This document discusses return to sport criteria and rehabilitation protocols for acute hamstring strains, noting that criteria should include measures of strength, range of motion, neuromuscular control and readiness, and that eccentric strengthening can help prevent reinjury for chronic or recurrent strains. Guidelines are proposed focusing on a progressive agility program without stretching to regain strength and function before clearing for full sport activity.
This document discusses tendinopathy injuries in football/soccer players. It provides epidemiological data showing that tendinopathy represents 6% of injuries in football, with patellar and Achilles tendinopathy being most common. Two case studies from FC Barcelona are presented: [1] A 26-year-old defender who was treated with injections and eccentric exercises for jumper's knee and returned to play with mild pain; [2] A 22-year-old striker undergoing an eccentric exercise protocol for mild patellar tendon pain, with good progress after 8 weeks. The document emphasizes that tendinopathy presents differently in each individual and treatments should be customized based on clinical symptoms rather than images alone.
This document summarizes information about injuries to the rectus femoris muscle from the Orthopaedic Surg & Sports Med Institute. It provides data on rectus femoris injuries in soccer players from 2012-2015, showing they made up 32% of thigh muscle injuries. Surgical techniques used to treat tears include reinsertion of the tendon for avulsions, muscle-tendon suture for complete ruptures at the musculotendinous junction, and complete release and suture for distal ruptures. Return to sport is typically within 3-5 months after surgery, when the athlete is pain-free and has full mobility and strength on ultrasound and tensiomyography.
Rehabilitation of rectus femoris injuries. Experience at Barcelona FCMuscleTech Network
This document outlines a rehabilitation plan for a 20-year-old soccer player who suffered a complete tear of the rectus femoris muscle in his left leg. The plan is divided into acute, subacute, advanced, and final phases. The acute phase focuses on rest, ice, compression, and bandaging. The subacute phase incorporates quadriceps activation, stretching, massage, and low-impact aerobic exercise. The advanced phase adds strength training and proprioception exercises. Manual therapy continues throughout. Criteria for progression include pain levels and ability to perform exercises with greater range of motion, intensity and velocity. The final phase includes an activation routine before returning to training.
Overview of the athletic hamstring injury with respect to mechanism, assessment, prognosis, rehabilitation, imaging, management, return to sport and prevention.
This document discusses the key determinants for ascending stairs, including:
1. Lower extremity force production from muscles like the quadriceps and hip extensors is needed to move the center of mass over the base of support.
2. Dynamic postural stability during single limb stance is required for balance.
3. Lower extremity coordination of simultaneous hip and knee movement advances the center of mass.
4. Proper alignment of the torso, hip, knee and ankle is important.
5. Sufficient range of motion at the hip, knee and ankle is necessary to complete the stair ascent task.
Fabrizio Tencone
Isokinetic Medical Group, Torino, Italy – Head Juventus Football Club Medical Department, Italy.
-
From injury to return to sport: 25 years of experience in Italian football
(6th MuscleTech Network Workshop)
14th October, Barcelona
This document discusses return to sport criteria and rehabilitation protocols for acute hamstring strains, noting that criteria should include measures of strength, range of motion, neuromuscular control and readiness, and that eccentric strengthening can help prevent reinjury for chronic or recurrent strains. Guidelines are proposed focusing on a progressive agility program without stretching to regain strength and function before clearing for full sport activity.
This document discusses tendinopathy injuries in football/soccer players. It provides epidemiological data showing that tendinopathy represents 6% of injuries in football, with patellar and Achilles tendinopathy being most common. Two case studies from FC Barcelona are presented: [1] A 26-year-old defender who was treated with injections and eccentric exercises for jumper's knee and returned to play with mild pain; [2] A 22-year-old striker undergoing an eccentric exercise protocol for mild patellar tendon pain, with good progress after 8 weeks. The document emphasizes that tendinopathy presents differently in each individual and treatments should be customized based on clinical symptoms rather than images alone.
This document summarizes information about injuries to the rectus femoris muscle from the Orthopaedic Surg & Sports Med Institute. It provides data on rectus femoris injuries in soccer players from 2012-2015, showing they made up 32% of thigh muscle injuries. Surgical techniques used to treat tears include reinsertion of the tendon for avulsions, muscle-tendon suture for complete ruptures at the musculotendinous junction, and complete release and suture for distal ruptures. Return to sport is typically within 3-5 months after surgery, when the athlete is pain-free and has full mobility and strength on ultrasound and tensiomyography.
