Journal: Clinics in sports medicine
The term, hip pointer, is applied in the setting of a blunt trauma injury to the iliac crest. It typically occurs in contact and collision sports and can cause significant pain and loss of practice or game time. A direct blow results in subperiosteal edema with hematoma formation within surrounding muscle or soft tissue and bone contusion of the iliac crest. Conservative management with compression, ice, antiinflammatories, and rehabilitation exercises are successful in treating hip pointers. Injection therapy with the use of local anesthetic can be helpful in minimizing pain and increasing function to allow more rapid return to play.
There has been an increased interest in the quantification of the knee laxity secondary to anterior cruciate ligament (ACL) injury. In clinical practice, the diagnosis is performed by clinical examination and magnetic resonance imaging analysis and confirmed arthroscopically. The pivot shift phenomenon has been identified as one of the essential signs of functional ACL insufficiency. A reliable system to adequately assess patients with ACL injury, quantifying the pivot shift test outcome, is needed. Several studies have been conducted in this regard but the proposed methods remain confined to a research area. The goal of this article is to summarize the actual knowledge and current concepts.
Rehabilitation after anterior cruciate ligament (ACL) reconstruction should consider control of postoperative pain and swelling, protection of the healing graft, restoration of full range of motion symmetric to the contralateral knee, strengthening of the muscles that stabilize the knee, hip, and trunk, enhancing neuromuscular control, and a gradual progression to functional activities that are required for return to sports. The effects of concomitant injuries and surgical procedures must also be considered in planning an individualized rehabilitation program. This article provides an overview, discusses our experience, and makes recommendations for rehabilitation after anatomic ACL reconstruction rehabilitation.
Peroneal tendon pathology is often found in patients complaining of lateral ankle pain and instability. Conditions encountered include tendinosis; tendinopathy; tenosynovitis; tears of the peroneus brevis, peroneus longus, and both tendons; subluxation and dislocation; and painful os peroneum syndrome. Injuries can be acute as a result of trauma or present as chronic problems, often in patients with predisposing structural components such as hindfoot varus, lateral ligamentous instability, an enlarged peroneal tubercle, and a symptomatic os peroneum. Treatment begins with nonoperative care, but when surgery is required, reported results and return to sport are in general very good.
The International Association for Athletics Federations (IAAF) has been granted 2 years to submit further evidence showing a correlation between higher levels of testosterone and a competitive advantage. This article first presents the case of Caster Semenya, which triggered the drafting by IAAF of the regulations on eligibility of female athletes to compete in the female category in 2011. Then the IAAF regulations are critically analyzed from a scientific and ethical point of view. Finally, the Court of Arbitration for Sport decision to suspend the regulations pending further evidence provided by IAAF, and what this means for the future of sports, is discussed.
Meniscal injury potentiates a sequence of events that leads to degenerative changes and early osteoarthritis. It is therefore imperative to preserve the meniscus whenever possible. Given the expanding indications for meniscus repair, it is important to continually analyze and advance the understanding of rehabilitation and return to play following meniscal surgery. This article presents evidence-based rehabilitation and return-to-play guidelines as well as a brief review of return-to-play outcomes following isolated meniscus repair.
Graphical representation of results are a central component of original research articles in sports medicine. There has been recent criticism in the scientific community of a heavy reliance on simple bar graphs and line graphs to illustrate results because they often fail to clearly represent the measures and changes to interventions of individual participants. This article aims to suggest alternatives to bar and line graphs, including those that emphasize the illustration of (1) individual subject measures and data set distribution, (2) magnitude of group differences, (3) the relationships between multiple variables, and (4) unique ways of displaying time series data.
Sport concussion (SC) has emerged as a major health concern in the medical community and general public owing to increased research and media attention, which has primarily focused on male athletes. Female athletes have an equal, if not increased, susceptibility to SC. An ever-growing body of research continues to compare male and female athletes in terms of SC before and after an injury. Clinicians must be cognizant of this literature to make evidence-based clinical decision when providing care to female athletes and discern between dated and/or unsupported claims in terms of SC.
The rehabilitation process begins immediately after injury to the anterior cruciate ligament (ACL). The goal of preoperative rehabilitation is to prepare the patient for surgery. Current rehabilitation programs focus on strengthening exercises and proprioceptive and neuromuscular control drills to provide a neurologic stimulus. It is also important to address preexisting factors, especially for the female athlete, that may predispose to future injury, such as hip and hamstring weakness. Our goal in the rehabilitation program is to restore full, unrestricted function and to assist the patient to return to 100% of the preinjury level while achieving excellent long-term outcomes.
Concussion is one of the most hotly debated topics in sports medicine today. Research surrounding concussion has experienced significant growth recently, especially in the areas of incidence, assessment, and recovery. However, there is limited research on the most effective rehabilitation approaches for this injury. This review evaluates the current literature for evidence for and against physical and cognitive rest and the emerging areas targeting vestibular, oculomotor, and pharmacologic interventions for the rehabilitation of sport-related concussion.