Current Clinical Concepts: Synthesizing the Available Evidence for Improved Clinical Outcomes in Iliotibial Band Impingement Syndrome.

The current paradigm of insidious lateral knee pain involving the iliotibial band (ITB) in repetitive knee-flexion activities has been termed ITB friction syndrome since 1975. The original model for ITB pain was based on a limited or incorrect understanding of the relevant anatomy, biomechanics, and tissue science, which gradually led to a plethora of frustrating and ineffective interventional strategies. Mounting evidence from arthroscopic, cadaveric, and biomechanical studies, as well as from diagnostic imaging and histologic reports, has helped deconstruct this long-held paradigm for ITB-related pathology and treatment. By outlining the historical paradigm for our understanding of ITB pain and gathering newer evidence through extensive research, I will synthesize the available data in this clinical update to present an updated, more informed model for understanding insidious-onset ITB-related pathology and treating patients. The result is called ITB impingement syndrome.

Iliotibial Band Pathology: Synthesizing the Available Evidence for Clinical Progress.

The current paradigm of practice concerning insidious lateral knee pain involving the iliotibial band in repetitive knee flexion activities has been presented as iliotibial band friction syndrome since 1974. Renne's original model for ITB pain was based on a limited or incorrect understanding of the relevant anatomy, biomechanics, and tissue science, which gradually led to a plethora of frustrating and ineffective interventional strategies. Mounting evidence from arthroscopic, cadaveric and biomechanical studies, as well as from diagnostic imaging and histology reports helps deconstruct this long-held paradigm for ITB related pathology and treatment. Using an archeological approach to gather relevant evidence, this clinical update synthesizes the available data in order to present an updated, more informed model for understanding and treating insidious onset related ITB related pathology. The result is a new, more informed paradigm called Iliotibial Band Impingement Syndrome.

Posttraumatic Deep Vein Thrombosis in Collegiate Athletes: An Exploration Clinical Case Series.

BACKGROUND: Although athletes are typically at low risk for developing venous thromboembolism (VTE), injured and noninjured athletes alike can be exposed to many acquired risk factors, including intense training, dehydration, trauma, immobilization, oral contraceptive use, and long-distance travel. Additionally, the risk of developing VTE might be increased by unidentified genetic clotting disorders. Due to the potential for fatal outcomes, knowledge of VTE pathoetiology and recognition of deep vein thrombosis (DVT) presentation should be an inherent part of the evaluation process for all who attend to athletes, regardless of age and apparent risk profile. OBJECTIVE: To present an exploration clinical case series consisting of 2 otherwise healthy, college-aged female athletes who, despite their ages and relative low risk profiles, experienced DVTs after lower extremity trauma. Each case will be discussed relative to known clinical prediction rules (CPRs) and published evidence. CONCLUSIONS: Collectively, both cases reinforce the need for the attending clinicians to perform a thorough history and pay attention to subtle clinical findings, regardless of the relatively low risk in college-aged athletes. Although the Wells' CPRs for DVT can be used as a diagnostic guideline in the general population, it might not fully address the risks inherent in a young, otherwise healthy athletic population. We propose a risk-screening tool that is based on and modified from our experiences with these 2 patients and the known prediction rules and positive probability influences.

Current Concepts in Hip Preservation Surgery: Part II--Rehabilitation.

CONTEXT: Successful treatment of nonarthritic hip pain in young athletic individuals remains a challenge. A growing fund of clinical knowledge has paralleled technical innovations that have enabled hip preservation surgeons to address a multitude of structural variations of the proximal femur and acetabulum and concomitant intra-articular joint pathology. Often, a combination of open and arthroscopic techniques are necessary to treat more complex pathomorphologies. Peri- and postoperative recovery after such procedures can pose a substantial challenge to the patient, and a dedicated, thoughtful approach may reduce setbacks, limit morbidity, and help optimize functional outcomes. EVIDENCE ACQUISITION: PubMed and CINAHL databases were searched to identify relevant scientific and review articles through December 2014 using the search terms hip preservation, labrum, surgical dislocation, femoroacetabular impingement, postoperative rehabilitation, peri-acetabular osteotomy, and rotational osteotomy. Reference lists of included articles were reviewed to locate additional references of interest. STUDY DESIGN: Clinical review. LEVEL OF EVIDENCE: Level 4. RESULTS: Hip preservation procedures and appropriate rehabilitation have allowed individuals to return to a physically active lifestyle. CONCLUSION: Effective postoperative rehabilitation must consider modifications and precautions specific to the particular surgical techniques used. Proper postoperative rehabilitation after hip preservation surgery may help optimize functional recovery and maximize clinical success and patient satisfaction.

Multiculturalism and athletic training education: implications for educational and professional progress.

OBJECTIVE: To introduce athletic training educators and practicing professionals to the pedagogic concept and professional benefits that multicultural education, awareness, and training might provide if implemented in athletic training education. DATA SOURCES: I reviewed textbook chapters and articles used in the course of my doctoral studies and searched the archives of Diversity Digest and Academic Medicine for the years 1998 to 2002 with the key words multiculturalism, diversity, cultural competence, education, and learning. I obtained additional information by cross-referencing pertinent articles. DATA SYNTHESIS: I present a rational argument for the inclusion of a critical pedagogy into the field of athletic training education. I outline the infrastructure in the professional field of athletic training, review some of the literature on critical multicultural theory and pedagogy, and examine some of the potential cognitive and intellectual implications of diversity and multicultural education. CONCLUSIONS/RECOMMENDATIONS: Future work in this area should focus on various and creative strategies for implementing a multicultural agenda in athletic training curricula and on the analysis of the associated benefits and outcomes of such educational strategies.