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G MK, S N, K K, S R, S S, V R, Kirthika S V, Raman K, Sankaranarayanan S, C P. Efficacy of Plyometric and TheraBand FlexBar Exercises in Tennis Elbow Patients: A Comparative Study. Cureus 2024; 16:e61525. [PMID: 38957235 PMCID: PMC11218717 DOI: 10.7759/cureus.61525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2024] [Indexed: 07/04/2024] Open
Abstract
Background Lateral epicondylitis is a common condition involving the arm. It is caused by degenerative changes or overuse of the tendon connecting the elbow joint to the forearm muscle. Plyometric and TheraBand FlexBar (Theraband, Akron, OH, USA) exercises can relieve elbow discomfort, soreness, and weakness. This study examines the effects of plyometric and TheraBand FlexBar exercises with ultrasound on tennis elbow patients. Methodology It is an experimental study comprising a total of 30 participants, including individuals of both genders with age groups of 20-40 years were selected by specific criteria for inclusion and exclusion. The participants were randomly assigned into two groups. Group A received plyometric exercises with ultrasound, whereas Group B received TheraBand FlexBar exercises with ultrasound. The outcome measures utilized in this study include patient-rated tennis elbow evaluation (PRTEE) and visual analog scale (VAS) for evaluating the functional disability of the hand, arm, and shoulder. Results The results showed a substantial reduction in mean values in Group A compared to Group B, with a p-value of less than 0.001, indicating that plyometric exercises with ultrasound were more effective than TheraBand FlexBar exercises. Conclusion Plyometric exercises combined with ultrasound therapy demonstrated significant reductions in discomfort and improvements in function, with plyometric exercises showing superior efficacy compared to TheraBand FlexBar exercises.
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Affiliation(s)
- Mohan Kumar G
- Musculoskeletal Physiotherapy, Faculty of Physiotherapy, Dr. M.G.R. Educational and Research Institute (Deemed to be University), Chennai, IND
| | - Nishanthi S
- Physiotherapy, Faculty of Physiotherapy, Dr. M.G.R. Educational and Research Institute (Deemed to be University), Chennai, IND
| | - Kamatchi K
- Neurological Physiotherapy, Faculty of Physiotherapy, Dr. M.G.R. Educational and Research Institute (Deemed to be University), Chennai, IND
| | - Ramachandran S
- Cardiovascular and Pulmonary Physiotherapy, Faculty of Physiotherapy, Dr. M.G.R. Educational and Research Institute (Deemed to be University), Chennai, IND
| | - Sudhakar S
- Sports Physiotherapy, Faculty of Physiotherapy, Dr. M.G.R. Educational and Research Institute (Deemed to be University), Chennai, IND
| | - Rajalaxmi V
- Neurological Physiotherapy, Faculty of Physiotherapy, Dr. M.G.R. Educational and Research Institute (Deemed to be University), Chennai, IND
| | - Veena Kirthika S
- Neurological Physiotherapy, Faculty of Physiotherapy, Dr. M.G.R. Educational and Research Institute (Deemed to be University), Chennai, IND
| | - Kaushik Raman
- Cardiovascular and Pulmonary Physiotherapy, Faculty of Physiotherapy, Dr. M.G.R. Educational and Research Institute (Deemed to be University), Chennai, IND
| | - Srisaisantoshini Sankaranarayanan
- Cardiovascular and Pulmonary Physiotherapy, Faculty of Physiotherapy, Dr. M.G.R. Educational and Research Institute (Deemed to be University), Chennai, IND
| | - Priya C
- Biotechnology, Dr. M.G.R. Educational and Research Institute (Deemed to be University), Chennai, IND
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Suzuki A, Kanda T. Understanding the Injury Mechanism in Hamate Hook Fractures by Investigating Fracture Morphologies: A Case Series Study. Hand (N Y) 2024:15589447241232096. [PMID: 38420764 DOI: 10.1177/15589447241232096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
BACKGROUND Many studies have described hamate hook fractures resulting from direct force from sporting tools. However, several authors have reported fractures that did not occur during swing-related activities. This study aimed to understand the injury mechanism of fractures by investigating their morphologies. METHODS We selected patients with hamate hook fractures and collected data on computed tomography scans, injury causes, and how athletes handled sporting tools. RESULTS We investigated 50 patients, and the study cohort included 32 patients who sustained injuries during sports: 24 during baseball (group A) and 8 during other sports (group B). Sixteen patients sustained injuries from falls (group C), and 2 had their hands crushed while using an industrial press machine (group D). In group A, most patients had a fracture line starting from the middle section of the radial side, accompanied by osteosclerotic changes in their lower hand. In group B, most patients had fracture morphologies similar to those of most patients in group A. The main morphology of fractures in group C was a transverse fracture at the base. Two patients in group D had minimal fragments at the tip of the hooks. CONCLUSIONS Our results question the theory that most hamate hook fractures in athletes are caused by direct force exerted on the palm because the fracture morphology was different from that of patients injured by acute trauma from direct force. Instead, these fractures likely stem from an indirect mechanism involving repetitive force generated by the tendons and muscles acting on the hook.