Rehabilitation of rectus femoris injuries. Experience at Barcelona FCMuscleTech Network
This document outlines a rehabilitation plan for a 20-year-old soccer player who suffered a complete tear of the rectus femoris muscle in his left leg. The plan is divided into acute, subacute, advanced, and final phases. The acute phase focuses on rest, ice, compression, and bandaging. The subacute phase incorporates quadriceps activation, stretching, massage, and low-impact aerobic exercise. The advanced phase adds strength training and proprioception exercises. Manual therapy continues throughout. Criteria for progression include pain levels and ability to perform exercises with greater range of motion, intensity and velocity. The final phase includes an activation routine before returning to training.
Overview of the athletic hamstring injury with respect to mechanism, assessment, prognosis, rehabilitation, imaging, management, return to sport and prevention.
This document discusses the key determinants for ascending stairs, including:
1. Lower extremity force production from muscles like the quadriceps and hip extensors is needed to move the center of mass over the base of support.
2. Dynamic postural stability during single limb stance is required for balance.
3. Lower extremity coordination of simultaneous hip and knee movement advances the center of mass.
4. Proper alignment of the torso, hip, knee and ankle is important.
5. Sufficient range of motion at the hip, knee and ankle is necessary to complete the stair ascent task.
Fabrizio Tencone
Isokinetic Medical Group, Torino, Italy – Head Juventus Football Club Medical Department, Italy.
-
From injury to return to sport: 25 years of experience in Italian football
(6th MuscleTech Network Workshop)
14th October, Barcelona
Isokitenic 2015: Clinical Practice Guidelines for Muscle Injury FC Barcelona...MuscleTech Network
Presentation at: 'Football Medicine Strategies for Player Care', XXIV International Conference on Sports Rehabilitation and Traumatology, 11th- 12th April, 2015- London
Rehabilitation of rectus Femoris Injuries. Experience at Sevilla FC
José Conde And Adolfo Muñoz
8th MuscleTech Network Workshop
Tuesday 4th October, 2016
This document discusses the rehabilitation process for quadriceps muscle injuries from initial injury through return to play. It begins by covering injury classification and the muscle architecture of the quadriceps. It then discusses muscle mechanics in running and kicking sports. Rehabilitation stages are outlined from early isometric exercises to advanced functional training mimicking sports movements. A case study is presented of an athlete who suffered multiple quadriceps injuries and underwent a rehabilitation process focused on hypertrophy, tendon elasticity and returning to high intensity running.
Biomechanics is the study of how forces affect living organisms during movement. It uses concepts from physics like mechanics, kinematics, and kinetics to understand human motion. Biomechanists study biomechanics to improve athletic performance and prevent injuries by understanding how forces impact the body during different activities. They analyze both the description of movement through kinematics and the causes of motion through kinetics.
A criteria based progression rehabilitation protocol for hamstring strain injuries presented at the Sports Medicine Australia conference 2015 during the Hamstring symposium
Preoperative physical therapy in primary total knee arthroplastyFUAD HAZIME
This study evaluated the effects of preoperative physical therapy in patients undergoing primary total knee arthroplasty. 10 patients completed 6 weeks of physical therapy before surgery while 10 control patients did not receive preoperative therapy. Both groups were tested before and after surgery and compared. The study found that preoperative physical therapy resulted in modest gains in knee flexion strength but no difference in extension strength or other short-term outcomes like function, range of motion, or muscle size. Therefore, the study did not support the routine use of preoperative physical therapy for knee replacement surgery.
Discus throwing performances and medical classification of wheelchair athlete...Ciro Winckler
CHOW, J. W.; MINDOCK, L. A. Discus throwing performances and medical classification of wheelchair athletes. Medicine and Science in Sports and Exercise, v. 31, n. 9, p. 1272-1279, 1999.
Osteitis pubis is an overuse injury characterized by inflammation at the pubic symphysis joint, causing groin pain. A 25-year old male soccer player developed this condition after performing soccer maneuvers like passing and tackling. Symptoms include pain in the pelvis and inner thighs that is worsened by activities like walking, sitting, and stairs. Treatment involves a phased approach starting with rest, ice, compression, and elevation to reduce inflammation. Later phases focus on soft tissue work and stretches to relax the abdominal and adductor muscles attaching at the injury site. Full recovery involves regaining strength and range of motion without pain.
