Does a SLAP lesion affect shoulder muscle recruitment as measured by EMG activity during a rugby tackle?

Background: The study objective was to assess the influence of a SLAP lesion on onset of EMG activity in shoulder muscles during a front on rugby football tackle within professional rugby players. Methods: Mixed cross-sectional study evaluating between and within group differences in EMG onset times. Testing was carried out within the physiotherapy department of a university sports medicine clinic. The test group consisted of 7 players with clinically diagnosed SLAP lesions, later verified on arthroscopy. The reference group consisted of 15 uninjured and full time professional rugby players from within the same playing squad. Controlled tackles were performed against a tackle dummy. Onset of EMG activity was assessed from surface EMG of Pectorialis Major, Biceps Brachii, Latissimus Dorsi, Serratus Anterior and Infraspinatus muscles relative to time of impact. Analysis of differences in activation timing between muscles and limbs (injured versus non-injured side and non injured side versus matched reference group). Results: Serratus Anterior was activated prior to all other muscles in all (P = 0.001-0.03) subjects. In the SLAP injured shoulder Biceps was activated later than in the non-injured side. Onset times of all muscles of the noninjured shoulder in the injured player were consistently earlier compared with the reference group. Whereas, within the injured shoulder, all muscle activation timings were later than in the reference group. Conclusions: This study shows that in shoulders with a SLAP lesion there is a trend towards delay in activation time of Biceps and other muscles with the exception of an associated earlier onset of activation of Serratus anterior, possibly due to a coping strategy to protect glenohumeral stability and thoraco-scapular stability. This trend was not statistically significant in all cases

Understanding acute ankle ligamentous sprain injury in sports

This paper summarizes the current understanding on acute ankle sprain injury, which is the most common acute sport trauma, accounting for about 14% of all sport-related injuries. Among, 80% are ligamentous sprains caused by explosive inversion or supination. The injury motion often happens at the subtalar joint and tears the anterior talofibular ligament (ATFL) which possesses the lowest ultimate load among the lateral ligaments at the ankle. For extrinsic risk factors to ankle sprain injury, prescribing orthosis decreases the risk while increased exercise intensity in soccer raises the risk. For intrinsic factors, a foot size with increased width, an increased ankle eversion to inversion strength, plantarflexion strength and ratio between dorsiflexion and plantarflexion strength, and limb dominance could increase the ankle sprain injury risk. Players with a previous sprain history, players wearing shoes with air cells, players who do not stretch before exercising, players with inferior single leg balance, and overweight players are 4.9, 4.3, 2.6, 2.4 and 3.9 times more likely to sustain an ankle sprain injury. The aetiology of most ankle sprain injuries is incorrect foot positioning at landing – a medially-deviated vertical ground reaction force causes an explosive supination or inversion moment at the subtalar joint in a short time (about 50 ms). Another aetiology is the delayed reaction time of the peroneal muscles at the lateral aspect of the ankle (60–90 ms). The failure supination or inversion torque is about 41–45 Nm to cause ligamentous rupture in simulated spraining tests on cadaver. A previous case report revealed that the ankle joint reached 48 degrees inversion and 10 degrees internal rotation during an accidental grade I ankle ligamentous sprain injury during a dynamic cutting trial in laboratory. Diagnosis techniques and grading systems vary, but the management of ankle ligamentous sprain injury is mainly conservative. Immobilization should not be used as it results in joint stiffness, muscle atrophy and loss of proprioception. Traditional Chinese medicine such as herbs, massage and acupuncture were well applied in China in managing sports injuries, and was reported to be effective in relieving pain, reducing swelling and edema, and restoring normal ankle function. Finally, the best practice of sports medicine would be to prevent the injury. Different previous approaches, including designing prophylactice devices, introducing functional interventions, as well as change of games rules were highlighted. This paper allows the readers to catch up with the previous researches on ankle sprain injury, and facilitate the future research idea on sport-related ankle sprain injury