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Affiliation(s)
- Ayumi Suzuki
- Department of Orthopedic Surgery, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | - Toshihiro Kanda
- Department of Orthopedic Surgery, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
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Pace V, Bronzini F, Novello G, Mosillo G, Braghiroli L. Review and update on the management of triangular fibrocartilage complex injuries in professional athletes. World J Orthop 2024; 15:110-117. [PMID: 38464359 PMCID: PMC10921179 DOI: 10.5312/wjo.v15.i2.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 10/30/2023] [Accepted: 12/14/2023] [Indexed: 02/07/2024] Open
Abstract
Triangular fibrocartilage complex injuries are common in amateur and professional sports. These injuries are mainly caused by acute or chronic repetitive axial loads on the wrist, particularly on the ulnar side and in association with rotations or radial/ulnar deviations. In order to treat professional athletes, a detailed specific knowledge of the pathology is needed. Moreover, the clinician should fully understand the specific and unique environment and needs of the athletes, their priorities and goals, the type of sport, the time of the season, and the position played. An early diagnosis and appropriate management with the quickest possible recovery time are the uppermost goals for both the athlete and the surgeon. A compromise between conservative vs surgical indications, athletes' needs and expectations, and financial implications should be achieved. Arthroscopic procedures should be timely planned when indicated as they could allow early diagnosis and treatment at the same time. Conservative measures are often used as first line treatment when possible. Peripheral lesions are treated by arthroscopic repair, whilst central lesions are treated by arthroscopic debridement. Further procedures (such as the Wafer procedure, ulnar osteotomies, etc.) have specific indications and great implications with regard to rehabilitation.
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Affiliation(s)
- Valerio Pace
- Department of Trauma and Orthopaedics, AOSP Terni, Terni 05100, Italy
| | - Francesco Bronzini
- Department of Trauma and Orthopaedics, University of Perugia, Perugia 06100, Italy
| | - Giovanni Novello
- Department of Trauma and Orthopaedics, University of Perugia, Perugia 06100, Italy
| | - Giuseppe Mosillo
- Department of Trauma and Orthopaedics, Hand Unit, AOSP Terni, Terni 05100, Italy
| | - Luca Braghiroli
- Department of Trauma and Orthopaedics, Hand Unit, AOSP Terni, Terni 05100, Italy
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Romero-Morales C, López-López D, Almazán-Polo J, Mogedano-Cruz S, Sosa-Reina MD, García-Pérez-de-Sevilla G, Martín-Pérez S, González-de-la-Flor Á. Prevalence, diagnosis and management of musculoskeletal disorders in elite athletes: A mini-review. Dis Mon 2024; 70:101629. [PMID: 37716840 DOI: 10.1016/j.disamonth.2023.101629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/18/2023]
Abstract
Musculoskeletal injuries in elite sports are ones of the most impact issue because their remarkable impact on performance caused by drastic absence of training and competition and a progressive deterioration in physical health, emotional and social athletes' dimensions. Also, the prevalence of epidemiologic research found an incidence of musculoskeletal disorders vary within sports and in elite athletes which is even higher as a consequence of higher demand physical performance. This way, the loss of physical performance due to an sport injury impacts not only the individual economic sphere of the professional but also that ofsports entities, reaching, according to some studies, a loss estimated in the range of 74.7 million pounds. Thus, the purpose of this article is to review and to provide an overview of the most common musculoskeletal injuries in elite sports precipitating factors, clinical presentation, evidence-based diagnostic evaluation, and treatment recommendations with a view to preventing medical conditions or musculoskeletal injuries that may alter performance and general health in the elite athletes.
