Vincent J. Leavey, Michelle A. Sandrey, Greg Dahmer

 The aim of this study was to determine whether Gluteus Medius strength (GMS) training, proprioception training, or a combination of the 2 has an effect on dynamic posture control. 

48 healthy male and female college students were split into 3 groups. Each group were given a 6 week program for either GMS training, proprioception training or a combination of both.

Eight Star Excursion Balance Test (SEBT) reach distances and Gluteus Medius Strength were measured before and after the 6 week programme for the dominant leg. 

The results indicated no significant difference between the groups. Most improvement was seen in the SEBT reach distances in the combination group, whereas the GMS only group demonstrated the highest increase in GM strength.

The authors conclude that the use of exercises for proprioception, GMS, or a combination of the 2 will help improve dynamic postural control in healthy, active individuals.

JSR Volume 19, Issue 3, August 2010 268 – 287

Eva Ageberg, Magnus Forssblad, Pär Herbertsson and Ewa M. Roos. 

Females have been shown to be at a higher risk for sustaining anterior cruciate ligament (ACL) injury. However, it is not known whether there is a difference between male and female patients following ACL injury/reconstruction. Therefore the aim of this study is to observe differences between the sexes in patient-reported outcomes before and at 1 and 2 years after ACL reconstruction and to present reference values.

The subjects included 10164 patients (mean age, 27 years; 42% females) with primary ACL reconstruction between 2005 and 2008. There were 4438 (44%) of these patients (42% females) who had completed the knee-specific questionnaire, Knee injury and Osteoarthritis Outcome Score (KOOS), and 5255 (52%) who had completed the generic score of health status, EQ-5D, before surgery and were included in this study. Independent t tests were used to study sex differences in KOOS and EQ-5D preoperatively, 1 and 2 years postoperatively, and over time.

The results demonstrated that before the reconstruction, female patients reported worse scores than male patients in 4 KOOS subscales (pain, symptoms, sport/recreation, quality of life) and EQ-5D, with the largest difference seen in KOOS sport/recreation.

At 1 year postoperatively, female patients reported worse scores than male patients in KOOS pain and KOOS sport/recreation and at 2 years postoperatively in KOOS sport/recreation and KOOS quality of life. Female patients reported less improvement from 1 to 2 years postoperatively than male patients in KOOS sport/recreation . In some age groups, female patients reported a clinically relevant worse KOOS sport/recreation score than male patients.

The study concludes that female patients reported statistically significant worse outcomes than male patients before and at 1 and 2 years after ACL reconstruction. There were no clinically relevant sex differences in improvements over time. We suggest that possible sex differences be analyzed in future studies on evaluation after ACL injury/reconstruction.

The American Jornal os Sports Medicine, July 2010, 38 (7), 1334-1342

The aim of this study was to observe if the inclusion of a night splint to an eccentric exercise programme is effective in improving functional outcome in chronic midportion Achilles tendinopathy.

All 58 (70 tendons) patients completed a 12-week heavy load eccentric training programme. The test group received a night splint as well as eccentric exercises.

Results were measured using the Victorian Institute of Sport Assessment—Achilles (VISAA) score, subjective patient satisfaction and neovascularisation score measured with power Doppler ultrasonography (PDU).

Results indicated that the VISA-A score increased significantly for both groups. No significant differences in the VISA-A score were found between the groups from baseline to one year (p = 0.32). The presence of neovessels at baseline did not predict a change in the VISA-A score after one year in the whole group (p = 0.71).

The authors concluded that eccentric exercises improved functional outcome at one year follow-up.  The additional use of a night splint did not significantly improve outcome scores. 

