moreira; Abdalla, Rene Jorge

    2016-01-01

    Recent anatomical and biomechanical studies on the anterolateral ligament (ALL) of the knee have shown that this structure has an important function in relation to joint stability, especially when associated with anterior cruciate ligament (ACL) injury. However, the criteria for its reconstruction have not yet been fully established and the surgical techniques that have been described present variations regarding anatomical points and fixation materials. This study presents a reproducible technique for ALL and ACL reconstruction using hamstring tendons, in which three interference screws are used for fixation.

  15. Reconstruction of anterior cruciate ligament and anterolateral ligament using interlinked hamstrings - technical note.

    PubMed

    Ferreira, Marcio de Castro; Zidan, Flavio Ferreira; Miduati, Francini Belluci; Fortuna, Caio Cesar; Mizutani, Bruno Moreira; Abdalla, Rene Jorge

    2016-01-01

    Recent anatomical and biomechanical studies on the anterolateral ligament (ALL) of the knee have shown that this structure has an important function in relation to joint stability, especially when associated with anterior cruciate ligament (ACL) injury. However, the criteria for its reconstruction have not yet been fully established and the surgical techniques that have been described present variations regarding anatomical points and fixation materials. This study presents a reproducible technique for ALL and ACL reconstruction using hamstring tendons, in which three interference screws are used for fixation. PMID:27517028

  16. 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

  17. 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

  18. [Evaluation of the adhesive characteristics of uropathogenic escherichia coli strains in patients with spinal cord injuries].

    PubMed

    Osipova, E V; Shipitsina, I V

    2014-01-01

    The adhesion characteristics of 9 clinical E.coli strains, isolated from the urine of 9 patients with spinal cord injuries in late period were evaluated. Patient age was 21 to 54 years. Neurogenic urination disordes observed in patients were the result of a spinal injury in the cervical (5 patients), thoracic (2 patients) and thoracolumbar (2 patients) spine. The duration of disease ranged from 2 to 12 years. Despite primarily a low adhesion activity of tested strains, the formation of biofilm occurs on the surfaces having both hydrophobic (polystyrene) and hydrophilic (cover glass) properties. After 24 h, according to the photometric evaluation, 7 of 9 strains had weak, 1 - medium, and 1 - high ability to form biofilms. After 48 hours, only 4 strains had low ability to form biofilms, of whom 2 had an increase ability compared to the previous period of observation. Other strains possess the medium ability to form biofilm. When quantifying the ability of bacteria to form biofilms on the surface of the cover glass, it was revealed that a large fraction of the area of the field of view was accounted for microcolonies with size 10 microm2 at 24 hours, and microcolony with size from 100 to 1000 microm2 at 48 h. There were number of significant correlations between parameters studied. After 24 h, the correlation coefficient between the optical density (OD630) and the number, OD630 and proportion of microcolonies with size 10 to 10000 microm2 varied from 0.79 to 0.9. After 48 hours, there was a direct correlation between the OD630 and the number (r = 0.73, P = 0.025), OD630 and proportion (r = 0.81, P = 0.009) of microcolonies with size 1,000 to 10,000 mkm2.

  19. [Changes in the work and life of bank employees with repetitive strain injury: RSI].

    PubMed

    Murofuse, N T; Marziale, M H

    2001-07-01

    Nowadays, Repetitive Strain Injury (RSI) has been one of the most serious problems concerning workers' health. Aiming at analyzing the main changes in the work and life of RSI bearers from an RSI Bearers Association in Cascavel--Paraná, we developed this qualitative study. Semi-structured interviews were applied to nine bank employees. The first symptoms had appeared during the period of automation and introduction of new technology in the Brazilian financial system, which was when changes in work organization took place. The main elements in this process were the increase in work load, use of computers, overtime work, absence of intervals, monotony, repetitive actions, intense work and productivity control, pressure and tension. The aggravation of injuries affected productivity and caused dependence to carry out activities at work and out of it. A challenge lies in ensuring these worker's rights.

  20. The effect of warm-up, static stretching and dynamic stretching on hamstring flexibility in previously injured subjects

    PubMed Central

    O'Sullivan, Kieran; Murray, Elaine; Sainsbury, David

    2009-01-01

    Background Warm-up and stretching are suggested to increase hamstring flexibility and reduce the risk of injury. This study examined the short-term effects of warm-up, static stretching and dynamic stretching on hamstring flexibility in individuals with previous hamstring injury and uninjured controls. Methods A randomised crossover study design, over 2 separate days. Hamstring flexibility was assessed using passive knee extension range of motion (PKE ROM). 18 previously injured individuals and 18 uninjured controls participated. On both days, four measurements of PKE ROM were recorded: (1) at baseline; (2) after warm-up; (3) after stretch (static or dynamic) and (4) after a 15-minute rest. Participants carried out both static and dynamic stretches, but on different days. Data were analysed using Anova. Results Across both groups, there was a significant main effect for time (p < 0.001). PKE ROM significantly increased with warm-up (p < 0.001). From warm-up, PKE ROM further increased with static stretching (p = 0.04) but significantly decreased after dynamic stretching (p = 0.013). The increased flexibility after warm-up and static stretching reduced significantly (p < 0.001) after 15 minutes of rest, but remained significantly greater than at baseline (p < 0.001). Between groups, there was no main effect for group (p = 0.462), with no difference in mean PKE ROM values at any individual stage of the protocol (p > 0.05). Using ANCOVA to adjust for the non-significant (p = 0.141) baseline difference between groups, the previously injured group demonstrated a greater response to warm-up and static stretching, however this was not statistically significant (p = 0.05). Conclusion Warm-up significantly increased hamstring flexibility. Static stretching also increased hamstring flexibility, whereas dynamic did not, in agreement with previous findings on uninjured controls. The effect of warm-up and static stretching on flexibility was greater in those with reduced

  1. Giant pseudocyst of the rectus femoris muscle--repetitive strain injury in recreational soccer player.

    PubMed

    Cicvarić, Tedi; Lucin, Ksenija; Roth, Sandor; Ivancić, Aldo; Marinović, Marin; Santić, Veljko

    2010-04-01

    We report a case of a traumatic pseudocyst, in a recreational soccer player, after rupture of rectus femoris muscle. 37-year-old male, with history of repetitive painful accidents, was examined because of a double fist-sized mass in the anterior thigh. Ultrasound examination revealed a cystic mass in the rectus femoris muscle. Surgical removal of the mass and proximal remnant of muscle was done. Primary healing and functional recovery was achieved. Histological analysis revealed pseudocyst filled with degenerating clot and surrounded with thick fibrous capsule. The repetitive strain muscle injury, with prolonged period of healing, can occur like pseudocyst.

  2. [Repetitive strain injury (RSI); a report from the Health Council of the Netherlands].

    PubMed

    Willems, J H B M

    2002-10-19

    The Health Council of the Netherlands has published its advisory report on Repetitive Strain Injury (RSI). The report provides clear information on the state of this syndrome, including the definition of the problem, the epidemiology, various hypothetical pathophysiological mechanisms, occupational and personal risk factors, and possible methods of treatment. The council states that with regard to the last aspect, too few data are available to draw any conclusion as to the most promising therapy. Nevertheless, patients should get consistent advice from their GP or company doctor. The council emphasises that encouraging physical exercise and eliminating any possible causative strain should be part of an integrated approach, embracing work-related psychosocial and personal issues. Of particular interest is the council's advice to prevent RSI by improving the physical condition and by selective training of muscle function. The report recommends that more research be carried out in order to provide insight into the effectiveness of the treatment of RSI.

  3. Rapid hamstring/quadriceps force capacity in male vs. female elite soccer players.

    PubMed

    Zebis, Mette K; Andersen, Lars L; Ellingsgaard, Helga; Aagaard, Per

    2011-07-01

    Knee joint injuries are a serious issue in soccer. The ability to protect the knee from injury depends largely on the strength of the hamstring relatively to the quadriceps, that is, a low hamstring/quadriceps (H/Q) strength ratio is suggested as a risk factor. Although maximal muscle strength (MVC) has often been used to evaluate the H/Q ratio, the ability to rapidly develop force (rate of force development [RFD]) is more relevant in relation to fast dynamic movements. The aim of this study was to introduce and investigate a rapid RFD H/Q strength ratio compared with the traditional MVC H/Q strength ratio in elite soccer players. Twenty-three elite soccer players (11 women, 12 men) performed maximal voluntary static contraction for the hamstring and quadriceps in an isokinetic dynamometer, from which the maximal muscles strength (MVC) and RFD were extracted. Test-retest reliability for the RFD H/Q ratio was high (intraclass correlation coefficient = 0.664-0.933). The initial contraction phase up to 50 milliseconds from the onset of contraction showed a low RFD H/Q ratio compared to the MVC H/Q ratio (p < 0.001). These results suggest a reduced potential for knee joint stabilization during the very initial phase of muscle contraction. Two female players-both with a markedly low RFD H/Q ratio, but a normal MVC H/Q ratio, compared with the group mean-sustained ACL rupture at a later occasion. The high reliability of the new RFD H/Q strength ratio indicates that the method is a relevant tool in standardized clinical evaluation of the knee joint agonist-antagonist relationship.

  4. Inter-Strain Differences in Liver Injury and One-Carbon Metabolism in Alcohol-Fed Mice

    PubMed Central

    Tsuchiya, Masato; Ji, Cheng; Kosyk, Oksana; Shymonyak, Svitlana; Melnyk, Stepan; Kono, Hiroshi; Tryndyak, Volodymyr; Muskhelishvili, Levan; Pogribny, Igor P.; Kaplowitz, Neil; Rusyn, Ivan

    2012-01-01

    Alcoholic liver injury is a major public health issue worldwide. Even though the major mechanisms of this disease have been established over the past decades, little is known about genetic susceptibility factors that may predispose individuals who abuse alcoholic beverages to liver damage and subsequent pathological conditions. We hypothesized that a panel of genetically diverse mouse strains may be used to examine the role of ER stress and one-carbon metabolism in the mechanism of inter-individual variability in alcoholic liver injury. We administered alcohol (up to 27 mg/kg/d) in high fat diet using intragastric intubation model for 28 days to male mice from 14 inbred strains (129S1/SvImJ, AKR/J, BALB/cJ, BALB/cByJ, BTBR T+tf/J, C3H/HeJ, C57BL/10J, DBA/2J, FVB/NJ, KK/HIJ, MOLF/EiJ, NZW/LacJ, PWD/PhJ, and WSB/EiJ). Profound inter-strain differences (more than 3-fold) in alcohol-induced steatohepatitis were observed among the strains in spite of consistently high levels of urine alcohol that was monitored throughout the study. We found that endoplasmic reticulum stress genes were induced only in strains with the highest liver injury. Liver glutathione and methyl donor levels were affected in all strains, albeit to a different degree. Most pronounced effects that were closely associated with the degree of liver injury were hyperhomocysteinemia and strain-dependent differences in expression patterns of one-carbon metabolism-related genes. Conclusion Our data demonstrate that strain differences in alcohol-induced liver injury and steatosis are striking and independent of alcohol exposure and the most severely affected strains exhibit major differences in the expression of ER stress markers and genes of one-carbon metabolism. PMID:22307928

  5. 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. PMID:27217932

  6. 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

  7. ACL reconstruction: patellar tendon versus hamstring grafts--economical aspects.

    PubMed

    Forssblad, Magnus; Valentin, Anders; Engström, Björn; Werner, Suzanne

    2006-06-01

    The aim of the present investigation was to compare the costs for the use of patellar tendon versus hamstring tendons as grafts for anterior cruciate ligament (ACL) reconstruction including the different fixation methods. The background is that during recent years there has been a dramatic shift from patellar tendon to hamstring tendons in ACL reconstructions in Sweden. All our patients with ACL reconstructions performed during 1 year (2004) were included. Knee joints numbering 440 in 439 patients were primary ACL reconstructions. A hamstring graft was used in 345 knee joints (78.4%) and a patellar tendon graft in 95 (21.6%) of the patients (Table 2). On average 34 (SD 12.9; range 14-63) ACL reconstructions per surgeon were performed by a total of 14 surgeons. The average cost for patellar tendon procedure was 197 euros compared to 436 euros for the hamstring procedure. Mean time for surgery in primary reconstructions was 11.5 min shorter (P<0.001) for patellar tendon reconstructions (71.3+/-31 min) compared to hamstring reconstructions (83.2+/-27 min). This means a difference in cost of 90 euros. The total additional cost (fixation and surgery time) for the hamstring method compared to the patellar tendon method was on an average 329 euros. From a strict economic point of view we therefore recommend or at least consider the use of the patellar tendon as a graft in ACL reconstructions. PMID:16570193

  8. Differentiation of hamstring short latency versus medium latency responses after tibia translation.

    PubMed

    Friemert, B; Bumann-Melnyk, M; Faist, M; Schwarz, W; Gerngross, H; Claes, L

    2005-01-01

    After injuries to the anterior cruciate ligament (ACL) a functional instability is frequently observed which has been attributed to a disturbed sensorimotor function. In light of the clinical importance of ACL injuries and the resulting functional instability, it is of enormous clinical interest to elucidate the role of sensorimotor pathways that involve the ACL. In animals and humans a direct reflex pathway between the ACL and the hamstrings has been shown. The onset latencies of responses reported after ventral tibia translation were around 40-50 ms (range 17.9-65) and were regarded as medium latency responses (MLR). However, ventral tibia translation should also induce a stretch of the hamstring muscles and evoke a short latency response (SLR). Before any muscle response after ventral tibia translation can be ascribed to anatomical structures, it is crucial to analyze the obtained muscle responses carefully. The aim of the present study was the development of an algorithm to differentiate SLR and MLR responses after ventral tibia translation. In ten healthy subjects reflex responses of the hamstrings after anterior tibia translation and after tendon taps on the biceps femoris tendon were evaluated. To investigate the influence of skin afferents, control experiments were performed after lidocain injection of the dorsal calf. The mean onset latency of the tendon jerk reflex was 21.9 +/- 3.1 ms (range 17.3 - 28.7 ms). Both SLR responses (mean onset latency: 20.3 +/- 3.5 ms; range 15.4 - 25.8) and MLR responses (mean onset latency: 38.9 +/- 4.2 ms; range 32.9 - 46.7) were obtained in all subjects. Skin afferents from the calf do not play a major role. The development of an evaluation algorithm is presented that allows a safe differentiation between these partly superimposed SLR and MLR components. It is demonstrated that by measuring the first part of the SLR from the onset to the first peak the end of the SLR can be predicted and that the onset latency of the MLR

  9. Knee extension and flexion muscle power after anterior cruciate ligament reconstruction with patellar tendon graft or hamstring tendons graft: a cross-sectional comparison 3 years post surgery.

    PubMed

    Ageberg, Eva; Roos, Harald P; Silbernagel, Karin Grävare; Thomeé, Roland; Roos, Ewa M

    2009-02-01

    Hamstring muscles play a major role in knee-joint stabilization after anterior cruciate ligament (ACL) injury. Weakness of the knee extensors after ACL reconstruction with patellar tendon (PT) graft, and in the knee flexors after reconstruction with hamstring tendons (HT) graft has been observed up to 2 years post surgery, but not later. In these studies, isokinetic muscle torque was used. However, muscle power has been suggested to be a more sensitive and sport-specific measures of strength. The aim was to study quadriceps and hamstring muscle power in patients with ACL injury treated with surgical reconstruction with PT or HT grafts at a mean of 3 years after surgery. Twenty subjects with PT and 16 subjects with HT grafts (mean age at follow up 30 years, range 20-39, 25% women), who were all included in a prospective study and followed the same goal-based rehabilitation protocol for at least 4 months, were assessed with reliable, valid, and responsive tests of quadriceps and hamstring muscle power at 3 years (SD 0.9, range 2-5) after surgery. The mean difference between legs (injured minus uninjured), the hamstring to quadriceps (H:Q, hamstring divided by quadriceps) ratio, and the limb symmetry index (LSI, injured leg divided by uninjured and multiplied by 100) value, were used for comparisons between the groups (analysis of variance). The mean difference between the injured and uninjured legs was greater in the HT than in the PT group for knee flexion power (-21.3 vs. 7.7 W, p = 0.001). Patients with HT graft had lower H:Q ratio in the injured leg than the patients with PT graft (0.63 vs. 0.77, p = 0.012). They also had lower LSI for knee flexion power than those in the PT group (88 vs. 106%, p < 0.001). No differences were found between the groups for knee extension power. The lower hamstring muscle power, and the lower hamstring to quadriceps ratio in the HT graft group than in the PT graft group 3 years (range 2-5) after ACL reconstruction, reflect imbalance

  10. Strain variability, injury distribution, and seizure onset in a mouse model of stroke in the immature brain.

    PubMed

    Comi, Anne M; Johnston, Michael V; Wilson, Mary Ann

    2005-01-01

    Neonatal stroke is an important cause of neurologic morbidity and cerebral palsy. Recently, we have determined that in postnatal day 12 CD1 mice unilateral carotid ligation alone results in seizures and brain injury. We have shown that, in this model, seizure scores correlate with brain injury scores. We have applied this model to another strain of mice to assess strain-related differences in vulnerability to seizures and brain injury after unilateral carotid ligation. Under isoflurane anesthesia, unilateral right-sided carotid ligation was performed in postnatal day 12 C3HeB/FeJ mice followed by a 4-hour period of observation in a 35 degrees C incubator. Seizure scores and brain jury scores were assigned and compared to scores in mice receiving sham surgery. Timing of seizure onset and regional distribution of brain injury were compared in the CD1 and C3HeB/FeJ mice. Unilateral carotid ligation in postnatal day 12 C3HeB/FeJ mice resulted in seizure behavior and brain injury in some animals, with similar time to seizure onset and regional injury distribution, but affected a significantly smaller percentage of C3HeB/FeJ pups than that observed in postnatal day 12 CD1 mice, indicating strain-related vulnerability in this model. PMID:16046846

  11. 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

  12. 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

  13. Stress-induced muscle effort as a cause of repetitive strain injury?

    PubMed

    Rietveld, S; van Beest, I; Kamphuis, J H

    2007-12-01

    The influence of stress-induced muscle effort during computer utilization was tested in patients with repetitive strain injury (RSI). Twenty academic researchers with a formal medical diagnosis of RSI and 20 matched controls, randomly selected from a sample of 71 colleagues with and without RSI, typed after stress (induced via an intelligence/skill task under social pressure) and after relaxation. Results indicated that both groups had more electromyography (EMG) activity in the shoulder muscles during typing after stress than after relaxation, but that patients started with higher baseline muscle activity. Furthermore, EMG activity of different muscle groups during typing after stress correlated among controls, but not among patients. Finally, analysis of intake forms showed that patients scored higher than controls on neuroticism and alexithymia, but not on extraversion, openness, agreeableness and conscientiousness. It was concluded that deviations in muscle activity during computer utilization, as well as neuroticism and alexithymia, may be risk factors for RSI.

  14. 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

  15. The role of hamstring tightness in plantar fasciitis.

    PubMed

    Labovitz, Jonathan M; Yu, Jenny; Kim, Chul

    2011-06-01

    The purpose of this prospective cohort study was to determine if hamstring tightness was an increased risk in plantar fasciitis. It was thought that there is an increased risk of plantar fasciitis when hamstring tightness is present. A total of 105 patients (68 women, 37 men) were included in the study, 79 of whom were diagnosed with plantar fasciitis. Body mass index (BMI) was calculated and the presence of plantar fasciitis, equinus, and calcaneal spurs were assessed. The popliteal angle was measured using standard diagnostic techniques. Without controlling for covariates, BMI, the presence of a calcaneal spur, tightness in the gastrocnemius, gastrocnemius-soleus, and hamstring all had statistically significant association with plantar fasciitis. After controlling for covariates, patients with hamstring tightness were about 8.7 times as likely to experience plantar fasciitis (P < .0001). Patients with BMI >35 were approximately 2.4 times as likely to experience plantar fasciitis compared with those with BMI <35 (P = .04). This study demonstrates that hamstring tightness plays a significant role in the presence of plantar fasciitis and should be addressed along with equinus and obesity when providing treatment to patients with this diagnosis.

  16. Nintendonitis? A case report of repetitive strain injury in a child as a result of playing computer games.

    PubMed

    Macgregor, D M

    2000-10-01

    Repetitive strain injury is a common occupational hazard but has not been previously reported in a child. With the escalating use of computers both in the home for recreational purposes and in schools for teaching, the possible incidence of hand and wrist problems may need to be highlighted. Perhaps "hand care" instruction should be implemented in UK schools as prophylaxis. PMID:11130299

  17. Nintendonitis? A case report of repetitive strain injury in a child as a result of playing computer games.

    PubMed

    Macgregor, D M

    2000-10-01

    Repetitive strain injury is a common occupational hazard but has not been previously reported in a child. With the escalating use of computers both in the home for recreational purposes and in schools for teaching, the possible incidence of hand and wrist problems may need to be highlighted. Perhaps "hand care" instruction should be implemented in UK schools as prophylaxis.

  18. Nonuniform changes in MRI measurements of the thigh muscles after two hamstring strengthening exercises.

    PubMed

    Mendiguchia, Jurdan; Garrues, Mirian A; Cronin, John B; Contreras, Bret; Los Arcos, Asier; Malliaropoulos, Nikos; Maffulli, Nicola; Idoate, Fernando

    2013-03-01

    Although many different hamstring strengthening exercises exist, the effect on site specific activation of these exercises on different muscles of the leg is unclear. This study investigated the effects of the eccentric leg curl (LC) and lunge (L) exercises on the biceps femoris long head (BFl), biceps femoris short head (BFs), semitendinosus (ST), semimembranosus (SM), and adductor magnus (AM). Each leg of 11 male professional soccer players was randomly assigned to an LC or L exercise protocol (3 sets of 6 repetitions). Functional magnetic resonance imaging (fMRI) of the subjects' thighs were performed before and 48 hours after the intervention. Fifteen axial scans of the thigh interspaced by a distance of 1/15 right femur length (Lf) were obtained. The fMRI data were analyzed for signal intensity changes. No significant changes were observed in absolute short tau inversion recovery values for the SM and BFs. Significant changes for the ST (∼21-45%) from sections 4 to 10, AM (∼2-13%) at section 4, and BFl (∼ -3 vs. 8%) at section 7 were noted. LC exercises load all the regions of the ST muscle. The L exercises load the proximal regions of the BFl and AM. These findings may have relevance when designing protocols for prevention and rehabilitation of hamstring injuries. PMID:23443215

  19. 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

  20. Sports Injuries

    MedlinePlus

    ... sometimes you can injure yourself when you play sports or exercise. Accidents, poor training practices, or improper ... can also lead to injuries. The most common sports injuries are Sprains and strains Knee injuries Swollen ...

  1. Inter-session reliability and sex-related differences in hamstrings total reaction time, pre-motor time and motor time during eccentric isokinetic contractions in recreational athlete.

    PubMed

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

    2014-04-01

    The purposes were twofold: (a) to ascertain the inter-session reliability of hamstrings total reaction time, pre-motor time and motor time; and (b) to examine sex-related differences in the hamstrings reaction times profile. Twenty-four men and 24 women completed the study. Biceps femoris and semitendinosus total reaction time, pre-motor time and motor time measured during eccentric isokinetic contractions were recorded on three different occasions. Inter-session reliability was examined through typical percentage error (CVTE), percentage change in the mean (CM) and intraclass correlations (ICC). For both biceps femoris and semitendinosus, total reaction time, pre-motor time and motor time measures demonstrated moderate inter-session reliability (CVTE<10%; CM<3%; ICC>0.7). The results also indicated that, although not statistically significant, women reported consistently longer hamstrings total reaction time (23.5ms), pre-motor time (12.7ms) and motor time (7.5ms) values than men. Therefore, an observed change larger than 5%, 9% and 8% for total reaction time, pre-motor time and motor time respectively from baseline scores after performing a training program would indicate that a real change was likely. Furthermore, while not statistically significant, sex differences were noted in the hamstrings reaction time profile which may play a role in the greater incidence of ACL injuries in women.

  2. 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

  3. 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

  4. 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

  5. Group training with healthy computing practices to prevent repetitive strain injury (RSI): a preliminary study.

    PubMed

    Peper, Erik; Gibney, Katherine H; Wilson, Vietta E

    2004-12-01

    This pilot study investigated whether group training, in which participants become role models and coaches, would reduce discomfort as compared to a nontreatment Control Group. Sixteen experimental participants participated in 6 weekly 2-hr group sessions of a Healthy Computing program whereas 12 control participants received no training. None of the participants reported symptoms to their supervisors nor were they receiving medical treatment for repetitive strain injury prior to the program. The program included training in ergonomic principles, psychophysiological awareness and control, sEMG practice at the workstation, and coaching coworkers. Using two-tailed t tests to analyze the data, the Experimental Group reported (1) a significant overall reduction in most body symptoms as compared to the Control Group and (2) a significant increase in positive work-style habits, such as taking breaks at the computer, as compared to the Control Group. This study suggests that employees could possibly improve health and work style patterns based on a holistic training program delivered in a group format followed by individual practice.

  6. The demise of repetitive strain injury in sceptical governing rationalities of workplace managers.

    PubMed

    MacEachen, Ellen

    2005-05-01

    In the mid-1990s, RSI (repetitive strain injury) loomed as an occupational health epidemic in industrialised countries. A decade later, the problem appears to have faded away, but there has been little explanation for how this problem might have diminished. This paper offers an explanation for the decline of RSI in the social relations of workplaces, in the pragmatic, day-to-day governance of occupational health by workplace managers. Using the conceptual lens of governmentality theory, this study examined how workplace managers conceptualised, rationalised and responded to RSI in their work organisations. Open-ended interviews were conducted with 35 managers at four Ontario newspaper workplaces. This paper describes managers as guided by a discourse of scepticism about the legitimacy of RSI complaints. This discourse was 'practised' in different ways at each newspaper in varied RSI-management strategies, but each strategy privileged ideas about RSI being problematic in certain types of workers rather than in types of physical work environments. This conceptualisation of RSI splintered, subordinated and collapsed the problem within a broad human resources framework. This paper suggests that the 'taming' of RSI might have occurred in the context of micro-political, workplace-level shifts in the conceptualisation and management of RSI as an occupational health problem.

  7. Anthropometrical analysis of the hand as a Repetitive Strain Injury (RSI) predictive method in pianists.

    PubMed

    Farias, J; Ordóñez, F J; Rosety-Rodriguez, M; Carrasco, C; Ribelles, A; Rosety, M; Rosety, J M; Gomez del Valle, M

    2002-01-01

    In the present work we have studied the anthropometrical characteristics of the pianists hands to predict their potential vulnerability to suffer from Repetitive Strain Injury (RSI). To get this goal we studied the size and morphotype of the hands of pianists affected by RSI. Firstly we observed that 222 individuals from 341 studied pianists (65.1% of the total) presented RSI. Secondly we appreciated that affected hands were mostly small sized (60% of the affected hands) and classifiable in a distinct morphotype named B (68% of the affected hands). This fact suggest they both were the most vulnerable to RSI. Finally we may conclude anthropometrical analysis of pianists hands may be used to reduce the high incidence of this illness given that it may predict performers potential vulnerability to RSI. It also has to be remarked that further studies in this knowledge field are required to reduce the incidence of playing-related medical problems in general, and RSI in particular, in pianist population.

