scholarly journals REDUCTION IN KNEE PAIN SYMPTOMS IN ATHLETES USING AN ACUPUNCTURE PROTOCOL

2018 ◽  
Vol 26 (6) ◽  
pp. 418-422 ◽  
Author(s):  
Ana Paula Rehme Siqueira ◽  
Lucas Menghin Beraldo ◽  
Eddy Krueger ◽  
Leandra Ulbricht
Keyword(s):  
Knee Pain ◽  
Vastus Lateralis ◽  
Case Series ◽  
Rectus Femoris ◽  
Motor Units ◽  
Lower Limbs ◽  
Limiting Factor ◽  
Level Of Evidence ◽  
Positive Effects ◽  
Pain Symptoms

ABSTRACT Pain in the lower limbs is common in athletes and a limiting factor in performance. Acupuncture has shown positive effects as an analgesic treatment and may potentially be used for pain reduction in runners. This study aimed to analyze the parameters associated with knee pain by correlating strength parameters of the musculature assessed in runners treated with acupuncture. A descriptive longitudinal study was conducted on 34 runners of both sexes aged 20 to 52 years, who presented with knee-related pain from January to June, 2015. Two pain questionnaires and a maximal strength test with electromyographic evaluation of the rectus femoris, vastus lateralis, and medialis muscles were used, and patients were monitored during five follow-up visits after an acupuncture protocol. All participants reported experiencing a decrease in knee pain after treatment. The affected limbs showed an increase in average strength by 34% and 25% compared to the contralateral limb. An increase in the number of motor units recruited for the three muscles was observed in both limbs. In conclusion, the proposed acupuncture protocol was effective in reducing pain symptoms in the knee region of athletes, thus influencing their gain in strength and muscle balance. Level of Evidence IV, Case series.

scholarly journals Magnetic Resonance Imaging Appearance of the Hip Musculature After Arthroscopic Labral-Level Iliopsoas Tenotomies

2017 ◽  
Vol 5 (5) ◽  
pp. 232596711770749 ◽  
Author(s):  
Brian E. Walczak ◽  
Donna G. Blankenbaker ◽  
Michael R. Tuite ◽  
James S. Keene
Keyword(s):  
Magnetic Resonance ◽  
Muscle Atrophy ◽  
Vastus Lateralis ◽  
Fatty Infiltration ◽  
Case Series ◽  
Psoas Muscle ◽  
Gluteus Maximus ◽  
Rectus Femoris ◽  
Low Grade ◽  
Level Of Evidence

Background: Iliopsoas (IP) muscle atrophy is a known consequence of open IP tenotomy, but the severity of IP muscle atrophy that occurs after arthroscopic labral-level IP tenotomies has not been documented. Purpose: To document the severity of muscle atrophy that occurs in the iliacus, psoas, and adjacent hip musculature after arthroscopic labral-level IP tenotomy. Study Design: Case series; Level of evidence, 4. Methods: Twenty-eight patients who had magnetic resonance arthrograms (MRAs) obtained prior to and 3 months to 5 years after arthroscopic labral-level IP tenotomies are the basis of this report. The pre- and postoperative MRAs of each patient were examined in consensus by 2 musculoskeletal radiologists who graded the postoperative muscle atrophy from 0 (no fatty infiltration) to 4 (>75% fatty infiltration) and noted any compensatory muscle hypertrophy or abnormal IP tendon morphology. Patients also were assessed with the Byrd 100-point modified Harris Hip Scoring system (MHHS) preoperatively and at the time of their postoperative MRA. Results: Postoperative MRAs were obtained on average 1.7 years (range, 3 months to 5 years) after hip arthroscopy. None of the patients had muscle atrophy on their preoperative MRAs. In contrast, 89% of patients had iliacus and psoas muscle atrophy on their postoperative MRAs, but only 2 (7%) developed grade 4 atrophy, and the majority (64%) had either grade 1 (n = 15) or no atrophy (n = 3). In addition, there were no significant differences in the MHHS of the patients with mild (grades 0-1), moderate (grades 2-3), or severe (grade 4) postoperative atrophy. Postoperative MRAs also demonstrated low-grade atrophy (grades 1-2) in the quadratus femoris (n = 5) and rectus femoris (n = 1) muscles, and 16 patients (57%) had distortion of the tendon, but none had a gap in their tendon. Conclusion: A majority of patients (89%) developed IP muscle atrophy after arthroscopic labral-level IP tenotomies, and although this percentage was similar (89% vs 90%) to that reported with lesser trochanteric IP tenotomies, the patients did not (1) develop atrophy of the gluteus maximus and vastus lateralis muscles, (2) have chronic IP tendon disruption, or (3) develop the severity of IP atrophy (55% grade 4 vs 7% grade 4) that has been reported after arthroscopic lesser trochanteric IP tenotomies.