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Affiliation(s)
- Carlos Romero-Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | - Daniel López-López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Industrial Campus of Ferrol , Universidade da Coruña, 15403 Ferrol, Spain.
| | - Jaime Almazán-Polo
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | - Sara Mogedano-Cruz
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | - María Dolores Sosa-Reina
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | | | - Sebastián Martín-Pérez
- Faculty of Health Sciences, Universidad Europea de Canarias, La Orotava, Santa Cruz de Tenerife 38300, Spain
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Schöffl V, von Schroeder H, Lisse J, El-Sheikh Y, Küpper T, Klinder A, Lutter C. Wrist Injuries in Climbers. Am J Sports Med 2023; 51:3416-3425. [PMID: 37800447 DOI: 10.1177/03635465231199671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
BACKGROUND Acute and chronic injuries to the wrist are among the most common sport-related complaints of climbing athletes but have not been extensively evaluated in this population. Therefore, it is important to categorize climbing injuries to the wrist, analyze risk factors, and assess treatment outcomes. PURPOSE To evaluate the distribution, outcomes, and influencing factors of wrist injuries in climbers. STUDY DESIGN Case series; Level of evidence, 4. METHODS Climbing athletes with wrist injuries who presented to our specialized sports medical center over the course of 4 years (2017-2020) were selected. All had prospectively completed questionnaires including their climbing-specific background (years of training, climbing level, training methods, etc). Injuries were analyzed (International Climbing and Mountaineering Federation [UIAA] grade and diagnosis), and treatment methods and outcomes were retrospectively assessed with a minimum follow-up of 2 years. Parameters included the climbing score, visual analog scale for pain score, Patient-Rated Wrist Evaluation (PRWE) score, and shortened version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) score including the sport component (DASH-Sport) score before and after treatment as well as time to return to climbing. RESULTS A total of 69 patients (25 female, 44 male) with 78 wrist injuries were identified and analyzed. Of these, 7 injuries were bilateral, occurring at the same time, and 2 injuries were independent reinjuries to either the same or the contralateral side. In addition, 24 injuries (30.8%) were acute, while 54 (69.2%) were chronic. Overall, 2 injuries had a UIAA grade of 3; all others had a UIAA grade of 2. The most frequent injuries were synovitis of the ulnocarpal recess, ulnar impaction, bone marrow edema of the lunate, wrist sprains (joint capsular pain with stress, with no pathological finding on magnetic resonance imaging), and wrist ganglion cysts. Nonoperative treatment was performed for 61 of the injuries, while 17 were treated surgically. In 51 cases (65.4%), injuries healed without consequences; in 27 cases (34.6%), discomfort remained. The visual analog scale pain score decreased from 4.8 ± 1.9 before treatment to 0.7 ± 1.0 after treatment (P < .001), the PRWE score decreased from 53.6 ± 24.9 to 10.3 ± 13.1 (P < .001), the QuickDASH score improved from 53.0 ± 16.6 to 20.0 ± 20.2 (P < .001), and the DASH-Sport score improved from 82.0 ± 16.1 to 38.1 ± 23.5 (P < .001). The climbing score improved from 2.5 ± 1.1 to 4.3 ± 1.0 points (P < .001). The patient-reported number of days with pain was negatively correlated with changes in the PRWE score (r = -0.351; P < .001), QuickDASH score (r = -0.316; P = .007), and climbing score (r = -0.264; P = .025) as well as the number of days without climbing (r = -0.266; P = .025). The number of days without climbing was positively correlated with changes in the PRWE score (r = 0.369; P < .001). CONCLUSION Wrist injuries in climbers constituted a diverse set of diagnoses. Ulnar-sided injuries were most common, and many patients had >1 diagnosis. Outcomes for all treatment methods (surgery and nonoperative care) were favorable, but approximately one-third of climbers had persistent wrist discomfort after treatment, underscoring the need for accurate diagnoses and acute and expert care.