  8. The sensory consequences of repetitive strain injury in musicians: focal dystonia of the hand.

    PubMed

    Byl, N; Hamati, D; Melnick, M; Wilson, F; McKenzie, A

    1996-01-01

    Some individuals with repetitive strain injury (RSI) develop focal dystonia of the hand (FDh), a disorder of motor control manifested in a specific context during skilled, hand movements. This descriptive study was designed to determine if musicians with FDh had reduced tactile discrimination. Ten healthy adults and ten patients with FDh participated in the study. From the standardized Sensory Integration and Praxis Test, five subtests were selected to measure tactile discrimination. The Paired Wilcoxon Test was used to analyze, meaningful, planned pairwise differences by side and by group. The two groups performed similarly on the three tests measuring tactile motor perception (Finger Identification, Localization and Kinesthesia). However, those with FDh performed significantly worse than the healthy comparison group on two tactile perceptual tasks: (1) Graphesthesia, right affected (P < 0.003) and left unaffected (p < 0.005); and (2) Manual Form Perception (stereognosis) on the right affected (P < 0.002) and left unaffected (P < 0.002). It is possible that the somatosensory differences as measured by tactile discrimination tasks represent some degradation of the hand representation following prolonged, repetitive, near simultaneous sensory stimulation of adjacent digits. Tactile discrimination should be tested in patients with RSI to detect potential risks for developing FDh. Effective treatment of patients with RSI including FDh may need to target the somatosensory deficits in order to restore stress-free motor movements.

  9. Sports injuries in school gaelic football: a study over one season.

    PubMed

    Watson, A W

    1996-01-01

    School football injuries were studied over the seven months of one season on 150 males aged 16.94 +/- 0.82 years. Training averaged 4.13 +/- 1.47 hours per week and matches 1.84 +/- 0.60 hours per week. Mean time injured was: 0.51 +/- 1.7 days in hospital, 34.27 +/- 37.08 days off sport and 13.98 +/- 5.22 days of restricted activity. There were 136 match and 63 training injuries giving 175.98 injuries per 10000 hours of matches and 31.06 injuries per 10000 hours of training. Injuries were treated as follows: hospital 83, general practitioners 51, physiotherapists 28, no treatment 38. The most common injuries were: ankle sprain (11.6% of the total), hamstring strain (6.5%), contusion (6.5%) back strain (6%) knee sprain (5.0%), finger sprain (5.0%), other muscle strains (5.0%), fracture of the wrist (5.0%), dislocation of the finger (4.5%), overuse injury of the back (4.0%), tenosynovitis (3.5%), fracture of the ankle (3.0%). Thirteen injuries were to goal-keepers, 85 to backs, 31 to mid-field players and 70 to forwards. In 34.83% of the injuries foul play was given as the major cause. This was followed by "Lack of fitness", "Poor kit or boots" and "Previous injury" (all 11.24%). The most common minor cause was "Poor state of the pitch" (17.42% of injuries).

  10. Reconstruction of the anterior cruciate ligament: a comparison between bone-patellar tendon-bone grafts and fourstrand hamstring grafts

    PubMed Central

    Razi, Mohammad; Sarzaeem, Mohammad Mahdi; Kazemian, Gholam Hossein; Najafi, Farideh; Najafi, Mohammad Amin

    2014-01-01

    Background: Disruption of anterior cruciate ligament (ACL) is a common ligamentous injury of the knee. The choice of graft for (ACL) reconstruction remains controversial. This prospective, randomized clinical trial aimed to compare clinical results of bone-patellar tendon-bone (BPTB) grafts and four-strand semitendinosus-gracilis (ST) grafts for ACL reconstruction over a 3-year follow-up interval. Methods: Seventy-one patients with an average age of 29± 4.5yearswere treated for torn ACL between 2008 and 2009. Forty-sixpatients underwent reconstruction with BPTB autograft, and 41 were treated with ST autograft. At the time of final follow-up, 37 patients in patella group and 34 patients in hamstring group were evaluated in terms of return to pre-injury activity level, pain, knee stability, range of motion, IKDC (International Knee Documentation Committee) score and complications. Results: At 36thmonth of follow-up, 34 (92%) and 28 (82%) patients in BPTB and ST group, respectively had good-to-excellent IKDC score (p > 0.05). The activity levels were higher in BPTB group (p> 0.05). At 3rd yearof follow up, the Lachman test was graded normal, for 23 (62%) and 11 (32%) patients in BPTB and ST group, respectively (p=0.019). Regarding the pivot-shift test, 29 (79%) and 15 (44%) patients in patella and hamstring group, respectively had normal test at the latest follow-up (p=0.021).There were no significant differences in terms of thigh circumference difference, effusion, knee range of motion, pain and complications. Conclusion: The results indicate a trend toward increased graft laxity and pivot-shift grades in patients undergoing reconstruction with hamstring autograft compared with patella tendon. However, the two groups had comparable results in terms of activity level and knee function. PMID:25694992

  11. 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

  12. 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

  13. Risk factors for repetitive strain injuries among school teachers in Thailand.

    PubMed

    Chaiklieng, Sunisa; Suggaravetsiri, Pornnapa

    2012-01-01

    Prolonged posture, static works and repetition are previously reported as the cause of repetitive strain injuries (RSIs) among workers including teachers. This cross-sectional analytic study aimed to investigate the prevalence and risk factors of RSIs among school teachers. Participants were 452 full-time school teachers in Thailand. Data were collected by the structural questionnaires, illuminance measurements and the physical fitness tests. Descriptive statistics and inferential statistics which were Chi-square test and multiple logistic regression analysis were used. Most teachers in this study were females (57.3%), the mean years of work experience was 22.6 ± 10.4 years. The six-month prevalence of RSIs was 73.7%. The univariate analysis identified the related risk factors to RSIs which were chronic disease (OR=1.8; 95% CI = 1.16-2.73), history of trauma (OR=2.0; 95% CI = 1.02-4.01), member of family had RSIs (OR=2.0; 95% CI = 1.02- 4.01), stretch to write on board (OR=1.7; 95% CI = 1.06-1.70) and high heel shoe >2 inch (OR=1.6; 95% CI = 1.03-2.51). Multiple logistic regression analysis showed that chronic diseases and high heel shoe >2 inch significantly related to developing of RSIs. The poor grip strength and back muscle flexibility significantly affected RSIs of teachers. In conclusions, RSIs were highly prevalent in school teachers that they should be aware of health promotion to prevent RSIs.

  14. 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.

  15. 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

  16. The Foam Roll as a Tool to Improve Hamstring Flexibility.

    PubMed

    Junker, Daniel H; Stöggl, Thomas L

    2015-12-01

    Although foam rolling is a common myofascial therapy used to increase range of motion (ROM), research is limited on the effectiveness of foam rolling on soft tissue extensibility. The aim of this study was to determine the effect of a 4-week training period of the foam roll method on hamstring flexibility. Furthermore, the study was designed to compare the effectiveness of the foam roll myofascial release with a conventional contract-relax proprioceptive neuromuscular facilitation (PNF) stretching method and a control group. Forty healthy males (age: 17-47 years) were randomly assigned to a foam roll group (FOAM, n = 13), a contract-relax PNF stretching group (CRPNF, n = 14), or a control group (CG, n = 13). The FOAM group massaged their hamstring muscles with the foam roll 3 times per week for 4 weeks (12 training sessions). The CRPNF group was assigned to 12 sessions of contract-relax PNF stretching. The CG underwent no intervention. Hamstring flexibility (ROM) was measured by a stand-and-reach test before and after the intervention period. Two-way repeated-measures analysis of variance showed a significant global time effect (p < 0.001) and an interaction effect for time × treatment (p = 0.004), demonstrating greater improvements in the FOAM and CRPNF compared with the CG, but no difference between the former. Delta changes from baseline to postintervention in ROM were not related to baseline ROM. The foam roll can be seen as an effective tool to increase hamstring flexibility within 4 weeks. The effects are comparable with the scientifically proven contract-relax PNF stretching method.

  17. The Foam Roll as a Tool to Improve Hamstring Flexibility.

    PubMed

    Junker, Daniel H; Stöggl, Thomas L

    2015-12-01

    Although foam rolling is a common myofascial therapy used to increase range of motion (ROM), research is limited on the effectiveness of foam rolling on soft tissue extensibility. The aim of this study was to determine the effect of a 4-week training period of the foam roll method on hamstring flexibility. Furthermore, the study was designed to compare the effectiveness of the foam roll myofascial release with a conventional contract-relax proprioceptive neuromuscular facilitation (PNF) stretching method and a control group. Forty healthy males (age: 17-47 years) were randomly assigned to a foam roll group (FOAM, n = 13), a contract-relax PNF stretching group (CRPNF, n = 14), or a control group (CG, n = 13). The FOAM group massaged their hamstring muscles with the foam roll 3 times per week for 4 weeks (12 training sessions). The CRPNF group was assigned to 12 sessions of contract-relax PNF stretching. The CG underwent no intervention. Hamstring flexibility (ROM) was measured by a stand-and-reach test before and after the intervention period. Two-way repeated-measures analysis of variance showed a significant global time effect (p < 0.001) and an interaction effect for time × treatment (p = 0.004), demonstrating greater improvements in the FOAM and CRPNF compared with the CG, but no difference between the former. Delta changes from baseline to postintervention in ROM were not related to baseline ROM. The foam roll can be seen as an effective tool to increase hamstring flexibility within 4 weeks. The effects are comparable with the scientifically proven contract-relax PNF stretching method. PMID:25992660

  18. 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

  19. 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

  20. Lung stress, strain, and energy load: engineering concepts to understand the mechanism of ventilator-induced lung injury (VILI).

    PubMed

    Nieman, Gary F; Satalin, Joshua; Andrews, Penny; Habashi, Nader M; Gatto, Louis A

    2016-12-01

    It was recently shown that acute respiratory distress syndrome (ARDS) mortality has not been reduced in over 15 years and remains ~40 %, even with protective low tidal volume (LVt) ventilation. Thus, there is a critical need to develop novel ventilation strategies that will protect the lung and reduce ARDS mortality. Protti et al. have begun to analyze the impact of mechanical ventilation on lung tissue using engineering methods in normal pigs ventilated for 54 h. They used these methods to assess the impact of a mechanical breath on dynamic and static global lung strain and energy load. Strain is the change in lung volume in response to an applied stress (i.e., Tidal Volume-Vt). This study has yielded a number of exciting new concepts including the following: (1) Individual mechanical breath parameters (e.g., Vt or Plateau Pressure) are not directly correlated with VILI but rather any combination of parameters that subject the lung to excessive dynamic strain and energy/power load will cause VILI; (2) all strain is not equal; dynamic strain resulting in a dynamic energy load (i.e., kinetic energy) is more damaging to lung tissue than static strain and energy load (i.e., potential energy); and (3) a critical consideration is not just the size of the Vt but the size of the lung that is being ventilated by this Vt. This key concept merits attention since our current protective ventilation strategies are fixated on the priority of keeping the Vt low. If the lung is fully inflated, a large Vt is not necessarily injurious. In conclusion, using engineering concepts to analyze the impact of the mechanical breath on the lung is a novel new approach to investigate VILI mechanisms and to help design the optimally protective breath. Data generated using these methods have challenged some of the current dogma surrounding the mechanisms of VILI and of the components in the mechanical breath necessary for lung protection.

  1. 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.

  2. Anterior cruciate ligament reconstruction by using otogenous [correction of otogeneous] hamstring tendons with home-based rehabilitation.

    PubMed

    Ugutmen, E; Ozkan, K; Kilincoglu, V; Ozkan, F U; Toker, S; Eceviz, E; Altintas, F

    2008-01-01

    We investigated patients undergoing arthroscopic anterior cruciate ligament (ACL) reconstruction using otogenous hamstring tendons with a cross-pin technique to compare a post-operative home-based rehabilitation programme with a clinic-based programme. ACL reconstruction was performed on 104 patients (103 male) by the same surgeon. The mean age of the patients was 31.5 years (range 18 - 43 years) and the mean time interval between injury and operation was 34.3 months. Patients were randomly allocated to either a home-based (n = 52) or clinic-based rehabilitation programme (n = 52). Mean follow-up was 31.1 months (range 12 - 66 months). Patients underwent a series of examinations before and after surgery in order to evaluate functional recovery of their injured knee. The results demonstrated that using otogeneous hamstring tendons for ACL reconstruction was safe and produced satisfactory results. The study also demonstrated that a home-based rehabilitation programme was as effective as a clinic-based programme.

  3. Effects of a Static Stretching Program on the Incidence of Lower Extremity Musculotendinous Strains

    PubMed Central

    Cross, Kevin M.; Worrell, Ted W.

    1999-01-01

    Objective: Musculotendinous strains are among the most prevalent injuries for which health care professionals provide treatment and rehabilitation interventions. Flexibility has been identified as one of the primary etiologic factors associated with musculotendinous strains, but limited research exists on the effect of a preventive stretching program on musculotendinous strains. Therefore, the purpose of our study was to compare the number of musculotendinous strains for the hamstrings, quadriceps, hip adductors, and gastrocnemius-soleus muscle groups before and after the incorporation of a static stretching program for each muscle group. Design and Setting: We analyzed the incidence of musculotendinous strains among the players of a Division III collegiate football team between 1994 and 1995. All variables were consistent between the 2 seasons except for the incorporation of a lower extremity stretching program in 1995. Subjects: One hundred and ninety-five Division III college football players. Measurements: We calculated the number of musculotendinous strains that required a minimum absence of 1 day from practices or games in 1994 and 1995. Results: A x² analysis revealed a significant reduction in the number of lower extremity musculotendinous strains in 1995 as opposed to 1994. Conclusions: Our statistical analysis indicates an association between the incorporation of a static stretching program and a decreased incidence of musculotendinous strains in Division III college football players. PMID:16558540

  4. Comparison of the hamstring/quadriceps ratio in females during squat exercise using various foot wedges.

    PubMed

    Yoo, Won-Gyu

    2016-08-01

    [Purpose] This study compared the hamstring/quadriceps ratio in females during squat exercise using various foot wedges. [Subjects and Methods] Nine females participated in this study. Surface electrodes measurements were taken over the hamstring and quadriceps under 3 squat exercise conditions, and the hamstring/quadriceps ratio was calculated. [Results] The hamstring/quadriceps ratio was significantly increased during squat exercise in inclined wedge condition (7.4 ± 1.8), compared to the declined wedge condition (5.3 ± 2.2) and no wedge condition (6.4 ± 3.2). [Conclusion] This study suggests that squat exercise in the inclined wedge condition may be effective for increasing the hamstring/quadriceps ratio in females. PMID:27630437

  5. Comparison of the hamstring/quadriceps ratio in females during squat exercise using various foot wedges

    PubMed Central

    Yoo, Won-gyu

    2016-01-01

    [Purpose] This study compared the hamstring/quadriceps ratio in females during squat exercise using various foot wedges. [Subjects and Methods] Nine females participated in this study. Surface electrodes measurements were taken over the hamstring and quadriceps under 3 squat exercise conditions, and the hamstring/quadriceps ratio was calculated. [Results] The hamstring/quadriceps ratio was significantly increased during squat exercise in inclined wedge condition (7.4 ± 1.8), compared to the declined wedge condition (5.3 ± 2.2) and no wedge condition (6.4 ± 3.2). [Conclusion] This study suggests that squat exercise in the inclined wedge condition may be effective for increasing the hamstring/quadriceps ratio in females.

  6. Comparison of the hamstring/quadriceps ratio in females during squat exercise using various foot wedges

    PubMed Central

    Yoo, Won-gyu

    2016-01-01

    [Purpose] This study compared the hamstring/quadriceps ratio in females during squat exercise using various foot wedges. [Subjects and Methods] Nine females participated in this study. Surface electrodes measurements were taken over the hamstring and quadriceps under 3 squat exercise conditions, and the hamstring/quadriceps ratio was calculated. [Results] The hamstring/quadriceps ratio was significantly increased during squat exercise in inclined wedge condition (7.4 ± 1.8), compared to the declined wedge condition (5.3 ± 2.2) and no wedge condition (6.4 ± 3.2). [Conclusion] This study suggests that squat exercise in the inclined wedge condition may be effective for increasing the hamstring/quadriceps ratio in females. PMID:27630437

  7. Timing of neuromuscular activation of the quadriceps and hamstrings prior to landing in high school male athletes, female athletes, and female non-athletes.

    PubMed

    Medina, Jennifer M; Valovich McLeod, Tamara C; Howell, Suzanne K; Kingma, Jackie J

    2008-08-01

    There is a discrepancy between males and females in regards to lower extremity injury rates, particularly at the knee [Agel, J., Arendt, E.A., Bershadsky, B., 2005. Anterior cruciate ligament injury in National Collegiate Athletic Association basketball and soccer: a 13-year review. American Journal of Sports Medicine 33, (4) 524-530]. Gender differences in neuromuscular recruitment characteristics of the muscles that stabilize the knee are often implicated as a factor in this discrepancy. There is considerable research in the area of gender differences in regards to neuromuscular characteristics of the lower extremity in response to perturbation; however, most studies have been performed on the adult population only. Additionally, there is no consensus as to the gender differences that have been demonstrated. The purpose of this study was to compare muscular preactivation of selected lower extremity muscles (vastus medialis, rectus femoris, and medial/lateral hamstrings) in adolescent female basketball athletes, male basketball athletes, and female non-athletes in response to a drop landing. Subjects in the female non-athlete group recruited rectus femoris significantly slower than both the female athlete and male athlete groups (619.9=588.5>200.1ms prior to ground contact). The female non-athlete group also demonstrated a significantly slower vastus medialis compared to the female athlete group (127.1 vs 408.1ms), but not significantly slower than the male athlete group (127.1 vs 275.7ms). There were no differences between female athletes and male athletes for time to initial contraction of any muscle groups. No differences were found among the groups for medial or lateral hamstring activation. This study demonstrates that physical conditioning due to basketball participation appears to affect neuromuscular recruitment in adolescents and reveals a necessity to find alternate methods of training the hamstrings for improved neuromuscular capabilities to prevent

  8. [Update in Current Care guidelines: repetitive strain injuries of the hand and forearm].

    PubMed

    Liira, Helena; Haukka, Eija; Karppinen, Jaro; Linnanen, Päivi; Malmivaara, Antti; Pasternack, Iris; Sirola, Joonas; Viikari-Juntura, Eira; Waris, Eero

    2013-01-01

    Repetitive strain injuriesof the upper extremities refer to pain in the forearm, wrist and hand, caused by excessive strain. Diagnoses include tenosynovitis, epicondylitis and carpal tunnel syndrome. Treatment is aimed at alleviating pain, restoring normal physical functioning and maintain ability to work. Preventive interventions have shown some attenuation of discomfort but no effects on disease prevalance or sick leave days. Return to work interventions seem to decrease length of sickness absences. Part time work has hastened return to work and decreased sickness absences in musculoskeletal disorders.

  9. Accessory bands of the hamstring tendons: A clinical anatomical study.

    PubMed

    Yasin, M N; Charalambous, C P; Mills, S P; Phaltankar, P M

    2010-10-01

    Gracilis and semitendinosus tendons are commonly used as grafts in ligamentous reconstruction. Awareness of accessory bands of these tendons is essential in preventing inadvertent diversion of the tendon harvester into the main tendon resulting in premature tendon amputation and inadequate tendon graft. The aim of this study was to describe the characteristics of these accessory bands. Twenty five patients undergoing arthroscopic anterior cruciate ligament reconstruction using hamstring tendons were included. The number of accessory bands and distance of the most proximal band from the distal periosteal insertion point on the tibial crest was recorded for both gracilis and semitendinosus. In most cases gracilis had two accessory bands; the average distance of the most proximal band from the tibial crest insertion being 5.1 cm. Semitendinosus had three bands in most cases, the average distance of the most proximal band from the tibial crest insertion being 8.1 cm. Five (20%) semitendinosus but no gracilis tendons had an accessory band originating greater than 10 cm from the tibial crest insertion. Semitendinosus had more accessory bands compared to gracilis. A significant proportion (20%) of semitendinosus and none of the gracilis tendons had bands originating greater than 10 cm proximal to the tibial crest insertion. This knowledge about the accessory bands of the hamstrings can guide toward safe harvesting of these tendons.

  10. 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

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

    PubMed

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

    2012-10-01

    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.

  12. Prone position prevents regional alveolar hyperinflation and mechanical stress and strain in mild experimental acute lung injury.

    PubMed

    Santana, Maria Cristina E; Garcia, Cristiane S N B; Xisto, Débora G; Nagato, Lilian K S; Lassance, Roberta M; Prota, Luiz Felipe M; Ornellas, Felipe M; Capelozzi, Vera L; Morales, Marcelo M; Zin, Walter A; Pelosi, Paolo; Rocco, Patricia R M

    2009-06-30

    Prone position may delay the development of ventilator-induced lung injury (VILI), but the mechanisms require better elucidation. In experimental mild acute lung injury (ALI), arterial oxygen partial pressure (Pa O2), lung mechanics and histology, inflammatory markers [interleukin (IL)-6 and IL-1 beta], and type III procollagen (PCIII) mRNA expressions were analysed in supine and prone position. Wistar rats were randomly divided into two groups. In controls, saline was intraperitoneally injected while ALI was induced by paraquat. After 24-h, the animals were mechanically ventilated for 1-h in supine or prone positions. In ALI, prone position led to a better blood flow/tissue ratio both in ventral and dorsal regions and was associated with a more homogeneous distribution of alveolar aeration/tissue ratio reducing lung static elastance and viscoelastic pressure, and increasing end-expiratory lung volume and Pa O2. PCIII expression was higher in the ventral than dorsal region in supine position, with no regional changes in inflammatory markers. In conclusion, prone position may protect the lungs against VILI, thus reducing pulmonary stress and strain.

  13. Lung stress, strain, and energy load: engineering concepts to understand the mechanism of ventilator-induced lung injury (VILI).

    PubMed

    Nieman, Gary F; Satalin, Joshua; Andrews, Penny; Habashi, Nader M; Gatto, Louis A

    2016-12-01

    It was recently shown that acute respiratory distress syndrome (ARDS) mortality has not been reduced in over 15 years and remains ~40 %, even with protective low tidal volume (LVt) ventilation. Thus, there is a critical need to develop novel ventilation strategies that will protect the lung and reduce ARDS mortality. Protti et al. have begun to analyze the impact of mechanical ventilation on lung tissue using engineering methods in normal pigs ventilated for 54 h. They used these methods to assess the impact of a mechanical breath on dynamic and static global lung strain and energy load. Strain is the change in lung volume in response to an applied stress (i.e., Tidal Volume-Vt). This study has yielded a number of exciting new concepts including the following: (1) Individual mechanical breath parameters (e.g., Vt or Plateau Pressure) are not directly correlated with VILI but rather any combination of parameters that subject the lung to excessive dynamic strain and energy/power load will cause VILI; (2) all strain is not equal; dynamic strain resulting in a dynamic energy load (i.e., kinetic energy) is more damaging to lung tissue than static strain and energy load (i.e., potential energy); and (3) a critical consideration is not just the size of the Vt but the size of the lung that is being ventilated by this Vt. This key concept merits attention since our current protective ventilation strategies are fixated on the priority of keeping the Vt low. If the lung is fully inflated, a large Vt is not necessarily injurious. In conclusion, using engineering concepts to analyze the impact of the mechanical breath on the lung is a novel new approach to investigate VILI mechanisms and to help design the optimally protective breath. Data generated using these methods have challenged some of the current dogma surrounding the mechanisms of VILI and of the components in the mechanical breath necessary for lung protection. PMID:27316442

  14. Whole-Genome Sequence of Multidrug-Resistant Pseudomonas aeruginosa Strain BAMCPA07-48, Isolated from a Combat Injury Wound.

    PubMed

    Sanjar, Fatemeh; Karna, S L Rajasekhar; Chen, Tsute; Chen, Ping; Abercrombie, Johnathan J; Leung, Kai P

    2016-07-07

    We report here the complete genome sequence of Pseudomonas aeruginosa strain BAMCPA07-48, isolated from a combat injury wound. The closed genome sequence of this isolate is a valuable resource for pathogenome characterization of P. aeruginosa associated with wounds, which will aid in the development of a higher-resolution phylogenomic framework for molecular-guided pathogen-surveillance.

  15. Hamstring graft fixation in MPFL reconstruction at the patella using a transosseous suture technique.

    PubMed

    Siebold, Rainer; Chikale, Shivanand; Sartory, Nico; Hariri, Nawid; Feil, Sven; Pässler, Hans H

    2010-11-01

    Controversy still exists about fixation methods of a hamstring graft to the patella in case of medial patellofemoral ligament (MPFL) reconstruction. This article presents a surgical technique of hamstring tendon graft fixation to the anatomical MPFL insertion on the patella using transosseous sutures. A superficial bony sulcus is created at the anatomical MPFL insertion site on the medial patellar rim with a bur. A looped hamstring tendon graft is fixed to this superficial sulcus by a pair of nonresorbable transosseous sutures passed across the patella. The retinaculum is sutured on top of the hamstring tendon graft at the level of the patella for additional fixation. The technique avoids bone tunnels as well as hardware at the patella. It reduces the risk of intraoperative or postoperative patella fracture or implant-related complications. The stable transosseous fixation technique allows for early rehabilitation.

  16. Tibial press-fit fixation of the hamstring tendons for ACL-reconstruction.

    PubMed

    Jagodzinski, M; Scheunemann, K; Knobloch, K; Albrecht, K; Krettek, C; Hurschler, C; Zeichen, J

    2006-12-01

    Press-fit fixation of patellar tendon bone anterior cruciate ligament autografts is an interesting technique because no hardware is necessary to achieve fixation. Up till the present point, there is no biomechanical data available for the tibial press-fit fixation of the hamstring tendons. Hamstring tendons of 21 human cadavers (age: 41.9 +/- 13.1 years) were used. A press-fit fixation with looped semitendinosus and gracilis tendons secured by a tape (T) over a bone bridge, or by a baseball-stitched suture (S), was compared with degradable interference screw fixation (I) in 21 porcine tibiae. The constructs were cyclically strained and subsequently loaded to failure. The maximum load to failure, stiffness, and elongation during cyclical loading were measured. The maximum load to failure was highest for the T-fixation at 970 +/- 83 N, followed by the I-fixation with 544 +/- 109 N, and the S-fixation with 402 +/- 78 N (P < 0.03). Stiffness of the constructs averaged 78 +/- 13 N/mm for T, 108 +/- 18 N/mm for S, and 162 +/- 27 N/mm for I (P < 0.03). Elongation during initial cyclical loading was 2.0 +/- 0.6 mm for T, 3.3 +/- 1.1 mm for S, and 1.4 +/- 0.5 mm for I (S inferior to I and T, P<0.05). Elongation between the 20th and 1,500th loading cycle was lower for T (2.2 +/- 0.7 mm) compared with I (4.1 +/- 2.7 mm) and S (4.8 +/- 0.7 mm; P < 0.001). The T-fixation technique exhibited a significantly higher failure load than the S-, and I- techniques. All techniques exhibited larger elongation during initial cyclical loading than is reported in the literature for grafts with bone blocks. Only one technique (T) showed satisfactory elongation behavior during long-term cyclic loading. Interference screw fixation demonstrated significantly higher stiffness. Only one of the investigated techniques (T) seemed to exhibit adequate mechanical properties necessary for early aggressive rehabilitation programs.