Br J Sports Med 2010;44:673-677 doi:10.1136/bjsm.2008.052142

Joel Humphrey, Otto Chan, Tom Crisp, Nat Padhiar, Dylan Morrissey, Richard Twycross-Lewis, John King, Nicola Maffulli

This study investigated neovascularisation, tendon thickness and clinical function in chronic resistant, mid portion Achilles tendinopathy following high volume image guided injections (HVIGI).
The subjects were 11 athletes with resistant tendinopathy of the main body of the Achilles tendon for a mean of 51.4 months who had failed to improve with an eccentric loading program. The morphological features, neovascularisation and maximal tendon thickness were assessed with power Doppler ultrasound. Clinical function was measured with the Victorian Institute of Sports Assessment-Achilles tendon (VISA-A) questionnaire. All the tendons were injected with 10mL of 0.5% bupivacaine hydrochloride, 25mg of hydrocortisone acetate, and 40mL of 0.9% NaCl saline solution under real time ultrasound guidance. All outcome measures were recorded at baseline and after a short-term follow-up (mean 2.9 weeks, range 2–4).

The results showed a statistically significant difference between baseline and 3-week follow-up in all the outcome measures after HVIGI. The grade of neovascularisation reduced, the maximal tendon diameter decreased, and the VISA-A scores improved.

In conclusion, HVIGI for resistant tendinopathy of the main body of the Achilles tendon is effective to improve symptoms, reduce neovascularisation, and decrease maximal tendon thickness at short-term follow-up.

Journal of Science and Medicine in Sport, Volume 13, Issue 3, Pages 295-298 (May 2010)

Wiltshire, E. Victoria; Poitras, Veronica; Pak, Melissa; Hong, Terence; Rayner, Jay; Tschakovsky, Michael E.

It is regularly quoted that sports massage helps to increase muscle blood flow which improves lactic acid removal. This study tested this theory.

12 subjects performed 2 min of strenuous isometric (static) handgrip (IHG) exercise at 40% maximum voluntary contraction (MVC) to increase forearm muscle lactic acid concentration. Forearm blood flow, deep venous forearm blood lactate and H+ concentration ([La-], [H+]) were measured every minute for 10 minutes post-IHG under three conditions: passive (passive rest), active (rhythmic exercise at 10% maximum voluntary contraction), and massage (effleurage and petrissage). Arterialized [La-] and [H+] from a superficial heated hand vein was measured at baseline.

The results indicated that massage actually impairs La- and H+ removal from muscle after strenuous exercise by mechanically impeding blood flow.

Medicine & Science in Sports & Exercise. 42(6):1062-1071, June 2010.

Deirdre E. McGhee and Julie R. Steele

Ill-fitting bras and poor breast support can result in the development of pain and prevent women from participating in physical activity.

The aim of this study was to systematically determine the best method for women to independently choose a well-fitted bra. The bra size of 104 women was determined through self-selection and bra size measurements. This was compared to the “correct bra size” as determined by professional bra fitting criteria, which were also used to assess the bra fit of each participant’s own bra. 85% of the participants were found to be wearing ill-fitting bras and the bra sizes determined by self-selection or using bra-sizing measurement systems were significantly different to the correct bra size.Therefore, women were found to have a poor ability to choose a well-fitted bra independently, which was not improved by trying on several bras or using bra-sizing measurements. Education of professional bra fitting criteria may offer medical practitioners and allied health professionals a simple strategy to improve the ability of their female patients to independently choose a well-fitted bra.Journal of Science and Medicine in Sport, Available online 7 May 2010

Mika Hangai, Koji Kaneoka, Yu Okubo, Shumpei Miyakawa, Shiro Hinotsu, Naoki Mukai, Masataka Sakane, Naoyuki Ochiai,

Low back pain is a problem for both adults, but also youths involved in sport. The relationship between low back pain during youth and the duration or types of sports has not been identified.

This study involved 4667 new university students who, from 2004 to 2006, answered a questionnaire concerning low back pain and their involvement in competitive sports. The students were then divided into a “no” group (NO), a middle group (MID), and a high group (HI) based on their involvement in competitive sports.

The authors also selected students who had participated in the same sport for 5 or more years and categorized the students according to the type of sport. Differences in low back pain among the groups were analyzed with the NO group as the reference group.