The document summarizes recent advances in ACL rehabilitation based on criteria-based guidelines. It discusses:
1) Post-operative rehabilitation is divided into early, intermediate, and late phases focused on restoring range of motion, strength, and neuromuscular control through specific exercises.
2) Rehabilitation criteria include benchmarks for knee flexion and extension range of motion, quadriceps strength, and gait that must be met before progressing between phases.
3) Recent rehabilitation emphasizes weight-bearing exercises, proprioception training, and criteria-based return to sport to reduce reinjury risk and optimize outcomes.
This document discusses chronic ankle instability (CAI) pathobiomechanics and manual therapy treatment approaches. It notes that individuals with CAI exhibit altered muscle activation patterns and eccentric weakness during gait compared to healthy individuals. Manual therapy techniques like joint mobilization and manipulation can improve ankle range of motion and landing kinematics in individuals with CAI. Combining manual therapy with exercises may provide better outcomes than exercises alone for treating acute ankle sprains.
Nikos Malliaropoulos - Rehabilitation of hamstring injuries MuscleTech Network
Nikos Malliaropoulos
Director of the Athletics National Sports Medicine Centre Thessaloniki Greece. Consultant SEM Physician Barts and The London Clinical Senior Lecturer QMUL CSEM.
-
The rehabilitation of Hamstring injuries - Can we be more injury specific?
(6th MuscleTech Network Workshop)
14th October, Barcelona
Bryan Heiderscheit
Professor, Department of Orthopedics and Rehabilitation, Department of Biomedical Engineering, Director, UW Runners' Clinic, Director, Badger Athletic Performance Research, Co-director, UW Neuromuscular Biomechanics Lab, University of Wisconsin-Madison, Madison, WI, USA.
-
MRI findings regarding hamstring strain injury and recovery
(6th MuscleTech Network Workshop)
14th October, Barcelona
This document discusses proposals for rehabilitation programs for rectus femoris injuries. It provides background on the anatomical features and functions of the rectus femoris muscle as well as risk factors and mechanisms of injury. The proposals aim to design rehabilitation programs based on scientific evidence regarding injury risk factors, appropriate exercises and progression. They involve standardized criteria and protocols to minimize bias and optimize loading during rehabilitation.
Return to play in rectus femoris muscle injuries. Our experience with profess...MuscleTech Network
This document outlines a 4-step in-field return-to-play process for professional football players recovering from rectus femoris muscle injuries. The 4 steps progress from running circuits in dry sand, to circuits with a ball in dry sand, to uphill/downhill running, and finally specific football skills circuits. Each step aims to gradually increase difficulty, coordination, strength and sport-specific movements while monitoring pain and GPS data. The process is tailored to each player and aims to return them to full training and play in an optimal way according to their symptoms and injury severity.
Lluis Til / Jordi Puigdellivol
Lluis Til is Senior Researcher and Sports Medicine & Orthopedics - FCBarcelona; Olympic Training Center (CAR); Consorci Sanitari de Terrassa (CST). Puigdellivol is Senior Researcher and Sports Medicine & Orthopedics – FCBarcelona.
-
Hamstring injuries: our surgery indication experiences
(6th MuscleTech Network workshop)
14th October, Barcelona
Johannes Tol
Sports medicine physician, Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
-
PRP for acute hamstring injuries: a 3-arm RCT in Qatar
(6th MuscleTech Network workshop)
14th October, Barcelona
Stiehl Jb. Design Factors Influencing Rom In TkaStruijs
The document discusses factors that influence range of motion (ROM) after total knee arthroplasty (TKA), including patient factors like obesity, surgical technique, and prosthetic design. It finds that posterior stabilized (PS) designs can provide higher ROM than posterior cruciate retaining designs, and that the LPS High Flex PS design further increases ROM, with reported passive flexion of 130-140 degrees in many cases. However, it also notes there may be increased risks of wear, synovitis, and anterior knee pain with such high flexion.
This study examined muscle activation patterns in the lower extremities during different squat techniques. 28 healthy subjects performed squats with neutral alignment (control), intentional frontal plane malalignment (medial knee displacement), and sagittal plane malalignment (anterior knee displacement). Electromyography was used to measure muscle activation in the quadriceps, hamstrings, and gastrocnemius. Results showed altered muscle activation patterns during the malaligned squats, with decreased quadriceps activation during medial knee displacement and changes in quadriceps and hamstring activation timing during anterior knee displacement compared to the control squat. The study provides information on how muscle activation changes with different squat alignments.
