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1.
Curr Sports Med Rep ; 20(2): 87-91, 2021 Feb 01.
Article in English | MEDLINE | ID: mdl-33560032

ABSTRACT

ABSTRACT: Triathlon is a popular sport among recreational and competitive athletes. As triathletes compete in races ranging from 16 to 140.6 miles and train in three disciplines simultaneously, it is difficult to identify injury risk factors. The aim of this study was to evaluate characteristics of a group of recreational triathletes regarding their medical history, training regimen, and injuries. Thirty-four triathletes completed this survey. We found a wide range of body types, training habits, and lifestyle characteristics. As in previous studies, we found a high rate of injuries in our surveyed triathletes. Injury rates were higher in athletes who had completed a longer race and those who reported higher training times per week. Additionally, many individuals have medical problems, use a variety of supplements, and follow specific dietary restrictions, which need to be considered in addition to training when assessing injury risk and recovery from injury.


Subject(s)
Bicycling/injuries , Competitive Behavior/physiology , Life Style , Physical Conditioning, Human , Running/injuries , Swimming/injuries , Adult , Aged , Body Mass Index , Diet , Dietary Supplements , Female , Humans , Male , Middle Aged , Risk Factors , Time Factors , Young Adult
3.
J Orthop Surg Res ; 11(1): 98, 2016 Sep 09.
Article in English | MEDLINE | ID: mdl-27608681

ABSTRACT

Stress fractures and other bony stress injuries occur along a spectrum of severity which can impact treatment and prognosis. When treating these injuries, it should be borne in mind that no two stress fractures behave exactly alike. Given that they are not a consistent injury, standardized treatment protocols can be challenging to develop. Treatment should be individualized to the patient or athlete, the causative activity, the anatomical site, and the severity of the injury. A holistic approach to the treatment of the most difficult stress fractures should be taken by orthopedists and sports medicine specialists. This approach is necessary to obtain optimal outcomes, minimize loss of fitness and time away from sports participation, and decrease the risk of recurrence.


Subject(s)
Athletic Injuries/diagnostic imaging , Athletic Injuries/therapy , Disease Management , Fractures, Stress/diagnostic imaging , Fractures, Stress/therapy , Holistic Health , Athletic Injuries/etiology , Clinical Decision-Making/methods , Fractures, Stress/etiology , Holistic Health/trends , Humans , Risk Factors , Vitamin D Deficiency/complications , Vitamin D Deficiency/diagnostic imaging , Vitamin D Deficiency/therapy
4.
Curr Sports Med Rep ; 14(3): 200-8, 2015.
Article in English | MEDLINE | ID: mdl-25968853

ABSTRACT

The use of self myofascial release (SMR) via a foam roller or roller massager is becoming increasingly popular both to aid recovery from exercise and prevent injury. Our objective was to review the literature on SMR and its use for preexercise, recovery, or maintenance. PUBMED, EBSCO (MEDLINE), EMBASE, and CINAHL were searched for variations and synonyms of "self myofascial release" and "foam rolling." Data from nine studies were examined, and overall quality varied based on study protocol, muscle group targeted, and outcomes measured. Despite the heterogeneity of these studies, SMR appears to have a positive effect on range of motion and soreness/fatigue following exercise, but further study is needed to define optimal parameters (timing and duration of use) to aid performance and recovery.


Subject(s)
Exercise , Massage/methods , Muscle, Skeletal , Myalgia/prevention & control , Range of Motion, Articular , Self Care/methods , Humans , Muscle Fatigue
5.
BMC Complement Altern Med ; 14: 393, 2014 Oct 13.
Article in English | MEDLINE | ID: mdl-25310893