Congenital internal rotation deformity of the distal femur presenting as patellofemoral instability and pain

2019 ◽  
Vol 4 (2) ◽  
pp. 93-97 ◽  
Author(s):  
Xinyuan Zhang ◽  
John Attenello ◽  
Marc R Safran ◽  
David W Lowenberg
Keyword(s):  
Internal Rotation ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
Distal Femur ◽  
Case Series ◽  
Patellofemoral Instability ◽  
Level Of Evidence ◽  
Femoral Antetorsion ◽  
Derotational Osteotomy ◽  
Anterior Knee

ObjectivesFemoral antetorsion, defined as the angle of rotation of the femoral head and neck axis in relation to the transcondylar axis of the distal femur, is a cause for patellofemoral instability and anterior knee pain. Most clinical reports do not distinguish between antetorsion of the femur distal to the isthmus and anteversion of the proximal femur, which is another cause of femoral internal rotational deformity.MethodsThis retrospective observational case series evaluated four cases in three female patients who underwent evaluation of surgical intervention for chronic anterior knee pain since childhood. Physical examination and radiographic images supported the diagnosis of internal rotation deformity at the distal femora in all four cases. Distal femoral derotational osteotomy of 45°, 60° and 30° were performed, respectively. Kujala scoring system for patellofemoral pathology was used to assess the change in knee symptoms before and after the osteotomies.ResultsThis study demonstrated successful treatment of the resultant knee symptoms from femoral antetorsion with distal femur derotational osteotomy in all three patients.ConclusionsPatellofemoral syndrome is multifactorial, and the true anatomic reason for each patient’s individual pathology must be determined before surgery proceeds.Level of evidenceLevel V.

Popliteomeniscal Fascicle Tears Causing Symptomatic Lateral Compartment Knee Pain

2005 ◽  
Vol 33 (8) ◽  
pp. 1231-1236 ◽  
Author(s):  
Robert F. LaPrade ◽  
Brian K. Konowalchuk
Keyword(s):  
Physical Examination ◽  
Knee Pain ◽  
Open Repair ◽  
Lateral Meniscus ◽  
Case Series ◽  
Lateral Compartment ◽  
Level Of Evidence ◽  
Arthroscopic Examination ◽  
Examination Techniques

Background Injuries to the popliteomeniscal fascicles of the lateral meniscus are difficult to identify from physical examination and magnetic resonance imaging scans. To our knowledge, there have been no described physical examination techniques to identify symptomatic isolated popliteomeniscal fascicle tears. The popliteomeniscal fascicles have been demonstrated to be important for lateral meniscus stability, and it has been reported that tears can lead to painful symptoms. Hypothesis Popliteomeniscal fascicle tears cause symptomatic lateral compartment knee pain and can be diagnosed by physical examination. Surgical repair can improve patient function. Study Design Case series; Level of evidence, 4. Methods Six patients with isolated tears of the popliteomeniscal fascicles, which caused lateral joint line knee pain, were identified by positive figure-4 test results. Results All patients were found to have replication of their symptoms while placing the affected knee in the figure-4 position and were found to have lateral meniscal hypermobility due to tears of the popliteomeniscal fascicles on arthroscopic examination. All patients had an open repair of the popliteomeniscal fascicles of the lateral meniscus with complete resolution of their symptoms at a mean follow-up of 3.8 years postoperatively. Conclusions The figure-4 test was found to be useful in identifying the source of lateral compartment knee pain due to popliteomeniscal fascicle tears. Open repair of isolated popliteomeniscal fascicle tears was also found to be effective in resolving lateral compartment knee pain due to popliteomeniscal fascicle tears.

scholarly journals The Relationship Between Additional Heads of the Quadriceps Femoris, the Vasti Muscles and the Patellar Ligament

2021 ◽  
Author(s):  
Łukasz Olewnik ◽  
Kacper Ruzik ◽  
Bartłomiej Szewczyk ◽  
Michał Podgórski ◽  
Paloma Aragonés ◽  
...  
Keyword(s):  
Vastus Lateralis ◽  
Rectus Femoris ◽  
Quadriceps Femoris ◽  
The Other ◽  
Lower Limbs ◽  
Patellar Ligament ◽  
Vastus Medialis ◽  
Vastus Intermedius ◽  
Deep Layers ◽  
The Relationship