  17. Basketball injuries.

    PubMed

    Newman, Joel S; Newberg, Arthur H

    2010-11-01

    Basketball injuries are most prevalent in the lower extremity, especially at the ankle and knee. Most basketball injuries are orthopedic in nature and commonly include ligament sprains, musculotendinous strains, and overuse injuries including stress fractures. By virtue of its excellent contrast resolution and depiction of the soft tissues and trabecular bone, magnetic resonance imaging has become the principal modality for evaluating many basketball injuries. In this article, commonly encountered basketball injuries and their imaging appearances are described. The epidemiology of basketball injuries across various age groups and levels of competition and between genders are reviewed.

  18. Does a 'tight' hamstring predict low back pain reporting during prolonged standing?

    PubMed

    Raftry, Sean M; Marshall, Paul W M

    2012-06-01

    The purpose of this study was to investigate the relationship between hamstring passive stiffness and extensibility in asymptomatic individuals with the reporting of low back pain during 2-h prolonged standing. Twenty healthy participants with no history of low back pain (mean±SD, age 22.6±2.7 years, height 1.74±0.09 m, weight 76.2±14.8 kg). Low back pain (VAS score; mm) was continuously monitored during 2-h prolonged standing. Hamstring extensibility, passive stiffness, and stretch tolerance were measured before and after prolonged standing using an instrumented straight leg raise (iSLR). Ten participants reported a clinically relevant increase (Δ VAS>10mm) in low back pain during prolonged standing. Hamstring extensiblity (leg°(max)), passive stiffness (Nm.°(-1)), and stretch tolerance (VAS; mm) were no different between pain developers and non-pain developers. No changes in hamstring measures were observed following 2-h prolonged standing. No relationship was observed in this study between measures of hamstring extensibility and the reporting of low back pain during prolonged standing. There is no evidence to recommend hamstring extensibility interventions (i.e. passive stretching) as a means of reducing pain reporting in occupations requiring prolonged standing.

  19. 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

  20. Ultrastructural and morphological characteristics of human anterior cruciate ligament and hamstring tendons.

    PubMed

    Zhu, Jingxian; Zhang, Xin; Ma, Yong; Zhou, Chunyan; Ao, Yingfang

    2012-09-01

    Hamstring tendons are a commonly used substitute for anterior cruciate ligament (ACL) reconstruction. Ligaments and tendons are similar in composition but the ACL is more complex than hamstring tendons in function and gross morphology, which are highly dependent on its structure and ultrastructure. The purpose of this study was to compare the morphology and ultrastructure of normal human ACL and hamstring tendons, including the cell type and arrangement, expression level of proteoglycans, diameter, and density of collagen fibrils. Twenty semitendinosus or gracilis tendons and 20 ACL specimens were harvested from patients with ACL rupture or osteoarthritis undergoing routine total knee arthroplasty. The specimens were examined histologically and the ultrastructure was observed using scanning and transmission electron microscopy. Semitendinosus and gracilis tendons showed a homogeneous arrangement of collagen fibers and cell type. They had lower fibril density and more widely distributed fibril diameters. In the ACL, there was a more complex arrangement of collagen fibers, distribution of proteoglycans and different cell types. Electronic microscopy demonstrated a combination of parallel, helical and nonlinear networks of ACL fibrils, and fibril diameters were smaller and more nonuniform. This study compared the anatomy of normal human ACL and hamstring tendons, which may provide a standard for evaluating hamstring tendons grafts after ACL reconstruction and may facilitate the application of hamstring tendons in clinical applications.

  1. [Work, exclusion, pain, suffering, and gender relations: a survey of female workers treated for repetitive strain injury at a public health clinic].

    PubMed

    Neves, Ilidio Roda

    2006-06-01

    This article presents the results of a qualitative study based on patient records from a public health clinic and focusing on four therapeutic groups from 1995 to 1997. The study aimed to reconstruct the life and work history of women with repetitive strain injury (RSI) in relation to family, friends, company, workmates, health services, and impacts on daily life. The results corroborate the data in the scientific literature pointing to greater frequency of RSI among women, and allow us to list the needs related to the resulting biopsychosocial distress, suggesting the need for new research and intervention aimed at producing preventive and therapeutic technologies for such injuries.

  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.

  3. 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

  4. Forearm blood flow and oxygen consumption in patients with bilateral repetitive strain injury measured by near-infrared spectroscopy.

    PubMed

    Brunnekreef, Jaap J; Oosterhof, Jan; Thijssen, Dick H J; Colier, Willy N J M; van Uden, Caro J T

    2006-05-01

    Despite the social impact of repetitive strain injury (RSI), little is known about its pathophysiological mechanism. The main objective of this study was to assess the local muscle oxygenation (mVO2) and blood flow (mBF) of the forearm in individuals with RSI during isometric contractions of the forearm. We employed the non-invasive optical technique near-infrared spectroscopy to assess forearm VO2 and BF. These variables were assessed at 10%, 20%, and 40% of their individual maximal voluntary strength. Twenty-two patients with RSI symptoms in both arms (bilateral RSI) and 30 healthy age-matched subjects participated in this cross-sectional study. The results showed lower mVO2 during exercise and a reduced mBF after exercise. The results suggest that mVO2 and mVO2 are lower in the forearms of individuals with RSI compared with their controls at similar working intensities. This finding indicates that the underlying vasculature may be impaired. Although these findings contribute to the understanding of RSI, future research is necessary to further unravel the mechanisms of this area.

  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. A survey of referee participation, training and injury in elite gaelic games referees

    PubMed Central

    Blake, Catherine; Sherry, James; Gissane, Conor

    2009-01-01

    Background Referees in Gaelic games are exposed to injury risk in match-play and training. Little is currently know about the degree of exposure or the prevalence of injury in this group. The aim of this study was to determine the time commitment to refereeing and training in elite-level Gaelic referees and to establish, for the first time, point and period (past 12 months) prevalence of Gaelic games injury in these officials. Methods A retrospective survey was posted to the complete list of 111 male referees who officiated in elite-level competition in Gaelic football and hurling at the end of the 2005 competition season. Data were summarised using percentages with 95% Confidence Intervals. Results The response rate was 80% (n = 89). Mean age was 42 ± 6 years, ranging from 28–55 years. Forty eight percent were football referees, 25% were hurling referees and 27% refereed both football and hurling. Most referees (69%) officiated at 3–4 games weekly (range 1–6) and most (62%) trained 2–3 times per week (range 1–7). Fourteen percent (n = 12) were currently injured (95% CI 9–21%). Annual injury prevalence was 58% (95% CI 46 to 70%) for football, 50% (95% CI 33 to 67%) for hurling and 42% (95% CI 27 to 58%) for dual referee groups. Sixty percent of injuries were sustained while refereeing match play. The majority (83%, n = 40) were to the lower limb and the predominant (56%, n = 27) injury mechanism was running or sprinting. The most prevalent injuries were hamstring strain (n = 12, 25% of injuries) and calf strain (n = 9, 19% of injuries). Injury causing time off from refereeing was reported by 31% of all referees (95% CI 24 to 40%, n = 28), for a median duration of 3 weeks. Conclusion Participation in official duties and training is high in elite Gaelic games referees, despite the amateur status of the sports. Gaelic games injury is common in the referee cohort, with lower limb injury predominating. These injuries have implications for both the referee

  7. Biceps femoris tendon injuries sustained while playing hockey

    PubMed Central

    Watura, Christopher; Harries, William

    2011-01-01

    A 42-year-old female nurse presented in March 2008 with a left proximal hamstring tendon injury sustained while playing hockey. At surgery, the proximal biceps femoris tendon and semitendonosus were found to be ruptured and were repaired. The patient made a good recovery but sustained a further hockey injury in January 2010 involving a complete tear and rupture of the biceps femoris tendon distally. This was managed conservatively and the patient was able to return to playing hockey 10 months later. Biceps femoris tendon injuries have been reported in sport but this is the first documented case of the injury occurring while playing hockey and is also the first reported case of a biceps tendon rupture proximally (hamstring tendon) followed by distal biceps femoris rupture at the knee in the same leg. PMID:22715185

  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. Whole-Genome Sequence of Multidrug-Resistant Pseudomonas aeruginosa Strain BAMCPA07-48, Isolated from a Combat Injury Wound

    PubMed Central

    Sanjar, Fatemeh; Karna, S. L. Rajasekhar; Chen, Tsute; Chen, Ping; Abercrombie, Johnathan J.

    2016-01-01

    We report here the complete genome sequence of Pseudomonas aeruginosa strain BAMCPA07-48, isolated from a combat injury wound. The closed genome sequence of this isolate is a valuable resource for pathogenome characterization of P. aeruginosa associated with wounds, which will aid in the development of a higher-resolution phylogenomic framework for molecular-guided pathogen-surveillance. PMID:27389262

  10. Fifteen Year Prospective Comparison of Patellar & Hamstring Tendon Grafts for ACL Reconstruction

    PubMed Central

    Roe, Justin; Salmon, Lucy; Kok, Alison; Linklater, James; Pinczewski, Leo

    2016-01-01

    Objective: This prospective longitudinal study compares isolated endoscopic ACL reconstruction utilizing 4-strand hamstring tendon (HT) or patellar tendon (PT) autograft over a 15-year period with respect to clinical outcomes and the development of osteoarthritis. Method: 90 consecutive patients with isolated ACL rupture were reconstructed with a PT autograft and 90 patients received HT autograft, with an identical surgical technique. Patients were assessed at 2, 5, 7, 10 and 15 years. Assessment included the IKDC Knee Ligament Evaluation including radiographic evaluation, KT1000, kneeling pain, and clinical outcomes. Results: Subjects who received the PT graft had significantly worse outcomes at 15 years for the variables of radiologically detectable osteoarthritis (p=0.001), motion loss (p=0.02), single leg hop test (p=0.002), participation in strenuous activity (p=0.03), knee related decrease in activity level (p=0.002) and kneeling pain (p=0.03). There was no significant difference between the HT and PT groups in overall IKDC grade (p=0.28). ACL graft rupture occurred in 16% of HT group and 8% of the PT group (p=0.10). Contralateral ACL rupture occurred in significantly more PT patients (24%) than HT patients (12%) (p=0.03). Conclusion: Significant differences have developed at 15 years after surgery which were not seen at earlier reviews. Compared to the HT Group, the PT group had significantly worse outcomes with respect to radiological osteoarthritis, range of motion and functional tests but no significant difference in laxity was identified. There was a high incidence of ACL injury after reconstruction, to both the reconstructed and the contralateral knee.

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

    PubMed

    Kim, Hyun-Jung; Lee, Jin-Hyuck; 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.

  12. 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

  13. 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 ( ...

  14. Autologous hamstring tendon used for revision of quadiceps tendon tears.

    PubMed

    McCormick, Frank; Nwachukwu, Benedict U; Kim, Jaehon; Martin, Scott D

    2013-04-01

    A paucity of literature exists on quadriceps tendon reruptures. Failed quadriceps tendon repair can cause significant morbidity and disability. Surgical management of quadriceps tendon rerupture can be challenging due to tissue degeneration, tendon retraction, muscle atrophy, and poor bone fixation. A lack of guidance in the literature exists on the appropriate surgical techniques for managing quadriceps tendon reruptures.This article describes the case of a male recreational athlete with a failed primary quadriceps tendon repair who presented 10 months after rerupture. Examination was significant for morbid obesity, assisted ambulation, and a significant defect at the superior pole of the patella on the affected side. Intraoperative findings were consistent with a 2.0- to 4.5-cm tendon defect across the extensor mechanism with complete retinaculi tears. The authors performed a novel surgical approach for revision of quadriceps tears using a bilateral hamstring autograft through a quadriceps tendon weave and a transosseous patellar repair. Tendon length was restored, and extensor mechanism tension was reapproximated. Postoperatively, the patient achieved a good outcome and had returned to full, painless, sport participation at 2-year follow-up.This surgical technique is suitable for revision quadriceps tendon repairs of large tendon gap defects, repairs desiring tendon-to-bone in-growth, and repairs requiring large-force transmission across the repair.

  15. Epidemiology of injuries in English professional rugby union: part 1 match injuries

    PubMed Central

    Brooks, J; Fuller, C; Kemp, S; Reddin, D

    2005-01-01

    Objectives: To undertake a detailed, large scale epidemiological study of match injuries sustained by professional rugby union players in order to define their incidence, nature, severity, and causes. Methods: A two season prospective design was used to study match injuries associated with 546 rugby union players at 12 English Premiership clubs. Team clinicians reported all match injuries on a weekly basis and provided details of the location, diagnosis, severity, and mechanism of each injury. Match exposures for individual players were recorded on a weekly basis. Loss of time from training and match play was used as the definition of an injury. Results: The overall incidence of injury was 91 injuries/1000 player-hours, and each injury resulted on average in 18 days lost time. Recurrences, which accounted for 18% of injuries, were significantly more severe (27 days) than new injuries (16 days). Thigh haematomas were the most common injury for forwards and backs, but anterior cruciate ligament injuries for forwards and hamstring injuries for backs caused the greatest number of days absence. Contact mechanisms accounted for 72% of injuries, but foul play was only implicated in 6% of injuries. The ruck and maul elements of the game caused most injuries to forwards, and being tackled caused most injuries to backs. The hooker and outside centre were the playing positions at greatest risk of injury. Conclusions: On average, a club will have 18% of their players unavailable for selection as a consequence of match injuries. PMID:16183774

  16. Immediate effect of stretching and ultrasound on hamstring flexibility and proprioception.

    PubMed

    Cho, Sung-Hak; Kim, Soo-Han

    2016-06-01

    [Purpose] This research explored the positive effects of self-myofascial release on hamstring muscular flexibility and proprioception and investigated the effectiveness of the stretch combined with therapeutic ultrasound. [Subjects and Methods] This study included 30 healthy university students with no history of pain in the Achilles tendon or hamstring within the recent 6 months. Each participant completed two experiments. In the first experiment (MS), they completed self-myofascial stretching using a foam roller for 7 days. In the second experiment (MSU), the same participants performed the self-myofascial stretching after the 15-minute application of ultrasound. This study involved a pre- and post-test on hamstring muscle flexibility and hip joint proprioception. [Results] The use of self-myofascial stretching in the MS experiment had a significant effect on hamstring muscle flexibility and hip joint proprioception. However, the addition of ultrasound in the MSU experiment had no additive effect. [Conclusion] Self-myofascial stretching immediately increased hamstring muscle flexibility and improved hip joint proprioception, but the addition of pre-stretch ultra sound provided no further benefit.

  17. Immediate effect of stretching and ultrasound on hamstring flexibility and proprioception

    PubMed Central

    Cho, Sung-Hak; Kim, Soo-Han

    2016-01-01

    [Purpose] This research explored the positive effects of self-myofascial release on hamstring muscular flexibility and proprioception and investigated the effectiveness of the stretch combined with therapeutic ultrasound. [Subjects and Methods] This study included 30 healthy university students with no history of pain in the Achilles tendon or hamstring within the recent 6 months. Each participant completed two experiments. In the first experiment (MS), they completed self-myofascial stretching using a foam roller for 7 days. In the second experiment (MSU), the same participants performed the self-myofascial stretching after the 15-minute application of ultrasound. This study involved a pre- and post-test on hamstring muscle flexibility and hip joint proprioception. [Results] The use of self-myofascial stretching in the MS experiment had a significant effect on hamstring muscle flexibility and hip joint proprioception. However, the addition of ultrasound in the MSU experiment had no additive effect. [Conclusion] Self-myofascial stretching immediately increased hamstring muscle flexibility and improved hip joint proprioception, but the addition of pre-stretch ultra sound provided no further benefit. PMID:27390420

  18. Immediate effect of stretching and ultrasound on hamstring flexibility and proprioception.

    PubMed

    Cho, Sung-Hak; Kim, Soo-Han

    2016-06-01

    [Purpose] This research explored the positive effects of self-myofascial release on hamstring muscular flexibility and proprioception and investigated the effectiveness of the stretch combined with therapeutic ultrasound. [Subjects and Methods] This study included 30 healthy university students with no history of pain in the Achilles tendon or hamstring within the recent 6 months. Each participant completed two experiments. In the first experiment (MS), they completed self-myofascial stretching using a foam roller for 7 days. In the second experiment (MSU), the same participants performed the self-myofascial stretching after the 15-minute application of ultrasound. This study involved a pre- and post-test on hamstring muscle flexibility and hip joint proprioception. [Results] The use of self-myofascial stretching in the MS experiment had a significant effect on hamstring muscle flexibility and hip joint proprioception. However, the addition of ultrasound in the MSU experiment had no additive effect. [Conclusion] Self-myofascial stretching immediately increased hamstring muscle flexibility and improved hip joint proprioception, but the addition of pre-stretch ultra sound provided no further benefit. PMID:27390420

  19. 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

  20. 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.

  1. The Relationship of the Sit and Reach Test to Criterion Measures of Hamstring and Back Flexibility in Young Females.

    ERIC Educational Resources Information Center

    Jackson, Allen W.; Baker, Alice A.

    1986-01-01

    This study tested 100 female adolescents to determine the relationships of the sit and reach test, a component of the Health Related Fitness Test, with back and hamstring flexibility. Findings indicate the sit and reach test is moderately related to hamstring flexibility but not to back and low back flexibility. (Author/MT)

  2. Anterior cruciate ligament injuries in female athletes: why are women more susceptible?

    PubMed

    Moeller, J L; Lamb, M M

    1997-04-01

    Anterior cruciate ligament (ACL) injuries occur most frequently in planting and cutting sports such as basketball, soccer, and volleyball. National Collegiate Athletic Association injury data show that female athletes injure the ACL more frequently than their male counterparts do. The greater incidence of ACL injuries in women probably stems from complex, interrelated factors, possibly including hamstring-quadriceps strength imbalances, joint laxity, and the use of ankle braces. Successful treatment often includes surgery.

  3. 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

  4. Comparison of hamstring-to-quadriceps ratio between accelerating and decelerating sections during squat exercise

    PubMed Central

    Yoo, Won-gyu

    2016-01-01

    [Purpose] The aim of this study was to compare hamstring-to-quadriceps ratio between the accelerating and decelerating sections for anterior cruciate ligament protection during squat exercise. [Subjects and Methods] Nine asymptomatic males were enrolled in this study. The hamstring (medial part) and quadriceps (rectus femoris) muscle activities during squat exercise were measured, and the squat exercises were classified into two sections (accelerating and decelerating) by using an accelerometer. [Results] The hamstring-to-quadriceps ratio was significantly higher in the decelerating section than in the accelerating section during the squat exercise. [Conclusion] Application of an increasing decelerating section strategy during the squat exercise can prevent damage in patients with a weakened anterior cruciate ligament due to sports activities. PMID:27799671

  5. Repetitive strain injury.

    PubMed

    Helliwell, P S; Taylor, W J

    2004-08-01

    Pain in the forearm is relatively common in the community. In the workplace forearm pain is associated with work involving frequent repetition, high forces, and prolonged abnormal postures. Nevertheless, other factors are involved in the presentation and the continuation of the pain. Notable among these factors are psychosocial issues and the workplace environment-the attitude to workers and their welfare, the physical conditions, and design of the job. Primary prevention may be effective but active surveillance is important with early intervention and an active management approach. Physical treatments have not been extensively evaluated. In the established case, management should be multidisciplinary, addressing physical aspects of the job but also addressing the "yellow, blue, and black flags" which should be viewed as obstacles to recovery. For the worker "on sick" a dialogue should be established between the worker, the primary care physician, and the workplace. Return to work should be encouraged and facilitated by medical interventions and light duty options. Rehabilitation programmes may be of use in chronic cases.

  6. 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

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

    PubMed

    Moon, Young-Wan; Kim, Hyun-Jung; 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.

  8. Peak torque of quadriceps and hamstring muscles in basketball and soccer players of different divisions.

    PubMed

    Zakas, A; Mandroukas, K; Vamvakoudis, E; Christoulas, K; Aggelopoulou, N

    1995-09-01

    Basketball and soccer are two games with different training and playing procedures. The purpose of this study was to examine the maximal voluntary peak torques of the quadriceps and hamstring muscles, and the torque ratio between these muscle groups in basketball players (n = 61) and soccer players (n = 51) participating in teams of different divisions. Isokinetic peak torques were measured using the Cybex II isokinetic dynamometer at 60 and 180 degrees.s-1. Basketball players of the national team produced higher peak torque values of quadriceps muscles than the other basketball players of different divisions (p < 0.05 to p < 0.001). Hamstring peak torques of the national basketball team were significantly higher the only velocities measured compared with the players from division II and IV (p < 0.05). Peak torque values of quadriceps muscles relative to body weight were significantly higher in the national basketball team compared with basketball players from division I. No significant differences were found in peak torque values of quadriceps and hamstring muscles within the different basketball and soccer divisions. Peak torque expressed in absolute terms was significantly higher in basketball players than in soccer players (p < 0.05 to p < 0.001). However, these differences were not significant when the strength of quadriceps and hamstring muscles was expressed relative to body weight. The H/Q ratio did not differ either ditto among the different divisions of basketball and soccer players. Based on the data obtained in this study, we concluded that the subjects' body weight have a decisive effect on the production of peak torque values of quadriceps and hamstring muscles in basketball and soccer players. Furthermore that the playing in different divisions, as well as participating in different sports, i.e. basketball or soccer, have surprisingly small effects on the peak isokinetic torque production of the quadriceps and hamstring muscles.

  9. 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.

  10. 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

  11. Effect of hamstring flexibility on isometric knee flexion angle-torque relationship.

    PubMed

    Alonso, J; McHugh, M P; Mullaney, M J; Tyler, T F

    2009-04-01

    The purpose of this study was to examine the relationship between hamstring flexibility and knee flexion angle-torque relationship. Hamstring flexibility was assessed in 20 subjects (10 men, 10 women) using the straight leg raise (SLR) and active knee extension (AKE) tests. Isometric knee flexion strength was measured at five knee flexion angles while subjects were seated with the test thigh flexed 40 degrees and the trunk flexed 80 degrees . Lower extremities were classified as tight or normal based on the SLR and AKE tests. Peak knee flexion torque, angle of peak torque, and angle-torque relationship were compared between flexibility groups. Peak knee flexion torque was not different between tight and normal groups (SLR P=0.82; AKE P=0.68) but occurred in greater knee flexion (shorter muscle length) in the tight group compared with the normal group (SLR P<0.01; AKE P<0.05). The tight group had higher torque than the normal group at the shortest muscle length tested but lower torque at longer muscle lengths (SLR P<0.001; AKE P<0.001). In conclusion, the angle-torque relationship was shifted to the left in less flexible hamstrings such that knee flexion torque was increased at short muscle lengths and decreased at long muscle lengths when compared with more flexible hamstrings.

  12. Predicting Hamstring Graft Diameter Using MRI and Anthropometry

    PubMed Central

    Fritsch, Brett A; Mhaskar, Vikram A; An, Vincent Vinh Gia; Scholes, Corey

    2016-01-01

    Objectives: Graft diameter is one variable that may affect outcome of ACL reconstruction. The ability to predict the size of a graft in a given patient pre-operatively may help guide graft selection and preparation technique. Various papers have correlated anthropometric data and MRI tendon measurements to intraoperative graft diameter, although no papers have investigated these together. The intra-operative diameter of a hamstring autograft will be influenced by graft preparation technique. Our study aimed to investigate the prediction of intraoperative graft diameter of 2 different graft construct techniques (4-strand semitendinosus versus quadrupled semitendinosus) using anthropometry and MRI measurements. Methods: Retrospective review of two groups of ACL reconstruction using different graft preparation techniques was performed. “Conventional” 4-strand gracilis + semitendinosus with fixed suspension at the femur and screw fixation at the tibia were compared with quadrupled semitendinosus grafts with adjustable suspensory fixation at each end (Graftlink). Cross-sectional areas (XSA) of the semitendinosus and gracilis tendons was measured in the axial slice of a T2 weighted MRI image using a region-of-interest tool. Stepwise linear regression using intraoperative graft diameter as the dependant variable was performed using MRI XSA of the semitendinosus and gracilis tendons, gender and height as predictors. Results: 129 ACL Reconstruction in 127 patients were done in the time period, 89 of which were done conventionally, and 40 which employed the Graftlink construct. The median graft diameter in the Graftlink group (8.5mm IQR8-9) was greater than that of the conventional group (8mm, IQR 7.5-8) (p < 0.001). MRI XSA of semitendinosus and height were statistically significant predictors of diameter in the Graftlink group (R2 = 51%), whilst MRI XSA of semitendinosus + gracilis and gender were predictors in the conventional group (R2 = 36%). Conclusion: Graftlink

  13. 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 ...

  14. 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

  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.

  16. 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

  17. [Non-industrial labor, internal conditions and repetitive strain injury: a case study in a shellfish-rearing community on Maré Island, State of Bahia, Brazil].

    PubMed

    Pena, Paulo Gilvane Lopes; Freitas, Maria do Carmo Soares de; Cardim, Adryanna

    2011-08-01

    Non-industrial labor is still widespread in Brazil. An appropriate approach ought to consider different social specificities from those of salaried-work relations. The scope was to examine non-industrial work practices, specifically those of extractive shellfishing, and their relation to health conditions in a small-scale fishing community. It focused on the cadences and time contingencies, as well as other working conditions, related to the development of ailments such as repetitive strain injury -RSI. A qualitative-ethnographic study was conducted between 2005 and 2007 in a community of 800 inhabitants, located on Maré Island in the state of Bahia. In a population consisting of fishing households, thirty families were interviewed, observed at work and - in cases of suspected RSI -referred to a specialized health service. The seriousness of the working conditions became evident, especially with respect to RSI. By way of illustration, an average frequency of 10,200 repetitive movements per hour were verified in extractive shellfishing, while the official Brazilian norm (NR17) for a keyboarder establishes a maximum of 8,000 movements per hour. This suggests that women shellfishers ought to be included in repetitive strain injury risk groups.

  18. 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

  19. 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.

  20. 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

  1. Influence of Hamstring and Abdominal Muscle Activation on a Positive Ober's Test in People with Lumbopelvic Pain

    PubMed Central

    Tenney, H. Rich; DeBord, Aaron

    2013-01-01

    ABSTRACT Purpose: To assess the immediate effect of hamstring and abdominal activation on pain levels as measured by the Numeric Pain Scale (NPS) and hip range of motion as measured by Ober's Test in people with lumbopelvic pain. Methods: Thirteen participants with lumbopelvic pain and positive Ober's Tests completed an exercise developed by the Postural Restoration Institute™ to recruit hamstrings and abdominal muscles. Results: There was a significant increase in passive hip-adduction angles (p<0.01) and decrease in pain (p<0.01) immediately after the intervention. Conclusion: Specific exercises that activate hamstrings and abdominal muscles appear to immediately improve Ober's Test measurements and reduce pain as measured by the NPS in people with lumbo-pelvic pain. Hamstring/abdominal activation, rather than iliotibial band stretching, may be an effective intervention for addressing lumbopelvic pain and a positive Ober's Test. PMID:24381375

  2. Traumatic brain injury causes delayed motor and cognitive impairment in a mutant mouse strain known to exhibit delayed Wallerian degeneration.

