Ilial anterior rotation hypermobility in a female collegiate tennis player.

BACKGROUND AND PURPOSE: This case report describes the examination, evaluation, and intervention by a physical therapist for a female collegiate tennis player with a right ilial anterior rotation hypermobility. CASE DESCRIPTION: The patient was a 21-year-old, female collegiate tennis player who developed a right anterior ilial rotation hypermobility as a result of her tennis stroke. Functional limitations were related to sitting, squatting, gait, and playing tennis. Treatment interventions consisted of massage, joint manipulation, stretching, stabilization exercises, sport-specific exercises and modification of tennis stroke, proprioceptive taping, and the use of a sacroiliac belt. OUTCOMES: After 26 weeks (33 treatments), tissue tenderness of the sacroiliac joint region was normalized, pelvic/trunk and lower-extremity mobility and flexibility were restored, sacroiliac symmetry and stability were regained, and the patient achieved her goal of returning to competitive tennis at the collegiate level. DISCUSSION: The patient's right ilial anterior rotation hypermobility was directly related to the mechanics of her tennis stroke. Her outcomes suggest that rehabilitation should focus on the entire abdomino-sacro-pelvic-hip complex, addressing articular, neural, and muscular inhibitions and deficiencies.

Range of motion in junior tennis players participating in an injury risk modification program.

This study evaluated changes in range of motion (ROM) in competitive male and female junior tennis players participating in a specific conditioning program over a two-year period. Subjects were also compared to an age and sex-matched control group of players not performing the exercises. Fifty-one tennis players, 29 male (mean age 13.6) and 22 female (mean age 13.2) entered the study. Baseline ROM measurements were performed on all players upon entering the study. The conditioning program employed standardised stretch-hold-relax flexibility exercises for all the areas tested. These exercises were taught to the players and each athlete was given a video of the exercises. Compliance with the program was assessed by exercise logs, the parents, and the athletes. High compliers were compared to low compliers. Mean changes in the combined ROM measurements over time indicate improvement in flexibility in most anatomical areas after one year of participation, with small improvements in the second year. With the exception of forearm supination, there were no differences between high compliers and low compliers. Compared to controls, the experimental group showed significant improvement in sit and reach, dominant and nondominant shoulder internal rotation, dominant and nondominant shoulder external rotation, nondominant gastrocnemius, dominant iliotibial band, dominant and nondominant hip internal rotation, dominant and nondominant hip external rotation, dominant and nondominant forearm pronation, and dominant wrist flexion. The areas of greatest significant change were in the shoulder and back, which correspond to the areas of most clinical risk of Injury. In conclusion, joint ROM can be positively influenced with a specific conditioning program.

Unresolving hip tendonitis leads to discovery of malignant tumor.

OBJECTIVE: To discuss a case of malignant bone tumor in the left hip of a patient who sought treatment following a tennis injury. CLINICAL FEATURES: A 27-year-old male patient visited a chiropractic clinic 6 months after a twisting injury to his left hip which occurred while playing tennis. His pain had remained moderate in intensity and intermittent to frequent in frequency since it originated but became more intense the week prior to his visit. INTERVENTION AND OUTCOME: The patient was diagnosed with a tendonitis/bursitis and received 3 weeks of treatment. Care consisted of various forms of passive modalities to reduce pain and inflammation, as well as hip mobilization and tissue stretching. Plain film examination was then performed, due to lack of progress, and revealed a possible chondroblastoma of the femoral head. The patient was referred to his primary care physician (PCP) for follow-up imaging. Surgical resection of the lesion occurred approximately 2 months later. Biopsy of the resected cells confirmed a new diagnosis of clear cell chondrosarcoma. A computed tomography (CT) scan of the chest was performed to rule out metastasis to the lungs. Regular follow-up care and imaging continued and revealed, 9 months following, that the femoral head lesion had returned and hip replacement surgery would be needed. CONCLUSION: Tendonitis, bursitis, and sprains commonly occur following sports-related trauma to the appendicular skeleton. A conservative trial of care should be performed on suspected soft tissue injuries. However, when lack of improvement occurs within the first month, further examination, special studies, or referral are warranted to ensure a proper diagnosis and to rule out a pathological condition.

Medial superior cluneal nerve entrapment neuropathy in teenagers: a report of two cases.

Medial superior cluneal nerve entrapment neuropathy causes pain radiating from the low back down to the posterior thigh. It tends to be misdiagnosed as a lumbar spine disorder. Patients in previous reports were in the middle or old age at the onset. Proposing simultaneous full flexion of the ipsilateral hip and knee joints as a provocation test, we present two cases of teenager females who spent long before diagnosis of their condition. Both of them had engaged in vigorous sports activities and completely recovered from the disability following local anaesthetic and corticosteroid injection at the trigger point.