Abstract Introduction: The quadriceps femoris consists of four muscles: the rectus femoris, vastus medialis, vastus intermedius and vastus lateralis. However, the effect of additional quadriceps femoris heads on the vasti muscles and patellar ligaments is unknown.Materials and Methods: One hundred and six lower limbs (34 male and 19 female cadavers) fixed in 10% formalin were examined.Results: On all lower extremities, the vastus lateralis consisted of superficial, intermediate and deep layers. The vastus medialis, on the other hand, consisted of only the longus and obliquus layers. Additional quadriceps femoris heads affected both the vasti muscles and the patellar ligaments.Conclusion: There is a strong correlation between the presence of accessory quadriceps femoris heads and effects on vasti muscles and patellar ligament.

scholarly journals Functional assessment of muscle response in lower limbs of tumbling gymnasts through tensiomyography

2016 ◽  
Vol 64 (3) ◽  
pp. 505
Author(s):  
Nicolás Rojas-Barrionuevo ◽  
Mercedes Vernetta-Santana ◽  
Jesús López-Bedoya
Keyword(s):  
Delay Time ◽  
High Performance ◽  
Vastus Lateralis ◽  
Rectus Femoris ◽  
Response Speed ◽  
Biceps Femoris ◽  
Lower Limbs ◽  
Muscle Response ◽  
Antagonist Muscles ◽  
Before And After

Introduction: Jumping capacity, a distinctive technical skill of tumbling gymnasts, is associated to a successful performance in training and competition; hence the need for an individualized, precise and localized assessment of the most demanded muscle structures.Objective: To assess muscle response of the flexo-extension structure in the knee joint and the extension of the ankle joint in a sample of 12 high-performance male gymnasts.Materials and methods: An acrobatic training protocol including sets of forward somersault in tumbling track was conducted. The contraction time, delay time and deformation of muscle belly were evaluated, and the muscular response speed was calculated using tensiomyography before and after the training intervention in different periods of time.Results: Significant differences were found (p<0.05) according to the muscle group involved, where rectus femoris and biceps femoris presented greater enhancement and shortening of the contraction and delay time. Major differences appeared between agonist-antagonist muscles (vastus lateralis-biceps femoris) (p<0.05) due to a decrease in the contraction and delay speed in vastus medialis (p<0.001).Conclusions: Tensiomyography allows estimating the states of activation-enhancing of the musculature responsible of jumping in tumblers, as well as planning the training based on the state of muscle fatigue.

scholarly journals INCIDENCE OF INJURIES IN SOCCER PLAYERS – MAPPINGFOOT: A PROSPECTIVE COHORT STUDY

2021 ◽  
Vol 27 (2) ◽  
pp. 189-194
Author(s):  
Felix Albuquerque Drummond ◽  
Douglas dos Santos Soares ◽  
Hélder Gabriel Rodrigues da Silva ◽  
Denise Entrudo ◽  
Sohaila Dalbianco Younes ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Body Part ◽  
The Body ◽  
Lower Limbs ◽  
Level Of Evidence ◽  
Male Athletes ◽  
Positive Effects ◽  
Professional Soccer

ABSTRACT Introduction: Although the positive effects of physical activity on global health are well documented, sports practice is associated with a greater risk of injury; in professional soccer in particular, the risk is substantial. Objective: The primary objective of this study was to investigate the incidence of injuries among male athletes competing in the regional soccer championship. The secondary objective was to determine the prevalence of injuries. Methods: In this prospective cohort study, level of evidence II, the incidence and prevalence of injuries were assessed using an adapted version of the UEFA Champions League Study questionnaire. Results: This study included 310 male athletes from ten teams, aged 26.53±4.75 years, height 180.93±6.49 cm, and weight 79.32±8.29 kg, with a 4-month follow-up. Ninety-two injuries were recorded, representing a prevalence of 29.68% injuries. The body part most frequently injured was the lower limbs (86.9%). The main types of injuries were muscle tear/strain (37.0%), sprain/ligament (19.6%), and other injuries (14.1%). The injuries were mainly caused during run/sprint (33.7%), kick (12.0%) and jumping/landing (6.5%). The incidences of injuries were 15.88±8.57, 2.04±1.09, and 3.65±1.50 injuries/1000h of exposure during matches, training, and matches/training, respectively. Time-loss over the season was between 1 and 50 days, and the severity of the injuries was as follows: light (25%), minor (22.8%), moderate (43.5%) and severe (8.7%). Conclusion: This study suggests that there is a higher incidence of injuries during matches compared to training, among male regional soccer championship players. The lower limbs are the body part most affected, with a higher prevalence of rupture/strain in the thigh region, during running/sprinting. Level of evidence II; Prospective Cohort Study .