    PubMed

    Fox, G B; Faden, A I

    1998-09-15

    Delayed Wallerian degeneration after neuronal injury is a feature of the C57BL/Wld(s) mouse mutant. In the present study, we examined the effect of unilateral controlled cortical impact (CCI) on motor and cognitive performance in C57BL/6 and C57BL/Wld(s) mice. Performance on a beam-walking task was impaired in both injured groups over the first 3 weeks; however, between 28 and 35 days post injury, C57BL/6 mice continued to improve whereas C57BL/Wld(s) mice showed increased footfaults. In a spatial learning task, C57BL/Wld(s) animals performed consistently better than C57BL/6 mice when tested 7-10 days and 14-17 days following CCI. C57BL/Wld(s) mice also demonstrated improved working memory performance as compared with C57BL/6 mice when trained on days 21-22 after injury; this effect was lost on days 23 and 24, and was not evident in other animals tested in the same task at 28-31 days following injury. These results indicate a marked delay in motor and cognitive impairment following CCI in C57BL/Wld(s) mice compared with injured C57BL/6 controls. This is consistent with previous work showing delayed temporal evolution of neuronal degeneration in C57BL/Wld(s) mice and suggests CCI may be a suitable model for examining the functional consequences of traumatic brain injury (TBI) in genetically altered mice.

  3. 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

  4. 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

  5. The comparison of the effects of three physiotherapy techniques on hamstring flexibility in children: a prospective, randomized, single-blind study.

    PubMed

    Czaprowski, Dariusz; Leszczewska, Justyna; Kolwicz, Aleksandra; Pawłowska, Paulina; Kędra, Agnieszka; Janusz, Piotr; Kotwicki, Tomasz

    2013-01-01

    The aim of the study was to evaluate changes in hamstring flexibility in 120 asymptomatic children who participated in a 6-week program consisting of one physiotherapy session per week and daily home exercises. The recruitment criteria included age (10-13 years), no pain, injury or musculoskeletal disorder throughout the previous year, physical activity limited to school sport. Subjects were randomly assigned to one of the three groups: (1) post-isometric relaxation - PIR (n = 40), (2) static stretch combined with stabilizing exercises - SS (n = 40) and (3) stabilizing exercises - SE (n = 40). Hamstring flexibility was assessed with straight leg raise (SLR), popliteal angle (PA) and finger-to-floor (FTF) tests. The examinations were conducted by blinded observers twice, prior to the program and a week after the last session with the physiotherapist. Twenty-six children who did not participate in all six exercise sessions with physiotherapists were excluded from the analysis. The results obtained by 94 children were analyzed (PIR, n = 32; SS, n = 31; SE, n = 31). In the PIR and SS groups, a significant (P<0.01) increase in SLR, PA, FTF results was observed. In the SE group, a significant (P<0.001) increase was observed in the SLR but not in the PA and FTF (P>0.05). SLR result in the PIR and SS groups was significantly (P<0.001) higher than in the SE group. As far as PA results are concerned, a significant difference was observed only between the SS and SE groups (P = 0.014). There were no significant (P = 0.15) differences regarding FTF results between the three groups. Post-isometric muscle relaxation and static stretch with stabilizing exercises led to a similar increase in hamstring flexibility and trunk forward bend in healthy 10-13-year-old children. The exercises limited to straightening gluteus maximus improved the SLR result, but did not change the PA and FTF results.

  6. Isokinetic quadriceps and hamstring muscle strength and knee function 5 years after anterior cruciate ligament reconstruction: comparison between bone-patellar tendon-bone and hamstring tendon autografts.

    PubMed

    Lautamies, Riitta; Harilainen, Arsi; Kettunen, Jyrki; Sandelin, Jerker; Kujala, Urho M

    2008-11-01

    Existing clinical studies have not proven which graft is to be preferred in anterior cruciate ligament (ACL) reconstruction. In recent years, bone-patellar tendon-bone and hamstring tendons have been the most frequently used graft types. Muscle strength deficit is one of the consequences after ACL reconstruction. The aim of this study was to evaluate possible differences in hamstring and quadriceps muscle strength and knee function 5 years after ACL reconstruction between the BPTB and the STG groups. The study group consisted of 288 patients (132 women, 156 men) with a unilateral ACL rupture who had received a BPTB (175 patients) or STG (113 patients) ACL reconstruction. Lower extremity concentric isokinetic peak extension and flexion torques were assessed at the angular velocities of 60 degrees /s and 180 degrees /s. The International Knee Documentation Committee (IKDC), the Tegner activity level, the Lysholm knee and the Kujala patellofemoral scores were also collected. Isokinetic quadriceps peak torque (percentage of the contralateral side) was 3.9% higher in the STG group than in the BPTB group at the velocity of 60 degrees /s and 3.2% higher at the velocity of 180 degrees /s and the isokinetic hamstring peak torque 2% higher in the BPTB group than in the STG group at the velocity of 60 degrees /s and 2.5% higher at the velocity of 180 degrees /s. In both groups the subjects had weaker quadriceps and hamstring muscle strength in the injured extremity compared with the uninjured one. In the single-leg hop test (according to the IKDC recommendations) there was a statistically significant difference (P = 0.040) between the groups. In the STG group, 68% of the patients had the single-leg hop ratio (injured vs. uninjured extremity) > or =90%, 31% of the patients 75-89% and 1% of the patients <75%, while in the BPTB group the corresponding percentages were 72, 21 and 7%. However, no statistically significant differences in clinical outcome were found between the

  7. Hamstring tendon harvesting--Effect of harvester on tendon characteristics and soft tissue disruption; cadaver study.

    PubMed

    Charalambous, C P; Alvi, F; Phaltankar, P; Gagey, O

    2009-06-01

    The purpose of this study was to determine whether the type of hamstring tendon harvester used can influence harvested tendon characteristics and soft tissue disruption. We compared two different types of tendon harvesters with regard to the length of tendon obtained and soft tissue disruption during hamstring tendon harvesting. Thirty six semitendinosus and gracilis tendons were harvested using either a closed stripper or a blade harvester in 18 paired knees from nine human fresh cadavers. Use of the blade harvester gave longer lengths of usable tendon whilst minimising the stripping of muscle and of any non-usable tendon. Our results suggest that the type of harvester per se can influence the length of tendon harvested as well as soft tissue disruption. Requesting such data from the industry prior to deciding which harvester to use seems desirable.

  8. 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...

  9. Arthroscopic posterior cruciate ligament reconstruction using four-strand hamstring tendon graft and interference screws.

    PubMed

    Pinczewski, L A; Thuresson, P; Otto, D; Nyquist, F

    1997-10-01

    We describe an arthroscopic technique for reconstruction of the posterior cruciate ligament (PCL) using a four-strand hamstring tendon graft. The femoral tunnel is drilled via the anterolateral portal and the tibial tunnel through the skin incision from the graft harvest. The graft is pulled through the tunnels with pullout sutures and fastened with interference screws. The results to date are good and the procedure can often be performed as day surgery. PMID:9343661

  10. 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.

  11. Utilization and efficacy of computational gait analysis for hamstring lengthening surgery.

    PubMed

    MacWilliams, Bruce A; Stotts, Alan K; Carroll, Kristen L; D'Astous, Jacques L

    2016-09-01

    A retrospective analysis of computational gait studies performed in a single lab over a 12 year period was undertaken to characterize how recommendations to perform or not to perform hamstring lengthenings were utilized by physicians and the effect on outcomes. 131 Subjects were identified as either having hamstring lengthening considered by the referring surgeon, recommended by gait analysis data, or performed. A subset of this data meeting inclusion criteria for pre- and post-surgical timeframes, and bilateral diagnosis was further analyzed to assess the efficacy of the recommendations. There was initial agreement between planned procedures and recommended procedures in just 41% of the cases. Including the cases where there was agreement, gait analysis altered the initial procedure in 54%. In the cases where the initial plan was not supported by gait data, surgeons followed gait recommendations in 77%. In subjects who underwent hamstring lengthening, when surgeons followed or agreed with gait recommendations, patients were 3.6 times more likely to experience a positive outcome. PMID:27505142

  12. 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…

  13. Repetitive Stress Injuries

    MedlinePlus

    ... any problems since. What Are Repetitive Stress Injuries? Repetitive stress injuries (RSIs) are injuries that happen when too much stress is placed on a part of the body, resulting in inflammation (pain and swelling), muscle strain, or tissue damage. This stress generally occurs from ...

  14. 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

  15. A taxonomically unique Acinetobacter strain with proteolytic and hemolytic activities recovered from a patient with a soft tissue injury.

    PubMed

    Almuzara, Marisa; Traglia, German Matías; Krizova, Lenka; Barberis, Claudia; Montaña, Sabrina; Bakai, Romina; Tuduri, Alicia; Vay, Carlos; Nemec, Alexandr; Ramírez, María Soledad

    2015-01-01

    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.

  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. 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…

  18. Factors affecting return to sports after anterior cruciate ligament reconstruction with patellar tendon and hamstring graft: a prospective clinical investigation.

    PubMed

    Gobbi, Alberto; Francisco, Ramces

    2006-10-01

    In athletes, anterior cruciate ligament (ACL) reconstruction is recommended after injury to restore the normal knee function and allow subsequent return to sport. Successful ACL reconstruction with patellar tendon (PT) and hamstring tendon (HT) grafts combined with a well-structured rehabilitation program could bring athletes back to their previous level of sport activities. We prospectively followed-up 100 athletes who underwent ACL reconstruction with either PT (n=50) or HT grafts (n=50). Evaluation was done pre-operatively and post-operatively (3, 6, 12, and 24 months) using International Knee Documentation Committee (IKDC), Lysholm, Noyes, and Tegner scales. Subjective assessment numeric evaluation (SANE), knee activity rating scale (Marx) and a psychological profile questionnaire (psychovitality) were also utilized. Objective evaluations included isokinetic tests and computerized knee motion analysis. Data gathered were statistically analyzed using the Mann-Whitney non-parametric U-test. Among the 100 patients who have undergone ACL reconstruction, 65% returned to the same level of sports, 24% changed sports and 11% ceased sport activities. No significant difference (P>0.05) in outcome between PT and HT grafts were observed. No significant differences (P>0.05) were noted between athletes who "returned" to their previous sport and those who "did not return" to sports at the same level when using the IKDC, Lysholm, Noyes, and Tegner knee evaluation scales. However, significant difference was observed with the knee scores obtained by those who returned and those who completely ceased participation in sport activities. Computerized laxity test revealed that 90% of these patients have less than 3 mm side-to-side difference with no significant difference between HT and PT groups. Patients who "returned to sports" obtained significantly better scores with the Marx scale (P=0.001) and the psychovitality questionnaire (P=0.001) than those who did not. Conventional knee

  19. 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

  20. 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.

  1. 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

  2. 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

  3. Bone tunnel enlargement after ACL reconstruction using autologous hamstring tendons: a CT study

    PubMed Central

    Iorio, Raffaele; Vadalà, Antonio; Argento, Giuseppe; Di Sanzo, Vincenzo

    2006-01-01

    Purpose: To evaluate prospectively the increase in the size of the tibial and femoral bone tunnel following arthroscopic anterior cruciate ligament (ACL) reconstruction with quadrupled-hamstring autograft. Methods: Twenty-five consecutive patients underwent arthroscopic ACL reconstruction with quadrupled-hamstring autograft. Preoperative clinical evaluation was performed using the Lysholm knee score, Tegner activity level, and International Knee Documentation Committee forms and a KT-1000 arthrometer (side to side). Computed tomography (CT) of the femoral and tibial tunnel was performed on the day after operation in all cases and at mean follow-up of 10 months (range 9–11 months).Results: All of the clinical evaluation scales performed showed an overall improvement. The postoperative anterior laxity difference was <3 mm in 16 patients (70%) and 3–5 mm in seven patients (30%). The mean average femoral tunnel diameter increased significantly (3%) from 9.04±0.05 mm postoperatively to 9.3±0.8 mm at 10 months; tibial tunnel increased significantly (11%) from 9.03±0.04 mm to 10±0.8 mm. There were no statistically significant differences between tunnel enlargement, clinical results, and arthrometer evaluation. Conclusions: The rate of tunnel widening observed in this study seems to be lower than that reported in previous studies that used different techniques. We conclude that an anatomical surgical technique and a less aggressive rehabilitation process influenced the amount of tunnel enlargement after ACL reconstruction with doubled hamstrings. PMID:16683112

  4. A musculoskeletal modeling approach for estimating anterior cruciate ligament strains and knee anterior-posterior shear forces in stop-jumps performed by young recreational female athletes.

    PubMed

    Kar, Julia; Quesada, Peter M

    2013-02-01

    The central goal of this study was to contribute to the advancements being made in determining the underlying causes of anterior cruciate ligament (ACL) injuries. ACL injuries are frequently incurred by recreational and professional young female athletes during non-contact impact activities in sports like volleyball and basketball. This musculoskeletal-neuromuscular study investigated stop-jumps and factors related to ACL injury like knee valgus and internal-external moment loads, knee anterior-posterior (AP) shear forces, ACL strains and internal forces. Motion capture data was obtained from the landing phase of stop-jumps performed by eleven young recreational female athletes and electromyography (EMG) data collected from quadriceps, hamstring and gastrocnimius muscles which were then compared to numerically estimated activations. Numerical simulation tools used were Inverse Kinematics, Computed Muscle Control and Forward Dynamics and the knee modeled as a six degree of freedom joint. Results showed averaged peak strains of 12.2 ± 4.1% in the right and 11.9 ± 3.0% in the left ACL. Averaged peak knee AP shear forces were 482.3 ± 65.7 N for the right and 430.0 ± 52.4 N for the left knees, approximately equal to 0.7-0.8 times body weight across both knees. A lack of symmetry was observed between the knees for valgus angles (p < 0.04), valgus moments (p < 0.001) and muscle activations (p < 0.001), all of which can be detrimental to ACL stability during impact activities. Comparisons between recorded EMG data and estimated muscle activations show the relation between electrical signal and muscle depolarization. In summary, this study outlines a musculoskeletal simulation approach that provides numerical estimations for a number of variables associated with ACL injuries in female athletes performing stop-jumps.

  5. 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

  6. Ischiofemoral Impingement and Hamstring Syndrome as Causes of Posterior Hip Pain: Where Do We Go Next?

    PubMed

    Martin, Hal David; Khoury, Anthony; Schröder, Ricardo; Palmer, Ian James

    2016-07-01

    Recent advances in understanding hip joint anatomy and biomechanics have contributed to improvement of diagnosis and treatment decisions for distal causes of deep gluteal syndrome (DGS). Ischiofemoral impingement and hamstrings syndrome are sources of posterior hip pain that can simulate symptoms of DGS. The combination of a comprehensive history and physical examination with imaging and ancillary testing are critical for diagnosis. Six key physical examination tests are described to differentiate distal versus proximal sources of extrapelvic posterior hip pain. Outcomes depend on patient compliance and the understanding of the entire anatomy, biomechanics, clinical presentation, and open versus endoscopic treatment options. PMID:27343397

  7. The passive hamstring stretch test: a comparison of clinical estimates with tension gauge measurements.

    PubMed

    Fisk, J W

    1979-05-01

    A comparison of the clinical estimate of the available passive stretch in the hamstring muscles is made against the changing tension in a spring gauge, as the leg is raised. It was found that the angle at which rotation was palpable in the contralateral anterior superior spine occurred after there was a sharp rise in the tension measurements. The spring gauge was incorporated in a pulley system which allowed the leg to be pulled up and the tension readings were taken at 5 degrees increments of raise. Comparison of the clinical estimates with the tension gauge measurements show the latter to be a more reliable and objective research tool. PMID:287950

  8. Interference screw position and hamstring graft location for anterior cruciate ligament reconstruction.

    PubMed

    Simonian, P T; Sussmann, P S; Baldini, T H; Crockett, H C; Wickiewicz, T L

    1998-01-01

    Anterior cruciate ligament reconstruction with hamstring tendon graft and interference screw fixation has recently been considered. Concerns for the use of interference screws with soft tissue grafts include damage to the graft during screw insertion, decreased fixation strength, and a decrease in the bone-tendon contact area for healing within the tunnel when the screw is placed in an eccentric position. This last concern could be addressed by placing the interference screw centrally between the four limbs of the hamstring graft. The purpose of this study was to determine the mode of failure, the pullout force, and graft slippage before graft fixation failure of hamstring tendons fixed with an interference screw positioned eccentrically in relation to the hamstring tendons verses an interference screw positioned centrally between the four graft limbs. The semitendinosus and gracilis tendons were harvested from six, fresh cadaveric specimens. Each tendon was divided into two segments of equal length. Both the semitendinosus and gracilis tendon segments were looped to form four strands. The specimens were then fixed with a bioabsorbable interference screw in the two different positions and pulled from a standardized polyurethane foam. All tendons in both groups failed by pulling out from between the interference screw and tunnel, regardless of the screw position. No tendon was cut by the screw in either group. There was no significant difference between the forces required to produce specific amounts of graft slippage between the two fixation techniques tested. There was no significant difference between the average total slippage at maximum pullout, 11.8 mm for the screw placed in the eccentric position and 13.7 mm for the screw placed in the central position. The maximum pullout force averaged 265.3 N for the screw placed in the eccentric position, and 244.7 N for the screw placed in the central position; these values were not significantly different. Placement of

  9. Efficacy of static stretching and proprioceptive neuromuscular facilitation stretch on hamstrings length after a single session.

    PubMed

    O'Hora, John; Cartwright, Abigail; Wade, Clive D; Hough, Alan D; Shum, Gary L K

    2011-06-01

    A number of studies have investigated the efficacy of several repetitions of proprioceptive neuromuscular facilitation stretching (PNF) and static stretching (SS). However, there is limited research comparing the effects of a single bout of these stretching maneuvers. The aim of this study was to compare the effectiveness of a single bout of a therapist-applied 30-second SS vs. a single bout of therapist-applied 6-second hamstring (agonist) contract PNF. Forty-five healthy subjects between the ages of 21 and 35 were randomly allocated to 1 of the 2 stretching groups or a control group, in which no stretching was received. The flexibility of the hamstring was determined by a range of passive knee extension, measured using a universal goniometer, with the subject in the supine position and the hip at 90° flexion, before and after intervention. A significant increase in knee extension was found for both intervention groups after a single stretch (SS group = 7.53°, p < 0.01 and PNF group = 11.80°, p < 0.01). Both interventions resulted in a significantly greater increase in knee extension when compared to the control group (p < 0.01). The PNF group demonstrated significantly greater gains in knee extension compared to the SS group (mean difference 4.27°, p < 0.01). It can be concluded that a therapist applied SS or PNF results in a significant increase in hamstring flexibility. A hamstring (agonist) contract PNF is more effective than an SS in a single stretching session. These findings are important to physiotherapists or trainers working in clinical and sporting environments. Where in the past therapists may have spent time conducting multiple repetitions of a PNF and an SS, a single bout of either technique may be considered just as effective. A key component of the study methodology was the exclusion of a warm-up period before stretching. Therefore, the findings of efficacy of a single PNF are of particular relevance in sporting environments and busy clinical

  10. Prevention of pediatric sports injuries.

    PubMed

    Demorest, Rebecca A; Landry, Gregory L

    2003-12-01

    With over 30 million children participating in sports each year across the United States, a number of significant injuries are to be expected. Although mild injuries such as strains, sprains, and contusions predominate, catastrophic injuries do occur. Young athletes are at an increased risk for growth plate and apophyseal injuries, overuse injuries, and heat illness. Many of these sports injuries can be prevented. Prevention strategies include protective equipment, rule changes, preseason and season prevention interventions, safety measures, better coaching, education, and a societal awareness of injury and prevention. This article discusses current injury prevention for children participating in baseball, football, soccer, and ice hockey.

  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. Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autograft With Preserved Insertions.

    PubMed

    Gupta, Ravi; Bahadur, Raj; Malhotra, Anubhav; Masih, Gladson David; Gupta, Parmanand

    2016-04-01

    We present a technique for anterior cruciate ligament (ACL) reconstruction using hamstring tendon autograft with preserved tibial insertions. The tendons, harvested with an open-ended tendon stripper while their tibial insertions are preserved, are looped around to prepare a quadrupled graft. The femoral tunnel is drilled independently through a transportal technique, whereas the tibial tunnel is drilled in a standard manner. The length of the quadrupled graft and loop of the RetroButton is adjusted so that it matches the calculated length of both tunnels and the intra-articular part of the proposed ACL graft. After the RetroButton is flipped, the graft is manually tensioned with maximal stretch on the free end, which is then sutured to the other end with preserved insertions. We propose that preserving the insertions is more biological and may provide better proprioception. The technique eliminates the need for a tibial-side fixation device, thus reducing the cost of surgery. Furthermore, tibial-side fixation of the free graft is the weakest link in the overall stiffness of the reconstructed ACL, and this technique circumvents this problem. Postoperative mechanical stability and functional outcome with this technique need to be explored and compared with those of ACL reconstruction using free hamstring autograft. PMID:27354946

  13. 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.

  14. 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.

  15. 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.

  16. 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

  17. [Trampoline injuries in children].

    PubMed

    Sinikumpu, Juha-Jaakko; Antila, Eeva; Korhonen, Jussi; Rättyä, Johanna; Serlo, Willy

    2012-01-01

    Trampolines for home use have become common in Finland during the past ten years, being especially favored by children. Trampoline jumping is beneficial and constructive physical exercise, but poses a significant risk for injuries. The most common injuries include sprains and strains. During summertime, trampoline injuries account for as many as 13% of children's accidents requiring hospital care. Fractures are by far the most common trampoline injuries requiring hospital care. Injuries can be prevented by using safety nets. Only one child at a time is allowed to jump on the trampoline.

  18. Indoor racquet sports injuries.

    PubMed

    Silko, G J; Cullen, P T

    1994-08-01

    Family physicians can care for most patients injured while participating in indoor racquet sports. However, patients with injuries to the eye usually require ophthalmologic referral. The most common injuries that occur in persons participating in indoor racquet sports include contusions, sprains and strains, lacerations, eye injuries, bursitis and tendinitis. Musculoskeletal injuries that merit special consideration include lateral epicondylitis, DeQuervain's tenosynovitis, wrist intersection syndrome, patellar pain syndrome, meniscal injuries, Achilles tendinitis and plantar fasciitis. The family physician plays a critical role in providing patients with information about preventive measures.

  19. Incidence of injuries in French professional soccer players.

    PubMed

    Dauty, M; Collon, S

    2011-12-01

    In this prevalence cohort study, injuries sustained during 15 seasons in a professional soccer team were investigated according to the different soccer seasons, number of matches per season, month the injury occurred, location, severity, playing position and the team's rank at the end of the French professional championship. Altogether, 903 injuries in 173 professional soccer players were reported. Injury incidence per 1 000 h of exposure during matches and training was 4.7±5. This incidence did not vary significantly between seasons. However, injury incidence increased after the year 2003 and constantly exceeded 4.2. In the same way, after 2002 muscle injury incidence always exceeded 2 per 1 000 h of exposure. Injury incidence peaked during the month of January. Hamstring muscle injury represented the most frequent injury. No difference in injury incidence was found according to the playing position or to the season whether the team participated or not in the European cup. No correlation was found with the team's rank at the end of the French championship. This study highlighted no significant variation on injury incidence over a 15-season period except for the muscle injury rate in high level soccer players.

  20. 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

  1. 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…

  2. Leg Injuries and Disorders

    MedlinePlus

    Your legs are made up of bones, blood vessels, muscles, and other connective tissue. They are important for motion ... falling, or having an accident can damage your legs. Common leg injuries include sprains and strains, joint ...

  3. 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

  4. Exposure-dependent increases in IL-1beta, substance P, CTGF, and tendinosis in flexor digitorum tendons with upper extremity repetitive strain injury.

    PubMed

    Fedorczyk, Jane M; Barr, Ann E; Rani, Shobha; Gao, Helen G; Amin, Mamta; Amin, Shreya; Litvin, Judith; Barbe, Mary F

    2010-03-01

    Upper extremity tendinopathies are associated with performance of forceful repetitive tasks. We used our rat model of repetitive strain injury to study changes induced in forelimb flexor digitorum tendons. Rats were trained to perform a high repetition high force (HRHF) handle-pulling task (12 reaches/min at 60 +/- 5% maximum pulling force [MPF]), or a low repetition negligible force (LRNF) reaching and food retrieval task (three reaches/min at 5 +/- 5% MPF), for 2 h/day in 30 min sessions, 3 days/week for 3-12 weeks. Forelimb grip strength was tested. Flexor digitorum tendons were examined at midtendon at the level of the carpal tunnel for interleukin (IL)-1beta, neutrophil, and macrophage influx, Substance P, connective tissue growth factor (CTGF), and periostin-like factor (PLF) immunoexpression, and histopathological changes. In HRHF rats, grip strength progressively decreased, while IL-1beta levels progressively increased in the flexor digitorum peritendon (para- and epitendon combined) and endotendon with task performance. Macrophage invasion was evident in week 6 and 12 HRHF peritendon but not endotendon. Also in HRHF rats, Substance P immunoexpression increased in week 12 peritendon as did CTGF- and PLF-immunopositive fibroblasts, the increased fibroblasts contributing greatly to peritendon thickening. Endotendon collagen disorganization was evident in week 12 HRHF tendons. LRNF tendons did not differ from controls, even at 12 weeks. Thus, we observed exposure-dependent changes in flexor digitorum tendons within the carpal tunnel, including increased inflammation, nociceptor-related neuropeptide immunoexpression, and fibrotic histopathology, changes associated with grip strength decline.

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

    PubMed

    Ho, Sean Wei Loong; Tan, Teong Jin Lester; Lee, Keng Thiam

    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.

  6. Basketball Injuries: An Overview.

    PubMed

    Apple, D F

    1988-12-01

    In brief: Why have basketball injuries escalated? The author points out that before 1960 basketball was largely a no-contact sport. Since then the amount of body contact allowed has increased, players are larger, and more athletes are playing basketball. In addition to these and other possible reasons for the increase in injuries, the author describes common basketball injuries-contusions, sprains, strains, inflammatory conditions, and stress fractures. He also outlines steps for diagnosis and treatment and makes recommendations.