ABSTRACT

BACKGROUND: The objective of this study was to quantify the transverse forces in skeletal muscle subjected to constant compressive massage-like loading (MLL) following eccentric exercise (ECC). METHODS: Twenty-eight New Zealand White rabbits were used for this two-part study. For all testing, a customized electromechanical device was utilized to apply a constant compressive force MLL to the tibialis anterior (TA) muscle and the resultant transverse forces were quantified. The device consisted of two stepper motors that were positioned orthogonally to each other and connected to separate sliding tracks. A stainless steel cylindrical massage tip was mounted to a customized two-axis sensor consisting of two strain gauges with which forces along the two axes were measured. First, we determined the effects of tissue loading frequency and compression magnitude on transverse forces in the TA. Following a bout of ECC, sixteen rabbits were randomly assigned to a protocol with MLL frequency of 0.25 Hz or 0.5 Hz at a constant compressive force of 5 N or 10 N. Secondly, we utilized a protocol of 0.5 Hz, 10 N, 15 min MLL that was performed on 4 consecutive days commencing immediately post ECC (n = 6 animals) or 48 hours following ECC (n = 6 animals). Transverse forces were measured during all 4 MLL sessions for the entire 15 min duration for both the immediate and the delayed groups. RESULTS: Both frequency and magnitude of compressive force due to MLL showed an effect on the magnitude of transverse force (p < 0.05 for each parameter). Furthermore, MLL beginning immediately following ECC produced higher transverse forces than MLL delayed by 48 hours with an average 20% difference between the two MLL groups over the four day protocol. Forces were higher in the middle 5 minutes compared to the first 5 minutes for all MLL bouts in both groups. CONCLUSIONS: Frequency and magnitude of MLL and timing for delivery of MLL following ECC affect resultant transverse force values for exercised muscle. The application of our findings to humans receiving massage following exercise remains unknown at this time.


Subject(s)
Massage , Models, Animal , Muscle, Skeletal/chemistry , Animals , Biomechanical Phenomena , Rabbits
6.
Clin Biomech (Bristol, Avon) ; 29(6): 671-8, 2014 Jun.
Article in English | MEDLINE | ID: mdl-24861827

ABSTRACT

BACKGROUND: This study compared immediate versus delayed massage-like compressive loading on skeletal muscle viscoelastic properties following eccentric exercise. METHODS: Eighteen rabbits were surgically instrumented with peroneal nerve cuffs for stimulation of the tibialis anterior muscle. Rabbits were randomly assigned to a massage loading protocol applied immediately post exercise (n=6), commencing 48h post exercise (n=6), or exercised no-massage control (n=6). Viscoelastic properties were evaluated in vivo by performing a stress-relaxation test pre- and post-exercise and daily pre- and post-massage for four consecutive days of massage loading. A quasi-linear viscoelastic approach modeled the instantaneous elastic response (AG0), fast (g1(p)) and slow (g2(p)) relaxation coefficients, and the corresponding relaxation time constants τ1 and τ2. FINDINGS: Exercise increased AG0 in all groups (P<0.05). After adjusting for the three multiple comparisons, recovery of AG0 was not significant in the immediate (P=0.021) or delayed (P=0.048) group compared to the control group following four days of massage. However, within-day (pre- to post-massage) analysis revealed a decrease in AG0 in both massage groups. Following exercise, g1(p) increased and g2(p) and τ1 decreased for all groups (P<0.05). Exercise had no effect on τ2 (P>0.05). After four days of massage, there was no significant recovery of the relaxation parameters for either massage loading group compared to the control group. INTERPRETATION: Our findings suggest that massage loading following eccentric exercise has a greater effect on reducing muscle stiffness, estimated by AG0, within-day rather than affecting recovery over multiple days. Massage loading also has little effect on the relaxation response.