There were statistically significant linear associations in the NO, MID, and HI groups, with 50.0%, 61.8%, and 71.7%, respectively, of the students experiencing low back pain. Among the NO, MID, and HI groups, 4.4%, 5.7%, 9.6%, respectively, had experienced school absence due to low back pain; and 4.0%, 8.5%, and 14.6%, respectively had low back pain with associated lower extremity pain and numbness. All 8 sports groups that were analyzed had experienced low back pain significantly higher than the NO group, and the odds ratios differed by sport with the highest (3.8) for the volleyball group.

High exposure to competitive sports activities during youth was linked to low back pain and symptoms in the lower extremities, with the severity varying with the sport. To reduce low back pain in youth, factors that may be causing low back pain, such as sport-specific postures and techniques, need to be investigated.

Am J Sports Med April 2010 vol. 38 no. 4 791-796

H. Collado, J. M. Coudreuse, F. Graziani, L. Bensoussan, J. M. Viton, A. Delarque

The aim of this study was to compare 2 methods of ankle evertor muscle (e.g. peroneus brevis and longus) strengthening after an ankle sprain: concentric (where the muscle shortens) vs eccentric (where it lengthens).


18 subjects with their 1st ankle sprain were randomized into 2 groups. One group underwent conventional physical therapy including concentric strengthening of the evertor ankle muscles. The second group underwent eccentric strengthening.

At the end of the physical therapy, the strength of the evertor muscles was tested using an isokinetic dynamometer. The measurements were peak torques in the concentric and eccentric modes; ankle strength deficits, expressed as percentages of the healthy ankle values recorded in the concentric and eccentric modes; ratios between concentric/eccentric values.

After the concentric reinforcement, in the concentric group, there is both significant concentric strength deficit and an eccentric strength deficit on the injured side in comparison with the healthy side. After the eccentric reinforcement in the eccentric group, the muscle strength was significantly greater during concentric movements. Eccentric rehabilitation therefore restored the strength of the injured evertor muscles. These results show the value of this method, especially as the weakness of these muscles after sprains is one of the main risk factors contributing to instability and the recurrence of sprains.

Scandinavian Journal of Medicine & Science in Sports, Volume 20 Issue 2, Pages 241 - 246

Siegel, R; Mate, J; Brearley, M; Watson, G; Nosaka, K; Laursen, P.

This study investigated the effects of ice slurry ingestion on thermoregulatory responses and submaximal running time in a hot environment.

To do this, 10 males ingested 7.5 g kg-1 of either ice slurry (-1[degrees]C) or cold water (4[degrees]C) before running to exhaustion at their first ventilatory threshold in a hot environment (34.0[degrees]C +/- 0.2[degrees]C, 54.9% +/- 5.9% relative humidity) on two separate occasions. Temperatures were taken at the rectum and skin, heart rate, sweating rate, and ratings of thermal sensation and perceived exertion were assessed.

The results demonstrated that running time was longer after ice slurry versus cold water ingestion. Before running, rectal temperature dropped 0.66[degrees]C +/- 0.14[degrees]C after ice slurry ingestion compared with 0.25[degrees]C +/- 0.09[degrees]C  with cold water and remained lower for the first 30 min of exercise. At exhaustion, however, rectal temperature was higher with ice slurry (39.36[degrees]C +/- 0.41[degrees]C) versus cold water ingestion (39.05[degrees]C +/- 0.37[degrees]C). During exercise, mean skin temperature was similar between conditions, as was HR and sweat rate. After ice slurry ingestion, subjects stored more heat during exercise and mean ratings of thermal sensation and perceived exertion were lower.

The authors concluded that compared with cold water, ice slurry reduced preexercise rectal temperature, raised submaximal endurance running time in the heat and allowed rectal temperature to become higher at exhaustion. As such, ice slurry ingestion may be an effective and practical precooling maneuver for athletes competing in hot environments.

Medicine & Science in Sports & Exercise. 42(4):717-725, April 2010.

Verschueren SM, Roelants M, Delecluse C, Swinnen S, Vanderschueren D, Boonen S.