  7. The Interaction of Trunk-Load and Trunk-Position Adaptations on Knee Anterior Shear and Hamstrings Muscle Forces During Landing

    PubMed Central

    Kulas, Anthony S.; Hortobágyi, Tibor; DeVita, Paul

    2010-01-01

    Abstract Context: Because anterior cruciate ligament (ACL) injuries can occur during deceleration maneuvers, biomechanics research has been focused on the lower extremity kinetic chain. Trunk mass and changes in trunk position affect lower extremity joint torques and work during gait and landing, but how the trunk affects knee joint and muscle forces is not well understood. Objective: To evaluate the effects of added trunk load and adaptations to trunk position on knee anterior shear and knee muscle forces in landing. Design: Crossover study. Setting: Controlled laboratory environment. Patients or Other Participants: Twenty-one participants (10 men: age  =  20.3 ± 1.15 years, height  =  1.82 ± 0.04 m, mass  =  78.2 ± 7.3 kg; 11 women: age  =  20.0 ± 1.10 years, height  =  1.72 ± 0.06 m, mass  =  62.3 ± 6.4 kg). Intervention(s): Participants performed 2 sets of 8 double-leg landings under 2 conditions: no load and trunk load (10% body mass). Participants were categorized into one of 2 groups based on the kinematic trunk adaptation to the load: trunk flexor or trunk extensor. Main Outcome Measure(s): We estimated peak and average knee anterior shear, quadriceps, hamstrings, and gastrocnemius forces with a biomechanical model. Results: We found condition-by-group interactions showing that adding a trunk load increased peak (17%) and average (35%) knee anterior shear forces in the trunk-extensor group but did not increase them in the trunk-flexor group (peak: F1,19  =  10.56, P  =  .004; average: F1,19  =  9.56, P  =  .006). We also found a main effect for condition for quadriceps and gastrocnemius forces. When trunk load was added, peak (6%; F1,19  =  5.52, P  =  .030) and average (8%; F1,19  =  8.83, P  =  .008) quadriceps forces increased and average (4%; F1,19  =  4.94, P  =  .039) gastrocnemius forces increased, regardless of group. We found a condition-by-group interaction for peak (F1,19

  8. 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

  9. Interference screw fixation of hamstring vs patellar tendon grafts for anterior cruciate ligament reconstruction.

    PubMed

    Aune, A K; Ekeland, A; Cawley, P W

    1998-01-01

    The present study was designed to investigate the fixation strength of a quadruple semitendinosus-gracilis graft compared with a middle-third bone-patellar tendon-bone graft using a new interference screw developed to fix hamstrings grafts for ACL reconstructions (RCL Smith & Nephew Donjoy). Five pairs of human cadaveric knees from donors with a mean age of 43 (range 33-52) years were used. One knee of each pair was randomly allocated to be reconstructed on the femoral side with a semitendinosus-gracilis graft from the same donor using RCL screw fixation. As the control, the contralateral knee was correspondingly reconstructed with a bone-patellar tendon-bone graft using the same interference screw. The grafts were pulled out at a velocity of 30 mm/s by an axially applied load using a MTS machine. The mean (SD) failure load for the bone-patellar tendon-bone graft fixations was 505 (25) N, 110% stronger than the mean failure load for the semitendinosus-gracilis graft fixations, which was 240 (47) N (P = 0.003). The stiffness for the patellar tendon-bone graft fixations was 46 (11) N/mm, 120% stiffer than the semitendinosus-gracilis graft fixations, which was 22 (11) N/mm (P = 0.01). This study shows that the interference screw principle used for ACL reconstructions with hamstrings tendons is inferior to that for bone-patellar tendon-bone reconstructions although the screw was developed especially for soft-tissue fixation in bone tunnels. PMID:9604194

  10. Does community-level Australian football support injury prevention research?

    PubMed

    Gabbe, B; Finch, C F; Wajswelner, H; Bennell, K

    2003-06-01

    The progress of injury prevention research in Australian football to date has been slow despite its recognition as a public health goal. In particular, field-based studies to identify injury risk factors and evaluate the effectiveness of injury prevention strategies need to be undertaken to ensure safety gains in this sport. For these types of studies to be successful and complied with, considerable support is required from clubs, coaches and players. To date, the actual level of support for injury prevention research at the community-level of football has not been established. A survey of 82 club administrators and coaches from the Victorian Amateur Football Association was undertaken to determine the level of support for injury prevention research, along with incentives for, and barriers towards, participation in such research. The highest priorities for injury prevention research were given as the prevention of knee, hamstring and concussion injuries and investigation into the content of training programs. The most common incentives reported as being necessary for participation in injury prevention research were financial assistance (59.5%), more club staff (57.0%) and further education (36.7%). The most commonly reported barriers to research were the expertise (50.0%) and number of (48.8%) of club medical staff members. Overall community-level football club administrators and coaches rank the importance of injury prevention research highly. The findings of this study are positive for injury prevention researchers and suggest that clubs are keen to participate in such research.

  11. 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.

  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.

  13. 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

  14. 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

  15. 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

  16. 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

  17. Cyclic pull-out strength of hamstring tendon graft fixation with soft tissue interference screws. Influence of screw length.

    PubMed

    Stadelmaier, D M; Lowe, W R; Ilahi, O A; Noble, P C; Kohl, H W

    1999-01-01

    Blunt-threaded interference screws used for fixation of hamstring tendons in anterior cruciate ligament reconstructions provide aperture fixation and may provide a biomechanically more stable graft than a graft fixed further from the articular surface. It is unknown if soft tissue fixation strength using interference screws is affected by screw length. We compared the cyclic and time-zero pull-out forces of 7 x 25 mm and 7 x 40 mm blunt-threaded metal interference screws for hamstring graft tibial fixation in eight paired human cadaveric specimens. A four-stranded autologous hamstring tendon graft was secured by a blunt-threaded interference screw into a proximal tibial tunnel with a diameter corresponding to the graft width. Eight grafts were secured with a 25-mm length screw while the other eight paired grafts were secured with a 40-mm length screw. During cyclic testing, slippage of the graft occurred as the force of pull became greater with each cycle until the graft-screw complex ultimately failed. All grafts failed at the fixation site, with the tendon being pulled past the screw. There were no measurable differences in the mean cyclic failure strength, pull-out strength, or stiffness between the two sizes of screws. Although use of the longer screw would make removal technically easier should revision surgery be necessary, it did not provide stronger fixation strength than the shorter, standard screw as had been postulated. PMID:10569365

  18. 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.

  19. Astym Therapy Improves Bilateral Hamstring Flexibility and Achilles Tendinopathy in a Child with Cerebral Palsy: A Retrospective Case Report

    PubMed Central

    Scheer, Nicole A.; Alstat, Lucas R.; Van Zant, Robert S.

    2016-01-01

    PURPOSE The purpose of this case report was to describe the use of Astym therapy to improve hamstring flexibility and Achilles tendinopathy in a child with cerebral palsy. CASE DESCRIPTION An eight-year-old female with cerebral palsy was referred to physical therapy for the treatment of bilateral hamstring inflexibility and Achilles tendinopathy. Treatment focused on an Astym therapy protocol of eccentric exercise, stretching, active and passive range of motion, gait training, and a home exercise program. The patient underwent a total of 11 physical therapy treatment sessions. OUTCOMES At the conclusion of treatment, the patient demonstrated improved resting muscle tone in bilateral lower extremities with active 90/90 hamstring flexibility measured at 165° and ankle dorsiflexion active range of motion of 5° without pain at 0° and 90° knee flexion. The patient exhibited an improved gait pattern with even stride length and diminished genu recurvatum, decreased pain with standing and walking, discontinued use of ankle–foot orthoses, and improved activity tolerance and overall function for daily activities. DISCUSSION The results of this case report indicate that physical therapy rehabilitation utilizing an Astym therapy protocol can successfully achieve gains in flexibility and strength and allow for improved function of bilateral lower extremities in a patient with cerebral palsy. CONCLUSION Based on the findings of this case report, clinicians should consider the use of Astym therapy in treating musculoskeletal soft tissue dysfunction in pediatric patients with cerebral palsy. PMID:27790051

  20. 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

  1. Prevention of anterior cruciate ligament injuries.

    PubMed

    Hewett, T E; Myer, G D; Ford, K R

    2001-12-01

    Numerous studies have found that female athletes who participate in jumping and pivoting sports are four to six times more likely to sustain a knee ligament injury, such as anterior cruciate ligament (ACL) injury, than male athletes participating in the same sports [1-8]. A widening gender gap in the number of serious knee ligament injuries exists due to geometric growth in female athletic participation, coupled with the four- to sixfold higher injury rate. More than 50,000 serious knee injuries are projected to occur in female varsity intercollegiate and high school athletics each year [9, 10]. Most ACL injuries occur by noncontact mechanisms, often during landing from a jump or making a lateral pivot while running [2, 11]. Knee instability, due to ligament dominance (decreased medial-lateral neuromuscular control of the joint), quadriceps dominance (increased quadriceps recruitment and decreased hamstring recruitment and strength), and leg dominance (side-to-side differences in strength, flexibility, and coordination) are possible contributing factors to the increased incidence of knee injury in female athletes [5, 6]. In this review, dynamic neuromuscular analysis (DNA) training is defined, and a rationale is presented for correcting the neuromuscular imbalances that may result in dynamic knee instability during sports play. Dynamic neuromuscular training has been shown to increase knee stability and decrease knee injury rates in female athletes [5, 12.., 13.]. Preliminary research on athlete screening and injury prediction based on the three aforementioned imbalances also is presented with recommendations for developing screening protocols for the identification of high-risk athletes.

  2. THE EFFECTIVENESS OF DRY NEEDLING AND STRETCHING VS. STRETCHING ALONE ON HAMSTRING FLEXIBILITY IN PATIENTS WITH KNEE PAIN: A RANDOMIZED CONTROLLED TRIAL

    PubMed Central

    Crowell, Michael; Dolbeer, Jeffery; Morris, Jamie; Terry, Aspen; Koppenhaver, Shane; Goss, Donald Lee

    2016-01-01

    Background Recently, dry needling has emerged as a popular treatment for muscular pain and impairments. While there are numerous studies detailing the benefits of dry needling for pain, few studies exist examining the effects on soft tissue mobility. Purpose The purpose of this study was to determine if the addition of hamstring dry needling to a standard stretching program results in greater improvements in hamstring flexibility compared to sham dry needling and stretching in subjects with atraumatic knee pain. Additionally, squat range of motion, knee pain, and the Lower Extremity Functional Scale were compared between the two groups. Study Design Double blinded randomized controlled trial. Methods Thirty-nine subjects were randomized to receive either dry needling (n = 20) or sham (n = 19) dry needling in addition to hamstring stretching, to all detected hamstring trigger points on two visits. All dependent variables were measured at baseline, immediately post intervention, and 1, 3, and 7 days after the initial treatment. Each subject also performed hamstring stretching three times daily for one week. Results Significant improvements in hamstring range of motion and all other dependent variables were observed across time regardless of treatment group. However, the lack of significant time by group interactions indicated the improvements were not different between dry needling and sham dry needling groups. Conclusions The results of the current randomized controlled trial suggest that two sessions of dry needling did not improve hamstring range of motion or other knee pain-related impairments more than sham dry needling in a young active population with atraumatic knee pain. Level of Evidence Therapy, Level 2 PMID:27757280

  3. Hamstring Architectural and Functional Adaptations Following Long vs. Short Muscle Length Eccentric Training.

    PubMed

    Guex, Kenny; Degache, Francis; Morisod, Cynthia; Sailly, Matthieu; Millet, Gregoire P

    2016-01-01

    Most common preventive eccentric-based exercises, such as Nordic hamstring do not include any hip flexion. So, the elongation stress reached is lower than during the late swing phase of sprinting. The aim of this study was to assess the evolution of hamstring architectural (fascicle length and pennation angle) and functional (concentric and eccentric optimum angles and concentric and eccentric peak torques) parameters following a 3-week eccentric resistance program performed at long (LML) vs. short muscle length (SML). Both groups performed eight sessions of 3-5 × 8 slow maximal eccentric knee extensions on an isokinetic dynamometer: the SML group at 0° and the LML group at 80° of hip flexion. Architectural parameters were measured using ultrasound imaging and functional parameters using the isokinetic dynamometer. The fascicle length increased by 4.9% (p < 0.01, medium effect size) in the SML and by 9.3% (p < 0.001, large effect size) in the LML group. The pennation angle did not change (p = 0.83) in the SML and tended to decrease by 0.7° (p = 0.09, small effect size) in the LML group. The concentric optimum angle tended to decrease by 8.8° (p = 0.09, medium effect size) in the SML and by 17.3° (p < 0.01, large effect size) in the LML group. The eccentric optimum angle did not change (p = 0.19, small effect size) in the SML and tended to decrease by 10.7° (p = 0.06, medium effect size) in the LML group. The concentric peak torque did not change in the SML (p = 0.37) and the LML (p = 0.23) groups, whereas eccentric peak torque increased by 12.9% (p < 0.01, small effect size) and 17.9% (p < 0.001, small effect size) in the SML and the LML group, respectively. No group-by-time interaction was found for any parameters. A correlation was found between the training-induced change in fascicle length and the change in concentric optimum angle (r = -0.57, p < 0.01). These results suggest that performing eccentric exercises lead to several architectural and

  4. 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

  5. Hamstring Architectural and Functional Adaptations Following Long vs. Short Muscle Length Eccentric Training

    PubMed Central

    Guex, Kenny; Degache, Francis; Morisod, Cynthia; Sailly, Matthieu; Millet, Gregoire P.

    2016-01-01

    Most common preventive eccentric-based exercises, such as Nordic hamstring do not include any hip flexion. So, the elongation stress reached is lower than during the late swing phase of sprinting. The aim of this study was to assess the evolution of hamstring architectural (fascicle length and pennation angle) and functional (concentric and eccentric optimum angles and concentric and eccentric peak torques) parameters following a 3-week eccentric resistance program performed at long (LML) vs. short muscle length (SML). Both groups performed eight sessions of 3–5 × 8 slow maximal eccentric knee extensions on an isokinetic dynamometer: the SML group at 0° and the LML group at 80° of hip flexion. Architectural parameters were measured using ultrasound imaging and functional parameters using the isokinetic dynamometer. The fascicle length increased by 4.9% (p < 0.01, medium effect size) in the SML and by 9.3% (p < 0.001, large effect size) in the LML group. The pennation angle did not change (p = 0.83) in the SML and tended to decrease by 0.7° (p = 0.09, small effect size) in the LML group. The concentric optimum angle tended to decrease by 8.8° (p = 0.09, medium effect size) in the SML and by 17.3° (p < 0.01, large effect size) in the LML group. The eccentric optimum angle did not change (p = 0.19, small effect size) in the SML and tended to decrease by 10.7° (p = 0.06, medium effect size) in the LML group. The concentric peak torque did not change in the SML (p = 0.37) and the LML (p = 0.23) groups, whereas eccentric peak torque increased by 12.9% (p < 0.01, small effect size) and 17.9% (p < 0.001, small effect size) in the SML and the LML group, respectively. No group-by-time interaction was found for any parameters. A correlation was found between the training-induced change in fascicle length and the change in concentric optimum angle (r = −0.57, p < 0.01). These results suggest that performing eccentric exercises lead to several architectural and

  6. 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

  7. 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

  8. Head Injuries

    MedlinePlus

    ... before. Often, 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 ...

  9. 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 ...

  10. Characteristics of anterior cruciate ligament injuries in Australian football.

    PubMed

    Cochrane, Jodie L; Lloyd, David G; Buttfield, Alec; Seward, Hugh; McGivern, Jeanne

    2007-04-01

    Anterior cruciate ligament (ACL) injuries are the most costly injuries in football at both professional and amateur levels (Orchard J, Seward H, McGivern J, Hood S. Intrinsic and extrinsic risk factors for anterior cruciate ligament injury in Australian footballers. Am J Sports Med 2001;29:196-200.). In this study video analysis of 34 ACL injuries in Australian football was performed to investigate the causes of these injuries. Factors that may have contributed to the cause of the injury were analysed, rated and reported. The factors analysed were: type of manoeuvre, direction the knee 'gave way', running speed, knee angle, cutting angle and if the player was accelerating or decelerating. The majority of the injuries analysed occurred in non-contact situations (56%). Of these 37% occurred during sidestepping manoeuvres, 32% in landing, 16% land and step, 10% stopping/slowing and 5% crossover cut manoeuvres. Ninety-two percent of the non-contact injuries occurred at extended knee angles of 30 degrees or less, which is also commonly known to place stress on the ACL and reduce the protective role of hamstrings. Over half (54%) of non-contact injuries occurred whilst decelerating. It would be expected that greater speed and angle cut too would increase the frequency of ACL injury. The results could not confirm this with most injuries occurring at running speeds of slow jogging to running and equal number of injuries occurred at cutting to angles of the ranges 15-45 degrees and 45-75 degrees. These results give greater understanding into potential causes or contributors of ACL injury and information to assist in the development of knee injury prevention programs. PMID:16807104

  11. Human hamstring tenocytes survive when seeded into a decellularized porcine Achilles tendon extracellular matrix.

    PubMed

    Lohan, Anke; Stoll, Christiane; Albrecht, Marit; Denner, Andreas; John, Thilo; Krüger, Kay; Ertel, Wolfgang; Schulze-Tanzil, Gundula

    2013-01-01

    Tendon ruptures and defects remain major orthopaedic challenges. Tendon healing is a time-consuming process, which results in scar tissue with an altered biomechanical competence. Using a xenogeneic tendon extracellular matrix (ECM) as a natural scaffold, which can be reseeded with autologous human tenocytes, might be a promising approach to reconstruct damaged tendons. For this purpose, the porcine Achilles (AS) tendons serving as a scaffold were histologically characterized in comparison to human cell donor tendons. AS tendons were decellularized and then reseeded with primary human hamstring tenocytes using cell centrifuging, rotating culture and cell injection techniques. Vitality testing, histology and glycosaminoglycan/DNA quantifications were performed to document the success of tendon reseeding. Porcine AS tendons were characterized by a higher cell and sulfated glycosaminoglycan content than human cell donor tendons. Complete decellularization could be achieved, but led to a wash out of sulfated glycosaminoglycans. Nevertheless, porcine tendon could be recellularized with vital human tenocytes. The recellularization led to a slight increase in cell number compared to the native tendon and some glycosaminoglycan recovery. This study indicates that porcine tendon can be de- and recellularized using adult human tenocytes. Future work should optimize cell distribution within the recellularized tendon ECM and consider tendon- and donor species-dependent differences.

  12. Bilateral concentric and eccentric isokinetic strength evaluation of quadriceps and hamstrings in basketball players.

    PubMed

    Hadzić, Vedran; Erculj, Frane; Bracic, Mitja; Dervisević, Edvin

    2013-09-01

    The aim of the study was to investigate the existence of bilateral asymmetry in healthy basketball players of different age, as evidence suggest that it may be an age related phenomenon which develops over the years of training. Fifty healthy basketball players (26 males and 24 females) participated in the study. The quadriceps (Q) and the hamstring (H) were tested concentrically and eccentrically at 60 degrees/s. The main outcome measure was body weight normalized peak torque (PT/BW). We have also calculated different strength ratios as well as the bilateral strength differences. The main findings indicate that (1) bilateral strength asymmetry is noticeable in senior basketball players relating predominantly to the Q (2) some gender related strength differences were mainly associated with the concentric strength of Q and H (3) when corrected for weight and height, age related strength differences were relatively small and observed only with respect to H strength in males (4) superiority of eccentric over concentric strength values of Q and H was more pronounced in females than in males. Strength asymmetry in senior basketball players may be more attributable to the better neuromuscular control during vertical jumping than to the strength itself as there were no age related differences between cadets and senior players.

  13. The comparison of the immediate effects of application of the suboccipital muscle inhibition and self-myofascial release techniques in the suboccipital region on short hamstring

    PubMed Central

    Cho, Sung-Hak; Kim, Soo-Han; Park, Du-Jin

    2015-01-01

    [Purpose] The purpose of this study was to research the effect of performing the suboccipital muscle inhibition (SMI) and self-myofascial release (SMFR) techniques in the suboccipital area on the flexibility of the hamstring. [Subjects] Fifty persons with short hamstrings participated in this research. According to the results of the finger-floor distance (FFD) test, the subjects were allocated to SMI and SMFR groups of 25 subjects each. [Methods] The SMI and SMFR techniques were applied to the groups. For the analysis, we used the FFD test and the straight leg raise (SLR) test for the flexibility of hamstring. The evaluator was blindfolded. [Results] In the SMI group, FFD, SLR, and PA were significantly changed after the intervention, and in the SMFR group, there was a significant change in SLR after the intervention. In a comparison between the groups, FED was found to be significantly increased in the SMI group. [Conclusion] Application of the SMI and SMFR to persons with short hamstrings resulted in immediate increases in flexibility of the hamstring. However, we could see that the SMI technique was more effective. PMID:25642072

  14. The comparison of the immediate effects of application of the suboccipital muscle inhibition and self-myofascial release techniques in the suboccipital region on short hamstring.

    PubMed

    Cho, Sung-Hak; Kim, Soo-Han; Park, Du-Jin

    2015-01-01

    [Purpose] The purpose of this study was to research the effect of performing the suboccipital muscle inhibition (SMI) and self-myofascial release (SMFR) techniques in the suboccipital area on the flexibility of the hamstring. [Subjects] Fifty persons with short hamstrings participated in this research. According to the results of the finger-floor distance (FFD) test, the subjects were allocated to SMI and SMFR groups of 25 subjects each. [Methods] The SMI and SMFR techniques were applied to the groups. For the analysis, we used the FFD test and the straight leg raise (SLR) test for the flexibility of hamstring. The evaluator was blindfolded. [Results] In the SMI group, FFD, SLR, and PA were significantly changed after the intervention, and in the SMFR group, there was a significant change in SLR after the intervention. In a comparison between the groups, FED was found to be significantly increased in the SMI group. [Conclusion] Application of the SMI and SMFR to persons with short hamstrings resulted in immediate increases in flexibility of the hamstring. However, we could see that the SMI technique was more effective.

  15. The comparison of the immediate effects of application of the suboccipital muscle inhibition and self-myofascial release techniques in the suboccipital region on short hamstring.

    PubMed

    Cho, Sung-Hak; Kim, Soo-Han; Park, Du-Jin

    2015-01-01

    [Purpose] The purpose of this study was to research the effect of performing the suboccipital muscle inhibition (SMI) and self-myofascial release (SMFR) techniques in the suboccipital area on the flexibility of the hamstring. [Subjects] Fifty persons with short hamstrings participated in this research. According to the results of the finger-floor distance (FFD) test, the subjects were allocated to SMI and SMFR groups of 25 subjects each. [Methods] The SMI and SMFR techniques were applied to the groups. For the analysis, we used the FFD test and the straight leg raise (SLR) test for the flexibility of hamstring. The evaluator was blindfolded. [Results] In the SMI group, FFD, SLR, and PA were significantly changed after the intervention, and in the SMFR group, there was a significant change in SLR after the intervention. In a comparison between the groups, FED was found to be significantly increased in the SMI group. [Conclusion] Application of the SMI and SMFR to persons with short hamstrings resulted in immediate increases in flexibility of the hamstring. However, we could see that the SMI technique was more effective. PMID:25642072

  16. 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

  17. 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

  18. 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

  19. AN ORGANOTYPIC UNIAXIAL STRAIN MODEL USING MICROFLUIDICS

    PubMed Central

    Dollé, Jean-Pierre; Morrison, Barclay; Schloss, Rene R.; Yarmush, Martin L.

    2012-01-01

    Traumatic brain injuries are the leading cause of disability each year in the US. The most common and devastating consequence is the stretching of axons caused by shear deformation that occurs during rotational acceleration of the brain during injury. The injury effects on axonal molecular and functional events are not fully characterized. We have developed a strain injury model that maintains the three dimensional cell architecture and neuronal networks found in vivo with the ability to visualize individual axons and their response to a mechanical injury. The advantage of this model is that it can apply uniaxial strains to axons that make functional connections between two organotypic slices and injury responses can be observed in real-time and over long term. This uniaxial strain model was designed to be capable of applying an array of mechanical strains at various rates of strain, thus replicating a range of modes of axonal injury. Long term culture, preservation of slice and cell orientation, and slice-slice connection on the device was demonstrated. The device has the ability to strain either individual axons or bundles of axons through the control of microchannel dimensions. The fidelity of the model was verified by observing characteristic responses to various strain injuries which included axonal beading, delayed elastic effects and breakdown in microtubules. Microtubule breakdown was shown to be dependent on the degree of the applied strain field, where maximal breakdown was observed at peak strain and minimal breakdown is observed at low strain. This strain injury model could be a powerful tool in assessing strain injury effects on functional axonal connections. PMID:23233120

  20. Isokinetic concentric quadriceps and hamstring normative data for elite collegiate American football players participating in the NFL Scouting Combine.

    PubMed

    Zvijac, John E; Toriscelli, Todd A; Merrick, W Shannon; Papp, Derek F; Kiebzak, Gary M

    2014-04-01

    Isokinetic concentric quadriceps and hamstring strength data using a Cybex dynamometer are collected for elite collegiate American football players invited to the annual National Football League Scouting Combine. We constructed a normative (reference) database of the Cybex strength data for the purpose of allowing comparison of an individual's values to his peers. Data reduction was performed to construct frequency distributions of hamstring/quadriceps (H/Q) ratios and side-to-side strength differences. For the cohort (n = 1,252 players), a statistically significant but very small (1.9%) mean quadriceps strength preference existed for dominant side vs. nondominant side. Peak torque (Newton meters, best repetition) for quadriceps and hamstrings was significantly correlated to player body mass (weight) (the same relationship was found for other variables using peak torque in the calculation). Peak torque varied by player position, being greatest for offensive linemen and lowest for kickers (p < 0.0001). Adjusting for body weight overcorrected these differences. The H/Q ratios and frequency distributions were similar across positions, with a mean of 0.6837 ± 0.137 for the cohort dominant side vs. 0.6940 ± 0.145 for the nondominant side (p = 0.021, n = 1,252). Considerable variation was seen for dominant-to-nondominant side difference for peak torque. For quadriceps, 47.2% of players had differences between -10% and +10%, 21.0% had a peak torque dominant-side deficit of 10% or greater compared to nondominant side, and for 31.8% of players, dominant-side peak torque was greater than 10% compared to nondominant side. For hamstrings, 57.0% of players had differences between -10% and +10%, 19.6% had a peak torque dominant-side deficit of 10% or greater compared to nondominant side, and 23.4% of players, dominant-side peak torque was greater than 10% compared to nondominant side. We observed that isokinetic absolute strength variables are dependent on body weight and vary

  1. [Biomechanical properties of interference screw implantation in replacement of the anterior cruciate ligament with patellar and hamstring transplants. An experimental study using roentgen stereometry analysis (RSA)].

    PubMed

    Adam, F; Pape, D; Steimer, O; Kohn, D; Rupp, S

    2001-09-01

    This experimental roentgen stereometric analysis (RSA) study was performed to measure micromotions between the graft and tunnel under submaximal load in anterior cruciate ligament (ACL) reconstruction. The aim was to evaluate the maximum load at failure, linear stiffness, and slippage of bone-patellar-tendon-bone (BPTB) grafts fixed with interference screws compared to quadrupled hamstring grafts fixed with interference screws. We used 15 porcine tibia specimens for the study. In the BPTB group, the 10 x 25-mm bone plugs were fixed in a tunnel with 10 mm in diameter using a 7 x 25-mm titanium interference screw (n = 5) or a biodegradable screw (n = 5). The five hamstring transplants were folded to a four-stranded graft and armed with a baseball stitch suture. The sutured side was fixed with a 7 x 25-mm biodegradable polylactide screw in an 8-mm tunnel. The tibial bones, tendon grafts, and interference screws were marked with tantalum beads. The grafts were mounted to a custom made load frame and loaded parallel to the axis under RSA control increasing the force in steps of 50 N. Micromotions between bone plug, screw, and tibia were measured with RSA. Accuracy of RSA for the in vitro study was evaluated as 0.05 mm. Hamstring grafts failed at significantly lower maximum loads (492 +/- 30 N) than BPTB grafts (658 +/- 98 N). Linear stiffness of the hamstring graft fixations was eight times lower compared to the BPTB grafts (403 +/- 141 N/mm vs 3500 +/- 1300 N/mm). There was no significant difference between the biodegradable and titanium screws in the BPTB group. Slippage of the graft started at 82 +/- 35 N load in the hamstring group and at 428 +/- 135 N in the BPTB group. Slippage of the graft at 75% of the maximum pull-out strength was measured as 0.36 +/- 0.25 mm in the BPTB and 2.58 +/- 1.08 mm in the hamstring group. The interference screw fixation of a quadrupled hamstring graft showed a lower linear stiffness and an earlier slippage compared to a patellar

  2. Inducement of tissue regeneration of harvested hamstring tendons in a rabbit model

    PubMed Central

    Soejima, T.; Murakami, H.; Noguchi, K.; Shiba, N.; Nagata, K.