Subject(s)
Elasticity/physiology , Massage/methods , Muscle Relaxation/physiology , Muscle, Skeletal/physiology , Physical Conditioning, Animal/methods , Animals , Exercise Test , Male , Models, Biological , Myalgia/prevention & control , Rabbits , Random Allocation , Range of Motion, Articular , Time Factors
7.
Ann Biomed Eng ; 42(1): 36-49, 2014 Jan.
Article in English | MEDLINE | ID: mdl-23943071

ABSTRACT

Massage therapy has a long history and has been widely believed effective in restoring tissue function, relieving pain and stress, and promoting overall well-being. However, the application of massage-like actions and the efficacy of massage are largely based on anecdotal experiences that are difficult to define and measure. This leads to a somewhat limited evidence-based interface of massage therapy with modern medicine. In this study, we introduce a mechatronic device that delivers highly reproducible massage-like mechanical loads to the hind limbs of small animals (rats and rabbits), where various massage-like actions are quantified by the loading parameters (magnitude, frequency and duration) of the compressive and transverse forces on the subject tissues. The effect of massage is measured by the difference in passive viscoelastic properties of the subject tissues before and after mechanical loading, both obtained by the same device. Results show that this device is useful in identifying the loading parameters that are most conducive to a change in tissue mechanical properties, and can determine the range of loading parameters that result in sustained changes in tissue mechanical properties and function. This device presents the first step in our effort for quantifying the application of massage-like actions used clinically and measurement of their efficacy that can readily be combined with various quantitative measures (e.g., active mechanical properties and physiological assays) for determining the therapeutic and mechanistic effects of massage therapies.


Subject(s)
Massage/instrumentation , Animals , Female , Massage/methods , Models, Biological , Rabbits , Rats , Rats, Sprague-Dawley
8.
Postgrad Med J ; 89(1057): 666-70, 2013 Nov.
Article in English | MEDLINE | ID: mdl-24129034

ABSTRACT

Skeletal muscle injuries are among the most common and frequently disabling injuries sustained by athletes. Repair of injured skeletal muscle is an area that continues to present a challenge for sports medicine clinicians and researchers due, in part, to complete muscle recovery being compromised by development of fibrosis leading to loss of function and susceptibility to re-injury. Injured skeletal muscle goes through a series of coordinated and interrelated phases of healing including degeneration, inflammation, regeneration and fibrosis. Muscle regeneration initiated shortly after injury can be limited by fibrosis which affects the degree of recovery and predisposes the muscle to reinjury. It has been demonstrated in animal studies that antifibrotic agents that inactivate transforming growth factor (TGF)-ß1 have been effective at decreasing scar tissue formation. Several studies have also shown that vascular endothelial growth factor (VEGF) can increase the efficiency of skeletal muscle repair by increasing angiogenesis and, at the same time, reducing the accumulation of fibrosis. We have isolated and thoroughly characterised a population of skeletal muscle-derived stem cells (MDSCs) that enhance repair of damaged skeletal muscle fibres by directly differentiating into myofibres and secreting paracrine factors that promote tissue repair. Indeed, we have found that MDSCs transplanted into skeletal and cardiac muscles have been successful at repair probably because of their ability to secrete VEGF that works in a paracrine fashion. The application of these techniques to the study of sport-related muscle injuries awaits investigation. Other useful strategies to enhance skeletal muscle repair through increased vascularisation may include gene therapy, exercise, neuromuscular electrical stimulation and, potentially, massage therapy. Based on recent studies showing an accelerated recovery of muscle function from intense eccentric exercise through massage-based therapies, we believe that this treatment modality offers a practical and non-invasive form of therapy for skeletal muscle injuries. However, the biological mechanism(s) behind the beneficial effect of massage are still unclear and require further investigation using animal models and potentially randomised, human clinical studies.

9.
Curr Sports Med Rep ; 12(4): 248-55, 2013.
Article in English | MEDLINE | ID: mdl-23851413

ABSTRACT

Despite the widely recognized benefits of daily play, recreation, sports, and physical education on the physical and psychosocial well-being of children and adolescents, many contemporary children and adolescents worldwide do not meet the recommendations for daily physical activity (PA). The decline in PA seems to start early in life, which leads to conditions characterized by reduced levels of PA in the pediatric population that are inconsistent with current public health recommendations. Unlike many other diseases and disorders in pediatrics, physical inactivity in youth is unique in that it currently lacks a clinical gold standard for diagnosis. This makes the diagnosis and treatment medically challenging, though no less important, as the resultant ramifications of a missed diagnosis are of significant detriment. Exercise-deficient children need to be identified early in life and treated with developmentally appropriate exercise programs designed to target movement deficiencies and physical weaknesses in a supportive environment. Without such interventions early in life, children are more likely to become resistant to our interventions later in life and consequently experience adverse health consequences. Integrative approaches that link health care professionals, pediatric exercise specialists, school administrators, community leaders, and policy makers may provide the best opportunity to promote daily PA, reinforce desirable behaviors, and educate parents about the exercise-health link.


