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Muscle injuries occur frequently in athletes, accounting for more than one-third of sport-related trauma. Athletes most affected by these injuries are those practicing football and track and field, with hamstrings and gastrocnemius-soleus as the mainly involved sites. Muscle injuries lead to loss of competitions, long recovery times and risk of re-...
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... tendon, ligament, and muscle). [1][2][3][4] In addition, ultrasonography can diagnose vascular conditions, such as atherosclerosis. [5][6][7] Soft fibrous biological tissues, including tendon, muscle, and blood vessel wall, are composed of fibrous proteins, such as collagen, elastin, myosin, and actin, which are important for the mechanical properties of these tissues. ...
Pulsed electromagnetic field (PEMF) stimulation has been widely applied clinically to promote bone healing; however, its detailed mechanism of action, particularly in endochondral ossification, remains elusive, and long‐term stimulation is required for its satisfactory effect. The aim of this study was to investigate the involvement of the mammalian target of rapamycin (mTOR) pathway in chondrocyte differentiation and proliferation using a mouse prechondroblast cell line (ATDC5), and establish an efficient PEMF stimulation strategy for endochondral ossification. The changes in cell differentiation (gene expression levels of aggrecan, type II collagen, and type X collagen) and proliferation (cellular uptake of bromodeoxyuridine [BrdU]) in ATDC5 cells in the presence or absence of rapamycin, an mTOR inhibitor, was measured. The effects of continuous and intermittent PEMF stimulation on changes in cell differentiation and proliferation were compared. Rapamycin significantly suppressed the induction of cell differentiation markers and the cell proliferation activity. Furthermore, only intermittent PEMF stimulation continuously activated the mTOR pathway in ATDC5 cells, significantly promoting cell proliferation. These results demonstrate the involvement of the mTOR pathway in chondrocyte differentiation and proliferation and suggest that intermittent PEMF stimulation could be effective as a stimulus for endochondral ossification during fracture healing process, thereby reducing stimulation time.
... tendon, ligament, and muscle). [1][2][3][4] In addition, ultrasonography can diagnose vascular conditions, such as atherosclerosis. [5][6][7] Soft fibrous biological tissues, including tendon, muscle, and blood vessel wall, are composed of fibrous proteins, such as collagen, elastin, myosin, and actin, which are important for the mechanical properties of these tissues. ...
Acoustically induced electric polarization and its anisotropy in soft fibrous biological tissues were investigated under wet conditions. Assuming that fibrous tissues have polar uniaxial symmetry, stress-induced polarization should occur in the direction of fiber orientation in the non-shear terms of the piezoelectric tensor. Using the acoustically stimulated electromagnetic method, we measured the anisotropic properties of acoustically induced polarization in wet samples of Achilles tendon, skeletal muscle, and aortic wall. In all these tissues, the major non-shear term was confirmed to be d 33 , with polarization occurring along the fibrous direction. In Achilles tendon, which contains highly oriented collagen fibers, the uniaxially symmetric fiber structure explains the anisotropic polarization well. However, substantial polarization perpendicular to the fiber orientation (the d 11 term) was observed in skeletal muscle and aortic wall, suggesting that the presence of fiber crimps and complex extracellular matrix produces polarization that does not occur in the uniaxially symmetric structures.
... Por su parte, el ultrasonido de alta definición y la imagen de resonancia magnética son las más útiles al permitir observar edema, hemorragia y rotura de fibras musculares. (26,27) La medición de la fuerza muscular concéntrica y excéntrica puede ser llevada a cabo mediante pruebas clínicas y dispositivos mecánicos, todas útiles para evaluar la respuesta a los diferentes métodos de tratamiento empleados tanto conservadores como quirúrgicos. (27) En el diagnóstico diferencial se involucran una serie de entidades, que se pueden dividir para su mejor entendimiento en dos grupos, las relacionadas con la parte superior del muslo y las distales. ...
