Putting "heavy" into heavy slow resistance

The body of literature on tendinopathy management has come a long way in the last few decades and a variety of changes in the clinical approach have emerged from this research. One particular approach that shows promise has been called "heavy slow resistance" (HSR), and this has been the subject of investigation in a number of randomized controlled trials. While the premise for this approach is defensible, a critical examination of the implementation of these HSR protocols results in some concerns when compared to basic exercise science principles. This article lays out some considerations that will help future investigators to improve their exercise prescription approaches in this area

Volume of physical activity and injury occurrence in young basketball players

Participation in organised, competitive physical activity by young athletes is increasing rapidly. This is concurrent with an increase in sporting injuries in the young population. This pilot study aimed to compare the weekly volume and types of physical activity in young basketball players injured and not injured during the season. Detailed physical activity and injury data were prospectively collected in 46 school-level basketball players aged 14 to 18 years. Participants completed physical activity logs which documented the type of physical activity undertaken, what the activity consisted of (i.e. training, competition) and the level at which it was played on a daily basis. Allied health staff completed a weekly injury form. Results showed that injured and uninjured athletes participated in a similar volume of total weekly physical activity over the season. However, injured athletes (p = 0.04) and athletes who specifically sustained overuse injuries (p = 0.01) participated in a greater amount of basketball refereeing than uninjured athletes. Based on these findings it was concluded that greater participation in running-type physical activity such as refereeing, as an addition to training and competition, may predispose the young basketball player to increased injury risk. Future research using larger sample sizes are required to further investigate the role of participation volume and type on injury occurrence in adolescent athletes.<br /

Patellar tendinopathy: pathomechanics and a modern approach to treatment

Patellar tendinopathy, a common condition in sport, can be recurrent and resistant to treatment, Risk factors include the level of training, biomechanics, and genetic factors. This review discusses several programs based on eccentric exercise and suggests principles for nonoperative treatment including improving shock absorption, load modification, and adaptation of the tendon to sporting stress. The level of pain that patients are asked to tolerate during tendon-exercise programs varies among programs, and it is unclear what level is optimal to stimulate tendon recovery. Rehabilitation presents several challenges: It can take a long time (3-12 months), exercise prescription in an athlete who is continuing to compete is not straightforward, and guidelines for treatment progression are poor, Nonoperative treatment can fail because of inappropriate exercise prescription and poor athlete compliance. If this occurs and surgical intervention is required, the athlete might still have an unpredictable outcome. Solutions to these problems require additional clinical research.<br /

EVALUATION OF PATELLAR TENDON MECHANICAL PROPERTIES AND THE PREFERRED LANDING LEG IN ELITE JUMPING ATHELTES

INTRODUCTION: The purpose of this investigation was to evaluate patellar tendon (PT) mechanical properties in healthy, elite jumping athletes and the association with their preferred landing leg

Does type 1 diabetes mellitus affect Achilles tendon response to a 10 km run? A case control study Epidemiology of musculoskeletal disorders

Background: Achilles tendon structure deteriorates 2-days after maximal loading in elite athletes. The load-response behaviour of tendons may be altered in type 1 diabetes mellitus (T1DM) as hyperglycaemia accelerates collagen cross-linking. This study compared Achilles tendon load-response in participants with T1DM and controls. Methods: Achilles tendon structure was quantified at day-0, day-2 and day-4 after a 10 km run. Ultrasound tissue characterisation (UTC) measures tendon structural integrity by classifying pixels as echo-type I, II, III or IV. Echo-type I has the most aligned collagen fibrils and IV has the least. Results: Participants were 7 individuals with T1DM and 10 controls. All regularly ran distances greater than 5 km and VISA-A scores indicated good tendon function (T1DM = 94 +/- 11, control = 94 +/- 10). There were no diabetic complications and HbA1c was 8.7 +/- 2.6 mmol/mol for T1DM and 5.3 +/- 0.4 mmol/mol for control groups. Baseline tendon structure was similar in T1DM and control groups -UTC echo-types (I-IV) and anterior-posterior thickness were all p > 0.05. No response to load was seen in either T1DM or control group over the 4-days post exercise. Conclusion: Active individuals with T1DM do not have a heightened Achilles tendon response to load, which suggests no increased risk of tendon injury. We cannot extrapolate these findings to sedentary individuals with T1DM

