A New Test for Achilles Tendinopathy Based on Kager's Fat Pad Clinical Assessment Predictive Values.

Background This study aimed to check the diagnostic accuracy of a new test to identify Achilles tendinopathy. STUDY DESIGN: Observational study. METHODS: Seventy patients recruited from a private medical centre met the diagnostic criteria for unilateral Achilles tendinopathy (age, 45.1 ± 12.7 years; weight, 75.00 ± 10 kg; height, 1.75 ± 0.1 m) and were tested based on both Achilles tendons. Seventy patients with a unilateral Achilles tendinopathy ultrasound diagnosis were tested using David's test. RESULTS: Most (86%) subjects demonstrated Kager's fat pad asymmetry in relation to the Achilles tendon in the complete passive dorsiflexion in the prone position (David's sign). No healthy tendons had David's sign. CONCLUSIONS: The presence of asymmetry in Kager's fat pad in relation to the Achilles tendon during complete passive dorsiflexion is strongly indicative of ultrasound-diagnosed tendinopathy. David's test demonstrated a sensitivity of 85.71% (95% CI, 77.51% to 93.91%) and a specificity of 100% (95% CI, 100% to 100%), while noting the lack of blinding of the assessors and the uncertainty of the diagnostic measures (95% CI). Asymmetry of the fat pad could potentially serve as a characteristic marker for patients with Achilles tendinopathy.

Thermography related to electromyography in runners with functional equinus condition after running.

OBJECTIVES: To assess how skin temperature could be related with gastrocnemius muscle activation and thus detect association between the extensibility of the triceps-surae and the skin temperature pattern. DESIGN: A Cross Sectional Study. Secondary level of care. SETTING: Recreational runners from an athletic club. PARTICIPANTS: 57 healthy male subjects with functional equinus condition were recruited (age 42.82 ±â€¯6.97 years, height 173.68 ±â€¯9.79 cm, weight 73.19 ±â€¯8.13 kg, body mass index 20.41 ±â€¯2.48). MAIN OUTCOME MEASURES: Skin temperature and electromyography of the gastrocnemius muscle before and after running exercise. RESULTS: Skin thermal assessment value for Gastrocnemius muscles were assessed in 57 participants before and after running. We found a significant increase of skin temperature after running deeply related with electromyography values (Confidence interval 95%). The temperature of Gastrocnemius was increased in runners after activity. CONCLUSIONS: Thermal imaging is deeply related with muscle pattern activation for lower limb. Based on our findings, we propose that infrared thermography assessment of the gastrocnemius is adequate to check Gastrocnemius muscle activity condition in runners.

Effect of Pre-training and Post-training Nordic Exercise on Hamstring Injury Prevention, Recurrence, and Severity in Soccer Players.

OBJECTIVE: To investigate the effect of adding Nordic exercise as post-training in decreasing hamstring initial, recurrent injuries rates, and their severity. METHODS: In this randomly controlled trial study, 34 professional football players aged 21 to 35 years were randomly assigned into two groups (17 players each) from Sporting clubs at Alexandria, Egypt. For group one, Nordic hamstring exercise (NHE) was performed pre-training and post-training. For group two, NHE was only performed pre-training. The control group was the same team during the previous season. Length of the trial was 12 weeks. The Australian football association injury form was used to collect incidence of injuries for each subject in both groups. RESULTS: Pooled results based on total injuries showed that group one had significantly less hamstring initial injuries (92% less) than the previous season, while group two had 80% less initial injuries and 85% less recurrent injuries than previous season. Regarding the severity of injuries in term of mean number of absent days, it was 1 day for group one and 2.7 days for group two while it was 7.95 days for the previous season during total risk time of 116.3±13.2 and 117.6±5.7 exposure hours for group one and group two, respectively. CONCLUSION: The use of NHE as a prevention protocol was effective in reducing all hamstring injuries with the use of NHE during pre-training and post-training having the greatest effect.