RESUMEN Las lesiones de los músculos isquiotibiales están relacionadas con la práctica sistemática de actividades deportivas. El diagnóstico oportuno de las mismas así como el tratamiento temprano son claves para obtener un buen resultado. El objetivo de este trabajo es brindar información actualizada sobre los elementos más importantes de esta entidad traumática. La búsqueda y el análisis de la información se realizaron en el periodo desde el 1 de julio al 25 de noviembre de 2023. Se emplearon las siguientes palabras del idioma inglés: hamstring injury, hamstring avulsion, hamstring ruptura. A partir de la información obtenida se realizó una revisión bibliográfica de un total de 402 artículos publicados en las bases de datos PubMed, Hinari, SciELO y Medline mediante el gestor de búsqueda y administrador de referencias EndNote. Se hace referencia a la presencia de factores de riesgo extrínsecos e intrínsecos, así como las divisiones de estos últimos. Se describen las formas de presentación clínica, así como los estudios imagenológicos más usados para el diagnóstico. Con relación al diagnóstico diferencial se describen un ABSTRACT Hamstring injuries are related to the systematic practice of sports. Timely diagnosis and early treatment are the keys to obtain a good outcome. The aim of this work is to provide updated information on the most important elements of this traumatic entity. The search and analysis of the information was carried out in the period from July 1st to November 25th, 2023. The following English words were used: hamstring injury, hamstring avulsion, hamstring rupture. Based on the information obtained, a bibliographic review of a total of 402 articles published in PubMed, Hinari, SciELO and Medline databases was carried out using the EndNote search engine and reference manager. Reference is made to the presence of extrinsic and intrinsic risk factors and how they are classified. The forms of clinical presentation are described, as well as the most commonly used imaging studies for diagnosis. In relation to the differential diagnosis, a group of entities related to pain localization is described. The scales for the evaluation of patients with this condition and the treatment modalities are mentioned, as well as causes of therapeutic failure, complications and return to sport activity. In summary,
... Despite the high frequency of muscle injuries in elite athletes and the prime concern being minimizing the number of days lost from sporting activities, there is still a lack of uniformity in the description, diagnostic approach, and grading of muscle injuries [42]. Ultrasound imaging is frequently used in the evaluation of musculoskeletal pathologies as a first-line approach [43], given its wide availability, good tolerability, easy use, fasting, and low cost, if compared with MRI. Moreover, US imaging offers dynamic evaluations in real time, being able to take advantage of the patient's collaboration to better characterize the lesion [43] and is particularly useful in the serial evaluation of an athlete after a muscle injury. ...
... Ultrasound imaging is frequently used in the evaluation of musculoskeletal pathologies as a first-line approach [43], given its wide availability, good tolerability, easy use, fasting, and low cost, if compared with MRI. Moreover, US imaging offers dynamic evaluations in real time, being able to take advantage of the patient's collaboration to better characterize the lesion [43] and is particularly useful in the serial evaluation of an athlete after a muscle injury. The ultrasound features of muscle strain found in different grades of injury were previously described by Peetrons [44] (Table 3). ...
Citation: Palermi, S.; Vittadini, F.; Vecchiato, M.; Corsini, A.; Demeco, A.; Massa, B.; Pedret, C.; Dorigo, A.; Gallo, M.; Pasta, G.; et al. Managing Lower Limb Muscle Reinjuries in Athletes: From Risk Factors to Return-to-Play Strategies. J. Funct. Morphol. Kinesiol. 2023, 8, 155. Abstract: Muscle injuries and subsequent reinjuries significantly impact athletes, especially in football. These injuries lead to time loss, performance impairment, and long-term health concerns. This review aims to provide a comprehensive overview of the current understanding of muscle reinjuries, delving into their epidemiology, risk factors, clinical management, and prevention strategies. Despite advancements in rehabilitation programs and return-to-play criteria, reinjury rates remain alarmingly high. Age and previous muscle injuries are nonmodifiable risk factors contributing to a high reinjury rate. Clinical management, which involves accurate diagnosis, individualized rehabilitation plans, and the establishment of return-to-training and return-to-play criteria, plays a pivotal role during the sports season. Eccentric exercises, optimal loading, and training load monitoring are key elements in preventing reinjuries. The potential of artificial intelligence (AI) in predicting and preventing reinjuries offers a promising avenue, emphasizing the need for a multidisciplinary approach to managing these injuries. While current strategies offer some mitigation, there is a pressing need for innovative solutions, possibly leveraging AI, to reduce the incidence of muscle reinjuries in football players. Future research should focus on this direction, aiming to enhance athletes' well-being and performance.
... Musculoskeletal ultrasound provides a missing visual dimension that PTs can employ to enhance diagnostic capabilities, improve patient care, and expedite referrals (Can et al., 2017;Whittaker et al., 2019). Musculoskeletal ultrasound can extend a clinical examination to visualize underlying trauma, disease, anatomical variations, soft tissue pathology, and dynamic motion (Paoletta et al., 2021). The diagnostic sensitivity and specificity of MSK-US for certain pathologies are comparable to magnetic resonance imaging (MRI) and computed tomography, minus the radiation risk and expense (Lento and Primack, 2008;Whittaker et al., 2019). ...
Background:
Musculoskeletal ultrasound (MSK-US) use for diagnostic purposes is expanding in physical therapy practice. Identifying and describing physical therapy-specific approaches to incorporating MSK-US into the evaluation process is needed. Musculoskeletal ultrasound extends the physical exam to allow clinicians to visualize anatomy and pathophysiology both statically and dynamically. Purpose: To document 1) weekly use of diagnostic MSK-US; and 2) clinical reasoning approach used in challenging patient cases by physical therapists (PTs) registered by Inteleos in musculoskeletal sonography (RMSK-certified).