Isokitenic 2015: Clinical Practice Guidelines for Muscle Injury FC Barcelona...MuscleTech Network
Presentation at: 'Football Medicine Strategies for Player Care', XXIV International Conference on Sports Rehabilitation and Traumatology, 11th- 12th April, 2015- London
Rehabilitation of rectus Femoris Injuries. Experience at Sevilla FC
José Conde And Adolfo Muñoz
8th MuscleTech Network Workshop
Tuesday 4th October, 2016
This document discusses the rehabilitation process for quadriceps muscle injuries from initial injury through return to play. It begins by covering injury classification and the muscle architecture of the quadriceps. It then discusses muscle mechanics in running and kicking sports. Rehabilitation stages are outlined from early isometric exercises to advanced functional training mimicking sports movements. A case study is presented of an athlete who suffered multiple quadriceps injuries and underwent a rehabilitation process focused on hypertrophy, tendon elasticity and returning to high intensity running.
Biomechanics is the study of how forces affect living organisms during movement. It uses concepts from physics like mechanics, kinematics, and kinetics to understand human motion. Biomechanists study biomechanics to improve athletic performance and prevent injuries by understanding how forces impact the body during different activities. They analyze both the description of movement through kinematics and the causes of motion through kinetics.
A criteria based progression rehabilitation protocol for hamstring strain injuries presented at the Sports Medicine Australia conference 2015 during the Hamstring symposium
Preoperative physical therapy in primary total knee arthroplastyFUAD HAZIME
This study evaluated the effects of preoperative physical therapy in patients undergoing primary total knee arthroplasty. 10 patients completed 6 weeks of physical therapy before surgery while 10 control patients did not receive preoperative therapy. Both groups were tested before and after surgery and compared. The study found that preoperative physical therapy resulted in modest gains in knee flexion strength but no difference in extension strength or other short-term outcomes like function, range of motion, or muscle size. Therefore, the study did not support the routine use of preoperative physical therapy for knee replacement surgery.
Discus throwing performances and medical classification of wheelchair athlete...Ciro Winckler
CHOW, J. W.; MINDOCK, L. A. Discus throwing performances and medical classification of wheelchair athletes. Medicine and Science in Sports and Exercise, v. 31, n. 9, p. 1272-1279, 1999.
Osteitis pubis is an overuse injury characterized by inflammation at the pubic symphysis joint, causing groin pain. A 25-year old male soccer player developed this condition after performing soccer maneuvers like passing and tackling. Symptoms include pain in the pelvis and inner thighs that is worsened by activities like walking, sitting, and stairs. Treatment involves a phased approach starting with rest, ice, compression, and elevation to reduce inflammation. Later phases focus on soft tissue work and stretches to relax the abdominal and adductor muscles attaching at the injury site. Full recovery involves regaining strength and range of motion without pain.
The document summarizes recent advances in ACL rehabilitation based on criteria-based guidelines. It discusses:
1) Post-operative rehabilitation is divided into early, intermediate, and late phases focused on restoring range of motion, strength, and neuromuscular control through specific exercises.
2) Rehabilitation criteria include benchmarks for knee flexion and extension range of motion, quadriceps strength, and gait that must be met before progressing between phases.
3) Recent rehabilitation emphasizes weight-bearing exercises, proprioception training, and criteria-based return to sport to reduce reinjury risk and optimize outcomes.
This document discusses chronic ankle instability (CAI) pathobiomechanics and manual therapy treatment approaches. It notes that individuals with CAI exhibit altered muscle activation patterns and eccentric weakness during gait compared to healthy individuals. Manual therapy techniques like joint mobilization and manipulation can improve ankle range of motion and landing kinematics in individuals with CAI. Combining manual therapy with exercises may provide better outcomes than exercises alone for treating acute ankle sprains.
Nikos Malliaropoulos - Rehabilitation of hamstring injuries MuscleTech Network
Nikos Malliaropoulos
Director of the Athletics National Sports Medicine Centre Thessaloniki Greece. Consultant SEM Physician Barts and The London Clinical Senior Lecturer QMUL CSEM.
-
The rehabilitation of Hamstring injuries - Can we be more injury specific?