Subject(s)
Exercise , Health Behavior , Health Promotion/organization & administration , Physical Education and Training/organization & administration , Physical Fitness , Sedentary Behavior , Adolescent , Child , Child Behavior , Child, Preschool , Female , Humans , Male , United States
11.
Med Sci Sports Exerc ; 45(6): 1105-12, 2013 Jun.
Article in English | MEDLINE | ID: mdl-23274593

ABSTRACT

PURPOSE: This study compared the effect of immediate versus delayed massage-like compressive loading (MLL) on peak isometric torque recovery and inflammatory cell infiltration after eccentric exercise (EEX). METHODS: Eighteen skeletally mature New Zealand White rabbits were instrumented with peroneal nerve cuffs for the stimulation of hindlimb tibialis anterior muscles. After a bout of EEX, rabbits were randomly assigned to an MLL protocol (0.5 Hz, 10 N, 15 min) that started immediately post-EEX, 48 h post-EXX, or no-MLL control and performed for four consecutive days. A torque-angle (T-Θ) relationship was obtained for 21 joint angles pre- and post-EEX and after four consecutive days of MLL or no-MLL. Muscle wet weights and immunohistochemical sections were obtained after final treatments. RESULTS: EEX produced an average 51% ± 13% decrease in peak isometric torque output. The greatest peak torque recovery occurred with the immediate application of MLL. There were differences in torque recovery between immediate and delayed MLL (P = 0.0012), immediate MLL and control (P < 0.0001), and delayed MLL and control (P = 0.025). Immunohistochemical analysis showed 39.3% and 366.0% differences in the number of RPN3/57 and CD11b-positive cells between immediate (P = 0.71) and delayed MLL (P = 0.12). The area under the T-Θ curve showed a difference for immediate (P < 0.0001) and delayed (P = 0.0051) MLL as compared with control. Exercise produced an average 10° ± 0.2° rightward shift from preexercise peak isometric torque angle. Control, immediate MLL, and delayed MLL produced an average leftward angular shift from the postexercise angle (P = 0.28, P = 0.03, and P = 0.47, respectively). CONCLUSION: Post-EEX, immediate MLL was more beneficial than delayed MLL in restoring muscle function and in modulating inflammatory cell infiltration. These findings invite similar human studies to make definitive conclusions on optimal timing of massage-based therapies.


Subject(s)
Leukocytes/metabolism , Massage/methods , Muscle, Skeletal/physiology , Physical Conditioning, Animal/physiology , Animals , Biomechanical Phenomena , Female , Immunohistochemistry , Inflammation/immunology , Linear Models , Muscle, Skeletal/immunology , Neutrophil Infiltration , ROC Curve , Rabbits , Random Allocation , Recovery of Function , Torque , Weight-Bearing
12.
Br J Sports Med ; 47(2): 83-8, 2013 Jan.
Article in English | MEDLINE | ID: mdl-22736207

