UPDATE IN MUSCLE INJURY. FROM HISTOLOGY TO THE RETURN TO PLAY

This past weekend in Barcelona we have organized a seminar on update of the muscle injury. Limited to 40 people.

Feedback from attendees was really good. This fact compels us to make a second edition probably next year.


Here I leave the complete program. You can also follow the best tips on twitter with the hashtag #muscleBCN (except most of my speeches because I was speaking... )

Actualización de la lesión muscular en el deporte. De la histología a la readaptación

En los últimos años ha existido un gran avance en el conocimiento de los factores de riesgo, en la calidad del diagnóstico por imagen mediante ecografía y resonancia magnética y en el tratamiento de las lesiones musculares en el deporte.

Uno de los principales condicionantes de este hecho es la progresión en el conocimiento anatómico, los factores de riesgo, y la localización exacta de las lesiones musculares. Todo esto provoca que el tratamiento pueda ser cada vez más individualizado y, por tanto, mucho más específico para cada tipo de lesión, deportista, deporte e incluso posición en el campo.

Es por este motivo que creemos, con el Dr. Ramon Balius (@Dr_Ramon_Balius), que es un buen momento para poder revisar y actualizar algunos de los conceptos que conciernen a las lesiones en los distintos grupos musculares.

Como novedad, y debido al auge del concepto del return-to-play, especialmente en ese delicado periodo de tiempo que abarca la readaptación final a la actividad deportiva con el resto del grupo, se ha intentado dotar a las distintas ponencias de este componente.

Para esto contamos con la presencia, a parte de la del Dr. Balius y de la mís propia, de destacados ponentes conocidos por todos por su trayectoria como son el Dr. José Peña, el Dr. Gil Rodas, el Dr. Ricard Pruna i el especialista en readaptación Dr. Toni Caparrós.

Toda la información así como el programa y las inscripciones se puede encontrar en el siguiente enlace.

http://www.geyseco.es/lesion_muscular/index.php?go=inicio

Anterior Chronic Exertional Compartment Syndrome of the Leg

I am really proud for the publication of our latest work in Journal of Ultrasound in Medicine as a Technical innovation.



Ultrasound-Guided Fasciotomy for Anterior Chronic Exertional Compartment Syndrome of the Leg

Chronic exertional compartment syndrome is characterized by exertional pain and elevated intracompartmental pressures affecting the leg in physically active young people. In patients who have failed conservative measures, fasciotomy is the treatment of choice. This study presents a new method for performing fasciotomy using high-resolution ultrasound (US) guidance and reports on the clinical outcomes in a group of these patients. Over a 3-year period, 7 consecutive patients with a total of 9 involved legs presented clinically with anterior compartment chronic exertional compartment syndrome, which was confirmed by intracompartmental pressure measurements before and after exercise. After a US examination, fasciotomy under US guidance was performed. Preoperative and postoperative pain and activity levels were assessed as well as number of days needed to "return to play." All patients had a decrease in pain, and all except 1 returned to presymptomatic exercise levels with a median return to play of 35 days.

J Ultrasound Med. 2016 Mar 9. pii: 15.04058. [Epub ahead of print]

http://www.ncbi.nlm.nih.gov/pubmed/26960800

Differential Diagnosis of Calf pain in athletes

Calf pain in athletes has a very varied aetiology. When you visit an athlete with calf pain you don't have to think only in a muscle strain (although it is probably the most common cause).

There is an amount of possible diagnosis. After reviewing the literature I adapted an schema of the whole differential diagnosis of the calf pain in athletes.

Most of this causes can be diagnosed with the use of ultrasond, you just have to think about them and, obviously, speak with the patient.

* Bibliography

- Burrus et al. Chronic Leg Pain in Athletes. The American Journal of Sports Medicine, Vol. XX, No. X. DOI: 10.1177/0363546514545859

- Brewer RB, Gregory AJ. Chronic lower leg pain in athletes: a guide for the differential diagnosis, evaluation, and treatment. Sports Health. 2012;4(2):121-127

- Brukner P. Exercise-related lower leg pain: bone. Med Sci Sports Exerc. 2000;32(3):S15-S26.

