Percutaneous Intramedullary Application of Stem Cells for Fifth Metatarsal Fractures Treated With a Cannulated Screw.

Non-union and refracture of fifth metatarsal fractures are common and devastating complications in the athletic population. Stem cell application at the fracture site, for biologic enhancement, is utilized to address this challenge. We present a simple technique to approach both the endosteum and the periosteum percutaneously, under a local anesthetic, in cases of cannulated screw intramedullary fixation.

Age-Related Constraints in the Visuomotor Plasticity of Postural Control as Revealed by a Whole-Body Mirror Learning Task.

Whether visuomotor plasticity of postural control is a trainable feature in older age remains an open question despite the wealth of visually guided exercise games promising to improve balance skill. We asked how aging affects adaptation and learning of a visual feedback (VF) reversal during visually guided weight shifting and whether this skill is modulated by explicit knowledge. Twenty-four older (71.43 ± 2.54 years) and 24 young (24.04 ± 0.93 years) participants were exposed to a 180° VF reversal while tracking a horizontally moving target by voluntarily weight shifting between two force platforms. An explicit strategy was available to half of the participants with detailed instruction to counter the VF rotation. Individual error data were fitted to an exponential function to assess adaptation. Fewer older (12/24) than younger (21/24) participants adapted to the VF reversal, displaying error curves that fitted the exponential function. Older adults who adapted to the VF reversal (responders, n = 12) reached an asymptote in performance in the same weight shifting cycle and displayed a similar mean asymptotic error compared with young participants. Young but not older responders exhibited an aftereffect when the VF reversal was removed. Instruction did not influence spatial error modulations regardless of age. The large individual variations within the older adults' group during early adaptation suggest age-specific limitations in using explicit cognitive strategies when older adults are exposed to an abrupt mirror feedback reversal that requires a change in weight shifting direction during whole-body postural tracking.

Vertical Jumping Performance: Recording the Effects of Proprioceptive Neuromuscular Facilitation Stretching at Different Plantar Flexor Lengths.

INTRODUCTION: Flexibility seems to be an essential part of both the training and rehabilitation processes. Several stretching techniques have been used to improve the range of motion (ROM) of the joints with the proprioceptive neuromuscular facilitation (PNF) method being the most effective one. Although plantar flexors are ideal to compare the acute effects of synergistic muscle groups on performance, it is not clear whether the PNF stretch at different muscle lengths could result in different alterations. MATERIAL AND METHODS: Sixteen male students randomly performed 2 levels of stretching (PNF with bended knees, or PNFshort, and with extended knee, or PNFlong) and 3 types of jumps, separated by 48 hours (7 sessions in total). Jumping parameters were recorded by a force plate, and the final jumping height (H) and ground reaction forces (Fz) were analyzed. Furthermore, the ROM of the ankle joint was recorded before, right after, and 15 minutes after the stretches.  Results: The ankle joint's ROM joint was increased after both interventions. No significant changes were found in the jumping height of all jumps. The Fz, during the squat jump (SJ) and countermovement jump (CMJ), were increased after PNFshort. Similarly, a significant increase was found in Fz in drop jumps (DJ) right after the PNFshort. CONCLUSION: Our findings demonstrated that PNF stretches of different lengths could potentially alter the stretch-shortening cycle's performance, possibly leading to a non-optimal muscle-tendon interaction.

Ankle-Specific Training Does Not Alter Drop Jumping Biomechanics Despite Increased Plantar Flexor Strength and Jumping Performance.

INTRODUCTION: Power plays a crucial role in determining an athlete's final performance, as it signifies the ability to rapidly generate force. The plantar flexor muscles have a crucial role in producing the necessary power. The plantar flexor muscles are important in explosive sports movements due to their ability to generate substantial force quickly during the propulsion phase and facilitate efficient energy transfer through the joints. This study aimed to investigate the effects of specific plantar flexor training on drop jumping (DJ) biomechanics, muscle activation, and muscle strength. MATERIAL AND METHODS: A total of 30 male participants were divided into three groups: the incline hopping (IH) group, which performed continuous jumps on a 15° inclined surface; the plane hopping (PH) group, which performed jumps on a plane surface; and the electrostimulation (EMS) group (n = 10 for each group). All groups trained four times weekly, performing 10 sets of 10 jumps per session. The intervention period lasted four weeks. Participants' drop jumping ability was assessed before and immediately after the training period using hip, knee, and ankle kinematics and electromyographic (EMG) activity of the medial gastrocnemius (MGas), tibialis anterior (TA), rectus femoris (RF), and semitendinosus (ST) muscles. In addition, maximal isokinetic plantar flexor force measurements were evaluated in eccentric and concentric conditions. RESULTS: Analysis of variance (ANOVA) revealed that only the inclined hopping showed significant improvements in the take-off velocity (Vto) of the fast drop jump (bounce drop jump (BDJ)) (p < 0.05). These improvements were accompanied by significantly higher MGas activity during the propulsion phase of the jump (p < 0.05). In addition, all groups demonstrated greater eccentric torque (p < 0.05), while IH also improved concentric torque (p < 0.05). CONCLUSIONS: The results support the efficacy of inclined hopping in improving the Vto of BDJs. The increased MGas activity and stable co-activation index (CI) during the propulsion phase are likely to contribute to these improvements. Coaches should consider incorporating incline hopping into the periodization of athletes, while level hopping and electrostimulation could be used to increase overall strength.