ABSTRACT

BACKGROUND: Optimal strategies for massage and its use in athletes have not been conclusively demonstrated. PURPOSE/STUDY DESIGN: Effects of varying duration, frequency and magnitude of massage-like compressive loading (MLL) on recovery of skeletal muscle active properties (torque angle (T-Θ) relationship) following exercise-induced muscle injury were studied. METHODS: Twenty-four New Zealand White rabbits were surgically instrumented with bilateral peroneal nerve cuffs for stimulation of hindlimb tibialis anterior muscles. Following a bout of eccentric exercise (EEX), rabbits were randomly assigned to a MLL protocol of 0.25 or 0.5 Hz at 5 or 10 N for 15 or 30 min. T-Θ was obtained for 21 tibiotarsal joint angles pre- and post-EEX and post 4 consecutive days of MLL. Muscle wet weight and H&E sections were obtained following final treatments. RESULTS: EEX produced an average 61.8%±2.1 decrease in peak isometric torque output. Differences in torque recovery were found between magnitudes (5 and 10 N; p=0.004, n=12) and frequencies (0.25 and 0.5 Hz; p=0.012, n=12), but no difference for durations (15 and 30 min) with the 0.5 Hz, 10 N, 15 min protocol showing greatest recovery 4 days post-EEX. MLL muscle (n=12) wet weight was 3.22±0.18 g, while no MLL tissue (n=9) weighed 3.74±0.22 g (p=0.029). Histological analysis showed a difference in torn fibres between low-parameter and high-parameter MLL (6.5±1.04 vs 0.5±0.29 per 0.59 mm(2), p=0.005). CONCLUSIONS: Results showed a dose-response effect for magnitude and frequency of MLL on recovery of active muscle properties following EEX. Future studies will investigate underlying biological mechanisms for this enhanced recovery of muscle function.


Subject(s)
Massage/methods , Muscle, Skeletal/injuries , Physical Conditioning, Animal/physiology , Stress, Physiological/physiology , Animals , Female , Hindlimb , Muscle, Skeletal/physiology , Pressure , Rabbits , Recovery of Function/physiology , Torque
13.
Br J Sports Med ; 47(9): 556-60, 2013 Jun.
Article in English | MEDLINE | ID: mdl-23197410

ABSTRACT

Skeletal muscle injuries are among the most common and frequently disabling injuries sustained by athletes. Repair of injured skeletal muscle is an area that continues to present a challenge for sports medicine clinicians and researchers due, in part, to complete muscle recovery being compromised by development of fibrosis leading to loss of function and susceptibility to re-injury. Injured skeletal muscle goes through a series of coordinated and interrelated phases of healing including degeneration, inflammation, regeneration and fibrosis. Muscle regeneration initiated shortly after injury can be limited by fibrosis which affects the degree of recovery and predisposes the muscle to reinjury. It has been demonstrated in animal studies that antifibrotic agents that inactivate transforming growth factor (TGF)-ß1 have been effective at decreasing scar tissue formation. Several studies have also shown that vascular endothelial growth factor (VEGF) can increase the efficiency of skeletal muscle repair by increasing angiogenesis and, at the same time, reducing the accumulation of fibrosis. We have isolated and thoroughly characterised a population of skeletal muscle-derived stem cells (MDSCs) that enhance repair of damaged skeletal muscle fibres by directly differentiating into myofibres and secreting paracrine factors that promote tissue repair. Indeed, we have found that MDSCs transplanted into skeletal and cardiac muscles have been successful at repair probably because of their ability to secrete VEGF that works in a paracrine fashion. The application of these techniques to the study of sport-related muscle injuries awaits investigation. Other useful strategies to enhance skeletal muscle repair through increased vascularisation may include gene therapy, exercise, neuromuscular electrical stimulation and, potentially, massage therapy. Based on recent studies showing an accelerated recovery of muscle function from intense eccentric exercise through massage-based therapies, we believe that this treatment modality offers a practical and non-invasive form of therapy for skeletal muscle injuries. However, the biological mechanism(s) behind the beneficial effect of massage are still unclear and require further investigation using animal models and potentially randomised, human clinical studies.