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Affiliation(s)
- Volker Schöffl
- Department of Orthopedic and Trauma Surgery, Klinikum Bamberg, Bamberg, Germany
- Department of Trauma Surgery, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
- Section of Wilderness Medicine, Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
- School of Health, Leeds Beckett University, Leeds, UK
| | - Herb von Schroeder
- Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Division of Plastic, Reconstructive & Aesthetic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Hand Program, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
- Dovigi Orthopaedic Sports Medicine Clinic, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Jens Lisse
- Department of Trauma Surgery, Klinikum Forchheim, Forchheim, Germany
| | - Yasser El-Sheikh
- Division of Plastic, Reconstructive & Aesthetic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Department of Surgery, North York General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Thomas Küpper
- Institute for Occupational, Social & Environmental Medicine, RWTH Aachen University, Aachen, Germany
| | - Annett Klinder
- Department of Orthopaedics, Rostock University Medical Center, Rostock, Germany
| | - Christoph Lutter
- Department of Orthopaedics, Rostock University Medical Center, Rostock, Germany
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Li D, Li X, Hou Z, Pan F. Measurement of bony anatomical parameters of the distal ulna based on healthy adult data: A cross-sectional study. Front Surg 2023; 10:1120030. [PMID: 37009615 PMCID: PMC10050329 DOI: 10.3389/fsurg.2023.1120030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 02/21/2023] [Indexed: 03/17/2023] Open
Abstract
PurposeThis study sought to conduct several three-dimensional measurements of the distal ulna in healthy Han Chinese, providing the anatomical basis for the diagnosis and treatment of hand trauma, distal ulnar disorders, and the design of wrist prostheses.Methods50 Han Chinese men and women that underwent computed tomography (CT) scans of the distal ulnar carpus were included in the present study. A three-dimensional digital model of the distal ulna was reconstructed using Mimics software. Moreover, the anatomical data of 10 indicators were measured using MIMICS software. Each index data was measured by 2 investigators independently, and the average value was taken. The data were stratified and compared between left and right sides and men and women.ResultsA 3D digital model of the distal ulnar bone with a realistic shape was reconstructed. The 10 anatomical parameters measured are as follows: The length of the ulnar styloid process (posterior anterior), The length of the ulnar styloid process(anterior and posterior); the transverse diameter of the ulnar head; the anteroposterior diameter of the ulnar head. The radial inclination angle of the ulna; the ulnar inclination angle; the distal space between the ulna and radius; the ulnar notch angle of the lower radius. The anterior and posterior diameters of the ulnar notch of the lower radius, and the superior and inferior diameters of the ulnar notch of the lower radius. Statistical analysis showed no significant difference after stratification by laterality and gender.Conclusionour findings can providing the anatomical basis for the diagnosis and treatment of hand trauma, distal ulnar disorders and further improve currently available wrist joint prostheses.Type of StudyObservational, Cross-sectional study, LOE: Level II
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Affiliation(s)
- Dengchen Li
- School of Medicine, Yangtze University, Jingzhou, China
- School of Medicine, Yangtze University, Jingzhou, China
- College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, WuhanChina
| | - Xiaolin Li
- School of Medicine, Yangtze University, Jingzhou, China
- School of Medicine, Yangtze University, Jingzhou, China
- Department of Medical Imaging, The First Affiliated Hospital of Yangtze University, Jingzhou, China
- Correspondence: Xiaolin Li
| | - Zexin Hou
- School of Medicine, Yangtze University, Jingzhou, China
- School of Medicine, Yangtze University, Jingzhou, China
- Department of Medical Imaging, First People's Hospital of Jingzhou, Jingzhou, China