Effect of paraspinal muscle vibration on position sense of the lumbosacral spine

Study Design. A two-group experimental design with repeated measures on one factor was used. Objectives. To investigate the role of the muscle spindles of the paraspinal muscles in lumbosacral position sense of healthy individuals. Summary of Background Data. Muscle spindles are recognized to be important mediators for position and movement sense in peripheral joints, and they are very sensitive to mechanical vibration. However, little is known about their role in the control of lumbosacral spine positioning. Methods. Twenty-five young individuals with no low back pain were assigned at random to an experimental or control group. Proprioceptive information of the multifidus muscle spindles was distorted in half of the trials in 16 individuals by manually applying vibration (70 Hz, 0.5 mm amplitude) for approximately 5 seconds. The control group (n = 9) only heard the vibrator noise during repositioning of the lumbosacral spine. Repositioning accuracy in the sitting position was estimated by calculating the mean absolute error, constant error, and variable error among six criteria and reproduction sacral tilt angles. Results. Multifidus muscle vibration induced a significant muscle lengthening illusion through which the members of the experimental group undershot the target position (F(1,15) = 30.77, P0.05). Conclusions. The findings suggest that precise muscle spindle input of the paraspinal muscles is essential for accurate positioning of the pelvis and lumbosacral spine in a sitting posture.status: publishe

Associations between physical activity, nutritional practices and health-related anthropometry in Flemish males: a 5-year follow-up study

OBJECTIVE: To examine the extent to which extent health-related anthropometric characteristics such as body mass index, waist-hip ratio, waist girth, percentage of body fat and weight gain are associated with physical activity and nutritional habits in a prospective follow-up study. DESIGN: A 5-y prospective follow-up study. SUBJECTS: 132 healthy men from The Leuven Longitudinal Study on Lifestyle, Physical Fitness, and Health. MEASUREMENTS: The main outcome measures in this study were body mass index, waist-hip ratio, waist girth, percentage of body fat and significant weight gain at the ages of 35 and 40 y. An unhealthy body composition was defined as a body mass index above 26, a waist-hip ratio above 0.95, a waist girth and body fat percentage above percentile 75 at the end of the 5-y follow-up period and a significant weight gain of 5 kg or more between the two examination periods. Anthropometric characteristics were derived from clinical examination. Physical activity at the age of 35 and 40 and nutritional habits at the age of 40 were determined from questionnaires. RESULTS: Physical activity was the most important predictor for the waist-hip ratio in this sample. In contrast, nutritional habits show a stronger relationship with body mass index. The absolute amount of energy intake is not as important as the dietary factors in predicting subjects with overweight or an unhealthy body composition. The index of occupational activities appears to be the most important physical activity variable. CONCLUSION: The relative contribution of physical activity and nutritional habits in health-related anthropometry varies with the characteristic considered. It is important to include all components of physical activity, and occupational activities in particular, in determining these relationships in a general population sample

Schnitzlersyndroom: casus en literatuuroverzicht

Het schnitzlersyndroom (SS) is een weinig gekende oorzaak van inflammatoire botpijn. De ziektegeschiedenis van een man die zich aanbood met glutealgie wordt besproken. SS wordt gekenmerkt door de aanwezigheid van chronische urticaria, monoklonale gammopathie en een wisselend aantal andere symptomen (minimum twee bij IgM en minimum drie bij IgG), zoals recurrente koorts, objectieve tekenen van abnormale botombouw met of zonder pijn, gestegen C-reactieve proteïne (CRP) of leukocytose en neutrofiele dermale infiltraten op huidbiopsie. Pathofysiologisch worden auto-immune en -inflammatoire mechanismen beschreven. Een therapeutisch algoritme werd voorgesteld door experten en omvat aanbevelingen voor een gerichte behandeling op basis van de graad van inflammatie en de weerslag op het dagelijkse functioneren. Een behandeling met anakinra, een interleukine(IL)-1-receptorantagonist voor zowel IL-1α en IL-1β, blijkt in veel gevallen doeltreffend. Schnitzler syndrome: case report and literature survey Schnitzler syndrome (SS) is a rare clinical picture first described in 1972. It is characterized by recurrent urticarial rash and monoclonal gammopathy with minor criteria such as recurrent fever, objective signs of abnormal bone remodeling, elevated C-reactive protein (CRP) level or leukocytosis, and a neutrophilic infiltrate on skin biopsy. Bone involvement is frequent and usually imaged as osteosclerosis. Literature shows that bone scan is sensitive for bone involvement in suspected cases. MRI will show T2 hyperintens lesions. No radiographic sign is specific. An evidence-based treatment protocol has not yet been set forth, but expert meetings have formed a consensus on the base of case-reports and case-series. SS is a rare cause of buttock pain and should be included in the broad differential diagnosis of pelvic pain. The medical history of a 41-year old man who presented with SS is described, as well as a survey of the literature.status: publishe