THE INFLUENCE OF BASEBALL PITCHING ON THE HARDNESS OF THE FLEXOR PRONATOR MUSCLES - USING ULTRASOUND REALTIME TISSUE ELASTGRAPHY

The purpose of this study was to examine changes of the individual hardness of the flexor - pronator muscle group after pitching. The twelve normal male volunteers who had played baseball participated in this study. One hundred pitches were performed, and the individual flexor pronator muscles hardness were analyzed using ultrasound real time tissue elastgraphy (RTE) both before and after 100 pitching. The hardness of the flexor pronator muscles were not significant different between before and after pitching. However, hardness of the most hardened muscle was significantly different between before and after pitching. Therefore RTE is useful method to manage of the pitching counts in pitchers who performed athletic rehabilitation after throwing injuries

Relationship between Medial Elbow Pain, Flexor Pronator Muscles, and the Ulnar Nerve in Baseball Players Using Ultrasonography

We aimed to clarify changes cross-sectional area (CSA) in flexor pronator muscles and the ulnar nerve (UN) in players with medial elbow pain between pitching phases. Forty-two male baseball players with and without medial elbow pain during throwing were included in this study. The players were divided into maximum external rotation (MER) and ball release (BR) groups according to the pitching phase in which pain was reported. The imaged region was the flexor digital profundus, flexor carpi ulnaris (FCU), flexor digitorum superficialis, and pronator teres muscles, as well as the UN. CSA at rest and during contraction was assessed using the ultrasonography software tracing function. For statistical analysis, the CSA at rest and at contraction in the healthy group, MER group and BR group was compared using one-way analysis of variance. There was a significant difference in CSA only in the FCU between the healthy (95.4 ± 15.5%) and the MER group (76.6 ± 12.5%) at rest (p = 0.004). There were significant differences in the UN between the healthy (105.0 ± 27.7%) and MER groups (176.4 ± 53.5%), and between the healthy and BR groups (132.9±21.1%) (p = 0.001 and p = 0.038, respectively). Our results suggest that athletes with medial elbow pain during the MER of pitching have ulnar nerve swelling

An Elastic Foot Orthosis for Limiting the Increase of Shear Modulus of Lower Leg Muscles after a Running Task: A Randomized Crossover Trial

Background: Excessive foot pronation may be attributed to an increasing burden on leg muscles during running, which might be a factor in medial tibial stress syndrome. We developed an elastic foot orthosis (EFO) that can decrease foot pronation and aimed to identify whether this orthosis could limit the increase in lower leg muscle hardness after running. Methods: Twenty-one healthy volunteers participated in this randomized crossover trial with an elastic or sham foot orthosis (SFO). All volunteers ran on a treadmill for 60 min while wearing either orthosis. Muscle hardness of the posterior lower leg was assessed using shear wave elastography before and after running. The Wilcoxon signed rank test was used to compare muscle hardness between the two orthotic conditions. Results: No significant differences were observed between the two orthotic conditions before running (p > 0.05). After running, the flexor digitorum longus (FDL) hardness in the EFO group was significantly lower than that in the SFO group (p < 0.01). No significant changes were observed in the other muscles. Conclusion: The results suggest that the EFO can restrict the increase in FDL hardness with running. The EFO may be an effective orthotic treatment for medial tibial stress syndrome

Posteromedial capsular anatomy of the tibia for consideration of the medial meniscal support structure using a multidimensional analysis

Abstract Medial meniscal extrusion (MME) is a structural abnormality that leads to early knee osteoarthritis; however, its formation remains debated. For anatomical consideration of the mechanism underlying MME formation, we examined the capsular attachment on the posteromedial tibia and its layered association with the semimembranosus. Fourteen knees of eight body donors were analyzed in this study; six knees were grouped for macroscopic analysis, whereas four knees each were grouped for histological and phosphotungstic acid-enhanced micro-computed tomography analyses. The capsular attachment varied in width according to location and was not distant from the articular cartilage and posterior root. A portion of the posteromedial joint capsule formed the semimembranosus tendinous sheath. The dense fibrous membrane superficial to the semimembranosus, which was continuous from its tendinous sheath, existed as one of the layers of the joint capsule. The aforementioned findings were confirmed in all specimens. Based on the capsular attachment and its layered association with the semimembranosus, the conventional posteromedial knee ligaments may be only a part of the joint capsule divided into two layers by the semimembranosus. If the coordinated action of the joint capsule and semimembranosus partially contributes to the medial meniscus stability, such a structural problem may affect MME formation