- Edwards PH Jr, Wright ML, Hartman JF. A practical approach for the differential diagnosis of chronic leg pain in the athlete. Am J Sports Med. 2005;33(8):1241-1249.

- Fabre T, Montero C, Gaujard E, Gervais-Dellion F, Durandeau A. Chronic calf pain in athletes due to sural nerve entrapment: a report of 18 cases. Am J Sports Med. 2000;28(5):679-682.

- Gallo RA, Plakke M, Silvis ML. Common leg injuries of long-distance runners: anatomical and biomechanical approach. Sports Health. 2012;4(6):485-495.

- Pell RFT, Khanuja HS, Cooley GR. Leg pain in the running athlete. J Am Acad Orthop Surg. 2004;12(6):396-404.

- Rajasekaran S, Kvinlaug K, Finnoff JT. Exertional leg pain in the athlete. PM R. 2012;4(12):985-1000.

BIBLIOGRAPHY UPDATE: SOCCER

Eating and nutrition habits in young competitive athletes: a comparison between soccer players and cyclists.
Galanti G, Stefani L, Scacciati I, Mascherini G, Buti G, Maffulli N.
Transl Med UniSa. 2014 Dec 19;11:44-7. eCollection 2015 Jan-Apr.


Factors Influencing Perception of Effort (Session-RPE) During Elite Soccer Training.
Gaudino P, Iaia FM, Strudwick AJ, Hawkins RD, Alberti G, Atkinson G, Gregson W.
Int J Sports Physiol Perform. 2015 Feb 11. [Epub ahead of print]


Injuries of Veteran Football (Soccer) Players in Germany.
Hammes D, Aus Der Fünten K, Kaiser S, Frisen E, Dvorák J, Meyer T.
Res Sports Med. 2015 Feb 11:1-12. [Epub ahead of print]


Two-year changes in anthropometric and motor ability values as talent identification indexes in youth soccer players.
Hirose N, Seki T.
J Sci Med Sport. 2015 Jan 23. pii: S1440-2440(15)00007-9. doi: 10.1016/j.jsams.2015.01.004. [Epub ahead of print]


Muscle injuries of the lower extremity: a comparison between young and old male elite soccer players.
Svensson K, Alricsson M, Karnebäck G, Magounakis T, Werner S.
Knee Surg Sports Traumatol Arthrosc. 2015 Feb 11. [Epub ahead of print]


A Preliminary Examination of Neurocognitive Performance and Symptoms Following a Bout of Soccer Heading in Athletes Wearing Protective Soccer Headbands.
Elbin RJ, Beatty A, Covassin T, Schatz P, Hydeman A, Kontos AP.
Res Sports Med. 2015 Feb 10:1-12. [Epub ahead of print


The Role of Instability with Plyometric Training in Sub-elite Adolescent Soccer Players.
Granacher U, Prieske O, Majewski M, Büsch D, Muehlbauer T.
Int J Sports Med. 2015 Feb 9. [Epub ahead of print]


Effect of creatine supplementation on physical performance are related to the AMPD1 and PPARG genes polymorphisms in football players.
Lifanov D, Khadyeva MN, Rahmatullina LSh, Demenev SV, Ibragimov RR.
Ross Fiziol Zh Im I M Sechenova. 2014 Jun;100(6):767-76.