| | - Fengman Pan
- School of Medicine, Yangtze University, Jingzhou, China
- Department of Medical Imaging, First People's Hospital of Jingzhou, Jingzhou, China
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Upper Extremity Kinematics and Electromyographic Activity in Uninjured Tennis Players. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12094638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
There has been an increase in ulnar-sided wrist pain among tennis players. The purpose of this study was to establish a normative dataset of kinematic and electromyography (EMG) data during the forehand and two-handed backhand groundstrokes. In total, 20 adolescent United States Tennis Association (USTA) ranked tennis players (11/20 Male, Age = 15.0 ± 1.8 years, Height = 1.7 ± 1.1 m, BMI = 21.3 ± 3.4 kg/m2, 18/20 right-arm dominant) participated in this study. Kinematics (range of motion and angular velocity) and EMG data were simultaneously acquired during the forehand and two-handed backhand groundstrokes. Minimal differences were found between groupings of age, sex, and USTA ranking. The two-handed backhand groundstroke is characterized by bilaterally flexed elbows and ulnarly deviated wrists, with a flexed wrist and pronated forearm on the non-dominant side and an extended wrist and supinated forearm on the dominant side. EMG activation occurs bilaterally by peak backswing. The forehand groundstroke is characterized by a flexed elbow, pronated forearm, and ulnarly deviated and extended wrist. The wrist is at maximum ulnar deviation at ball impact. This study established an initial foundation for normative data for the forehand and two-handed backhand groundstrokes, which can be used for injury detection, rehabilitation, prevention, and ultimately performance improvement of tennis athletes.
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Logli AL, Loushin SR, Orlando AF, Tetzloff S, Kaufman KR, Kakar S. Ulnar Wrist Pain in a Tennis Player: Case Review and Discussion: A Team-Based Approach. JBJS Rev 2022; 10:01874474-202204000-00003. [PMID: 35394979 DOI: 10.2106/jbjs.rvw.21.00158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
» Ulnar-sided wrist pain is a common cause of debilitating wrist pain in stick-handling athletes. Due to the complexity of surrounding anatomy, the evaluation and diagnosis can be challenging. » Injury of the triangular fibrocartilage complex (TFCC) is the most common cause of ulnar-sided wrist pain. Repetitive, unrestricted pronosupination, wrist deviation, and axial-loading activity, such as in tennis, place substantial stress on the TFCC. » The ulnotriquetral (UT) ligament is a palmar thickening of the ulnar capsule arising from the palmar radioulnar (PRU) ligament of the TFCC. When injured, the UT ligament can be a source of acute or chronic ulnar-sided wrist pain. The ligament can avulse off bone, can rupture completely, or can split longitudinally. » Arthroscopic-assisted repair is a safe, reliable, and effective treatment for UT ligament split tears and peripheral TFCC tears. » Although the benefit of a team-based approach may be realized by most patients, high-performing, stick-handling athletes are part of a unique population who execute repetitive, extraordinary wrist movements. The high demand and functional requirement expected of the wrists require a uniquely tailored approach to return them to the same level of competitive play.
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Affiliation(s)
- Anthony L Logli
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
| | - Stacy R Loushin
- Department of Biomechanics Research-Motion Analysis Laboratory, Mayo Clinic, Rochester, Minnesota
| | - Adam F Orlando
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota
| | - Sabine Tetzloff
- RAC Tennis Department, Rochester Athletic Club, Inc., Rochester, Minnesota
| | - Kenton R Kaufman
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.,Department of Biomechanics Research-Motion Analysis Laboratory, Mayo Clinic, Rochester, Minnesota.,Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
| | - Sanjeev Kakar
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
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