(6th MuscleTech Network Workshop)
14th October, Barcelona
Bryan Heiderscheit
Professor, Department of Orthopedics and Rehabilitation, Department of Biomedical Engineering, Director, UW Runners' Clinic, Director, Badger Athletic Performance Research, Co-director, UW Neuromuscular Biomechanics Lab, University of Wisconsin-Madison, Madison, WI, USA.
-
MRI findings regarding hamstring strain injury and recovery
(6th MuscleTech Network Workshop)
14th October, Barcelona
This document discusses proposals for rehabilitation programs for rectus femoris injuries. It provides background on the anatomical features and functions of the rectus femoris muscle as well as risk factors and mechanisms of injury. The proposals aim to design rehabilitation programs based on scientific evidence regarding injury risk factors, appropriate exercises and progression. They involve standardized criteria and protocols to minimize bias and optimize loading during rehabilitation.
Return to play in rectus femoris muscle injuries. Our experience with profess...MuscleTech Network
This document outlines a 4-step in-field return-to-play process for professional football players recovering from rectus femoris muscle injuries. The 4 steps progress from running circuits in dry sand, to circuits with a ball in dry sand, to uphill/downhill running, and finally specific football skills circuits. Each step aims to gradually increase difficulty, coordination, strength and sport-specific movements while monitoring pain and GPS data. The process is tailored to each player and aims to return them to full training and play in an optimal way according to their symptoms and injury severity.
Lluis Til / Jordi Puigdellivol
Lluis Til is Senior Researcher and Sports Medicine & Orthopedics - FCBarcelona; Olympic Training Center (CAR); Consorci Sanitari de Terrassa (CST). Puigdellivol is Senior Researcher and Sports Medicine & Orthopedics – FCBarcelona.
-
Hamstring injuries: our surgery indication experiences
(6th MuscleTech Network workshop)
14th October, Barcelona
Johannes Tol
Sports medicine physician, Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
-
PRP for acute hamstring injuries: a 3-arm RCT in Qatar
(6th MuscleTech Network workshop)
14th October, Barcelona
Stiehl Jb. Design Factors Influencing Rom In TkaStruijs
The document discusses factors that influence range of motion (ROM) after total knee arthroplasty (TKA), including patient factors like obesity, surgical technique, and prosthetic design. It finds that posterior stabilized (PS) designs can provide higher ROM than posterior cruciate retaining designs, and that the LPS High Flex PS design further increases ROM, with reported passive flexion of 130-140 degrees in many cases. However, it also notes there may be increased risks of wear, synovitis, and anterior knee pain with such high flexion.
This study examined muscle activation patterns in the lower extremities during different squat techniques. 28 healthy subjects performed squats with neutral alignment (control), intentional frontal plane malalignment (medial knee displacement), and sagittal plane malalignment (anterior knee displacement). Electromyography was used to measure muscle activation in the quadriceps, hamstrings, and gastrocnemius. Results showed altered muscle activation patterns during the malaligned squats, with decreased quadriceps activation during medial knee displacement and changes in quadriceps and hamstring activation timing during anterior knee displacement compared to the control squat. The study provides information on how muscle activation changes with different squat alignments.
Delayed onset of vastii muscle activity in response to rapid postural perturb...Nosrat hedayatpour
In the current study, we analysed the relative timing of activation of the VMO and VL muscles during unexpected knee
perturbations performed before and after eccentric
exercise. The type of perturbation used resembles
perturbations that might commonly be encountered
during sport activities
Physiotherapy management of Patellofemoral pain SyndromeSharafadeenIbrahim
The document provides an orthopedic presentation on physiotherapy management of patellofemoral pain syndrome (PFPS). PFPS is characterized by anterior knee pain that is aggravated by activities involving the patellofemoral joint. Treatment involves a multimodal physiotherapy approach including joint mobilization, therapeutic exercises to strengthen the quadriceps and hips, electrotherapy such as neuromuscular electrical stimulation, and cryotherapy. The goal of rehabilitation is to reduce pain and improve function through strengthening, stretching, and knee stabilization exercises.
Surplus value of hip adduction in leg press exercise in patients with patello...FUAD HAZIME
1) This randomized controlled trial examined the effects of incorporating hip adduction into leg press exercise (LPHA group) compared to leg press exercise alone (LP group) and a no exercise control group for patients with patellofemoral pain syndrome (PFPS).