Difference in Movement between Superficial and Deep Parts of the Infrapatellar Fat Pad during Knee Extension

(1): The superficial and deep parts of the infrapatellar fat pat (IFP) have different morphological and functional characteristics. Knee pain often occurs during movement, and it is important to clarify the movement of the IFP during knee joint movement. The purpose of this study is to clarify that the movement of the superficial and deep parts of the IFP are different during knee extension in vivo using ultrasonography (US). (2): US was performed on 15 knees of 15 healthy adults. The probe was placed longitudinally at the center of the patellar tendon and the IFP was imaged. Measurements were taken during active extension of the knee from 90 degrees to 10 degrees of knee flexion at a rate of 30 times/min. The captured US videos were analyzed using Flow particle image velocimetry (Flow PIV) fluid measurement software. The region-of-interest (ROI) was set at the superficial part and the deep part of the IFP, and the flow velocity was calculated for each. (3): The flow velocity of the deep part (1.37 ± 0.13 cm/s) of the IFP was significantly faster than that of the superficial part (0.80 ± 0.23 cm/s). (4): Our results show that the flow velocity of the IFP is different between the superficial and deep parts and that US may be a better assessment tool for the movement of the IFP

The Effect of Functional Biomechanics Garment for Walking

The purpose of this study was to investigate the effects of a functional biomechanics garment (FBG) with a lower extremity assist function. 32 healthy male participants were included in this study. Participants were divided into an FBG with taping function group (FBG group) and a compression garment group (CG group). Cadence (steps/min), step length (m), and usual walking speed (m/s) were measured as spatio-temporal data. Kinetics, kinematics data, and dynamic joint stiffness (DJS) of the lower extremity were calculated using a three-dimensional gait analysis system. The FBG group showed significantly faster walking speed (FBG, 1.54 ± 0.12 m/s; CG, 1.42 ± 0.15 m/s, p < 0.05) and reduced hip DJS in terminal stance (FBG, 0.033 ± 0.014 Nm/kg/degree; CG: 0.049 ± 0.016 Nm/kg/degree, p < 0.05) compared to the CG group. The FBG decreased hip DJS in the terminal stance and affected walking speed. The passive elastic moment generated by the high elasticity part of the hip joint front in the FBG supported the internal hip flexion moment. Therefore, our FBG has a biomechanical effect. The FBG may be useful as a tool to promote health activities

Validity and Reliability of Criteria for Plantar Sensation Assessment Using Semmes–Weinstein Monofilament as a Clinically Usable Index

There is no standard clinically adaptable criterion for assessing plantar sensation for pre- and post-intervention comparisons. Studies using Semmes–Weinstein monofilaments (SWMs) to investigate intervention effects on plantar sensation vary in procedure and do not consider measurement errors. This study aimed to develop a simple criterion using SWMs to assess plantar sensation, determine the measurement error range, and identify areas of low error. Six examiners assessed 87 healthy young adults in Experiment 1, while two examiners assessed 10 participants in Experiment 2. Filaments were graded from 1 to 20 based on increasing diameter. The smallest grade that could be perceived for three sequential stimuli was used as the criterion (smallest perceivable grade, SPG). The SPG was significantly smaller at the hallux and larger at the heel than at other sites. There were no significant differences between the SPG of the repeated tests performed by the same versus different examiners. The interquartile range of the differences was <±3 at all sites. Thus, our criteria were reliable in evaluating the effects of plantar sensation interventions, especially at the heel and the middle of the metatarsal heads and could contribute to the development of more effective treatments for plantar sensations