An insidious rectus abdominis muscle injury in an elite volleyball player: a case report.

BACKGROUND: Structural muscle injuries are characterized by acute and localized onset of pain. Abdominal muscle injuries are an insidious pathology in overhead athletes. However, only a few cases are reported in literature related to volleyball players, where clinical presentation may not have reflected the severity of the lesion. CASE PRESENTATION: An elite volleyball player, a 21-year-old Caucasian female, reported the onset of mild abdominal muscular pain, confirmed on clinical evaluation findings and self-reported symptoms. Abdominal muscle ultrasound was performed following 2 weeks of continuing symptoms. This evidenced a more serious structural muscle injury of the rectus abdominis (type 3b). Having this correct diagnosis allowed a personalized rehabilitation program to be instituted to enable a safe return to play. CONCLUSION: In presence of persistent abdominal muscle pain, even if mild, the possibility of a structural muscle injury must be considered. Clinical evaluation must be complemented by an instrumental evaluation including an ultrasound by an experienced operator for correct diagnosis and the setting of functional recovery related to biological healing.

Quantitative analysis of patellar tendon size and structure in asymptomatic professional players: sonographic study.

BACKGROUND: Ultrasonographic abnormalities of the patellar tendon frequently occur in asymptomatic athletes and it is not always clear whether they precede (and may predict) the development of tendinopathy. OBJECTIVE: This study aimed to investigate by ultrasonography the prevalence of patellar tendon abnormalities in players of "pallapugno" and to establish whether structural tendon abnormalities predict tendinopathy development. METHODS: Ultrasound B-mode images of the patellar tendon of both sides were acquired in fourteen throwers. Qualitative assessments of tendon structure and neovascularization and quantitative assessments of tendon thickness, cross sectional area (CSA), and echo-intensity were performed. RESULTS: Qualitative assessments showed a subclinical tendinopathy of the non-dominant tendon in 5 out of 14 throwers (35% of cases), while quantitative assessments showed abnormalities of the non-dominant tendon in 8 out of 14 players (57% of cases). Echo-intensity and CSA were the quantitative variables most discriminant between asymptomatic players without structural tendon abnormalities and those with tendon abnormalities. Two players (2 out of 8 cases: 25%) developed a clinical tendinopathy after a follow-up of six months. CONCLUSION: The prevalence of subclinical tendinopathy in the non-dominant patellar tendon of throwers was high. Patellar tendon abnormalities at baseline seem to increase the risk of development of subsequent patellar tendinopathy. LEVEL OF EVIDENCE: II b (individual cohort study).