Subject(s)
Massage , Muscle, Skeletal/injuries , Stem Cell Transplantation/methods , Stem Cells/physiology , Athletic Injuries/therapy , Electric Stimulation Therapy/methods , Exercise Therapy/methods , Humans , Muscle, Skeletal/blood supply , Neovascularization, Physiologic/physiology , Recovery of Function , Vascular Endothelial Growth Factor A/metabolism , Vascular Endothelial Growth Factor A/physiology , Wound Healing/physiology
14.
J Biomech ; 45(15): 2630-6, 2012 Oct 11.
Article in English | MEDLINE | ID: mdl-22944344

ABSTRACT

A quasi-linear viscoelasticity (QLV) model was used to study passive time-dependent responses of skeletal muscle to repeated massage-like compressive loading (MLL) following damaging eccentric exercise. Six skeletally mature rabbits were surgically instrumented with bilateral peroneal nerve cuffs for stimulation of the hindlimb tibialis anterior (TA) muscles. Following the eccentric exercise, rabbits were randomly assigned to a four-day MLL protocol mimicking deep effleurage (0.5 Hz, 10 N for 15 min or for 30 min). The contralateral hindlimb served as the exercised, no-MLL control for both MLL conditions. Viscoelastic properties of the muscle pre-exercise, post-exercise on Day 1, and pre- and post-MLL Day 1 through Day 4 were determined with ramp-and-hold tests. The instantaneous elastic response (AG(0)) increased following exercise (p<0.05) and decreased due to both the 15 min and 30 min four-day MLL protocols (p<0.05). Post-four days of MLL the normalized AG(0) decreased from post-exercise (Day 1, 248.5%) to the post-MLL (Day 4, 98.5%) (p<0.05), compared to the no-MLL group (Day 4, 222.0%) (p<0.05). Exercise and four-day MLL showed no acute or cumulative effects on the fast and slow relaxation coefficients (p>0.05). This is the first experimental evidence of the effect of both acute (daily) and cumulative changes in viscoelastic properties of intensely exercised muscle due to ex vivo MLL. It provides a starting point for correlating passive muscle properties with mechanical effects of manual therapies, and may shed light on design and optimization of massage protocols.


Subject(s)
Massage , Muscle, Skeletal/physiology , Physical Conditioning, Animal/physiology , Animals , Elasticity , Muscle Relaxation/physiology , Rabbits , Tibia
15.
PM R ; 3(6 Suppl 1): S78-81, 2011 Jun.
Article in English | MEDLINE | ID: mdl-21703585

ABSTRACT

Prolotherapy is a technique that involves the injection of an irritant, usually a hyperosmolar dextrose solution, typically in the treatment of chronic painful musculoskeletal conditions. Despite its long history and widespread use as a form of complementary therapy, there still are disparities over its optimal indications and injection preparations. There are, however, numerous studies available regarding the use and efficacy of prolotherapy for various musculoskeletal conditions. The most frequently published indication is in the treatment of chronic low back pain, but there are recent studies that examined its use in the management of refractory tendinopathies as well as osteoarthritis. There is growing evidence to suggest that prolotherapy may be helpful in treating chronic low back pain when coupled with adjunctive therapies, such as spinal manipulation or corticosteroid injections. There is also evidence to suggest that prolotherapy is effective in treating refractory tendinopathies, particularly for lateral epicondylosis and Achilles tendinopathy. Additional larger, randomized controlled trials are needed to make specific recommendations regarding ideal protocols and indications. There is emerging evidence for the use of prolotherapy as a treatment option for osteoarthritis; however, further studies are needed to conclusively demonstrate its efficacy. Overall, prolotherapy remains a promising option for the treatment of painful musculoskeletal conditions, particularly when other standard treatments have proved ineffective.


Subject(s)
Chronic Pain/drug therapy , Complementary Therapies/methods , Musculoskeletal Pain/drug therapy , Sclerosing Solutions/administration & dosage , Humans , Injections , Treatment Outcome
16.
Phys Sportsmed ; 39(1): 74-84, 2011 Feb.
Article in English | MEDLINE | ID: mdl-21378489

ABSTRACT

As more children and adolescents participate in sports and conditioning activities (sometimes without consideration for cumulative workload), it is important to establish age-appropriate training guidelines that may reduce the risk of sports-related injury and enhance athletic performance. The purpose of this article is to review the scientific evidence on youth strength and conditioning and to provide age-appropriate recommendations for integrating different strength and conditioning activities into a well-designed program that is safe, effective, and enjoyable. Integrative training is defined as a program or plan that incorporates general and specific strength and conditioning activities that enhance both health- and skill-related components of physical fitness. The cornerstone of integrative training is age-appropriate education and instruction by qualified professionals who understand the physical and psychosocial uniqueness of children and adolescents.