scholarly journals Electromyographic evaluation of the lower limbs of patients with Down syndrome in hippotherapy

2017 ◽  
Vol 39 (1) ◽  
pp. 17 ◽  
Author(s):  
Mariane Fernandes Ribeiro ◽  
Ana Paula Espindula ◽  
Alex Abadio Ferreira ◽  
Luciane Aparecida Pascucci Sande de Souza ◽  
Vicente De Paula Antunes Teixeira
Keyword(s):  
Down Syndrome ◽  
Muscle Activation ◽  
Motor Behavior ◽  
Vastus Lateralis ◽  
Rectus Femoris ◽  
Gluteus Medius ◽  
Biceps Femoris ◽  
Functional Results ◽  
Lower Limbs ◽  
Tensor Fasciae Latae

Hippotherapy is a therapeutic method that uses the horse’s movement to achieve functional results in practitioners with Down syndrome (DS), who present motor and neurophysiological changes that affect the musculoskeletal system. Evaluating the motor behavior related to the control and the improvement of muscle activation in practitioners with Down syndrome subjected to hippotherapy. 10 practitioners were divided into two groups: Down Group (DG) – practitioners with DS, and Healthy Group (HG) – practitioners with no physical impairment. The muscles gluteus medius, tensor fasciae latae, rectus femoris, vastus medialis, vastus lateralis, biceps femoris, tibialis anterior and gastrocnemius were evaluated by electromyography using gross RMS values, which correspond to muscle activation; the evaluations were performed on the 1st and 10th hippotherapy sessions (frequency: once a week), and after 2 months interval without treatment, they were performed on the 1st and 10th hippotherapy sessions (frequency: twice a week). It was noted that activation of the studied muscles increased with the passing of sessions, regardless the weekly frequency of attendance; however, the period without treatment resulted in reduction of this effect. Practitioners with DS presented satisfactory changes in muscle activation pattern, in learning and in motor behavior during hippotherapy sessions. 

scholarly journals Surgical Management of Rectus Femoris Avulsion Among Professional Soccer Players

2017 ◽  
Vol 5 (1) ◽  
pp. 232596711668394 ◽  
Author(s):  
Bertrand Sonnery-Cottet ◽  
Nuno Camelo Barbosa ◽  
Sanesh Tuteja ◽  
Roland Gardon ◽  
Matt Daggett ◽  
...  
Keyword(s):  
Case Series ◽  
Rectus Femoris ◽  
Quadriceps Strength ◽  
Return To Play ◽  
Suture Repair ◽  
Return To Sports ◽  
Level Of Evidence ◽  
Professional Soccer ◽  
Isokinetic Test

Background: Rectus femoris injuries are common among athletes, especially in kicking sports such as soccer; however, proximal rectus femoris avulsions in athletes are a relatively rare entity. Purpose/Hypothesis: The purpose of this study was to describe and report the results of an original technique of surgical excision of the proximal tendon remnant followed by a muscular suture repair. Our hypothesis was that this technique limits the risk of recurrence in high-level athletes and allows for rapid recovery without loss of quadriceps strength. Study Design: Case series; Level of evidence, 4. Methods: Our retrospective series included 5 players aged 31.8 ± 3.9 years with acute proximal rectus femoris avulsion injuries who underwent a surgical resection of the proximal tendon between March 2012 and June 2014. Four of these players had recurrent rectus femoris injuries in the 9 months before surgery, while 1 player had surgery after a first injury. Mean follow-up was 18.2 ± 12.6 months, and minimum follow-up was 9 months. We analyzed the age, sex distribution, physical examination outcomes, type and mechanism of injury, diagnosis, treatment and complications during surgery, postoperative follow-up, and time to return to play. The Lower Extremity Functional Scale (LEFS) and Marx scores were obtained at 3-month follow-up, and isokinetic tests were performed before return to sports. A telephone interview was completed to determine the presence of recurrence at an average follow-up of 18.2 months. Results: At 3-month follow-up, all patients had Marx activity scores of 16 and LEFS scores of 80. Return to the previous level of play occurred at a mean of 15.8 ± 2.6 weeks after surgery, and none of the athletes suffered a recurrence. Isokinetic test results were comparable between both sides. Conclusion: The surgical treatment of proximal rectus femoris avulsions, consisting of resection of the tendinous part of the muscle, is a reliable and safe technique allowing a fast recovery in professional athletes.