Gross Measurement of Intraarticular Graft Length in All-Inside Anterior Cruciate Ligament Reconstruction.

Intra articular length (IAL) of the graft has not been measured yet in anatomic, single bundle, anterior cruciate ligament (ACL) reconstruction. Especially in the all-inside ACL reconstruction technique, the IAL of the graft is of great importance due to the philosophy of the technique and the risk of graft "bottoming out". We present a simple arthroscopic measurement of the IAL of the ACL graft in anatomic, single bundle ACL reconstruction, that will allow optimal application of the all-inside technique.

Incline plyometrics-induced improvement of jumping performance.

The aim of this study was to examine the effects of incline plyometrics training on muscle activation and architecture during vertical jumping and maximum strength. Twenty male participants were divided in two training groups which followed after a 4 week training program. The incline plyometrics group (n = 10) trained by performing consecutive jumps on an inclined surface (15°) while the plane plyometrics (PP) group (n = 10) performed the same jumps on a plane surface. Both groups trained four times per week and performed 8 sets of 10 jumps in each session. Subjects performed squat jumps, counter movement jumps and drop jumps (DJ) prior to and immediately after the training period, while the electromyographic activity of the medial gastrocnemius (MGAS) and tibialis anterior muscles and the architecture of MGAS were recorded. Maximal isokinetic and isometric strength of the plantar flexors were performed. Analysis of variance showed that only the IP group improved fast DJ height performance by 17.4 and 14.4% (20 and 40 cm, p < 0.05). This was accompanied by a significantly higher MGAS activity during the propulsion phase (24% from 20 cm and 50% from 40 cm, p < 0.05) of the DJ and a longer working fascicle length (5.08%, p < 0.05) compared with the PP group. There were no significant changes in isokinetic and isometric strength of the plantar flexors after training for both groups. The increase of jumping performance, after incline plyometrics should be taken into consideration by coaches, when they apply hopping exercise to improve explosiveness of the plantar flexors.

Biomechanical differences between incline and plane hopping.

Kannas, TM, Kellis, E, and Amiridis, IG. Biomechanical differences between incline and plane hopping. J Strength Cond Res 25(12): 3334-3341, 2011-The need for the generation of higher joint power output during performance of dynamic activities led us to investigate the force-length relationship of the plantar flexors during consecutive stretch-shortening cycles of hopping. The hypothesis of this study was that hopping (consecutive jumps with the knee as straight as possible) on an inclined (15°) surface might lead to a better jumping performance compared with hopping on a plane surface (0°). Twelve active men performed 3 sets of 10 consecutive hops on both an incline and plane surface. Ground reaction forces; ankle and knee joint kinematics; electromyographic (EMG) activity from the medial gastrocnemius (MG), soleus (Sol) and tibialis anterior (TA); and architectural data from the MG were recorded. The results showed that participants jumped significantly higher (p < 0.05) when hopping on an inclined surface (30.32 ± 8.18 cm) compared with hopping on a plane surface (27.52 ± 4.97 cm). No differences in temporal characteristics between the 2 types of jumps were observed. Incline hopping induced significantly greater ankle dorsiflexion and knee extension at takeoff compared with plane hopping (p < 0.05). The fascicle length of the MG was greater at initial contact with the ground during incline hopping (p < 0.05). Moreover, the EMG activities of Sol and TA during the propulsion phase were significantly higher during incline compared with that during plane hopping (p < 0.05). It does not seem unreasonable to suggest that, if the aim of hopping plyometrics is to improve plantar flexor explosivity, incline hopping might be a more effective exercise than hopping on a plane surface.