BIBLIOGRAPHY UPDATE

The Sympathetic Nervous System and Tendinopathy: A Systematic Review.
Jewson JL, Lambert GW, Storr M, Gaida JE.
Sports Med. 2015 Feb 6. [Epub ahead of print]


Extracellular matrix proteins interact with cell-signalling pathways in modifying risk of Achilles tendinopathy.
Saunders CJ, van der Merwe L, Cook J, Handley CJ, Collins M, September AV.
J Orthop Res. 2015 Jan 30. doi: 10.1002/jor.22820. [Epub ahead of print]

Mechanisms of tendon injury and repair.
Thomopoulos S, Parks WC, Rifkin DB, Derwin KA.
J Orthop Res . 2015 Jan 29. doi: 10.1002/jor.22806. [Epub ahead of print]

Biologics in Achilles tendon healing and repair: a review.
Shapiro E, Grande D, Drakos M.
Curr Rev Musculoskelet Med. 2015 Feb 6. [Epub ahead of print]

Surgical management of Achilles tendon re-ruptures: a prospective cohort study.
Maffulli N, Oliva F, Del Buono A, Florio A, Maffulli G.
Int Orthop. 2015 Feb 3. [Epub ahead of print]

BIBLIOGRAPHY UPDATE (FOCUSED ON ACHILLES TENDON)

Tendinopathy of the Achilles Tendon: Volume Assessed by Automated Contour Detection in Submillimeter Isotropic 3-Dimensional Magnetic Resonance Imaging Data Sets Recorded at a Field Strength of 3 T.
Syha R, Springer F, Würslin C, Ipach I, Ketelsen D, Grözinger G, Notohamiprodjo M, Nikolaou K, Claussen CD, Schick F, Grosse U.
J Comput Assist Tomogr. 2015 Jan 15. [Epub ahead of print]

Achilles tendons in people with type 2 diabetes show mildly compromised structure: an ultrasound tissue characterisation study.
de Jonge S, Rozenberg R, Vieyra B, Stam HJ, Aanstoot HJ, Weinans H, van Schie HT, Praet SF.
Br J Sports Med. 2015 Jan 13. pii: bjsports-2014-093696. doi: 10.1136/bjsports-2014-093696. [Epub ahead of print]

Pharmacological interventions for the treatment of Achilles tendinopathy: a systematic review of randomized controlled trials.
Maffulli N, Papalia R, D'Adamio S, Diaz Balzani L, Denaro V.
Br Med Bull. 2015 Jan 12. pii: ldu040. [Epub ahead of print] Review.

Ultrasonography as a prognostic and objective parameter in Achilles tendinopathy: A prospective observational study.
Bakkegaard M, Johannsen FE, Højgaard B, Langberg H.
Eur J Radiol. 2014 Dec 16. pii: S0720-048X(14)00535-X. doi: 10.1016/j.ejrad.2014.11.028. [Epub ahead of print]

Achilles tendon strain energy in distance running: consider the muscle energy cost.
Fletcher JR, MacIntosh BR.
J Appl Physiol (1985). 2015 Jan 15;118(2):193-9. doi: 10.1152/japplphysiol.00732.2014. Epub 2014 Nov 13.

BIBLIOGRAPHY WEEKLY UPDATE (FOCUSED ON HAMSTRING MUSCLES)

An anatomical and histological study of the structures surrounding the proximal attachment of thehamstring muscles.
Pérez-Bellmunt A, Miguel-Pérez M, Brugué MB, Cabús JB, Casals M, Martinoli C, Kuisma R.
Man Ther. 2014 Nov 21. pii: S1356-689X(14)00225-2. doi: 10.1016/j.math.2014.11.005. [Epub ahead of print]

Physical principles demonstrate that the biceps femoris muscle relative to the other hamstringmuscles exerts the most force: implications for hamstring muscle strain injuries.
Dolman B, Verrall G, Reid I.
Muscles Ligaments Tendons J. 2014 Nov 17;4(3):371-7. eCollection 2014 Jul.


Platelet-rich plasma injections for the treatment of hamstring injuries: a randomized controlled trial.
A Hamid MS, Mohamed Ali MR, Yusof A, George J, Lee LP.
Am J Sports Med. 2014 Oct;42(10):2410-8. doi: 10.1177/0363546514541540. Epub 2014 Jul 29.


The financial cost of hamstring strain injuries in the Australian Football League.
Hickey J, Shield AJ, Williams MD, Opar DA.
Br J Sports Med. 2014 Apr;48(8):729-30. doi: 10.1136/bjsports-2013-092884. Epub 2013 Oct 11.