scholarly journals EFFECTS OF TRADITIONAL STRENGTH TRAINING AND OLYMPIC WEIGHTLIFTING IN HANDBALL PLAYERS

2019 ◽  
Vol 25 (3) ◽  
pp. 230-234
Author(s):  
Bárbara Slovak ◽  
Leandro Carvalho ◽  
Fernando Rodrigues ◽  
Paulo Costa Amaral ◽  
Deborah Duarte Palma ◽  
...  
Keyword(s):  
Strength Training ◽  
Vastus Lateralis ◽  
Vertical Jump ◽  
Gluteus Maximus ◽  
Rectus Femoris ◽  
Biceps Femoris ◽  
Level Of Evidence ◽  
Jump Performance ◽  
Plyometric Exercise ◽  
Regular Training

ABSTRACT Introduction Olympic weightlifting has been adopted as an alternative to plyometric exercise. However, the effects of these exercises in young handball athletes is not known. Objective To compare the effect of Olympic weightlifting training with traditional strength training on jumping, squatting and acceleration performance in young handball athletes. Ten female handball athletes were evaluated. After six weeks of regular training, the athletes underwent eight weeks of training specifically designed for the survey, with equivalence of the total volume of training and differences in the means used. The evaluations were performed after six weeks of regular training (Baseline), after four weeks of traditional strength training and after four weeks of Olympic weightlifting. Vertical Jumps with and without movement of the arms, acceleration of 10 m, 20 m and 30 m, and 1RM in squatting were quantified. Results Increases (p<0.05) were observed in accelerations and squatting in the Olympic weightlifting and in squatting in the traditional strength training. Differences in coordination, time to activation of the gastrocnemius, vastus lateralis, rectus femoris, biceps femoris and gluteus maximus, peak force and power and rate of force development between the jumps and exercises used in the training are hypotheses to be considered for the different responses adaptations found in the jumps. Conclusion The Olympic weightlifting training resulted in an increase in accelerations and strength, but not in vertical jump performance in young handball athletes. Level of Evidence I; Prognostic Studies - Investigation of the Effect of a Patient Characteristic on Disease Outcome.

scholarly journals Adaptation of balance reactions following forward perturbations in people with joint hypermobility syndrome

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Alexander Vernon Bates ◽  
Alison McGregor ◽  
Caroline M. Alexander
Keyword(s):  
Balance Control ◽  
Vastus Lateralis ◽  
Rectus Femoris ◽  
Gluteus Medius ◽  
Joint Hypermobility ◽  
Lower Limbs ◽  
Hypermobility Syndrome ◽  
Joint Hypermobility Syndrome ◽  
Time To Peak ◽  
Heritable Disorder

Abstract Background Joint Hypermobility Syndrome (JHS) is a Heritable Disorder of Connective tissue characterised by joint laxity and chronic widespread arthralgia. People with JHS exhibit a range of other symptoms including balance problems. To explore balance further, the objective of this study is to compare responses to forward perturbations between three groups; people who are hypermobile with (JHS) and without symptoms and people with normal flexibility. Methods Twenty-one participants with JHS, 23 participants with Generalised Joint Hypermobility (GJH) and 22 participants who have normal flexibility (NF) stood on a platform that performed 6 sequential, sudden forward perturbations (the platform moved to the anterior to the participant). Electromyographic outcomes (EMG) and kinematics for the lower limbs were recorded using a Vicon motion capture system. Within and between group comparisons were made using Kruskal Wallis tests. Results There were no significant differences between groups in muscle onset latency. At the 1st perturbation the group with JHS had significantly longer time-to-peak amplitude than the NF group in tibialis anterior, vastus medialis, rectus femoris, vastus lateralis, and than the GJH group in the gluteus medius. The JHS group showed significantly higher cumulative joint angle (CA) than the NF group in the hip and knee at the 1st and 2nd and 6th perturbation, and in the ankle at the 2nd perturbation. Participants with JHS had significantly higher CA than the GJH group at the in the hip and knee in the 1st and 2nd perturbation. There were no significant differences in TTR. Conclusions The JHS group were able to normalise the timing of their muscular response in relation to control groups. They were less able to normalise joint CA, which may be indicative of impaired balance control and strength, resulting in reduced stability.

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