Subject(s)
Athletic Injuries/prevention & control , Athletic Performance/physiology , Muscle Strength/physiology , Physical Education and Training/methods , Physical Fitness , Adolescent , Child , Humans , Physical Education and Training/standards
17.
Clin J Sport Med ; 21(1): 31-6, 2011 Jan.
Article in English | MEDLINE | ID: mdl-21200168

ABSTRACT

OBJECTIVE: To review the evidence for the clinical utilization of autologous plasma products in the management of muscle strain injuries. METHOD: Systematic review using EMBASE and MEDLINE (up to March 2010). RESULTS: There is no level 1, 2, and 3 evidence for the use of autologous plasma products in muscle strain injuries. Furthermore, significant methodological limitations impact on the interpretation of the few published studies in this field. CONCLUSIONS: Although basic science and the use of recombinant growth factors in animal models support the concept of applying growth factors to acute muscle injuries, it is unclear if this evidence can be directly translated to reflect outcomes from platelet-enriched plasma. There remain a large number of unanswered questions, including the principle questions regarding safety and efficacy, which require appropriate scientific investigation. It is incumbent on sports physicians wishing to enhance athlete care, together with researchers, to search for these answers.


Subject(s)
Blood Transfusion, Autologous , Muscle, Skeletal/injuries , Platelet-Rich Plasma , Sprains and Strains/therapy , Clinical Trials as Topic , Evidence-Based Practice , Humans , Injections, Intramuscular , Sprains and Strains/rehabilitation , Treatment Outcome
18.
Br J Sports Med ; 45(1): 57-64, 2011 Jan.
Article in English | MEDLINE | ID: mdl-18812419

ABSTRACT

OBJECTIVES: The authors examined the most current evidence for treatment options in athletes with osteitis pubis and osteomyelitis pubis, attempting to determine which options provide optimal pain relief with rapid return to sport and prevention of symptom reoccurrence. METHODS: Three databases-MEDLINE, Cochrane Database of Systematic Reviews and CINAHL-were searched using the OVID interface for all years between 1985 and May 2008. References were analysed from included studies, and additional relevant articles were obtained for inclusion. Inclusion criteria included (1) humans only, (2) subjects had no apparent risk factors for development of osteitis pubis or osteomyelitis of the pubic symphysis other than athletic involvement, (3) both physical exam findings and diagnostic imaging were used to confirm either diagnosis, and (4) a definitive treatment strategy was identifiable for management of osteitis pubis or osteomyelitis of the pubic symphysis. In total, 25 articles were included in the review. RESULTS: There were no randomised controlled trials identified with this study's search strategy. A total of 195 athletes were diagnosed as having osteitis pubis (186 males, nine females) and treated with either conservative measures/physical therapy, local injection with corticosteroids and/or local anaesthetic, dextrose prolotherapy, surgery or antibiotic therapy. Six case reports/series described conservative treatment measures (physical therapy, rest, non-steroid anti-inflammatory drugs). Four case series explored the use of corticosteroid injections in treatment. One case series described the use of dextrose prolotherapy as a treatment modality. Six case series described various surgical techniques (pubic symphysis curettage, polypropylene mesh placement and pubic bone stabilisation) in treatment. Ten case reports/series (10 subjects) outlined antibiotic treatment of osteomyelitis of the pubic symphysis. CONCLUSIONS: The current medical literature shows only level 4 evidence of the treatment for osteitis pubis in 24 case reports/series in athletes. Without any direct comparison of treatment modalities, it is difficult to determine which individual treatment option is the most efficacious. Further study comparing the different treatment options is necessary to determine which modality provides the fastest return to sport.