Recurrent hamstring muscle injury: applying the limited evidence in the professional football setting with a seven-point programme.
Brukner P, Nealon A, Morgan C, Burgess D, Dunn A.
Br J Sports Med. 2014 Jun;48(11):929-38. doi: 10.1136/bjsports-2012-091400. Epub 2013 Jan 15.

Analysis of the Three Most Prevalent Injuries in Australian Football Demonstrates a Season to Season Association Between Groin/Hip/Osteitis Pubis Injuries With ACL Knee Injuries.
Verrall GM, Esterman A, Hewett TE.
Asian J Sports Med. 2014 Sep;5(3):e23072. doi: 10.5812/asjsm.23072. Epub 2014 Sep 10.

Sonographic Evaluation of the Distal Iliopsoas Tendon Using a New Approach

Sonographic Evaluation of the Distal Iliopsoas Tendon Using a New Approach


Ramon Balius, MD, PhD, Carles Pedret, MD, PhD⇑, Marc Blasi, Maribel Miguel, MD, PhD, Beatriz Vallejo, MD, Eric Margalet, MD, PhD, David A. Bong, MD and Carlo Martinoli, MD, PhD

Abstract


Sonography of the iliopsoas tendon plays an important role in the diagnosis and preoperative and postoperative management for the increasing number of patients under consideration for arthroscopically guided hip interventions such as iliopsoas tenotomy in a variety of conditions, including arthropathy, periarticular calcifications, and cam-type deformities of the femoral head. The ability to visualize the iliopsoas tendon pre-operatively can be helpful diagnostically in patients presenting with hip pain and can aid in planning surgery, while evaluating the tendon postoperatively is important in the assessment of causes of postoperative pain and other potential complications. We present a novel technique for visualizing the distal iliopsoas tendon complex in the longitudinal axis at its insertion on the lesser trochanter on sonography.



http://www.jultrasoundmed.org/content/33/11/2021.abstract  

BIBLIOGRAPHY UP-TO-DATE

The Copenhagen Standardised MRI protocol to assess the pubic symphysis and adductor regions of athletes: outline and intratester and intertester reliability. 

Branci S, Thorborg K, Bech BH, Boesen M, Magnussen E, Court-Payen M, Nielsen MB, Hölmich P. Br J Sports Med. 2014 Dec 8. pii: bjsports-2014-094239. doi: 10.1136/bjsports-2014-094239

Classification of rotator cuff tendinopathy using high definition ultrasound.
Hinsley H, Nicholls A, Daines M, Wallace G, Arden N, Carr A.
Muscles Ligaments Tendons J . 2014 Nov 17;4(3):391-397. eCollection 2014 Jul.


Clinical predictors of time to return to competition following hamstring injuries.
Guillodo Y, Here-Dorignac C, Thoribé B, Madouas G, Dauty M, Tassery F, Saraux A.
Muscles Ligaments Tendons J. 2014 Nov 17;4(3):386-390. eCollection 2014 Jul.


The Fifth Metatarsal Base: Anatomic Evaluation Regarding Fracture Mechanism and Treatment Algorithms.
DeVries JG, Taefi E, Bussewitz BW, Hyer CF, Lee TH.
J Foot Ankle Surg. 2014 Oct 16. pii: S1067-2516(14)00425-6. doi: 10.1053/j.jfas.2014.08.019


Ultrasound-Guided Musculoskeletal Interventions in American Football: 18 Years of Experience.
Dave RB, Stevens KJ, Shivaram GM, McAdams TR, Dillingham MF, Beaulieu CF.
AJR Am J Roentgenol. 2014 Dec;203(6):W674-W683.

The Impact of the FIFA 11+ Training Program on Injury Prevention in Football Players: A Systematic Review.
Barengo NC, Meneses-Echávez JF, Ramírez-Vélez R, Cohen DD, Tovar G, Bautista JE.
Int J Environ Res Public Health. 2014 Nov 19;11(11):11986-12000. Review