    2016-01-01

    Objectives The objective of this study was to determine if the use of fascia lata as a tendon regeneration guide (placed into the tendon canal following harvesting the semitendinosus tendon) would improve the incidence of tissue regeneration and prevent fatty degeneration of the semitendinosus muscle. Materials and Methods Bilateral semitendinosus tendons were harvested from rabbits using a tendon stripper. On the inducing graft (IG) side, the tendon canal and semitendinosus tibial attachment site were connected by the fascia lata, which was harvested at the same width as the semitendinosus tendon. On the control side, no special procedures were performed. Two groups of six rabbits were killed at post-operative weeks 4 and 8, respectively. In addition, three healthy rabbits were killed to obtain normal tissue. We evaluated the incidence of tendon tissue regeneration, cross-sectional area of the regenerated tendon tissue and proportion of fatty tissue in the semitendinosus muscle. Results At post-operative week 8, the distal end of the regenerated tissue reached the vicinity of the tibial insertion on the control side in two of six specimens. On the IG side, the regenerated tissue maintained continuity with the tibial insertion in all specimens. The cross-sectional area of the IG side was significantly greater than that of the control side. The proportion of fatty tissue in the semitendinosus muscle on the IG side was comparable with that of the control side, but was significantly greater than that of the normal muscle. Conclusions Tendon tissue regenerated with the fascia lata graft was thicker than naturally occurring regenerated tissue. However, the proportion of fatty tissue in the semitendinosus muscle was greater than that of normal muscle. Cite this article: K. Tabuchi, T. Soejima, H. Murakami, K. Noguchi, N. Shiba, K. Nagata. Inducement of tissue regeneration of harvested hamstring tendons in a rabbit model. Bone Joint Res 2016;5:247–252. DOI: 10

  3. Genome Sequence of a Multidrug-Resistant Strain of Klebsiella pneumoniae, BAMC 07-18, Isolated from a Combat Injury Wound.

    PubMed

    Van Laar, Tricia A; Chen, Tsute; Childers, Brandon M; Chen, Ping; Abercrombie, Johnathan J; Leung, Kai P

    2014-11-26

    Klebsiella pneumoniae is an important infectious agent of surgical sites and combat wounds. Antibiotic resistance and tolerance are common impediments to the healing of chronic infections. Here, we report the genome sequence of a highly multidrug-resistant strain of K. pneumoniae, BAMC 07-18, isolated from a combat wound of a soldier.

  4. Genome Sequence of a Multidrug-Resistant Strain of Klebsiella pneumoniae, BAMC 07-18, Isolated from a Combat Injury Wound

    PubMed Central

    Van Laar, Tricia A.; Chen, Tsute; Childers, Brandon M.; Chen, Ping; Abercrombie, Johnathan J.

    2014-01-01

    Klebsiella pneumoniae is an important infectious agent of surgical sites and combat wounds. Antibiotic resistance and tolerance are common impediments to the healing of chronic infections. Here, we report the genome sequence of a highly multidrug-resistant strain of K. pneumoniae, BAMC 07-18, isolated from a combat wound of a soldier. PMID:25428975

  5. The Injury Profile of an Australian Specialist Policing Unit.

    PubMed

    Larsen, Brianna; Aisbett, Brad; Silk, Aaron

    2016-04-01

    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

  6. 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

  7. Head Injuries

    MedlinePlus

    ... injuries internal head injuries, which may involve the skull, the blood vessels within the skull, or the brain Fortunately, most childhood falls or ... knock the brain into the side of the skull or tear blood vessels. Some internal head injuries ...

  8. 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 ...

  9. Blast Injuries

    MedlinePlus

    ... Service Members & Veterans Family & Caregivers Medical Providers Blast Injuries U.S. Army photo by Sgt. Gustavo Olgiati How ... tertiary injury Does a blast cause different brain injuries than blunt trauma? There currently is no evidence ...

  10. Focusing on Increasing Velocity during Heavy Resistance Knee Flexion Exercise Boosts Hamstring Muscle Activity in Chronic Stroke Patients

    PubMed Central

    Jakobsen, Markus D.

    2016-01-01

    Background. Muscle strength is markedly reduced in stroke patients, which has negative implications for functional capacity and work ability. Different types of feedback during strength training exercises may alter neuromuscular activity and functional gains. Objective. To compare levels of muscle activity during conditions of blindfolding and intended high contraction speed with a normal condition of high-intensity knee flexions. Methods. Eighteen patients performed unilateral machine knee flexions with a 10-repetition maximum load. Surface electromyography (EMG) was recorded from the quadrics and hamstring muscles and normalized to maximal EMG (nEMG) of the nonparetic limb. Results. For the paretic leg, the speed condition showed higher values of muscle activity compared with the normal and blindfolded conditions for both biceps femoris and semitendinosus. Likewise, the speed condition showed higher co-contraction values compared with the normal and blindfolded conditions for the vastus lateralis. No differences were observed between exercise conditions for the nonparetic leg. Conclusion. Chronic stroke patients are capable of performing heavy resistance training with intended high speed of contraction. Focusing on speed during the concentric phase elicited higher levels of muscle activity of the hamstrings compared to normal and blindfolded conditions, which may have implications for regaining fast muscle strength in stroke survivors. PMID:27525118

  11. The effect of screw length and position on fixation of four-stranded hamstring grafts for anterior cruciate ligament reconstruction.

    PubMed

    Harvey, A R; Thomas, N P; Amis, A A

    2003-03-01

    The aim of this study was to examine interference screw fixation of four strand hamstring grafts for anterior cruciate ligament reconstruction in vitro. Bovine tibiae and cannon tendons were used. Screws were introduced from 'outside-in'. The tendons were loaded cyclically to 150 N to simulate walking and 450 N to simulate jogging. Slippage of the tendon from the anchorage was recorded after 100, 300 and 1000 cycles. Cortico-cancellous and cancellous only fixations were compared using a 7-mm screw in an 8-mm tunnel with a 7-mm graft. The effect of screw length was studied by comparing 8 x 25 and 8 x 45 mm screws. Graft slippage with cancellous only fixation was significantly greater than with cortico-cancellous screw fixation (P0.105), the longer screws gave more consistent behaviour. We concluded that the screw should be placed so that its head engages the cortex, while increasing screw length within cancellous bone did not significantly improve graft fixation. Cyclical load testing reflects the repetitive forces imposed in the early post-operative period following hamstring anterior cruciate ligament reconstruction and is important for the evaluation of graft fixations. PMID:12649035

  12. Focusing on Increasing Velocity during Heavy Resistance Knee Flexion Exercise Boosts Hamstring Muscle Activity in Chronic Stroke Patients.

    PubMed

    Vinstrup, Jonas; Calatayud, Joaquin; Jakobsen, Markus D; Sundstrup, Emil; Andersen, Lars L

    2016-01-01

    Background. Muscle strength is markedly reduced in stroke patients, which has negative implications for functional capacity and work ability. Different types of feedback during strength training exercises may alter neuromuscular activity and functional gains. Objective. To compare levels of muscle activity during conditions of blindfolding and intended high contraction speed with a normal condition of high-intensity knee flexions. Methods. Eighteen patients performed unilateral machine knee flexions with a 10-repetition maximum load. Surface electromyography (EMG) was recorded from the quadrics and hamstring muscles and normalized to maximal EMG (nEMG) of the nonparetic limb. Results. For the paretic leg, the speed condition showed higher values of muscle activity compared with the normal and blindfolded conditions for both biceps femoris and semitendinosus. Likewise, the speed condition showed higher co-contraction values compared with the normal and blindfolded conditions for the vastus lateralis. No differences were observed between exercise conditions for the nonparetic leg. Conclusion. Chronic stroke patients are capable of performing heavy resistance training with intended high speed of contraction. Focusing on speed during the concentric phase elicited higher levels of muscle activity of the hamstrings compared to normal and blindfolded conditions, which may have implications for regaining fast muscle strength in stroke survivors. PMID:27525118

  13. Treatment of Anterior Cruciate Ligament Injuries by Major League Soccer Team Physicians

    PubMed Central

    Farber, Joseph; Harris, Joshua D.; Kolstad, Kaare; McCulloch, Patrick C.

    2014-01-01

    Background: The treatment and rehabilitation procedures of anterior cruciate ligament (ACL) injuries in elite soccer players are controversial. Points of debate include surgical timing, technique, graft choice, rehabilitation, and return-to-sport criteria and timing. Purpose: To identify practice preferences among current Major League Soccer (MLS) team orthopaedic surgeons for ACL injuries. Study Design: Cross-sectional study; Level of evidence, 4. Methods: The survey was administered at the MLS team physician annual meeting in January 2013. At least 1 orthopaedic surgeon representative from each of the 19 clubs (16 from the United States, 3 from Canada) was in attendance. Teams with more than 1 affiliated orthopaedic surgeon were given an additional survey to be completed either at the meeting or returned via e-mail. Descriptive statistics, Wilcoxon Mann-Whitney (return-to-play parameters, running, and ball drills), and Fisher exact tests (graft selection, bracing, continuous passive motion) were applied to the various data sets from the survey responses. Results: A 100% survey participation rate was achieved (22 team orthopaedic surgeons representing 19 MLS teams). A single-incision, arthroscopically assisted, single-bundle reconstruction was the most common technique (91%). Surgeons were split regarding femoral tunnel drilling (50% transtibial, 46% accessory medial). Autograft bone–patellar tendon–bone (BPTB) was the most common preferred graft choice (68%). The biggest concerns about BPTB autograft and hamstring autograft were anterior knee pain (76%) and hamstring weakness (46%), respectively. Most surgeons did not recommend postoperative continuous passive motion (64%) or functional bracing (68%). Most surgeons permitted return to sport without restrictions at 6 to 8 months following surgery (82%). Surgeons who routinely used functional bracing after ACL surgery more frequently used hamstring autograft than those who used BPTB autograft (P = .04

  14. Adductor muscle strains in sport.

    PubMed

    Nicholas, Stephen J; Tyler, Timothy F

    2002-01-01

    An in-season adductor muscle strain may be debilitating for the athlete. Furthermore, an adductor strain that is treated improperly could become chronic and career threatening. Any one of the six muscles of the adductor group could be involved. The degree of injury can range from a minor strain (Grade I), where minimal playing time is lost, to a severe strain (Grade III) in which there is complete loss of muscle function. Ice hockey and soccer players seem particularly susceptible to adductor muscle strains. In professional ice hockey players throughout the world, approximately 10% of all injuries are groin strains. These injuries, which have been linked to hip muscle weakness, previous injuries to that area, preseason practice sessions and level of experience, may be preventable if such risk factors can be addressed before each season. Hip-strengthening exercises were shown to be an effective method of reducing the incidence of adductor strains in one closely followed National Hockey League ice hockey team. Despite the identification of risk factors and strengthening intervention for ice hockey players, adductor strains continue to occur throughout sport. Clinicians feel an active training programme, along with completely restoring the strength of the adductor muscle group, is the key to successful rehabilitation. Surgical intervention is available if nonoperative treatment fails for 6 months or longer. Adductor release and tenotomy was reported to have limited success in athletes. PMID:11929360

  15. Sports injuries in a high school.

    PubMed

    McLain, L G; Reynolds, S

    1989-09-01

    A 1-year study was undertaken investigating all sports injuries at a large high school. A total of 1283 student athletes participated in sports and suffered 280 injuries for an overall injury rate of 22%. The largest injury rate was in football (61%) followed by girls and boys gymnastics, wrestling, and boys basketball. Five sports had no injuries--boys' tennis, golf, boys' and girls' swimming, and girls' water polo. Severity of injury was measured by number of days lost per injury. Girls' track had the greatest number of days lost per injury (320) followed by girls' basketball, girls' cross country, boys' track, and boys' wrestling. Sprains and strains accounted for 57% of all injuries. Of the injured athletes, 87 were seen by a physician and only 5 athletes required surgery. The small number of serious injuries requiring surgery suggests that a motivated and competent pediatrician can play an integral role as a team physician.

  16. 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.

  17. 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

  18. 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

  19. The Utility of a High-intensity Exercise Protocol to Prospectively Assess ACL Injury Risk.

    PubMed

    Bossuyt, F M; García-Pinillos, F; Raja Azidin, R M F; Vanrenterghem, J; Robinson, M A

    2016-02-01

    This study investigated the utility of a 5-min high-intensity exercise protocol (SAFT(5)) to include in prospective cohort studies investigating ACL injury risk. 15 active females were tested on 2 occasions during which their non-dominant leg was analysed before SAFT(5) (PRE), immediately after (POST0), 15 min after (POST15), and 30 min after (POST30). On the first occasion, testing included 5 maximum isokinetic contractions for eccentric and concentric hamstring and concentric quadriceps and on the second occasion, 3 trials of 2 landing tasks (i. e., single-leg hop and drop vertical jump) were conducted. Results showed a reduced eccentric hamstring peak torque at POST0, POST15 and POST30 (p<0.05) and a reduced functional HQ ratio (Hecc/Qcon) at POST15 and POST30 (p<0.05). Additionally, a more extended knee angle at POST30 (p<0.05) and increased knee internal rotation angle at POST0 and POST15 (p<0.05) were found in a single-leg hop. SAFT(5) altered landing strategies associated with increased ACL injury risk and similar to observations from match simulations. Our findings therefore support the utility of a high-intensity exercise protocol such as SAFT(5) to strengthen injury screening tests and to include in prospective cohort studies where time constraints apply. PMID:26509378

  20. 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

  1. 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

  2. Injuries to athletes with disabilities: identifying injury patterns.

    PubMed

    Ferrara, M S; Peterson, C L

    2000-08-01

    Participation in sport activities for people with disabilities continues to gain in popularity. With participation in sports, there is an inherent risk of injury. A review of current sport epidemiological studies was used and we concluded that injury patterns for this population are similar to those for athletes without disabilities. Injury data from Paralympic competitions dating back to 1976 indicate that most elite athletes with disabilities seek medical care for illness and musculo-skeletal injuries. However, there are very limited injury data regarding Winter Paralympic events or skiing injuries. For those athletes who participate in Summer Paralympic events, abrasions, strains, sprains and contusions are more common than fractures and dislocations. However, location of injuries appears to be disability and sport dependent. Lower extremity injuries are more common in ambulatory athletes (visually impaired, amputee, cerebral palsy) and upper extremity injuries are more frequent in athletes who use a wheelchair. While it appears that the majority of the injuries occurring in this population are minor in nature, inconsistencies in the definition of injury in the literature make this conclusion tenuous. When injuries are expressed as time lost in participation, 52% of injuries resulted in 7 days lost or less, 29% in 8 to 21 days lost and 19% in greater than 22 days lost. The only prospective study addressing injury rates of athletes with disabilities in a manner consistent with other sport epidemiological studies found an injury rate of 9.3 injuries per 1000 athlete-exposures (AE). This injury rate is less than American football (10.1 to 15/1000 AE) and soccer (9.8/1000 AE), and greater than basketball (7.0/1000 AE). It is unclear whether comparative statistics such as these take into consideration the number of illness and injury episodes that resulted from the disability. Further complicating epidemiological studies for athletes with disabilities is the

  3. 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

  4. A primate genesis model of focal dystonia and repetitive strain injury: I. Learning-induced dedifferentiation of the representation of the hand in the primary somatosensory cortex in adult monkeys.

    PubMed

    Byl, N N; Merzenich, M M; Jenkins, W M

    1996-08-01

    In this study we tested a neuroplasticity/learning origins hypothesis for repetitive strain injuries (RSIs), including occupationally induced focal dystonia. Repetitive movements produced in a specific form and in an appropriate behavioral context cause a degradation of the sensory feedback information controlling fine motor movements, resulting in the "learned" genesis of RSIs. Two adult New World owl monkeys were trained at a behavioral task that required them to maintain an attended grasp on a hand grip that repetitively and rapidly (20 msec) opened and closed over short distances. The monkeys completed 300 behavioral trials per day (1,100 to 3,000 movement events) with an accuracy of 80 to 90%. A movement control disorder was recorded in both monkeys. Training was continued until the performance accuracy dropped to below 50%. We subsequently conducted an electrophysiologic mapping study of the representations of the hand within the primary somatosensory (SI) cortical zone. The hand representation in the true primary somatosensory cortical field, SI area 3b, was found to be markedly degraded in these monkeys, as characterized by (1) a dedifferentiation of cortical representations of the skin of the hand manifested by receptive fields that were 10 to 20 times larger than normal, (2) the emergence of many receptive fields that covered the entire glabrous surface of individual digits or that extended across the surfaces of two or more digits, (3) a breakdown of the normally sharply segregated area 3b representations of volar glabrous and dorsal hairy skin of the hand, and (4) a breakdown of the local shifted-overlap receptive field topography of area 3b, with many digital receptive fields overlapping the fields of neurons sampled in cortical penetrations up to more than four times farther apart than normal. Thus, rapid, repetitive, highly stereotypic movements applied in a learning context can actively degrade cortical representations of sensory information guiding

  5. 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.

  6. 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

  7. Pancreatic injury.

    PubMed

    Ahmed, Nasim; Vernick, Jerome J

    2009-12-01

    Injury to the pancreas, because of its retroperitoneal location, is a rare occurrence, most commonly seen with penetrating injuries (gun shot or stab wounds). Blunt trauma to the pancreas accounts for only 25% of the cases. Pancreatic injuries are associated with high morbidity and mortality due to accompanying vascular and duodenal injuries. Pancreatic injuries are not always easy to diagnose resulting in life threatening complications. Physical examination as well as serum amylase is not diagnostic following blunt trauma. Computed tomography (CT) scan can delineate the injury or transaction of the pancreas. Endoscopic retrograde pancreaticography (ERCP) is the main diagnostic modality for evaluation of the main pancreatic duct. Unrecognized ductal injury leads to pancreatic pseudocyst, fistula, abscess, and other complications. Management depends upon the severity of the pancreatic injury as well as associated injuries. Damage control surgery in hemodynamic unstable patients reduces morbidity and mortality.

  8. Snowboard injuries.

    PubMed

    Pino, E C; Colville, M R

    1989-01-01

    A retrospective survey of 267 snowboarders was undertaken to determine the population at risk and types and mechanisms of injuries sustained in this sport. Snowboarders are young (average age, 21 years), male (greater than 90%), view themselves in average or above average physical condition (96%), and have varied sports interests. One hundred ten injuries that resulted in a physician visit were reported. Ligament sprains, fractures, and contusions were the most frequent types of injury. Fifty percent of all injuries occurred in the lower extremities, with ankle injuries being the most common. Snowboard riders using equipment with increased ankle support seem to be more protected from lower extremity injuries. The lower extremity injuries were concentrated in the forward limb of the snowboarder, where the rider's weight is disproportionately distributed. Differences in the mechanism and spectrum of injury between snowboarding and skiing injuries were noted, including: impact rather than torsion as the major mechanism of injury, a significant lack of thumb injuries, comparative increase in ankle injuries, a decrease in knee injuries, and a higher percentage of upper extremity injuries.

  9. Accuracy and feasibility of video analysis for assessing hamstring flexibility and validity of the sit-and-reach test.

    PubMed

    Mier, Constance M

    2011-12-01

    The accuracy of video analysis of the passive straight-leg raise test (PSLR) and the validity of the sit-and-reach test (SR) were tested in 60 men and women. Computer software measured static hip-joint flexion accurately. High within-session reliability of the PSLR was demonstrated (R > .97). Test-retest (separate days) reliability for SR was high in men (R = .97) and women R = .98) moderate for PSLR in men (R = .79) and women (R = .89). SR validity (PSLR as criterion) was higher in women (Day 1, r = .69; Day 2, r = .81) than men (Day 1, r = .64; Day 2, r = .66). In conclusion, video analysis is accurate and feasible for assessing static joint angles, PSLR and SR tests are very reliable methods for assessing flexibility, and the SR validity for hamstring flexibility was found to be moderate in women and low in men.

  10. Cervical Spine Injuries in the Athlete.

    PubMed

    Schroeder, Gregory D; Vaccaro, Alexander R

    2016-09-01

    Cervical spine injuries are extremely common and range from relatively minor injuries, such as cervical muscle strains, to severe, life-threatening cervical fractures with spinal cord injuries. Although cervical spine injuries are most common in athletes who participate in contact and collision sports, such as American football and rugby, they also have been reported in athletes who participate in noncontact sports, such as baseball, gymnastics, and diving. Cervical spine injuries in athletes are not necessarily the result of substantial spine trauma; some athletes have chronic conditions, such as congenital stenosis, that increase their risk for a serious cervical spine injury after even minor trauma. Therefore, physicians who cover athletic events must have a thorough knowledge of cervical spine injures and the most appropriate ways in which they should be managed. Although cervical spine injuries can be career-ending injuries, athletes often are able to return to play after appropriate treatment if the potential for substantial re-injury is minimized.

  11. 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.

  12. Ankle flexibility and injury patterns in dancers.

    PubMed

    Wiesler, E R; Hunter, D M; Martin, D F; Curl, W W; Hoen, H

    1996-01-01

    Lower-extremity injuries are common among dancers and cause significant absences from rehearsals and performances. For this study of lower-extremity injuries in 101 ballet and 47 modern dance students, injuries requiring medical attention sustained over 1 academic year were associated with the following data obtained at the beginning of the school year: ankle flexibility, sex, dance discipline, previous injury, body mass index, and years of training. Eighty-three of the 148 students (age range, 12 to 28 years) reported prior lower-limb injuries, the most common being ankle sprains (28% of all dancers). Previous leg injuries correlated significantly with lower dorsiflexion measurements and with more new injuries. Female students had greater ankle and first metatarsophalangeal flexibility. Modern dancers had greater ankle inversion. Ninety-four students sustained 177 injuries during the study, including 75 sprains or strains and 71 cases of tendinitis. Thirty-nine percent (N = 69) were ankle injuries; 18% (N = 33) were knee injuries; 23% (N = 40) were foot injuries; and 20% (N = 35) were either hip or thigh injuries. Sixty-seven percent (N = 78) of the injured students were ballet dancers. Age, years of training, body mass index, sex, and ankle range of motion measurement had no predictive value for injury; previous injury and dance discipline both correlated with increased risk of injury. PMID:8947396

  13. 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 ...

  14. 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 ...

  15. Spinal injury

    MedlinePlus

    ... head. Alternative Names Spinal cord injury; SCI Images Skeletal spine Vertebra, cervical (neck) Vertebra, lumbar (low back) Vertebra, thoracic (mid back) Vertebral column Central nervous system Spinal cord injury Spinal anatomy Two person roll - ...

  16. Early versus late start of open kinetic chain quadriceps exercises after ACL reconstruction with patellar tendon or hamstring grafts: a prospective randomized outcome study.

    PubMed

    Heijne, Annette; Werner, Suzanne

    2007-04-01

    The purpose of the present investigation was to evaluate physical outcome after anterior cruciate ligament (ACL) reconstruction with early versus late initiation of open kinetic chain (OKC) exercises for the quadriceps in patients operated on either patellar tendon or hamstring grafts. Sixty-eight patients, 36 males and 32 females, with either patellar tendon graft (34 patients) or hamstring graft (34 patients) were enrolled in this study. All patients were randomly allocated to either early (the 4th postoperative week) or late (the 12th postoperative week) start of OKC exercises for the quadriceps, resulting in four subgroups: patellar tendon reconstruction, early start (P4) or late start (P12) of OKC quadriceps exercises, hamstring tendon reconstruction, early start (H4) or late start (H12) of quadriceps OKC exercises. Prior to surgery and 3, 5 and 7 months later, assessments of range of motion (goniometer), anterior knee laxity (KT-1000), postural sway (KAT 2000), thigh muscle torques (Kin-Com dynamometer) and anterior knee pain (anterior knee pain score) were evaluated. No significant group differences were found in terms of range of motion 3, 5 and 7 months postoperatively. The H4 group showed a significantly higher mean difference of laxity over time of 1.0 mm (CI: 0.18-1.86) than the P4 group (P=0.04). Within the same type of surgery, the H4 against the H12, the mean difference over time was 1.2 mm (0.37-2.1) higher in the H4 group than in the H12 group (P=0.01). There were no significant group differences in terms of postural sway or anterior knee pain at the different test occasions. Significant differences in trends (changes over time) were found when comparing the four groups, for both quadriceps muscle torques (P<0.001) and hamstring muscle torques (P<0.001). All groups, except the P4 group, reached preoperative values of quadriceps muscle torques at the 7 months follow-up. In the H4 and the H12 groups, significantly lower hamstring muscle torques at

  17. Head injury.

    PubMed

    Hureibi, K A; McLatchie, G R

    2010-05-01

    Head injury is one of the commonest injuries in sport. Most are mild but some can have serious outcomes. Sports medicine doctors should be able to recognise the clinical features and evaluate athletes with head injury. It is necessary during field assessment to recognise signs and symptoms that help in assessing the severity of injury and making a decision to return-to-play. Prevention of primary head injury should be the aim. This includes protective equipment like helmets and possible rule changes. PMID:20533694

  18. Bicycling injuries.

    PubMed

    Silberman, Marc R

    2013-01-01

    Bicycling injuries can be classified into bicycle contact, traumatic, and overuse injuries. Despite the popularity of cycling, there are few scientific studies regarding injuries. Epidemiological studies are difficult to compare due to different methodologies and the diverse population of cyclists studied. There are only three studies conducted on top level professionals. Ninety-four percent of professionals in 1 year have experienced at least one overuse injury. Most overuse injuries are mild with limited time off the bike. The most common site of overuse injury is the knee, and the most common site of traumatic injury is the shoulder, with the clavicle having the most common fracture. Many overuse and bicycle contact ailments are relieved with simple bike adjustments.

  19. 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.

  20. 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

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

    2015-04-01

    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.

  1. 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

  2. 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

  3. Natural Strain

    NASA Technical Reports Server (NTRS)

    Freed, Alan D.

    1997-01-01

    Logarithmic strain is the preferred measure of strain used by materials scientists, who typically refer to it as the "true strain." It was Nadai who gave it the name "natural strain," which seems more appropriate. This strain measure was proposed by Ludwik for the one-dimensional extension of a rod with length l. It was defined via the integral of dl/l to which Ludwik gave the name "effective specific strain." Today, it is after Hencky, who extended Ludwik's measure to three-dimensional analysis by defining logarithmic strains for the three principal directions.

  4. Rationale and implementation of anterior cruciate ligament injury prevention warm-up programs in female athletes.

    PubMed

    Bien, Daniel P

    2011-01-01

    The sex disparity in anterior cruciate ligament (ACL) injury risk and the subsequent adverse effects on knee joint health, psychosocial well-being, and financial costs incurred have produced a surge in research on risk factors and interventions designed to decrease this disparity and overall incidence. Biomechanical and neuromuscular differences have been identified throughout the trunk and lower extremity that may increase noncontact ACL injury risk in female athletes. Evidence demonstrates that many risk factors are modifiable with intervention programs and that athletic performance measures can be enhanced. No universally accepted ACL injury prevention program currently exists, and injury prevention programs are diverse. Anterior cruciate ligament injury prevention programs introduced in a warm-up format offer multiple benefits, primarily, improved compliance based on improved practicality of implementation. However, drawbacks of warm-up style formats also exist, most notably that a lack of equipment and resources may preclude measurable improvements in athletic performance that foster improved compliance among participants. The purpose of this review is to analyze the current literature researching possible biomechanical and neuromuscular risk factors in noncontact ACL injury in female athletes and the most effective means of implementing critical elements of a program to decrease ACL injury risk in female athletes while improving athletic performance. Hip and hamstring training, core stabilization, plyometrics, balance, agility, neuromuscular training with video and verbal feedback to modify technique, and stretching appear to be essential components of these programs. Further research is critical to determine ideal training program volume, intensity, duration, and frequency.