2) 89 patients with PFPS were randomly assigned to one of the three groups and underwent either LPHA, LP, or no exercise over 8 weeks. Outcome measures included pain, function, and vastus medialis oblique (VMO) muscle morphology.
3) Both exercise groups experienced significant improvements in pain, function and VMO size after treatment compared to the control group, but there were no differences between the LPHA and LP groups
Effect of Sit To Sit And Activity On Forward Bending TestApeksha Besekar
Sit-to-stand activity was found to be an effective pre-stretching tool to improve flexibility of the lower back, hamstrings, and Achilles tendon muscles based on this study of 50 females. Participants were divided into two groups that performed either 10 or 20 repetitions of sit-to-stand activity. Both groups had statistically significant improvements in flexibility as measured by increased forward bending distance and decreased muscle tightness. However, there was no significant difference found between the two groups, suggesting that 10 and 20 repetitions were equally effective. The study concluded that sit-to-stand activity provides warm-up and increases flexibility through mechanisms of reciprocal inhibition and autogenic inhibition.
This document summarizes a study that examined the effectiveness of retro walking (backward walking) in patients with chronic osteoarthritis of the knee. 30 patients with grade 3 knee osteoarthritis underwent 10 minutes of retro walking per day on an inclined treadmill for 10 days. Outcome measures assessed before and after the intervention included pain, stiffness, physical function via the WOMAC index, knee extension lag, dynamic balance, and parameters of forward walking. The results showed statistically significant improvements in all outcome measures following the retro walking intervention. The study concluded that retro walking is an effective approach for reducing symptoms and improving physical function in patients with osteoarthritis of the knee.
Patella dislocation is a common problem in the young. Recurrence of dislocation can be significant problem causing pain and discomfort. The assessment and guidelines towards non-surgical and surgical treatment options are discussed here.
This document provides background information and literature review for a study comparing the effectiveness of kinesio taping and exercise for shoulder impingement syndrome. It introduces shoulder impingement as a common shoulder problem caused by inadequate space for rotator cuff tendons. The literature review summarizes previous studies that found scapular taping, therapeutic kinesio taping, and exercise programs can reduce pain and improve function in impingement. Outcome measures to be used in the proposed study include VAS (visual analog scale) for pain, DASH scale for function assessment, and goniometry for range of motion measurements.
This study examined the effects of whole body vibration (WBV) exercise on muscle strength and proprioception in females with knee osteoarthritis. Fifty-two female patients were randomly assigned to one of three groups: 1) WBV exercise on a balance board, 2) WBV exercise on a stable platform, or 3) a non-exercise control group. The WBV groups underwent twice weekly sessions for 8 weeks that progressively increased in intensity. The study found that muscle strength significantly increased in the stable platform group compared to the control group. Proprioception significantly improved in the balance board group compared to the control group. WBV exercise provided benefits to muscle strength and proprioception in females with knee osteoarthritis.
The study investigated whether high-intensity (HI) strength training increased pain after total knee replacement (TKR) compared to low-intensity (LI) training. It found that the HI group experienced no more pain or stiffness than the LI group. Both groups improved significantly from baseline on all outcomes measured. The HI exercises were well tolerated, with no patients withdrawing. The study concluded that progressive, submaximal exercise after TKR is safe and tolerated by patients, and more intense interventions should be considered to potentially provide better long-term benefits.
Ijpr.2015.105EFFECT OF HIP ABDUCTOR STRENGTHENING AMONG NON-PROFESSIONAL CYCL...jayanta Jayanta0074U
EFFECT OF HIP ABDUCTOR STRENGTHENING AMONG
NON-PROFESSIONAL CYCLISTS WITH ILIOTIBIAL BAND FRICTION
SYNDROME.Background and Objectives: The studywas carried out to find out the effect of hip abductor strengthening among
non-professional cyclists with iliotibial band friction syndrome.
Subjects: 40 non-professional cyclists with ipsilateral ITBFS subject including male and female age between 18
to 50 with positive ober’s and nobble test were included in this study.
Methods: 40 subject were selected according to the inclusion criteria and they were assessed pre and post for
ROM(hip adduction, IR), hip abductor strength and pain using goniometer,sphygmomanometer and VAS .Subject
were assign experimental group(group A 20 subject) who received IT band stretching,US,and hip abductor
strengthening exercise and control group (group B 20 subject) who received same treatment except hip abductor
strengthening.