Subject(s)
Osteitis/therapy , Osteomyelitis/therapy , Pubic Symphysis , Sports , Adolescent , Adult , Anti-Inflammatory Agents/therapeutic use , Athletic Injuries/therapy , Female , Humans , Male , Physical Therapy Modalities , Young Adult
19.
Clin J Sport Med ; 18(5): 446-60, 2008 Sep.
Article in English | MEDLINE | ID: mdl-18806553

ABSTRACT

OBJECTIVE: Sport massage, a manual therapy for muscle and soft tissue pain and weakness, is a popular and widely used modality for recovery after intense exercise. Our objective is to determine the effectiveness of sport massage for improving recovery after strenuous exercise. DATA SOURCES: We searched MEDLINE, EMBASE, and CINAHL using all current and historical names for sport massage. Reference sections of included articles were scanned to identify additional relevant articles. STUDY SELECTION: Study inclusion criteria required that subjects (1) were humans, (2) performed strenuous exercise, (3) received massage, and (4) were assessed for muscle recovery and performance. Ultimately, 27 studies met inclusion criteria. DATA EXTRACTION: Eligible studies were reviewed, and data were extracted by the senior author (TMB). The main outcomes extracted were type and timing of massage and outcome measures studied. DATA SYNTHESIS: Data from 17 case series revealed inconsistent results. Most studies evaluating post-exercise function suggest that massage is not effective, whereas studies that also evaluated the symptoms of DOMS did show some benefit. Data from 10 randomized controlled trials (RCTs) do, however, provide moderate evidence for the efficacy of massage therapy. The search identified no trend between type and timing of massage and any specific outcome measures investigated. CONCLUSIONS: Case series provide little support for the use of massage to aid muscle recovery or performance after intense exercise. In contrast, RCTs provide moderate data supporting its use to facilitate recovery from repetitive muscular contractions. Further investigation using standardized protocols measuring similar outcome variables is necessary to more conclusively determine the efficacy of sport massage and the optimal strategy for its implementation to enhance recovery following intense exercise.


Subject(s)
Athletic Injuries/therapy , Massage/methods , Muscle, Skeletal/injuries , Physical Exertion/physiology , Sports , Female , Humans , Male , Muscle, Skeletal/blood supply , Treatment Outcome
20.
Med Sci Sports Exerc ; 40(7): 1289-96, 2008 Jul.
Article in English | MEDLINE | ID: mdl-18580410

ABSTRACT

PURPOSE: To assess the biologic basis of massage therapies, we developed an experimental approach to mimic Swedish massage and evaluate this approach on recovery from eccentric exercise-induced muscle damage using a well-controlled animal model. METHODS: Tibialis anterior muscles of six New Zealand White rabbits were subjected to one bout of damaging, eccentric contractions. One muscle was immediately subjected to cyclic compressive loads, and the contralateral served as the exercised control. RESULTS: We found that commencing 30 min of cyclic compressive loading to the muscle, immediately after a bout of eccentric exercise, facilitated recovery of function and attenuated leukocyte infiltration. In addition, fiber necrosis and wet weight of the tissue were also reduced by compressive loading. CONCLUSION: We conclude that subjecting muscle to compressive loads immediately after exercise leads to an enhanced recovery of muscle function and attenuation of the damaging effects of inflammation in the rabbit model. Although these observations suggest that skeletal muscle responds to cyclic compressive forces similar to those generated by clinical approaches, such as therapeutic massage, further research is needed to assess the translational efficacy of these findings.


Subject(s)
Adaptation, Physiological , Massage , Muscle, Skeletal/physiology , Physical Conditioning, Animal/physiology , Stress, Physiological/physiology , Animals , Biomechanical Phenomena , Female , Inflammation/etiology , Inflammation/therapy , Lower Extremity , Models, Animal , Muscle, Skeletal/pathology , Rabbits , Torque
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