Hides JA, Stanton WR, McMahon S, Sims K, Richardson CA

The study looked at the cross-sectional area (csa) of Multifidus (at L2,3,4 & 5) and the effect of a 13 week staged stabilisation exercise program on csa in elite cricket players 7 players with and 14 without low back pain (lbp).

The stabilisation program involved voluntary contraction of the multifidus, transversus abdominis, and pelvic floor muscles, progressed from non-weight-bearing to weight-bearing positions and movement training.

The CSA at L5 increased in all 7 players with lbp. Muscle symmetry improved in those subjects with lbp and a 50% decrease in pain was also reported.

The study demonstrates that even elite athletes can be subject to multifidus muscle wasting and that stabilisation training can decrease muscle wasting and associated pain.

Journal of Orthopedic and Sports Physical Therapy, 2008, 38(3), 101-8

Julie Hides, Craig Gilmore, Warren Stanton and Emma Bohlscheid

A group of 50 subjects with lower back pain were compared against 40 healthy, asymptomatic subjects for Multifidus size and symmetry. Results showed that the lower back pain group had significantly smaller Multifidus size than the control group. The Multifidus on the ipsilateral (same) side as the reported back pain was smaller in all cases.

The results of this study are in agreement with previous research and highlights the need for Multifidus assessment and rehabilitation in patients with chronic lower back pain.

Manual Therapy, 2008, 13(1), 43-49

Tennis elbow or ‘chronic extensor tendinosis’ is a common injury. An Australian study recently looked at the application of topical nitric oxide would aid rehabilitation. Nitric oxide has been used successfully to treat fractures and skin wounds in animals.

86 patients with extensor tendinosis were divided into 2 groups. One group was given a placebo patch and the other an active glycerol trinitrate patch on the skin.

The study concluded that application of nitric oxide improved early pain with activity, late functional measures, and outcomes of patients with extensor tendinosis.

From: American Journal of Sports Medicine Nov / Dec 2003

J. Vas, C. Ortega, V. Olmo, F. Perez-Fernandez, L. Hernandez, I. Medina, A. Herrera, F. Luna, E. Perea-Milla, C. Mendez, F. Madrazo, C. Jimenez, M. A. Ruiz and I. Aguilar

425 patients with a clinical diagnosis of unilateral subacromial syndrome were recruited and divided into two groups. Both groups received 15 sessions of physiotherapy over a period of three weeks. One group also received single-point acupuncture once a week in addition to their physiotherapy treatments.

The Constant–Murley Score (CMS) was used as a predictor of function, during the fourth week. The mean CMS score increased 16.6 points among the combined group, compared with only 10.6 points in the physiotherapy alone group. At the end of the study 53% of patients in the combined group had decreased their intake of analgesics compared to only 30% of the physio group.

Combining physiotherapy treatment with acupuncture improves shoulder function and reduces the intake of analgesics in patients with unilateral subacromial syndrome

Rheumatology, Apr 10 2008, online advance access

Bolgla LA, Malone TR, Umberger BR, Uhl TL

This study aimed to determine if females suffering from patellofemoral pain syndrome demonstrate reduced hip strength, and increased hip adduction, internal rotation and knee valgus whilst walking downstairs.

Strength measures were taken for hip abduction and external rotation as were hip and knee kinematics from 18 females with diagnosed PFPS and 18 healthy controls whilst performing a stair descent.

Results showed that females with PFPS demonstrated lower hip abduction and external rotation torques than the control group. However no differences were found for hip or knee kinematics between groups.

Journal of Orthopedic and Sports Physical Therapy, 2008, 38(1), 12-8

Marcio J. Santos & Wen Liu

Previous research has shown that functional ankle instability (FIA) may be the result of a number of factors including impaired balance, muscle weakness, proprioceptive deficit, joint laxity and delayed neuromuscular reaction times. This study aimed to look at the prevelence and association of these factors. 21 subjects with FIA and 16 healthy control subjects were assessed for the 5 factors.

Balance control and evertor strength were significantly reduced on the unstable side in comparison to the unaffected side in subjects with FAI. The evertor strength was also significantly different between the side difference of the FAI group and the side difference of the control group. Passive ankle stiffness was significantly related to balance control, ankle proprioception, and evertor peak torque. Individuals with FAI demonstrated a large variation in the deficit categories ranging from multiple to no noticeable deficits.

The study concluded that mechanical changes in the ankle joint may affect several aspects of the ankle’s functional ability. For example changes in ankle proprioception may affect the evertors’ strength or vice versa. More importantly, individuals with FAI exhibit high variability in ankle deficits.

Journal of Orthopedic and Sports Physical Therapy, 2008, 38(3), 150-7

Daniel C. Herman, PhD, Paul S. Weinhold, PhD, Kevin M. Guskiewicz, ATC, PhD, William E. Garrett, MD, PhD, Bing Yu, PhD and Darin A. Padua, ATC, PhD

Strength training is considered to be a preventative measure for ACL rupture in women although relatively little is known about the effect strength training has on the correction of lower limb biomechanics.

66 female recreational athletes performed a 3 stop-jump tasks whilst 3D knee and hip kinetic and kinematic data was recorded as was maximal voluntary isometric contraction strength data. After this participants were divided into either the control group (who performed no exercise) or the exercise group who performed resistance training focusing on the quads, hamstrings and gluts for a total of 9 weeks.

The results demonstrated that strength training alone does not alter knee and hip kinetics and kinematics in healthy female athletes. As females have a higher rate of ACL rupture due to altered biomechanics, strength training alone may not be enough to reduce the risk of non-contact ACL rupture.

The American Journal of Sports Medicine 36:733-740 (2008)

Yeong-Fwu Lin, PhD, MD, Jiu-Jenq Lin, PhD, PT, Mei-Hwa Jan, MS, PT, Tung-Ching Wei, MS, PT, Hsin-Yen Shih, PT and Cheng-Kung Cheng, PhD

Patellofemoral pain (PFP) syndrome has always been associated with a mal-tracking patella and the involvement of the Vastus Medialis Obliquus (VMO) in controlling patella maltracking is unclear.

112 patients with PFP syndrome were tested using computed tomograpgy (CT) axial images in which knee flexion was 0, 15 or 30 degrees and the quad muscles either relaxed or contracted. Measurements of the VMO cross-sectional area and patella tilt and lateral shift were made.

The results demonstrated significant correlations between VMO cross-sectional area and patella tilt at 0 and 30 degrees. The clinical relevance of these findings suggests that it is important to consider the function of VMO in any rehabilitation program for PFP syndrome.

The American Journal of Sports Medicine 36:741-746 (2008)