Data Analysis and Results: Based on statistical analysis using Wilcoxon test to compare the pre and post test
pain in both group,Mann-whitney U- test to compare the post test pain scores of between groups ,Paired t - test
to compare the pre and post ROM and strength in both groups, Unpaired t – test to compare post test ROM in
between groups showed that pre post difference within group A there was significant difference for adduction
ROM (p value <.0001),ir><.0001),vas(p><.0001),and><.0001).However in group B adduction ROM and VAS were found to be significant.
In comparision in difference between groups it was found that adduction ROM,IR ROM,VAS and strength all
were significant. Baseline data for outcome variable were not statistically significant.
Conclusion: Based on outcome variable there was significant difference of hip abductor strengthening among
non-professional cyclist with iliotibial band friction syndrome.
The document discusses rehabilitation after ACL reconstruction surgery. It begins with an introduction noting that ACL tears are a common sports injury. It then covers knee anatomy, the anatomy and biomechanics of the ACL, surgical treatment, and post-operative rehabilitation phases and techniques. The rehabilitation process involves regaining range of motion and quadriceps strength in early phases, advancing to sport-specific drills, with a focus on gradually increasing loads on the knee through strengthening and proprioceptive exercises.
Comparison between Hamstring Lengthening Tendon and Hamstring Tendon Transfer...Service_supportAssignment
Cerebral Palsy (CP) is defined as a non-progressive brain lesion and has many disorders that may affect both movement and posture (Bobath 1991). Spastic cerebral palsy influence 70% of child population with CP and happen when white matter tracks damage between the cortex and the spinal cord. Moreover, a main problem for children with spastic CP is their feet and leg muscles, which might shorten or tighten around certain joints (Bjorklund 2006). C
Physiotherapy Management of anterior knee pain.pptxHezekiahAyuba1
Anterior knee pain is a common symptom with many potential underlying causes that can be related to muscles, ligaments, tendons, meniscus or bone. It is diagnosed through a thorough history and physical exam to determine potential patellar abnormalities, muscular imbalances or other causes. Treatment involves physical therapy focusing on exercises to improve strength, flexibility, and mechanics, as well as bracing, with surgery reserved for more severe cases. Proper rehabilitation after surgery aims to regain quadriceps strength and knee flexibility.
The document examines back muscle activity during three traditional mat Pilates exercises - swimming, single leg kick with static prone back extension, and double leg kick - through surface electromyography of healthy adult females. The study found that swimming increased lumbar extensor muscle activity the most at 29% on average compared to the other two exercises. Double leg kicking produced significantly more back muscle activation than single leg kicking. Overall, back muscle activation during the exercises ranged from 15-61% of participants' maximum voluntary isometric contraction levels.
The document discusses the anatomy and biomechanics of the cervical spine. It describes the seven cervical vertebrae, their characteristics, and motion segments. It also covers indications for cervical manipulation, mechanisms of action, and importance of screening for vascular risks prior to cervical manipulation.
This randomized controlled trial examined the effects of two modified posterior shoulder stretching exercises (PSSEs) on shoulder mobility, pain, and dysfunction in patients with subacromial impingement syndrome (SIS). 67 patients with SIS and internal rotation deficit were assigned to receive either a modified cross-body stretch, modified sleeper stretch, or a control treatment of modalities and exercises without PSSEs. Both stretching groups demonstrated greater improvements in pain with activity, internal rotation range of motion, function, and disability compared to the control group. However, there was no significant difference between the two stretching groups. All treatments led to improvements in pain, shoulder mobility, function, and disability.
Similar to BILATERAL PROXIMAL HAMSTRING TENDINOPATHY IN ULTRAMARATHON RUNNER (20)
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
BILATERAL PROXIMAL HAMSTRING TENDINOPATHY IN ULTRAMARATHON RUNNER
1. THE MANAGEMENT OF BILATERAL PROXIMAL HAMSTRING
TENDINOPATHY IN ULTRAMARATHON RUNNER
WITH ISOINERTIAL FUNCTIONAL EXERCISES:
A CASE REPORT
Giacomo Quaglia, Luca Stefanini, Maurizio Giacchino, Stefano Ventura, Angelo Cacchio, Davide Dardanello
Giacomo Quaglia PT
info@giacomoquaglia.it
2. INTRODUCTION
INJURY
Semimembranosus and biceps femuris muscles combine
to create a common tendon that insert medially in the
ischial tuberosity.
