Determination of Effect of Platelet Rich Plasma Injection on Improving Pain and Function in Young Healthy Athletes with Isolated Grade 2 or 3 Knee Medial Collateral Ligament Sprains

Background: Knee medial collateral ligament (MCL) sprain is common in athletes, which keeps them away from trainings. Platelet-rich plasma (PRP) injection is used as an adjunct for treatment of musculoskeletal injuries. This study was supposed to define effect of PRP injection on high-grade MCL sprain healing, in comparison to rehabilitation alone.Materials and Methods: This study was performed on 46 healthy athletes with high-grade MCL sprains who came to sports medicine clinic of Taleghani Hospital, Tehran over a one-year period (2017-2018). In first visit injury grade, its location, baseline pain, Lysholm score and joint stability was determined. Participants randomly allocated to 2 groups (n=23), “group A” had 12-week functional rehabilitation and “group B” had the same rehabilitation plus a single PRP injection. At 4-week intervals valgus stress testing, pain and Lysholm scores was reassessed. The scores of 4th, 8th and 12th weeks was compared to the baseline scores.Results: Mean baseline pain score in control and intervention group was 5.09±0.949 and 5.26±0.810 respectively that in the fourth week of study reduced to 1.30±0.765 and 2.43±0.507 (p<0.001). In intervention group, fourth week pain was significantly reduced while stability and Lysholm scores of the groups had no significant difference.Conclusion: PRP injection had a short-term statistically significant pain reduction effect that may assist in faster rehabilitation progress, shorter return to play and less detraining which is crucial to professional athletes

Evaluation of Efficacy of Neuro Muscular Electrical Stimulation and Electro Acupuncture in Improving the Pain and Disability in Patients with the Lumbar Degenerative Intervertebral Disk Disease

Background: Chronic low back pain (CLBP) due to the degenerative intervertebral disk diseases is one of the most common musculoskeletal conditions in contemporary societies. A variety of pharmacological, non-pharmacological and surgical options is available for treatment of CLBP. The use of non-pharmacological methods have drastically increased in recent years, offering fewer complications and expenses. This study was conducted to compare the efficacy of the neuromuscular electrical stimulation (NMES) and electro acupuncture (EAP) with exercise therapy alone in patients with chronic low back pain. Materials and Methods: This was a randomized case-controlled clinical trial. Sixty patients with CLBP were randomly assigned to 3 groups (20 cases each) of the EAP with exercise therapy, NMES with exercise therapy, and exercise therapy only. Severity of pain and disability improvement were assessed using the visual analog scale (VAS) and Quebec back pain disability scale respectively. Results: A total of 66 individuals were enrolled, out of which 6 were excluded due to patients’ lack of cooperation. A significant decline in the amounts of Quebec and VAS was observed in the three groups (p<0.001). The pain and disability improvements did not display any significant difference in the NMES or EAP groups compared to the control group. However, the severity of disability and pain in the NMES group were significantly higher than the EAP group (p<0.05). Conclusion: These findings may indicate an almost identical efficacy of exercise therapy alone compared to the combination with electrical stimulation techniques in improving the pain and disability in patients suffering CLBP

A systematic review and meta-analysis of the application of platelet rich plasma in sports medicine

Introduction: In recent years, platelet rich plasma (PRP) has been receiving increasing attention for the treatment of soft tissue injuries. These numerous applications have raised a great deal of questions and debate about the effectiveness of this method. This study aimed to determine the efficacy of PRP in improving sports injuries and subsequently throw some light on these controversies. Methods: A systematic review of the literature and meta-analysis of results were undertaken. All related databases, such as PubMed, Cochrane Database of Systematic Reviews, DARE, and EMBASE, were searched on the use of PRP on athletes and in sports medicine. The search was conducted from June 2013 to February 2014. Results: Our search retrieved 905 studies, of which 13 randomized control trials (RCT) met our inclusion criteria for systematic review and meta-analysis. All articles were appraised by Critical Appraisal Skills Program (CASP) checklist for RCT studies. The analysis of the results of pain scores and physical activity/functions did not show any superiority for PRP as opposed to the other options. Conclusions: The meta-analysis showed no more effectiveness for PRP application in sports-related injuries in terms of physical function improvement and pain relief. Therefore, the extensive use of PRP for such injuries should be limited. Well-designed RCTs are needed to support the findings

Investigating Eccentric Contraction Mechanism in the Prevention of Sports Injuries

Introduction: Eccentric contraction exercises such as hamstring Nordic have been used nowadays to prevent injury. Maximum force in the muscle happens when the outer force is more than the force made by the muscle. Muscle force can reach its maximum in eccentric contraction and this damages contraction components and cytoskeleton (infraconstruction) of the muscle fiber and weakness and pain happens. But how a contraction which causes pain and injury can help in preventing injury? The goal of the present study was to evaluate the eccentric contraction mechanism in the prevention of sports injuries. Materials and Methods: For this study, background research has been done using search engines from 1980 to 2017. Studies including information about eccentric exercises and sports injury prevention have been chosen next after eliminating unrelated articles. Results: Eccentric exercises affect muscle morphology and peripheral and central nerve activities. Muscle structure characteristics can create force which include pennation angle, muscle thickness, and fascial length and differ according to mechanical trigger. When the muscles are lengthened, the force attracts the mechanical work and acts as a spring. The energy which has been attracted during muscle and tendon lengthening, is usually wasted as heat and then recovery of stretching combustion energy happens. Stretching and energy recovery depend on the energy and resilience of the muscle. Eccentric contraction respectively causes more stretching of the sarcomeres, detatchment of the sarcomeres, cortex damage, localized contraction, muscle fiber inflammation and eventually inflammation and pain which shows injury to the muscle tissue. Moreover eccentric exercises change the call for alpha motor units, sarcomere activity, corticopostal sensitivity and brain activity. Continual muscle adaptation ability to tissue damage is a step for preventing acute injury in the future in eccentric contraction. Conclusion: Eccentric exercises have caused small injury in muscle tissue which eventually causes adaptation in the muscle and increases their strength and resistance and this happens by increasing muscle diameter and fascia length and pennation angle. Although it could be damaging but it is better to consider useful as muscle adaptation.Keywords: Sports Injury, Eccentric Contraction, Preventing Injury, Eccentric Exercises, Nerve-Muscl