Low-noise custom VLSI for CdZnTe pixel detectors

A custom analog VLSI chip is being developed for the readout of pixellated CdZnTe detectors in the focal plane of an astronomical hard X-ray telescope. The chip is intended for indium bump bonding to a pixel detector having pitch near 0.5 mm. A complete precision analog signal processing chain, including charge sensitive preamplifier, shaping amplifiers and peak detect and hold circuit, is provided for each pixel. Here we describe the circuitry and discuss the performance of a functional prototype fabricated in a 1.2um CMOS process at Orbit Semiconductor. Dynamic performance is found to be close to SPICE model predictions over a self-triggering range extending from 1 to 150 keV (200 to 30000 electrons). Integral nonlinearity (1 %) and noise (0.25 keV or 50 electrons FWHM with 200 fF input capacitance) while acceptable are not as good as predicted. Power consumption is only 250 uW per pixel. Layout and design techniques are discussed which permit successful self-triggering operation at the low 1 keV threshold

Development of Clinical Rating Criteria for Tests of Lumbopelvic Stability

Background. Lumbopelvic stability (LPS) is regarded as important for injury prevention, yet there are few reliable or valid tests that can be used in the clinical assessment of LPS. Three dynamic functional tests were identified that assess LPS in multiple planes of motion: dip test (DT), single leg squat (SLS), and runner pose test (RPT). Existing rating criteria for SLS have limited reliability and rating criteria for DT and RPT have not been established. Objective. To develop rating criteria for three clinical tests of LPS. Design. Qualitative research: focus group. Method. A focus group of five expert physiotherapists used qualitative methods to develop rating criteria for the three clinical tests. Results. Detailed rating criteria were established for the three tests. Each key factor considered important for LPS had characteristics described that represented both good and poor LPS. Conclusion. This study established rating criteria that may be used to clinically assess LPS

Game and training load differences in elite junior Australian football

Game demands and training practices within team sports such as Australian football (AF) have changed considerably over recent decades, including the requirement of coaching staff to effectively control, manipulate and monitor training and competition loads. The purpose of this investigation was to assess the differences in external and internal physical load measures between game and training in elite junior AF. Twenty five male, adolescent players (mean &plusmn;SD: age 17.6 &plusmn; 0.5 y) recruited from three elite under 18 AF clubs participated. Global positioning system (GPS), heart rate (HR) and rating of perceived exertion (RPE) data were obtained from 32 game files during four games, and 84 training files during 19 training sessions. Matched-pairs statistics along with Cohen\u27s d effect size and percent difference were used to compare game and training events. Players were exposed to a higher physical load in the game environment, for both external (GPS) and internal (HR, Session-RPE) load parameters, compared to in-season training. Session time (d = 1.23; percent difference = 31.4% (95% confidence intervals = 17.4 - 45.4)), total distance (3.5; 63.5% (17.4 - 45.4)), distance per minute (1.93; 33.0% (25.8 - 40.1)), high speed distance (2.24; 77.3% (60.3 - 94.2)), number of sprints (0.94; 43.6% (18.9 - 68.6)), mean HR (1.83; 14.3% (10.5 - 18.1)), minutes spent above 80% of predicted HRmax (2.65; 103.7% (89.9 - 117.6)) and Session-RPE (1.22; 48.1% (22.1 - 74.1)) were all higher in competition compared to training. While training should not be expected to fully replicate competition, the observed differences suggest that monitoring of physical load in both environments is warranted to allow comparisons and evaluate whether training objectives are being met. Key pointsPhysical loads, including intensity, are typically lower in training compared to competition in junior elite Australian football.Monitoring of player loads in team sports should include both internal and external measures.Selected training drills should look to replicate game intensities, however training is unlikely to match the overall physical demands of competition

Categorising sports injuries in epidemiological studies : the subsequent injury categorisation (SIC) model to address multiple, recurrent and exacerbation of injuries

Objective: Sports injuries are often recurrent and there is wide recognition that a subsequent injury (of either the same or a different type) can be strongly influenced by a previous injury. Correctly categorising subsequent injuries (multiple, recurrent, exacerbation or new) requires substantial clinical expertise, but there is also considerable value in combining this expertise with more objective statistical criteria. This paper presents a new model, the subsequent injury categorisation (SIC) model, for categorising subsequent sports injuries that takes into account the need to include both acute and overuse injuries and ten different dependency structures between injury types. Methods: The suitability of the SIC model was demonstrated with date ordered sports injury data from a large injury database from community Australian football players over one playing season. A subsequent injury was defined to have occurred in the subset of players with two or more reported injuries. Results: 282 players sustained 469 subsequent injuries of which 15.6% were coded to categories representing injuries that were directly related to previous index injuries. This demonstrates that players can sustain a number of injuries over one playing season. Many of these will be unrelated to previous injuries but subsequent injuries that are related to previous injury occurrences are not uncommon. Conclusion: The handling of subsequent sports injuries is a substantial challenge for the sports medicine field—both in terms of injury treatment and in epidemiological research to quantify them. Application of the SIC model allows for multiple different injury types and relationships within players, as well as different index injuries