Overuse
Poor lumbo-pelvic motor control
Weakness in hamstring muscles
What the proximal hamstring tendinopathy (PHT) is?
Goom TS, et Al., J Orthop Sports Phys Ther. 2016
Rio E. et Al., Br J Sports Med 2015
Cook JL, et Al., Br J Sports Med 2016
Cook JL, et Al., Br J Sports Med 2015
3. Isoinertial machine
Huge load for tendons
Eccentric strengthening
Tendons are highly responsive to increased mechanical loading and adapt
through changes of their mechanical, material, and morphological
properties.
Bohm S. et Al. , Sports Medicine Open. 2015
INTRODUCTION
Tesch Per A. et Al., Frontiers in physiologhy, 2017
5. OBJECTIVES
Find a way to increase mechanical loading in common
tendon
Present exercices which functionally reproduce the
running act
6. CASE PRESENTATION
•41 year-old healthy male, who had been partecipating in ultra-
endurance runs for 10 years
•Insidious onset of bilateral deep buttock pain which started 7 months
(March 2016) prior our clinical evaluation (December 2016)
•Pain exacerbated with:
Running: his pain prevents him from running from August 2016
Sitting on hard surfaces
Analytical hamstring contraction
Forward bending on the trunk with extended knees
•Musculoskeletal ultrasound showed «bilateral insertional enthesopathy
of hamstring with focal lesion on right leg».
7. CASE PRESENTATION
•Physical examination (day 0)
Pain in palpation of the tendons and bellies hamstring’s muscle
Pain with all the maneuvers that put stress in hamstrings’ structures
(bent-knee test, Puranen-Orava test).
NPRS left = 2,5/10
right = 7/10
NPRS left = 2,5/10
right = 7/10
8. CASE PRESENTATION
Pain in execution of MVIC of hamstring in prone position
SLR test left/right -, Slump test left/right -
No pain-relation with lumbar motion
MVIC in 90° knee flexion
NPRS left = 3/10
right = 5/10
MVIC first evaluation’ values aren’t available because of
the patient pain.
9. METHODS
Musculoskeletal ultrasound report
NRPS during the MVIC
NPRS during running
Running distance without pain
VISA-H questionnaire values
Cacchio A, et Al., Development and validation of a new VISA questionnaire (VISA-H) for patients with proximal
hamstring tendinopathy. Br J Sports Med. 2014.
Maximal Voluntary Isometric Contraction (MVIC) test at 90°knee of flexion
with Hand-Held Dynamometer
Hamstring’s strength (N) during MVIC at 90°knee of flexion
Seongh-Gil K. et Al., The intra- and inter-rater reliabilities of lower extremity muscle strength assessment of
healthy adults using a hand held dynamometer, J. Phys. Ther. Sci., 2015
10. INTERVENTION
In upright running, which can be a key aggravating factor in athletic
populations, the hamstrings eccentrically decelerate knee extension in
terminal swing phase.
Goom TS et Al., J Orthop Sports Phys Ther. 2016
Ascertained this, we use isoinertial machine for the possibilities to join:
1. Eccentric training reproducing the swing phase of run
2. Increase mechanical loading to common tendon
12. INTERVENTION
(Weeks 1 to 3)
(Weeks 3 to 12)
Education of patient, respect of pain, progressive
trunk stabilty exercices, lumbo-pelvic motor control
exercices.
Introduction of eccentric exercices performed by
isoinertial machine
Phase I
Phase II
13. INTERVENTION
We proposed eccentric exercises which reproduce faithfully the functional
act of running, with the purpose of acting mainly in the proximal hamstring
segment.
1. 2.
Figure 1.,2. – Progression of an exercise performed by isoinertial machine in supine position
16. LIMITATIONS
«The major advantage
of case reporting is
probably its ability to
detect novities»
Trygve Nissen and Rolf Wynn, BMC Research Notes, 2014
17. CONCLUSIONS
Body functions & structures
(impairment)
Activities
(limitations)
Participation
(restriction)
&
Tendons healing shown by ultrasound
Reduction of pain in hamstrings’
strenght evaluation
Significative amelioration of
hamstrings’ strenght values (N)
Significative reduction of pain in run
Increasment of running distance
without any pain
Significative amilioration of VISA-H
values
Return to high-level competions