Case report: Favorable outcomes of spinal cord stimulation in complex regional pain syndrome Type II consistent with thermography findings.

BACKGROUND: Complex regional pain syndrome (CRPS) is a chronic pain disorder that develops as a consequence of trauma to one or more limbs. Despite the availability of multiple modalities to diagnose CRPS, a gold standard technique for definitive diagnosis is lacking. Moreover, there are limited reports describing the use of spinal cord stimulation (SCS) to treat CRPS Type II, given the low prevalence of this condition. Herein, we present the case of a patient with CRPS Type II with novel thermography findings who underwent SCS for pain management after an Achilles tendon repair surgery. CASE DESCRIPTION: A 38-year-old woman was referred to our institute because of chronic left leg pain after Achilles tendon rupture repair surgery. Her case was diagnosed as CRPS Type II based on the International Association for the Study of Pain diagnostic criteria. After an epidural block, thermography showed a significant increase in the body surface temperature of the foot on the observed side. She was subsequently treated with SCS, following which her pain ameliorated. She reported no pain flare-ups or new neurological deficits over 2 years of postoperative follow-up assessments. CONCLUSION: SCS could be a useful surgical treatment for medication refractory CRPS Type II as supported by our thermography findings. We may refine surgical indication for permanent implantation of SCS with the presented method.

Injuries and physical characteristics affecting swimmer participation in the Olympics: A prospective survey.

OBJECTIVE: To identify injuries and physical characteristics affecting swimmers' performance. DESIGN: Prospective study. SETTING: Laboratory-based. PARTICIPANTS: Sixty-four Rio Olympic candidates (36 men, 28 women), who were high level swimmers ranked among the top 32 in the 2014 World Ranking in swimming. The participants were categorized into the Olympian group (n = 25), swimmers who were consecutively selected for the Olympic team, and the non-Olympian group (n = 39), swimmers who were not. MAIN OUTCOME MEASURES: Four months prior to the Olympic qualification in 2016, an orthopedist and two physical therapists evaluated injuries and 11 physical characteristics of the swimmers. The prevalence of total overuse injuries, shoulder and low back injury, and physical characteristics were compared between the two groups. RESULTS: The female swimmers in the non-Olympian group had a 53.3% prevalence of total overuse injuries, which was significantly higher than that of those in the Olympian group with 15.4% (p = 0.037). The prevalence of total over use injuries in male swimmers in both the Olympian and non-Olympian groups was 41.7%. Female Olympian group showed that the shoulder external rotation range of motion was significantly less than that of non-Olympian group (97.8 ± 5.7 and 103.6 ± 7.3, p = 0.046). CONCLUSIONS: In female swimmers, total overuse injuries four months before an important competition influence their performance at the event.

Injury trend analysis in the Japan national swim team from 2002 to 2016: effect of the lumbar injury prevention project.

OBJECTIVES: This study aimed to clarify the trends of injury occurrence in the Japan national swim team for 15 years and to evaluate the effectiveness of the lumbar injury prevention project. It also aimed to verify the incidence of swimming-related injuries among swimmers by sex, age and swimming style. METHODS: The target group comprised 488 swimmers who participated in the Olympics, Asian Games and Universiade from 2002 to 2016; we compiled data for the total number of injuries in each body part. The lumbar injury prevention project started in 2008 and included two components (deep trunk muscle exercises and evaluation of lumbar disc degeneration using MRI). We analysed the prevalence of lumbar injury before (2002-2008) and after (2009-2016) implementation of the lumbar injury prevention project by χ2 test. We compared age, sex and swim strokes between the injured and non-injured groups by χ2 test and unpaired t-test. RESULTS: The most common injury site was the lower back, followed by the shoulder and knee. The lumbar injury prevalence was significantly lower after implementation of the prevention project (23.5% vs 14.8%; p<0.05). Shoulder injuries were common in backstroke swimmers. The injury rate was significantly higher in female than in male swimmers. The injured group was significantly older than the non-injured group. CONCLUSIONS: Lumbar injury prevention intervention might be effective to prevent lower back injury in swimmers. Injury risk factors included female and old age; younger female athletes should prevent the development of injuries as they mature.