  5. 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

  6. Diving injuries.

    PubMed

    Dickey, L S

    1984-01-01

    This is a collective review about the pathophysiology, diagnosis, and management of SCUBA and diving injuries by the emergency physician. These injuries can be classified into those resulting from the toxic effects of the inhaled gas, from the pressure changes in the water and gas mixture while diving, and from decompression sickness. With the increasing popularity of SCUBA diving, it is hoped that this discussion will enable a recognition of these injuries and therefore minimize the morbidity and mortality from them.

  7. 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.

  8. Differences in Neuromuscular Control and Quadriceps Morphology Between Potential Copers and Noncopers Following Anterior Cruciate Ligament Injury

    PubMed Central

    Macleod, Toran D.; Snyder-Mackler, Lynn; Buchanan, Thomas S.

    2015-01-01

    Study Design Prospective cross-sectional study. Objectives To compare knee muscle morphology and voluntary neuromuscular control in individuals who sustained an anterior cruciate ligament (ACL) injury and were identified as being capable of avoiding surgery (potential copers) and those who were recommended for surgery (noncopers), within 6 months of injury. Background Quadriceps atrophy and poor neuromuscular control have been found in noncopers. However, the reasons why some noncopers may be able to avoid surgery remain elusive. Methods Twenty participants (10 ACL-deficient noncopers and 10 ACL-deficient potential copers) were included in this study. Axial spin-echo, T1-weighted magnetic resonance imaging data of the lower extremities were captured. The volume and maximum cross-sectional area (CSA) of each muscle of the quadriceps and hamstrings were calculated following digital reconstruction. In addition, voluntary neuromuscular control was evaluated using an established target-matching task that required participants to produce static isometric loads across the knee joint. Electromyography was acquired from 5 muscles as participants performed the target-matching task. Circular statistics were used to calculate a specificity index to describe how well focused each muscle was activated toward its primary direction of muscle action. The ACL-deficient limb was then compared to the uninvolved limb of the noncopers and potential copers. Results The vasti (vastus medialis and vastus intermedius) of the involved limb of the noncopers were significantly smaller (P<.031) in comparison to those of their uninvolved limb. The potential copers' vastus lateralis maximum CSA (P = .047), total quadriceps muscle volume (P = .020) and maximum CSA (P = .015), and quadriceps-hamstring ratio volume (P = .021) and maximum CSA (P = .007) demonstrated quadriceps atrophy. However, only the ACL-deficient limb of the older (mean ± SD age, 27.4 ± 11.4 versus 19.9 ± 3.3 years; P = .032

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

    PubMed

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

    2015-10-01

    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

  10. Injury Control.

    ERIC Educational Resources Information Center

    Christophersen, Edward R.

    1989-01-01

    Injuries are now the cause of more deaths to children than the next six most frequent causes combined. Reviews the research evidence on the effectiveness of approaches to injury control such as legislation, health education, and behavioral strategies. Suggests avenues of further research. (Author/BJV)

  11. 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

  12. Knee Injuries

    MedlinePlus

    ... Sprains A sprain means you've stretched or torn a ligament. Common knee sprains usually involve damage ... A strain means you've partly or completely torn a muscle or tendon. With knee strains, you ...

  13. An epidemiologic study of squash injuries.

    PubMed

    Berson, B L; Rolnick, A M; Ramos, C G; Thornton, J

    1981-01-01

    A retrospective investigation of squash-related injuries incurred at a private and a public club in New York was undertaken to gain insight into the incidence and nature of such injuries. Telephone interviews were conducted with 200 randomly selected individuals to obtain their entire injury history. Sixty-nine of the 155 squash players contacted sustained injuries during their participation. Some had multiple injuries. This resulted in an overall injury rate of 44.5%. Strains and sprains accounted for over one-third of the injuries. Nearly one-half of the injuries involved the lower extremity, with the ankle and lower leg being injured most often. Forty-seven percent of the injuries seen were considered disabling because the patients were out of action for more than two weeks after injury. Players over the age of 40 are at increased risk for injury, as are newcomers to the game. Increased injury rates were also associated with an increased frequency of play among females. Only rarely will an injured squash player become permanently impaired.

  14. Muscle Injuries in Athletes

    PubMed Central

    Delos, Demetris; Maak, Travis G.; Rodeo, Scott A.

    2013-01-01

    Context: Muscle injuries are extremely common in athletes and often produce pain, dysfunction, and the inability to return to practice or competition. Appropriate diagnosis and management can optimize recovery and minimize time to return to play. Evidence Acquisition: Contemporary papers, both basic science and clinical medicine, that investigate muscle healing were reviewed. A Medline/PubMed search inclusive of years 1948 to 2012 was performed. Results: Diagnosis can usually be made according to history and physical examination for most injuries. Although data are limited, initial conservative management emphasizing the RICE principles and immobilization of the extremity for several days for higher grade injuries are typically all that is required. Injection of corticosteroids may clinically enhance function after an acute muscle strain. Additional adjunctive treatments (nonsteroidal anti-inflammatory drugs, platelet-rich plasma, and others) to enhance muscle healing and limit scar formation show promise but need additional data to better define their roles. Conclusion: Conservative treatment recommendations will typically lead to successful outcomes after a muscle injury. There is limited evidence to support most adjunctive treatments. PMID:24459552

  15. Badminton injuries.

    PubMed Central

    Krøner, K; Schmidt, S A; Nielsen, A B; Yde, J; Jakobsen, B W; Møller-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

  16. 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.

  17. Use of cervical collar after whiplash injuries.

    PubMed

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

    2014-08-08

    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.

  18. Successful feed-forward strategies following ACL injury and reconstruction.

    PubMed

    Bryant, Adam L; Newton, Robert U; Steele, Julie

    2009-10-01

    The purpose of this study was to elucidate the most successful feed-forward strategies responsible for enhancing dynamic restraint following anterior cruciate ligament (ACL) injury and ACL reconstruction (ACLR). Ten male ACL deficient (ACLD) subjects (18-35 years) together with 27 matched males who had undergone ACLR (14 using a patella tendon graft and 13 using a combined semitendinosus and gracilis graft) and 22 matched-control subjects were recruited. After their knee functionality (0- to 100-point scale) was rated using the Cincinnati Knee Rating System, each subject performed a maximal, countermovement hop for distance on their involved limb while EMG data were collected from the vastus lateralis (VL), vastus medialis (VM), semitendinosus (ST) and biceps femoris (BF) muscles. Acceleration transients at the proximal tibia were recorded using a uniaxial accelerometer mounted at the level of the tibial tuberosity. Whilst pre-programmed muscle activation strategies and tibial acceleration transients when landing from a single-leg long hop for distance were not contingent upon ACL status, a number of significant correlations were identified between neuromuscular variables and knee functionality of ACLD and ACLR subjects. Increased hamstring preparatory activity together with a greater ability to control tibial motion during dynamic deceleration was associated with higher levels of knee functionality in the ACLD subjects. Successful feed-forward strategies following ACLR were related to graft selection; STGT subjects with superior knee function activated their quadriceps earlier and were better able to synchronise peak hamstring muscle activity closer to initial ground contact whilst more functional PT subjects demonstrated enhanced tibial control despite a lack of evidence supporting modified pre-programmed muscular activation patterns. Our conclusion was that more functional individuals used sensory feedback to build treatment-specific, feed-forward strategies to

  19. Arthroscopic anterior cruciate ligament reconstruction with the tibial-remnant preserving technique using a hamstring graft.

    PubMed

    Lee, Byung-Ill; Min, Kyung-Dae; Choi, Hyung-Suk; Kim, Jun-Bum; Kim, Seong-Tae

    2006-03-01

    We propose that the tibial remnant of the anterior cruciate ligament (ACL) is able to enhance the revascularization and cellular proliferation of the graft, to preserve proprioceptive function, and to be able to acquire anatomic placement of the graft without roof impingement. Therefore, it seems reasonable to assume that preserving the tibial remnant as much as possible as a source of reinnervation, if technically possible without causing impingement, would be of potential benefit to the patient. Our surgical technique was developed to maximize the preservation of the tibial remnant. The distally attached semitendinosus and gracilis tendons are harvested using the tendon stripper. After satisfactory placement of 2 guide pins convergently, a closed-end socket in the lateral femoral condyle is created using an adequately sized curved curette. For anatomic placement of the graft, the tibial tunnel should be positioned within the boundaries of the normal ACL tibial remnant. The reamer must be advanced very carefully to minimize injury to the residual remnant at the intra-articular margin of the tibial tunnel. Penetration should stop at the base of the stump. The folded grafts are then pulled intra-articularly through the tibial tunnel, the tibial remnant, and the femoral socket by pulling sutures under arthroscopic visualization. The ACL tibial remnant is compacted by the tendon passage. The graft is secured proximally by tying sutures in the lateral femoral condyle and distally at the tibia with double staples by a belt-buckle method. The advantages of our technique include maximal preservation of the tibial remnant, no roof impingement caused by intrasynovial anatomic placement of the graft, the simplicity of the procedure, the minimal need for hardware or special instruments, the economic benefit, and the potential prevention of tibial tunnel enlargement by preventing synovial fluid leakage. PMID:16517320

  20. Sports Injuries

    MedlinePlus

    ... heart, to help decrease swelling. The Body’s Healing Process From the moment a bone breaks or a ... what happens at each stage of the healing process: At the moment of injury: Chemicals are released ...

  1. Three-layered architecture of the popliteal fascia that acts as a kinetic retinaculum for the hamstring muscles.

    PubMed

    Satoh, Masahiro; Yoshino, Hiroyuki; Fujimura, Akira; Hitomi, Jiro; Isogai, Sumio

    2016-09-01

    When patients report pain in the popliteal fossa upon knee extension, the pain is usually localized in the lower region of the popliteal fossa. However, some patients complain of pain in the upper region of the popliteal fossa as the knee is flexed, which motivated us to examine the role of the popliteal fascia as the retinaculum of the hamstring muscles. Thirty-four thighs from 19 Japanese cadavers were dissected. The popliteal fascia was defined as the single aponeurotic sheet covering the popliteal fossa. We found that the fascia acted as a three-layered retinaculum for the flexor muscles of the thigh and provided a secure route for neurovascular structures to the lower leg in any kinetic position of the knee joint. The superficial layer of the popliteal fascia covering the thigh was strongly interwoven with the epimysium of biceps femoris along its lateral aspect and with that of the semimembranosus along its medial aspect, ensuring that the flexor muscles remained in their correct positions. The intermediate layer arose from the medial side of biceps femoris and merged medially with the superficial layer. The profound layer stretched transversely between the biceps femoris and the semimembranosus. Moreover, we investigated the nerve distribution in the popliteal fascia using Sihler's staining and whole-mount immunostaining for neurofilaments. The three-layered fascia was constantly innervated by branches from the posterior femoral cutaneous or saphenous nerve. The nerves were closely related and distributed to densely packed collagen fibers in the superficial layer as free or encapsulated nerve endings, suggesting that the fascia is involved in pain in the upper region of the popliteal fossa.

  2. 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

  3. A comparison of men's and women's professional basketball injuries.

    PubMed

    Zelisko, J A; Noble, H B; Porter, M

    1982-01-01

    Injuries sustained by male and female professional basketball teams were compared. Injuries from two consecutive seasons were coded, and computer-based cross-tabulations comparing sex, body part, and type of injury were performed. The women's injury frequency was 1.6 times that of men. The body part most frequently injured on both teams was the ankle. Women sustained significantly more knee and thigh injuries as well as sprains, strains, and contusions. Men had significantly more muscle spasms. Other injuries occurred in similar patterns in both sexes. Alterations in training programs are suggested with emphasis on women's strengthening and men's flexibility.

  4. Cold injuries.

    PubMed

    Kruse, R J

    1995-01-01

    There are two categories of cold injury. The first is hypothermia, which is a systemic injury to cold, and the second is frostbite, which is a local injury. Throughout history, entire armies, from George Washington to the Germans on the Russian Front in World War II, have fallen prey to prolonged cold exposure. Cold injury is common and can occur in all seasons if ambient temperature is lower than the core body temperature. In the 1985 Boston Marathon, even though it was 76 degrees and sunny, there were 75 runners treated for hypothermia. In general, humans adapt poorly to cold exposure. Children are at particular risk because of their relatively greater surface area/body mass ratio, causing them to cool even more rapidly than adults. Because of this, the human's best defense against cold injury is to limit his/her exposure to cold and to dress appropriately. If cold injury has occurred and is mild, often simple passive rewarming such as dry blankets and a warm room are sufficient treatment.

  5. 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.

  6. 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

  7. Incidence of injury in kickboxing participation.

    PubMed

    Romaine, Linda J; Davis, Shala E; Casebolt, Kevin; Harrison, Kelly A

    2003-08-01

    Cardio kickboxing classes have become a popular form of exercise to enhance fitness. This study surveyed kickboxing participants and instructors to ascertain the severity, type, and incidence of injuries sustained while performing cardio kickboxing exercise. The respondents consisted of 77.4% instructors and 29.3% participants with a mean age of 32.29 years (+/-8.98 years). Injury from kickboxing exercise was reported by 29.3% of the respondents, 31% of the instructors, and 15.5% of the participants. The most common site of injury for instructors was the back, followed by the knee, hip, and shoulder. The most common site of injury for participants was the back, knee, and ankle. Strains were the most common type of injury reported, followed by sprains and tendinitis. More than half of the injuries reported were new injuries (64%), with almost 59% of the total injuries reported causing a disruption of the normal exercise routine or an alteration of normal daily activities. Instructors who reported using music speeds greater than 140 beats per minute had a higher incidence of injury, compared with instructors who used music between 125 and 139 beats per minute. The wrist and elbow had the highest percentage of new injuries reported. This study suggests that kickboxing exercise can be a safe form of exercise for fitness purposes. Keeping music speeds below 140 beats per minute and limiting the number of kickboxing sessions per week may help to reduce injury rates.

  8. 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.

  9. 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.

  10. 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

  11. The influence of ankle sprain injury on muscle activation during hip extension.

    PubMed

    Bullock-Saxton, J E; Janda, V; Bullock, M I

    1994-08-01

    The likely influence of a localised injury in a distal joint on the function of proximal muscles is an important consideration in assessment and treatment of musculoskeletal injuries. However, little experimental evidence in humans exists in this area. Accordingly, a controlled study was carried out, in which the function of muscles at the hip was compared between subjects who had suffered previous severe unilateral ankle sprain and matched control subjects. The pattern of activation of the gluteus maximus, the hamstring muscles and the ipsilateral and contralateral erector spinae muscles was monitored through the use of surface electromyography during hip extension from prone lying. Analyses revealed that the pattern of muscle activation in subjects with previous injury differed markedly from normal control subjects, and that changes appeared to occur on both the uninjured and the injured sides of the body. A significant difference between the two groups was the delay in onset of activation of the gluteus maximus in previously injured subjects. The existence of remote changes in muscle function following injury found in this study emphasise the importance of extending assessment beyond the side and site of injury.

  12. 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

  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

  14. 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.

  15. The outcome at 15 years of endoscopic anterior cruciate ligament reconstruction using hamstring tendon autograft for 'isolated' anterior cruciate ligament rupture.

    PubMed

    Bourke, H E; Gordon, D J; Salmon, L J; Waller, A; Linklater, J; Pinczewski, L A

    2012-05-01

    The purpose of this study was to report the outcome of 'isolated' anterior cruciate ligament (ACL) ruptures treated with anatomical endoscopic reconstruction using hamstring tendon autograft at a mean of 15 years (14.25 to 16.9). A total of 100 consecutive men and 100 consecutive women with 'isolated' ACL rupture underwent four-strand hamstring tendon reconstruction with anteromedial portal femoral tunnel drilling and interference screw fixation by a single surgeon. Details were recorded pre-operatively and at one, two, seven and 15 years post-operatively. Outcomes included clinical examination, subjective and objective scoring systems, and radiological assessment. At 15 years only eight of 118 patients (7%) had moderate or severe osteo-arthritic changes (International Knee Documentation Committee Grades C and D), and 79 of 152 patients (52%) still performed very strenuous activities. Overall graft survival at 15 years was 83% (1.1% failure per year). Patients aged < 18 years at the time of surgery and patients with > 2 mm of laxity at one year had a threefold increase in the risk of suffering a rupture of the graft (p = 0.002 and p = 0.001, respectively). There was no increase in laxity of the graft over time. ACL reconstructive surgery in patients with an 'isolated' rupture using this technique shows good results 15 years post-operatively with respect to ligamentous stability, objective and subjective outcomes, and does not appear to cause osteoarthritis.

  16. Comparative pull-out and cyclic-loading strength tests of anchorage of hamstring tendon grafts in anterior cruciate ligament reconstruction.

    PubMed

    Giurea, M; Zorilla, P; Amis, A A; Aichroth, P

    1999-01-01

    This study examined four devices for anchorage of hamstring tendons used as anterior cruciate ligament grafts: a stirrup, a clawed washer and screw, and "soft" and round-headed interference screws. Ultimate strength tests were performed using bovine tendons and bones. The stirrup was significantly stronger than the other anchorage devices, failing at 898 N. The clawed washer failed at 502 N, the soft screw at 691 N, and the round-headed screw at 445 N. Cyclic loading to 150 N (to simulate walking) caused elongation of 2.1 mm with the stirrup by 1100 cycles, and 6.7 mm with the clawed washer by 300 cycles. Different hole and soft screw diameters and placements (inside-out versus outside-in) allowed 1-to 3-mm slippage (no significant differences) by 1100 cycles. The round-headed screw allowed 6.8-mm slippage by 1100 cycles, and a sharp edge below the screw head caused tendon damage. Cyclic loads to 450 N (to simulate jogging) were then imposed until failure, and all specimens failed rapidly; only stirrup fixation kept all specimens intact after 300 load cycles. We concluded that anterior cruciate ligament reconstructions using hamstring tendons will slacken if rehabilitation is too aggressive, so forces on the reconstructed ligament should be minimized until tendon-to-bone healing occurs. PMID:10496580

  17. Fingertip injuries

    PubMed Central

    Saraf, Sanjay; Tiwari, VK

    2007-01-01

    Background: Fingertip injuries are extremely common. Out of the various available reconstructive options, one needs to select an option which achieves a painless fingertip with durable and sensate skin cover. The present analysis was conducted to evaluate the management and outcome of fingertip injuries. Materials and Methods: This is a retrospective study of 150 cases of fingertip Injuries of patients aged six to 65 years managed over a period of two years. Various reconstructive options were considered for the fingertip lesions greater than or equal to 1 cm2. The total duration of treatment varied from two to six weeks with follow-up from two months to one year. Results: The results showed preservation of finger length and contour, retention of sensation and healing without significant complication. Conclusion: The treatment needs to be individualized and all possible techniques of reconstruction must be known to achieve optimal recovery. PMID:21139772

  18. Wrestling injuries.

    PubMed

    Halloran, Laurel

    2008-01-01

    The sport of wrestling has a history dating back to ancient times as one of the original Olympic sports. It particularly appeals to adolescents as equally matched opponents engage in competition. There can be no argument that participation in sports helps promote a physically active lifestyle. However, despite the documented health benefits of increased physical activity, those who participate in athletics are at risk for sports-related injuries. This article will discuss wrestling injuries and recommend prevention strategies to keep athletes safe. PMID:18521035

  19. Eye Injuries at Home

    MedlinePlus

    ... Patient Stories Español Eye Health / Tips & Prevention Eye Injuries Sections Preventing Eye Injuries Recognizing and Treating Eye ... Sports Eye Injuries by the Numbers — Infographic Eye Injuries at Home Reviewed by: Brenda Pagan-Duran MD ...

  20. Spinal Cord Injury Map

    MedlinePlus

    ... on the severity of the injury. Tap this spinal column to see how the level of injury affects loss of function and control. Learn more about spinal cord injuries. A spinal cord injury affects the ...

  1. Electrical Injuries

    MedlinePlus

    ... your injuries are depends on how strong the electric current was, what type of current it was, how it moved through your body, and how long you were exposed. Other factors include how ... you should see a doctor. You may have internal damage and not realize it.

  2. 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.

  3. 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

  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.

  5. Soccer injuries and their relation to physical maturity.

    PubMed

    Backous, D D; Friedl, K E; Smith, N J; Parr, T J; Carpine, W D

    1988-08-01

    A prospective study of injuries encountered during participation in a summer soccer camp for youths aged 6 through 17 years revealed an injury incidence of 10.6 per 1000 hours for girls (107 injuries in 458 girls) and 7.3 per 1000 hours for boys (109 injuries in 681 boys). For both sexes, the incidence of injury increased at age 14 years. One certified athletic trainer (W.D.C.) assessed and documented all injuries during the course of the study. Seventy percent of injuries involved the lower extremities. Contusions represented 35.2%, strains 27.8%, sprains 19.4%, and fractures and dislocations 2% of all reported injuries. The ankle was the most frequent site of injury in both sexes. Quadriceps strain was a common injury in boys. The boys with the highest incidence of injury were tall (greater than 165 cm) and had a weak grip (less than 25 kg), suggesting that skeletally mature but muscularly weak boys may be more susceptible to injury while playing soccer with peers of the same chronological age.

  6. Rectus abdominis muscle strains in tennis players

    PubMed Central

    Maquirriain, Javier; Ghisi, Juan P; Kokalj, Antonio M

    2007-01-01

    Rectus abdominis muscle strains are common and debilitating injuries among competitive tennis players. Eccentric overload, followed by forced contraction of the non‐dominant rectus abdominis during the cocking phase of the service motion is the accepted injury mechanism. A tennis‐specific rehabilitation program emphasising eccentrics and plyometric strengthening of the abdominal wall muscles, contributes to the complete functional recovery in tennis players, and could help reduce recurrences. PMID:17957025

  7. 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...

  8. Genetic networks controlling retinal injury

    PubMed Central

    Vazquez-Chona, Felix R.; Khan, Amna N.; Chan, Chun K.; Moore, Anthony N.; Dash, Pramod K.; Hernandez, M. Rosario; Lu, Lu; Chesler, Elissa J.; Manly, Kenneth F.; Williams, Robert W.; Geisert, Eldon E.

    2010-01-01

    Purpose The present study defines genomic loci underlying coordinate changes in gene expression following retinal injury. Methods A group of acute phase genes expressed in diverse nervous system tissues was defined by combining microarray results from injury studies from rat retina, brain, and spinal cord. Genomic loci regulating the brain expression of acute phase genes were identified using a panel of BXD recombinant inbred (RI) mouse strains. Candidate upstream regulators within a locus were defined using single nucleotide polymorphism databases and promoter motif databases. Results The acute phase response of rat retina, brain, and spinal cord was dominated by transcription factors. Three genomic loci control transcript expression of acute phase genes in brains of BXD RI mouse strains. One locus was identified on chromosome 12 and was highly correlated with the expression of classic acute phase genes. Within the locus we identified the inhibitor of DNA binding 2 (Id2) as a candidate upstream regulator. Id2 was upregulated as an acute phase transcript in injury models of rat retina, brain, and spinal cord. Conclusions We defined a group of transcriptional changes associated with the retinal acute injury response. Using genetic linkage analysis of natural transcript variation, we identified regulatory loci and candidate regulators that control transcript levels of acute phase genes. PMID:16288200

  9. Pathophysiology of Acute Exercise-Induced Muscular Injury: Clinical Implications

    PubMed Central

    Page, Phillip

    1995-01-01

    Acute muscular injury is the most common injury affecting athletes and those participating in exercise. Nearly everyone has experienced soreness after unaccustomed or intense exercise. Clinically, acute strains and delayed-onset muscle soreness are very similar. The purpose of this paper is to review the predisposing factors, mechanisms of injury, structural changes, and biochemical changes associated with these injuries. Laboratory and clinical findings are discussed to help athletic trainers differentiate between the two conditions and to provide a background knowledge for evaluation, prevention, and treatment of exercise-induced muscular injury. PMID:16558305

  10. MR imaging of sports-related muscle injuries.

    PubMed

    Yang, C W; Liu, G C; Chen, H Y; Wang, M L; Lin, M B; Kuo, Y T

    1994-04-01

    Magnetic resonance (MR) imaging of the thighs of 26 baseball athletes and one softball athlete were studied to evaluate muscle injuries. We documented the abnormalities present in MR imaging after a muscle injury and evaluated the role of MR imaging in muscle injuries. Fifteen of the athletes showed muscle abnormalities in MR images. These include muscle strains without tear, muscle tear, scar and chronic tendon injury. Having the advantages of high tissue contrast and multiplanar display capability, MR allowed direct visualization of the injured muscles and characterization of traumatic lesions. We conclude that MR could be a good imaging modality for evaluating muscle injuries.

  11. Sports injuries in adolescents' ball games: soccer, handball and basketball.

    PubMed

    Yde, J; Nielsen, A B

    1990-03-01

    In a prospective study of 302 adolescent players in three ball games (soccer, handball and basketball), 119 incurred injuries. The injury incidence (number of injuries per 1000 playing hours) was 5.6 in soccer, 4.1 in handball and 3.0 in basketball. Ankle sprains accounted for 25 per cent of the injuries, finger sprains 32 per cent, strains in the thigh and leg 10 per cent, and tendinitis/apophysitis 12 per cent. The most serious injuries were four fractures, one anterior cruciate ligament rupture, and two meniscus lesions. The most serious injuries, with the longest rehabilitation period, occurred in soccer. In soccer, many injuries occurred during tackling and contact with an opposing player, while the injuries in handball and basketball were often caused by ball contact and running.

  12. Cervical Spine Injuries in the Athlete.

    PubMed

    Schroeder, Gregory D; Vaccaro, Alexander R

    2016-09-01

    Cervical spine injuries are extremely common and range from relatively minor injuries, such as cervical muscle strains, to severe, life-threatening cervical fractures with spinal cord injuries. Although cervical spine injuries are most common in athletes who participate in contact and collision sports, such as American football and rugby, they also have been reported in athletes who participate in noncontact sports, such as baseball, gymnastics, and diving. Cervical spine injuries in athletes are not necessarily the result of substantial spine trauma; some athletes have chronic conditions, such as congenital stenosis, that increase their risk for a serious cervical spine injury after even minor trauma. Therefore, physicians who cover athletic events must have a thorough knowledge of cervical spine injures and the most appropriate ways in which they should be managed. Although cervical spine injuries can be career-ending injuries, athletes often are able to return to play after appropriate treatment if the potential for substantial re-injury is minimized. PMID:27479833

  13. 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.

  14. 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

  15. Adductor pollicis jamming injuries in the professional baseball player: 2 case reports.

    PubMed

    Altobelli, Grant G; Ruchelsman, David E; Belsky, Mark R; Graham, Thomas; Asnis, Peter; Leibman, Matthew I

    2013-06-01

    We characterize a mechanism of injury, injury pattern, and treatment algorithm for adductor pollicis myotendinous injuries in 2 professional baseball players. Similar to myotendinous eccentric injuries in other anatomical areas, the adductor pollicis sustains a sudden forceful eccentric load during a jammed swing, resulting in intramuscular strain or tendon rupture. Based on the reported injury mechanism, and magnetic resonance imaging features of these myotendinous injuries, the thumb of the top hand during a jammed swing was suddenly and forcefully eccentrically abducted from a contracted and adducted position, resulting in injury patterns. PMID:23707017

  16. Adductor pollicis jamming injuries in the professional baseball player: 2 case reports.

    PubMed

    Altobelli, Grant G; Ruchelsman, David E; Belsky, Mark R; Graham, Thomas; Asnis, Peter; Leibman, Matthew I

    2013-06-01

    We characterize a mechanism of injury, injury pattern, and treatment algorithm for adductor pollicis myotendinous injuries in 2 professional baseball players. Similar to myotendinous eccentric injuries in other anatomical areas, the adductor pollicis sustains a sudden forceful eccentric load during a jammed swing, resulting in intramuscular strain or tendon rupture. Based on the reported injury mechanism, and magnetic resonance imaging features of these myotendinous injuries, the thumb of the top hand during a jammed swing was suddenly and forcefully eccentrically abducted from a contracted and adducted position, resulting in injury patterns.

