Combined osteopathy and exercise management of Achilles tendinopathy in an athlete.

Mid-portion Achilles tendinopathy is a common injury in sporting populations. There is conflicting evidence about the best approach to conservative management. This report focuses on the rehabilitation of an Achilles tendinopathy utilizing osteopathic manual therapy (OMT) and a structured exercise program in a semi-professional volleyballer. The patient presented with a 4-month history of right mid-portion Achilles tendon pain that began after a lateral inversion sprain of the right ankle. The primary complaint was pain impacting the patients vertical jump performance. The patient complained of pain that was greatest in the morning and at the beginning of a training session prior to warming up. The inventory therapy was a combination of OMT. The manual therapy was complemented with a rehabilitation program. Outcomes were assessed with the Victorian Institute of Sport Assessment - Achilles (VISA-A), visual analogue scales (VAS), painful arc, London Hospital Test, soleus lunge test and maximum vertical jump. This case presented many challenging management options including a resolving right ankle lateral inversion sprain, a past history of contralateral Achilles tendinopathy and a high training load. The case demonstrated the importance of patient-centered practice. It was integral that the patient's role as a semi-professional athlete on the volleyball court was analyzed closely in order to replicate different facets of his game, so that the rehabilitation program could support a return to performance at the highest level. Once the initial deficits in mobility and strength were addressed, the rehabilitation program focus moved to injury prevention.

Prevalência de subluxações cervicais e torácicas com relação ao membro dominante superior em atletas amadores de voleibol / Prevalence of cervical and thoracic subluxations in relation to the dominant upper limb in amateur volleyball players

O voleibol exige um ótimo condicionamento físico, força, velocidade, agilidade e flexibilidade de seus participantes. Nele, a repetição de determinados tipos de movimentos e a sobrecarga de treinamento exigida produz um processo de adaptação orgânica do corpo que resulta, muitas vezes, em desequilíbrio muscular. Somado a isso, os gestos específicos e os erros na técnica de execução dos movimentos podem aumentar a prevalência de alterações posturais influenciando o aumento de possibilidades de lesões (JUNIOR, 2004). As alterações posturais, por sua vez, podem ocasionar distúrbios que afetam a coluna vertebral. Objetivo: o propósito do estudo foi detectar as principais subluxações - vertebrais cervicais e torácicas - por meio da análise das rotações do processo espinhoso de cada vértebra e lateralidade do atlas com o membro dominante superior, relacionando com as categorias e com a posição em quadra de atletas de Voleibol. Método: para tanto, realizou-se uma pesquisa descritiva com 145 atletas de categorias de base e adulta que treinam mais de dois dias por semana. Os atletas foram submetidos a uma avaliação quiroprática. Resultados e Discussão: verificou-se que as subluxações mais prevalentes foram das vértebras C1, C7, T4, T8 e T12. Observou-se que a musculatura e a articulação do ombro estão diretamente interligadas com as subluxações encontradas. Atletas ambidestros apresentaram menor percentagem de subluxações e maior equilíbrio rotacional dos processos espinhosos e da lateralidade do atlas. Os demais atletas apresentaram a lateralidade do atlas e as rotações do processo espinhoso das regiões cervical e torácica para o lado direito...

Volleyball requires a great physical fitness, strength, speed, agility and flexibility of its players. In it, the repetition of certain types of movements and the overload of training required may produces an organic process of adaptation of the body that often results in muscle imbalance. Added to this, the specific gestures and errors in technique of the movements may increase the prevalence of postural changes influencing the increased possibilities of injuries. Postural changes, inturn, can lead to disorders affecting the spine. Objective: the purpose of the study was to identify the main subluxations - cervical and thoracic - through the analysis of rotations of the spinous process of each vertebra and laterality of the atlas with the dominant upper limb, in what respect the categories and the position in court of volleyball athletes. Method: it was carried out a descriptive study of 145 athletes from youth teams and adult training more than two days per week. The athletes underwent a chiropractic evaluation. Results and Discussion: it was found that the most prevalent vertebral subluxation are C1, C7, T4, T8 and T12. It was noted that the muscles and the shoulder joint are directly interconnected with the subluxations found. Ambidextrous athletes showed lower percentage of subluxations and higher rotational equilibrium of the spinous processes and the laterality of the atlas. The other athletes showed the laterality of the atlas and the rotations of the spinous process of the cervical and thoracic regions to the right side...

Management of shoulder injuries using dry needling in elite volleyball players.

These case reports describe the short-term benefits of dry needling in shoulder injuries in four international female volleyball athletes during a month-long intense competitive phase, using both replicable subjective and objective measures. Dry needling of scapulohumeral muscles was carried out. Range of movement, strength and pain were assessed before and after treatment, with a functional assessment of pain immediately after playing and overhead activity, using the short form McGill Pain Questionnaire. All scores were improved post-treatment and athletes were able to continue overhead activities. Previous studies have suggested that myofascial trigger points may cause significant functional weakness and reduced range of motion, with referred pain. Trigger point dry needling has been successful in treating athletes with myofascial pain and impingement symptoms but with only subjective improvement and not during a competitive phase. These cases support the use of dry needling in elite athletes during a competitive phase with short-term pain relief and improved function in shoulder injuries. It may help maintain rotator cuff balance and strength, reducing further pain and injury.