Isolated Adductor Magnus Injuries in Athletes : A Case Series

Little is known about injuries to the adductor magnus (AM) muscle and how to manage them. To describe the injury mechanisms of the AM and its histoarchitecture, clinical characteristics, and imaging features in elite athletes. Case series; Level of evidence, 4. A total of 11 competitive athletes with an AM injury were included in the study. Each case was clinically assessed, and the diagnosis and classification were made by magnetic resonance imaging (MRI) according to the British Athletics Muscle Injury Classification (BAMIC) and mechanism, location, grade, and reinjury (MLG-R) classification. A 1-year follow-up was performed, and return-to-play (RTP) time was recorded. Different mechanisms of injury were found; most of the athletes (10/11) had flexion and internal rotation of the hip with extension or slight flexion of the knee. Symptoms consisted of pain in the posteromedial (7/11) or medial (4/11) thigh during adduction and flexion of the knee. Clinically, there was a suspicion of an injury to the AM in only 3 athletes. According to MRI, 5 lesions were located in the ischiocondylar portion (3 in the proximal and 2 in the distal myoconnective junction) and 6 in the pubofemoral portion (4 in the distal and 2 in the proximal myoconnective junction). Most of the ischiocondylar lesions were myotendinous (3/5), and most of the pubofemoral lesions were myofascial (5/6). The BAMIC and MLG-R classification coincided in distinguishing injuries of moderate and mild severity. The management was nonoperative in all cases. The mean RTP time was 14 days (range, 0-35 days) and was longer in the ischiocondylar cases than in the pubofemoral cases (21 vs 8 days, respectively). Only 1 recurrence, at <10 months, was recorded. Posteromedial thigh pain after an eccentric contraction during forced adduction of the thigh from hip internal rotation should raise a suspicion of AM lesions. The identification of the affected portion was possible on MRI. An injury in the ischiocondylar portion entailed a longer RTP time than an injury in the pubofemoral portion

Sciatic nerve movement in the deep gluteal space during hip rotations maneuvers

We hypothesize that the sciatic nerve in the subgluteal space has a specific behavior during internal and external coxofemoral rotation and during isometric contraction of the internal and external rotator muscles of the hip. In 58 healthy volunteers, sciatic nerve behavior was studied by ultrasound during passive internal and external hip rotation movements and during isometric contraction of internal and external rotators. Using MATLAB software, changes in nerve curvature at the beginning and end of each exercise were evaluated for longitudinal catches and axial movement for transverse catches. In the long axis, it was observed that during the passive internal rotation and during the isometric contraction of external rotators, the shape of the curve increased significantly while during the passive external rotation and the isometric contraction of the internal rotators the curvature flattened out. During passive movements in internal rotation, on the short axis, the nerve tended to move laterally and forward, while during external rotation the tendency of the nerve was to move toward a medial and backward position. During the isometric exercises, this displacement was less in the passive movements. Passive movements of hip rotation and isometric contraction of the muscles affect the sciatic nerve in the subgluteal space. Retrotrochanteric pain may be related to both the shear effect of the subgluteus muscles and the endoneural and mechanosensitive aggression to which the sciatic nerve is subjected

Rotura del músculo Latissimus dorsi en un deportista de trialsín

Paciente de 24 años, deportista de alto nivel de trialsín. Durante una exhibición deportiva, en un salto, sufre la inusual rotura del músculo Latissimus dorsi por mecanismo indirecto. El tratamiento conservador da buenos resultados, de manera que el deportista no presenta secuelas en el ámbito funcional; en el aspecto estético presenta alteración en el relieve muscular durante la contracción. A la palpación no aparece la cobertura muscular que proporcionaría el músculo en condiciones normales. La revisión bibliográfica muestra que la lesión del Latissimus dorsi está poco referenciada en la literatura

El peu de la tennista adolescent

En el treball que es presenta amb el títol de "El peu de la tennista adolescent" es van estudiar 15 jugadores de tennis d'entre 13 i 18 anys, totes elles pertanyents als equips nacionals. Després de fer l'estudi clínic pertinent, es va realitzar un estudi radiològic. El primer va posar de manifest un gran nombre de metatarsàlgies i un alt nombre d' hallux valgus. L'estudi radiològic va confirmar els resultats clínics. També es va efectuar l'estudi podològic estàtic que va demostrar que hi havia un elevat nombre d'hiperpressions a nivell dels caps dels metatarsians i finalment es va dur a terme un estudi podológic dinàmic

Púrpura de Schönlein-Henoch. A propósito de un caso en una deportista

Presentamos el caso de una deportista de natación sincronizada de 15 años de edad que presentó una púrpura de Schönlein-Henoch (también conocida como púrpura anafilactoide), una vasculitis sistémica de pequeños vasos, considerada la más frecuente en la infancia, y que afecta preferentemente a niños de entre 3 y 15 años, con prevalencia de los varones sobre las mujeres (2:1). La afección fue exclusivamente cutánea en forma de petequias, con diversos brotes de lesiones dérmicas, y su evolución fue benigna y autolimitada, sin precisar otro tratamiento que el reposo deportivo (como prevención de posibles complicaciones más graves) y los controles clínicos y analíticos correspondiente

Return to Play After Soleus Muscle Injuries

BACKGROUND: Soleus muscle injuries are common in different sports disciplines. The time required for recovery is often difficult to predict, and reinjury is common. The length of recovery time might be influenced by different variables, such as the involved part of the muscle. HYPOTHESIS: Injuries in the central aponeurosis have a worse prognosis than injuries of the lateral or medial aponeurosis as well as myofascial injuries. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: A total of 61 high-level or professional athletes from several sports disciplines (soccer, tennis, track and field, basketball, triathlon, and field hockey) were reviewed prospectively to determine the recovery time for soleus muscle injuries. Clinical and magnetic resonance imaging evaluation was performed on 44 soleus muscle injuries. The association between the different characteristics of the 5 typical muscle sites, including the anterior and posterior myofascial and the lateral, central, and medial aponeurosis disruption, as well as the injury recovery time, were determined. Recovery time was correlated with age, sport, extent of edema, volume, cross-sectional area, and retraction extension or gap. RESULTS: Of the 44 patients with muscle injuries who were analyzed, there were 32 (72.7%) strains affecting the myotendinous junction (MT) and 12 (23.7%) strains of the myofascial junction. There were 13 injuries involving the myotendinous medial (MTM), 7 affecting the MT central (MTC), 12 the MT lateral (MTL), 8 the myofascial anterior (MFA), and 4 the myofascial posterior (MFP). The median recovery time (±SD) for all injuries was 29.1 ± 18.8 days. There were no statistically significant differences between the myotendinous and myofascial injuries regarding recovery time. The site with the worst prognosis was the MTC aponeurosis, with a mean recovery time of 44.3 ± 23.0 days. The site with the best prognosis was the MTL, with a mean recovery time of 19.2 ± 13.5 days (P < .05). There was a statistically significant correlation between recovery time and age (P < .001) and between recovery time and the extent of retraction (P < .05). CONCLUSION: Wide variation exists among the different types of soleus injuries and the corresponding recovery time for return to the same level of competitive sports. Injuries in the central aponeurosis have a significantly longer recovery time than do injuries in the lateral and medial aponeurosis and myofascial sites