  17. A Prospective Study of Overuse Knee Injuries Among Female Athletes With Muscle Imbalances and Structural Abnormalities

    PubMed Central

    Pescatello, Linda S.; Faghri, Pouran; Anderson, Jeffrey

    2004-01-01

    Objective: To prospectively examine the influence of hamstring-to-quadriceps (H:Q) ratio and structural abnormalities on the prevalence of overuse knee injuries among female collegiate athletes. Design and Setting: We used chi-square 2 × 2 contingency tables and the Fischer exact test to examine associations among H:Q ratios, structural abnormalities, and overuse knee injuries. Subjects: Fifty-three apparently healthy women (age = 19.4 ± 1.3 years, height = 167.6 ± 10.1 cm, mass = 65.0 ± 10.0 kg) from National Collegiate Athletic Association Division I women's field hockey (n = 23), soccer (n = 20), and basketball teams (n = 10) volunteered. Measurements: The H:Q ratio was determined from a preseason isokinetic test on a Biodex system at 60°/s and 300°/s. We measured athletes for genu recurvatum and Q-angles with a 14-in (35.56-cm) goniometer. Iliotibial band flexibility was assessed via the Ober test. Results: Ten overuse knee injuries (iliotibial band friction syndromes = 5, patellar tendinitis = 3, patellofemoral syndrome = 1, pes anserine tendinitis = 1) occurred in 9 athletes. The H:Q ratio below the normal range at 300°/s (P = 0.047) was associated with overuse knee injuries, as was the presence of genu recurvatum (P = 0.004). In addition, athletes possessing lower H:Q ratios at 300°/s and genu recurvatum incurred more overuse knee injuries than athletes without these abnormalities (P = 0.001). Conclusions: The presence of genu recurvatum and an H: Q ratio below normal range was associated with an increased prevalence of overuse knee injuries among female collegiate athletes. Further investigation is needed to clarify which preseason screening procedures may identify collegiate athletes who are susceptible to overuse knee injuries. PMID:15496997

  18. A Prospective Study of Overuse Knee Injuries Among Female Athletes With Muscle Imbalances and Structural Abnormalities.

    PubMed

    Devan, Michelle R; Pescatello, Linda S; Faghri, Pouran; Anderson, Jeffrey

    2004-09-01

    OBJECTIVE: To prospectively examine the influence of hamstring-to-quadriceps (H:Q) ratio and structural abnormalities on the prevalence of overuse knee injuries among female collegiate athletes. DESIGN AND SETTING: We used chi-square 2 x 2 contingency tables and the Fischer exact test to examine associations among H:Q ratios, structural abnormalities, and overuse knee injuries. SUBJECTS: Fifty-three apparently healthy women (age = 19.4 +/- 1.3 years, height = 167.6 +/- 10.1 cm, mass = 65.0 +/- 10.0 kg) from National Collegiate Athletic Association Division I women's field hockey (n = 23), soccer (n = 20), and basketball teams (n = 10) volunteered. MEASUREMENTS: The H:Q ratio was determined from a preseason isokinetic test on a Biodex system at 60 degrees /s and 300 degrees /s. We measured athletes for genu recurvatum and Q-angles with a 14-in (35.56-cm) goniometer. Iliotibial band flexibility was assessed via the Ober test. RESULTS: Ten overuse knee injuries (iliotibial band friction syndromes = 5, patellar tendinitis = 3, patellofemoral syndrome = 1, pes anserine tendinitis = 1) occurred in 9 athletes. The H:Q ratio below the normal range at 300 degrees /s (P = 0.047) was associated with overuse knee injuries, as was the presence of genu recurvatum (P = 0.004). In addition, athletes possessing lower H:Q ratios at 300 degrees /s and genu recurvatum incurred more overuse knee injuries than athletes without these abnormalities (P = 0.001). CONCLUSIONS: The presence of genu recurvatum and an H: Q ratio below normal range was associated with an increased prevalence of overuse knee injuries among female collegiate athletes. Further investigation is needed to clarify which preseason screening procedures may identify collegiate athletes who are susceptible to overuse knee injuries. PMID:15496997

  19. A Prospective Study of Overuse Knee Injuries Among Female Athletes With Muscle Imbalances and Structural Abnormalities.

    PubMed

    Devan, Michelle R; Pescatello, Linda S; Faghri, Pouran; Anderson, Jeffrey

    2004-09-01

    OBJECTIVE: To prospectively examine the influence of hamstring-to-quadriceps (H:Q) ratio and structural abnormalities on the prevalence of overuse knee injuries among female collegiate athletes. DESIGN AND SETTING: We used chi-square 2 x 2 contingency tables and the Fischer exact test to examine associations among H:Q ratios, structural abnormalities, and overuse knee injuries. SUBJECTS: Fifty-three apparently healthy women (age = 19.4 +/- 1.3 years, height = 167.6 +/- 10.1 cm, mass = 65.0 +/- 10.0 kg) from National Collegiate Athletic Association Division I women's field hockey (n = 23), soccer (n = 20), and basketball teams (n = 10) volunteered. MEASUREMENTS: The H:Q ratio was determined from a preseason isokinetic test on a Biodex system at 60 degrees /s and 300 degrees /s. We measured athletes for genu recurvatum and Q-angles with a 14-in (35.56-cm) goniometer. Iliotibial band flexibility was assessed via the Ober test. RESULTS: Ten overuse knee injuries (iliotibial band friction syndromes = 5, patellar tendinitis = 3, patellofemoral syndrome = 1, pes anserine tendinitis = 1) occurred in 9 athletes. The H:Q ratio below the normal range at 300 degrees /s (P = 0.047) was associated with overuse knee injuries, as was the presence of genu recurvatum (P = 0.004). In addition, athletes possessing lower H:Q ratios at 300 degrees /s and genu recurvatum incurred more overuse knee injuries than athletes without these abnormalities (P = 0.001). CONCLUSIONS: The presence of genu recurvatum and an H: Q ratio below normal range was associated with an increased prevalence of overuse knee injuries among female collegiate athletes. Further investigation is needed to clarify which preseason screening procedures may identify collegiate athletes who are susceptible to overuse knee injuries.

  20. Injuries in a modern dance company effect of comprehensive management on injury incidence and cost.

    PubMed

    Ojofeitimi, Sheyi; Bronner, Shaw

    2011-09-01

    Injury costs strain the finances of many dance companies. The objectives of this study were to analyze the effect of comprehensive management on injury patterns, incidence, and time loss and examine its financial impact on workers compensation premiums in a modern dance company. In this retrospective-prospective cohort study, injury was defined as any physical insult that required financial outlay (workers compensation or self insurance) or caused a dancer to cease dancing beyond the day of injury (time-loss injury). Injury data and insurance premiums were analyzed over an eight-year period. Injuries were compared using a mixed linear model with phase and gender as fixed effects. It was found that comprehensive management resulted in 34% decline in total injury incidence, 66% decrease in workers compensation claims, and 56% decrease in lost days. These outcomes achieved substantial savings in workers compensation premiums. Thus, this study demonstrates the effectiveness of an injury prevention program in reducing injury-related costs and promoting dancers' health and wellness in a modern dance company. PMID:22040757

  1. Descriptive Epidemiology of Musculoskeletal Injuries in the Army 101st Airborne (Air Assault) Division.

    PubMed

    Lovalekar, Mita T; Abt, John P; Sell, Timothy C; Nagai, Takashi; Keenan, Karen; Beals, Kim; Lephart, Scott M; Wirt, Michael D

    2016-08-01

    The purpose of this study was to describe the epidemiology of musculoskeletal injuries among Soldiers of the 101st Airborne (Air Assault) Division. A total of 451 subjects (age: 27.6 ± 6.2 years, gender: males 395/451 = 87.6%) volunteered. Musculoskeletal injury data were extracted from subjects' medical charts and injuries that occurred during 1 year were described. Injury frequency, injury anatomic location and sublocation, injury cause, activity when injury occurred, and injury type were described. Injury frequency was 29.5 injuries per 100 subjects per year. Most injures affected the lower extremity (60.2% of injuries) and common anatomic sublocations for injuries were the ankle (17.3%) and knee (15.0%). Frequent causes of injuries were running (13.5%) and direct trauma (9.0%). Physical training was associated with 29.3% of the injuries. A majority of injuries were classified as pain/spasm/ache (29.3%), without further elucidation of pathology. Other frequent injury types were sprain (21.8%) and strain (14.3%). The descriptive epidemiology of musculoskeletal injuries in this population underscores the need to explore the modifiable risk factors of potentially preventable lower extremity injuries associated with physical training and running. There is scope for the development of an optimized and targeted physical training program for injury prevention in this population.

  2. 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

  3. Injuries in Youth and National Combined Events Championships.

    PubMed

    Edouard, P; Samozino, P; Escudier, G; Baldini, A; Morin, J-B

    2012-10-01

    In major track and field competitions, the most risky discipline is the combined event. Therefore, we aimed to record and analyze the incidence and characteristics of sports injuries incurred during the Youth and National Combined Events Championships. During the French Athletics Combined Events Championships in 2010, all newly occurred injuries were prospectively recorded by the local organising committee of physicians and physiotherapists working in the medical centres at the stadium, in order to determine incidence and characteristics of newly occurred injuries. In total, 51 injuries and 9 time-loss injuries were reported among 107 registered athletes, resulting in an incidence of 477 injuries and 84 time-loss injuries per 1,000 registered athletes. Approximately 72% of injuries affected lower limbs and 60% were caused by overuse. Thigh strain (17.6%) was the most common diagnosis. 14 dropouts were recorded, 8 were caused by an injury (57.1%). During the National and Youth Combined Events Championships, over one third of the registered athletes incurred an injury, with an injury incidence higher than in international elite track and field competitions. Interestingly, this higher injury risk concerned the younger population affecting immature musculoskeletal structures. In combined events, preventive interventions should mainly focus on overuse and thigh injuries. PMID:22562740

  4. Incidence of injury in Texas girls' high school basketball.

    PubMed

    Gomez, E; DeLee, J C; Farney, W C

    1996-01-01

    We studied the incidence of injury in girl's varsity basketball to characterize injury demographics in high school athletics. We defined a reportable injury as one that occurred during organized practice or competition, resulted in either missed practice or game time, required physician consultation, or involved the head or face. We prospectively evaluated the athletes on team rosters during the 1993 to 1994 season from 100 randomly selected Class 4A and 5A Texas public high schools that employed full-time certified athletic trainers. The 890 student athletes from 80 schools ranged in age from 14 to 18 years. Four hundred thirty-six injuries were reported for a rate of 0.49 per athlete per season. Injury risk, calculated on the basis of exposure time, was 0.4% per hour per athlete. Although game time accounted for only 12.5% of exposure time, it represented one half of the total injuries. Sprains and strains (56%) were the most common injuries, followed by contusions (15%) and dental injuries (14%). Injuries to the ankle (31%) and knee (19%) were by far the most common. There were 34 severe injuries defined as requiring surgery or hospitalization, for a rate of 0.038 per athlete per season. Knee injuries were by far the most likely to require surgeries, and ACL injuries accounted for 69% of the severe knee injuries.

  5. Bilateral Simultaneous Anterior Cruciate Ligament Injury: A Case Report and National Survey of Orthopedic Surgeon Management Preference

    PubMed Central

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

    2014-01-01

    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

  6. 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

  7. 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

  8. 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 ...

  9. 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 ...

  10. 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 ...

  11. 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 ...

  12. 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)

  13. 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 ...

  14. 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.

  15. 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

  16. Basketball injuries of the foot and ankle.

    PubMed

    McDermott, E P

    1993-04-01

    Foot and ankle injuries in basketball are discussed in three unrelated categories in this article. This includes a practical differential diagnosis of ankle sprains, acute conditions of the mid and hindfoot, overuse syndromes of nerve entrapment, fascial strain, synovitis, joint subluxation, and inflammation resulting from repetitive stress. The diagnosis and treatment of tendon inflammation of the extrinsic foot musculature is also reviewed.

  17. Basketball Injuries: An Overview.

    ERIC Educational Resources Information Center

    Apple Jr., David F.

    1988-01-01

    This article discusses reasons for the increase in basketball-related injuries, describes common injuries, outlines steps for diagnosis and treatment, and offers recovery and prevention strategies. (IAH)

  18. Baseball and softball injuries.

    PubMed

    Wang, Quincy

    2006-05-01

    Baseball and softball injuries can be a result of both acute and overuse injuries. Soft tissue injuries include contusions, abrasions, and lacerations. Return to play is allowed when risk of further injury is minimized. Common shoulder injuries include those to the rotator cuff, biceps tendon, and glenoid labrum. Elbow injuries are common in baseball and softball and include medial epicondylitis, ulnar collateral ligament injury, and osteochondritis dissecans. Typically conservative treatment with relative rest, medication, and a rehabilitation program will allow return to play. Surgical intervention may be needed for certain injuries or conservative treatment failure.

  19. Age and competition level on injuries in female ice hockey.

    PubMed

    Keightley, M; Reed, N; Green, S; Taha, T

    2013-08-01

    The objective of this study was to describe the number, types and locations of known injuries occurring across different age categories and levels of competition in female ice hockey within the Ontario Women's Hockey Association from 2004/05 to 2007/08. We further examined under which aforementioned factors and combination of factors an unusually high or low number of injuries was recorded. Secondary analysis of anonymized injury data was conducted. The most common known injury type was strain/sprain, followed by concussion while the most frequent injury location was head/face/mouth. Analysis of deviance indicated that a significantly higher than expected number of sprain/strain, concussion and laceration injuries were recorded compared to all other injury types. In addition, there were a higher number of injuries recorded at the AA level compared to all other levels of competition. Finally, the age categories of Peewee, Midget and Intermediate within the AA level of competition, as well as Senior/Adult within the Houseleague level of competition also recorded a significantly higher number of injuries compared to other combinations of descriptive factors. Further research with female youth is needed to better understand the high number of injuries, including concussions, reported overall. PMID:23516144

  20. Sports injuries of the ear.

    PubMed

    Wagner, G A

    1972-07-01

    The author describes common sports injuries involving the ear. Such injuries include hematoma, lacerations, foreign bodies (tattoo), and thermal injuries. Ear canal injuries include swimmer's ear and penetrating injuries. Tympanum injuries include tympanic membrane perforations, ossicular discontinuity, eustachian tube dysfunction, temporal bone fractures and traumatic facial nerve palsy. Inner ear injuries include traumatic sensorineural deafness. The author emphasizes the management of these injuries.

  1. 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

  2. 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.

  3. 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.

  4. 38 CFR 4.58 - Arthritis due to strain.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... arthritis in the joints directly subject to strain. Amputation, or injury to an upper extremity, is not..., arthritis in the injured extremity, including also arthritis of the lumbosacral joints and lumbar spine, if..., that arthritis affecting joints not directly subject to strain as a result of the service...

  5. 38 CFR 4.58 - Arthritis due to strain.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... arthritis in the joints directly subject to strain. Amputation, or injury to an upper extremity, is not..., arthritis in the injured extremity, including also arthritis of the lumbosacral joints and lumbar spine, if..., that arthritis affecting joints not directly subject to strain as a result of the service...

  6. 38 CFR 4.58 - Arthritis due to strain.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... arthritis in the joints directly subject to strain. Amputation, or injury to an upper extremity, is not..., arthritis in the injured extremity, including also arthritis of the lumbosacral joints and lumbar spine, if..., that arthritis affecting joints not directly subject to strain as a result of the service...

  7. 38 CFR 4.58 - Arthritis due to strain.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... arthritis in the joints directly subject to strain. Amputation, or injury to an upper extremity, is not..., arthritis in the injured extremity, including also arthritis of the lumbosacral joints and lumbar spine, if..., that arthritis affecting joints not directly subject to strain as a result of the service...

  8. 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

  9. Nutrition, illness, and injury in aquatic sports.

    PubMed

    Pyne, David B; Verhagen, Evert A; Mountjoy, Margo

    2014-08-01

    In this review, we outline key principles for prevention of injury and illness in aquatic sports, detail the epidemiology of injury and illness in aquatic athletes at major international competitions and in training, and examine the relevant scientific evidence on nutrients for reducing the risk of illness and injury. Aquatic athletes are encouraged to consume a well-planned diet with sufficient calories, macronutrients (particularly carbohydrate and protein), and micronutrients (particularly iron, zinc, and vitamins A, D, E, B6, and B12) to maintain health and performance. Ingesting carbohydrate via sports drinks, gels, or sports foods during prolonged training sessions is beneficial in maintaining energy availability. Studies of foods or supplements containing plant polyphenols and selected strains of probiotic species are promising, but further research is required. In terms of injury, intake of vitamin D, protein, and total caloric intake, in combination with treatment and resistance training, promotes recovery back to full health and training.

  10. 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

  11. Injury surveillance in construction: eye injuries.

    PubMed

    Welch, L S; Hunting, K L; Mawudeku, A

    2001-07-01

    Occupational eye injuries are both common and preventable. About 20% of occupational eye injuries occur in construction. To investigate the nature of eye injuries among construction workers, we analyzed a large data set of construction worker injuries. In addition, we interviewed 62 workers with eye injuries to further explore circumstances of eye injury and workers' attitudes and behavior toward the use of eye protection. Eleven percent (363 cases) of the 3,390 construction workers in our data set were treated for eye injuries. Welders, plumbers, insulators, painters/glaziers, supervisors, and electricians had a higher proportion of all injuries due to eye injuries than other trades. Nearly half of the diagnoses were abrasions (46%) followed by foreign objects or splash in the eye (29%), conjunctivitis (10%), and burns (5%). In the interviews with 62 workers, we found that employers very frequently required eye protection for all tasks or for high-risk tasks, and workers report wearing eye protection regularly. However, most did not wear eye protection with top and side shields; if we believe the injuries occurred because a particle or liquid passed between the glasses and the workers' faces, increased use of goggles or full shields would have prevented two-thirds of this group of injuries.

  12. 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

  13. 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…

  14. Sports-specific injuries.

    PubMed

    Plancher, K D; Minnich, J M

    1996-04-01

    Injuries to the upper extremities can happen in any sport. Injury patterns are common to specific sports. Understanding which injuries occur with these sports allows the examiner to diagnose and treat the athlete easily. This article reviews some of the injuries common in sports such as bicycling, golf, gymnastics, martial arts, racquet sports, and weightlifting.

  15. The influence of hamstring autograft size on patient reported outcomes and risk of revision following anterior cruciate ligament reconstruction: A MOON cohort study

    PubMed Central

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

    2013-01-01

    Purpose The purpose of this study is to evaluate the effect of graft size on patient-reported outcomes and revision risk following ACL reconstruction. Methods A retrospective chart review of prospectively collected cohort data, 263 of 320 consecutive patients (82.2%) undergoing primary ACL reconstruction with hamstring autograft were evaluated. Graft size, femoral tunnel drilling technique, patient age, sex, and BMI at the time of ACL reconstruction, pre-operative and 2-year post-operative KOOS and IKDC scores, and whether each patient underwent revision ACL reconstruction during the 2 year follow-up period were recorded. Revision was used as a marker for graft failure. The relationship between graft size and patient-reported outcomes was determined by multiple linear regression. The relationship between graft size and risk of revision was determined by dichotomizing graft size at 8mm and stratifying by age. Results After controlling for age, sex, operative side, surgeon, BMI, graft choice, and femoral tunnel drilling technique, a 1 mm increased in graft size was noted to correlate with 3.3-point increase in the KOOS-pain subscale (p = 0.003), a 2.0-point increased in the KOOS activities of daily living subscale (p = 0.034), a 5.2-point increase in the KOOS-sport/recreation function subscale (p = 0.004), and a 3.4-point increase in the subjective IKDC score (p = 0.026). Revision was required in 0 of 64 patients (0.0%) with grafts greater than 8mm in diameter and 14 of 199 patients (7.0%) with 8 mm or smaller grafts (p = 0.037). Among patients age 18 and under, revision was required in 0 of 14 patients (0.0%) with grafts greater than 8mm in diameter and 13 of 71 patients (18.3 %) with 8 mm or smaller grafts. Conclusions Smaller hamstring autograft size is a predictor of poorer KOOS Sport and Recreation function 2 years following primary ACL reconstruction. Larger sample size is required to confirm the relationship between graft size and risk of revision ACL

  16. Absolute reliability of hamstring to quadriceps strength imbalance ratios calculated using peak torque, joint angle-specific torque and joint ROM-specific torque values.

    PubMed

    Ayala, F; De Ste Croix, M; Sainz de Baranda, P; Santonja, F

    2012-11-01

    The main purpose of this study was to determine the absolute reliability of conventional (H/Q(CONV)) and functional (H/Q(FUNC)) hamstring to quadriceps strength imbalance ratios calculated using peak torque values, 3 different joint angle-specific torque values (10°, 20° and 30° of knee flexion) and 4 different joint ROM-specific average torque values (0-10°, 11-20°, 21-30° and 0-30° of knee flexion) adopting a prone position in recreational athletes. A total of 50 recreational athletes completed the study. H/Q(CONV) and H/Q(FUNC) ratios were recorded at 3 different angular velocities (60, 180 and 240°/s) on 3 different occasions with a 72-96 h rest interval between consecutive testing sessions. Absolute reliability was examined through typical percentage error (CVTE), percentage change in the mean (CM) and intraclass correlations (ICC) as well as their respective confidence limits. H/Q(CONV) and H/Q(FUNC) ratios calculated using peak torque values showed moderate reliability values, with CM scores lower than 2.5%, CV(TE) values ranging from 16 to 20% and ICC values ranging from 0.3 to 0.7. However, poor absolute reliability scores were shown for H/Q(CONV) and H/Q(FUNC) ratios calculated using joint angle-specific torque values and joint ROM-specific average torque values, especially for H/Q(FUNC) ratios (CM: 1-23%; CV(TE): 22-94%; ICC: 0.1-0.7). Therefore, the present study suggests that the CV(TE) values reported for H/Q(CONV) and H/Q(FUNC) (≈18%) calculated using peak torque values may be sensitive enough to detect large changes usually observed after rehabilitation programmes but not acceptable to examine the effect of preventitive training programmes in healthy individuals. The clinical reliability of hamstring to quadriceps strength ratios calculated using joint angle-specific torque values and joint ROM-specific average torque values are questioned and should be re-evaluated in future research studies.

  17. 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.

  18. Eye injuries in childhood.

    PubMed

    Grin, T R; Nelson, L B; Jeffers, J B

    1987-07-01

    A 3-year survey was conducted of all children with eye injuries admitted to Wills Eye Hospital to determine demographic, etiologic, and prophylactic factors. There were 278 cases, representing 22% of all ocular injuries in children requiring admission. The frequency of childhood ocular injuries is high, often resulting in serious visual impairment. Many of these injuries are preventable. The causes of pediatric eye injuries and preventive measures are discussed.

  19. Pediatric Hand Injuries.

    PubMed

    Sullivan, Matthew A; Cogan, Charles J; Adkinson, Joshua M

    2016-01-01

    Pediatric hand injuries are extremely common. Although many hand injuries are adequately managed in the emergency department, some may need evaluation and treatment by a pediatric hand surgeon to ensure a good functional outcome. This article discusses the diagnosis and management of the most common pediatric hand maladies: fingertip injuries/amputation, tendon injuries, and phalangeal and metacarpal fractures. The plastic surgery nurse should be familiar with hand injuries that require intervention to facilitate efficient management and optimal postoperative care. PMID:27606586

  20. Assessment of injuries sustained in mixed martial arts competition.

    PubMed

    Scoggin, James F; Brusovanik, Georgiy; Pi, Michael; Izuka, Byron; Pang, Pierre; Tokumura, Seren; Scuderi, Gaetano

    2010-05-01

    Mixed martial arts (MMA) competitions have gained much popularity, and the sport is watched by many millions annually. Despite ongoing controversy, there have been no objective studies of the injuries sustained in MMA based on on-site evaluation. In the study reported in this article, we attempted to delineate injury patterns for MMA participants. We conducted an observational cohort study of MMA competitions held in Hawaii between 1999 and 2006. The study included 116 bouts, involving 232 "exposures" and 179 male participants between ages 18 and 40. All the fighters were examined by 1 of 4 physicians, both before and after each bout. Fighters were referred to an emergency department when necessary, and follow-up was recommended as needed. Among the 232 exposures were 55 injuries: 28 abrasions and lacerations (6 requiring on-site suturing or referral to an emergency department for suturing), 11 concussions (4 with retrograde amnesia), 5 facial injuries (2 nasal fractures, 1 tympanum rupture, 1 temporomandibular joint sprain, 1 Le Fort fracture), and 11 orthopedic injuries (3 metacarpal injuries, with 1 confirmed fracture; 1 acromioclavicular separation; 1 traumatic olecranon bursitis; 1 elbow subluxation; 1 midfoot sprain; 1 aggravation of elbow medial collateral ligament sprain; 1 elbow lateral collateral ligament strain; 1 trapezius strain; 1 Achilles tendon contusion). We describe the injuries sustained in MMA competition to make comparisons with other sports. We discuss distribution and mechanism of injuries as well as injury incidence based on on-site evaluation in MMA. PMID:20567743

  1. Assessment of injuries sustained in mixed martial arts competition.

    PubMed

    Scoggin, James F; Brusovanik, Georgiy; Pi, Michael; Izuka, Byron; Pang, Pierre; Tokumura, Seren; Scuderi, Gaetano

    2010-05-01

    Mixed martial arts (MMA) competitions have gained much popularity, and the sport is watched by many millions annually. Despite ongoing controversy, there have been no objective studies of the injuries sustained in MMA based on on-site evaluation. In the study reported in this article, we attempted to delineate injury patterns for MMA participants. We conducted an observational cohort study of MMA competitions held in Hawaii between 1999 and 2006. The study included 116 bouts, involving 232 "exposures" and 179 male participants between ages 18 and 40. All the fighters were examined by 1 of 4 physicians, both before and after each bout. Fighters were referred to an emergency department when necessary, and follow-up was recommended as needed. Among the 232 exposures were 55 injuries: 28 abrasions and lacerations (6 requiring on-site suturing or referral to an emergency department for suturing), 11 concussions (4 with retrograde amnesia), 5 facial injuries (2 nasal fractures, 1 tympanum rupture, 1 temporomandibular joint sprain, 1 Le Fort fracture), and 11 orthopedic injuries (3 metacarpal injuries, with 1 confirmed fracture; 1 acromioclavicular separation; 1 traumatic olecranon bursitis; 1 elbow subluxation; 1 midfoot sprain; 1 aggravation of elbow medial collateral ligament sprain; 1 elbow lateral collateral ligament strain; 1 trapezius strain; 1 Achilles tendon contusion). We describe the injuries sustained in MMA competition to make comparisons with other sports. We discuss distribution and mechanism of injuries as well as injury incidence based on on-site evaluation in MMA.

  2. Robust human body model injury prediction in simulated side impact crashes.

    PubMed

    Golman, Adam J; Danelson, Kerry A; Stitzel, Joel D

    2016-01-01

    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). T