Major international sport profiles.

Sports are part of the sociocultural fabric of all countries. Although different sports have their origins in different countries, many sports are now played worldwide. International sporting events bring athletes of many cultures together and provide the opportunity not only for athletic competition but also for sociocultural exchange and understanding among people. This article reviews five major sports with international appeal and participation: cricket, martial arts, field hockey, soccer, and tennis. For each sport, the major aspects of physiological and biomechanical demands, injuries, and prevention strategies are reviewed.

Condropatia rotuliana en el deporte / Patellar chondropathy in sports

La actividad física y el deporte reglado son realizados en la actualidad por un elevado número de personas a todas las edades que precisarían de un control médico que en algunos medios no se hace. Esto ha desencadenado una avalancha de lesiones a nivel de la articulación fémoro-rotuliana que es preocupante sobre todo en deportistas jóvenes. Esto significa que cualquier cosa que hagamos para aclarar la etiopatogenia, prevención y tratamiento de estas lesiones sea del máximo interés. Se realiza un estudio sobre una población de 1.224 personas que han sido tratadas de condropatía rotuliana relacionada con la actividad física o el deporte. Dichos deportistas han sido sometidos a un test estándar de revisión clínica sobre todo centrado en las alteraciones anatómicas que afectan a los miembros inferiores por lo que representan de sobrecarga para el aparato extensor de la rodilla. En dicho estudio se demuestra la prevalencia de aparición por edades, deportes y su relación con alteraciones anatómicas previas(13), procurando sacar conclusiones que ayuden a evitar su aparición o en su defecto a conseguir una recuperación de la misma (AU)

Shoulder impingement in tennis/racquetball players treated with subscapularis myofascial treatments.

Conservative care of the athlete with shoulder impingement includes activity modification, application of ice, nonsteroidal anti-inflammatory drugs, subacromial corticosteroid injections, and physiotherapy. This case report describes the clinical treatment and outcome of three patients with shoulder impingement syndrome who did not respond to traditional treatment. Two of the three were previously referred for arthroscopic surgery. All three were treated with subscapularis trigger point dry needling and therapeutic stretching. They responded to treatment and had returned to painless function at follow-up 2 years later.

A rational management of tennis elbow.

Tennis elbow is due to a torque injury or sudden overstretching of tendons which insert into the epicondyles of the humerus. The predominant lesion is an enthesopathy--a pathological lesion at the insertion of tendon into bone. The most common site is at the lateral epicondyle and this is 3 times as frequent as at the medial epicondyle. Approximately 50% of tennis players can expect to get a tennis elbow at some time during their playing lifetime. In one-third of the players this will be severe enough to interfere with their tasks of daily living. The major unresolved question about the aetiology of tennis elbow is why it has its peak incidence between the ages of 40 and 50 years and why 90% of players then have no further recurrence. Making sense of the literature on the treatment of tennis elbow is difficult because there are few studies that have used the acceptable epidemiological techniques of the prospective randomised controlled trial or case-controlled study. Most papers are based on a collection of highly selected cases which represent the more intractable end of the tennis elbow spectrum and their reported results have been inconsistent. Tennis elbow is largely a self-limiting condition. The prime aim of treatment should be based on Hippocrates' first tenet of medicine--first do no harm. Therapy should start with the simple and conservative before progressing to the more complex and invasive therapies. It should be acceptable to the patient, cost-effective and where invasive therapy is recommended, the potential benefits should clearly outweigh the risks. The principles of therapy for tennis elbow are to relieve pain, microbleeding and inflammation, promote healing, rehabilitate the injured arm and try to prevent recurrence. The most effective modalities of treatment are found to be cryotherapy in the acute stage then nonsteroidal anti-inflammatory drugs and heat in its various modalities including ultrasound. This is combined with rest which is best defined as the absence of painful activity. Injection of a depot preparation of cortisone is effective although patient reports are not as flattering as those of doctors. There is no advantage and in fact considerable disadvantage in using more than 2 such injections. Therapies such as acupuncture and chiropractic have not been evaluated. Nevertheless they cause no harm, may result in good and should be tried before resorting to more invasive therapy. Rehabilitation should run parallel to treatment.(ABSTRACT TRUNCATED AT 400 WORDS)

Overuse syndromes in baseball, tennis, gymnastics, and swimming.

The shoulder is the "center of action" for most sports including those discussed in this article. Overuse problems of the shoulder are the most common group of injuries affecting the athlete involved in baseball, tennis, swimming, and gymnastics. Most of the injuries can be directly related to the mechanics of throwing, swimming, or gymnastics. After diagnosis, treatment is directed at "selective rest" of the injured shoulder and modalities and medications intended to decrease the inflammatory response of the body to stress.