Methods:
Longitudinal, observational, cohort study using mixed methods for data collection and analysis. All 23 currently RMSK-certified PTs using MSK-US in clinical practice across the United States were contacted, and 16 participated. Data were collected using an online survey created with the Research Electronic Data Capture System. Participants documented MSK-US clinical use and significant cases using weekly, reflective, online journals for three months. Demographic data were summarized using descriptive statistics. Case data were analyzed thematically.
Results:
Participating RMSK-certified PTs performed 1110 MSK-US examinations over 110 weeks. Clinicians averaged 7 (range 1-25) MSK-US examinations weekly, representing 28% of an average caseload. Examinations contributed significant anatomical/ pathological information 100% of the time. The most common joints scanned were the knee (n = 281), shoulder (n = 254), and wrist (n = 228). Case data revealed three themes: 1) augmenting the clinical evaluation to extend or narrow a diagnosis; 2) outcomes guiding action; and 3) lessons learned from clinical findings.
Conclusion:
RMSK-certified PTs regularly used MSK-US to validate and refine their clinical diagnoses and treatment. Ultrasound imaging directly influenced patient care by informing the diagnostic process, guiding treatment, and appropriately identifying referrals.
... mit hyperechogenen Septen i.R. des Resorptions-und Umbauprozesses. Mittels Farbdoppler kann sowohl intra-als auch periläsional eine deutliche Hyperämie und Neovaskularisierung dargestellt werden [8,20,21]. ...
... Bei vollständigem Abriss der Muskulatur und/oder der Muskelsehne kann ein Muskeloder Sehnenstumpf, evtl. mit Retraktion, und meist ein ausgedehntes Hämatom dargestellt werden [9,20,21,22]. ...
... Muskelverletzungen (Abb. 4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31 ) Muskelfaserriss ...
Zusammenfassung. Muskelverletzungen sind häufig und treten nicht nur bei Sportler_innen, sondern auch im Alltag auf. Für die Therapie und Prognose ist es wichtig, das Ausmass der Verletzung, die geschädigten Strukturen und mögliche Komplikationen zu erkennen. Mittels Ultraschallbildgebung kann in den meisten Fällen die Verletzung gut erfasst werden und die Sonografie erleichtert die Einleitung entsprechender therapeutischer Schritte. Der Muskelultraschall ist jedoch nicht ganz so verbreitet und definiert wie der Gelenksultraschall. Der Artikel erläutert verschiedene Arten der Muskelverletzungen, die diagnostischen Möglichkeiten mit dem hochauflösenden und dynamischen Ultraschall und seine Grenzen.
... A grade 2 hamstring strain is defined as recognizable partial tissue disruption with considerable pain, oedema, and function loss due to partial-thickness tears of the musculotendinous fibres. A grade 3 hamstring strain is defined as musculotendinous unit disruption or tear with severe discomfort, oedema, and loss of function [36]. ...
Background:
Hamstring weakness has been associated with an increased risk of hamstring strain, a common sports injury that occurs when athletes perform actions such as quick sprints. The hamstring complex comprises three distinct muscles: the long and short heads of the bicep femoris, the semimembranosus, and the semitendinosus.
Methods:
The researchers collected the data from different electronic databases: PubMed, Google Scholar, and the Web of Science.
Results:
Many studies have been conducted on the numerous benefits of hamstring strength, in terms of athletic performance and injury prevention. Isotonic and isometric exercises are commonly used to improve hamstring strength, with each exercise type having a unique effect on the hamstring muscles. Isotonic exercise improves the muscles' strength, increasing their ability to resist any force, while isometric training increases strength and the muscles' ability to produce power by changing the muscle length.
Conclusions:
These exercises, when performed at low intensity, but with high repetition, can be used by the healthy general population to prepare for training and daily exercise. This can improve hamstring muscle strength and flexibility, leading to enhanced performance and reduced injury risk.
... In particular, the Special Issue consists of ten articles of wide interest for clinicians that manage MSK injuries in athletes, starting from the definition and epidemiology of these lesions [3] and an update about the role of ultrasound (US) imaging in muscle injuries [4]. These lesions frequently affect lower limb muscles, particularly in football players and track and field athletes, leading to long recovery times and risk of re-injury. ...
The etymology of the word “athlete” derives from the ancient Greek ἀθλητής (athletés, from âthlos that is, fight, competition) [...]
The teaching of human anatomy (HA) constitutes one of the fundamental pillars of the curriculum in biological and healthcare-related programs. Therefore, it is imperative that the methodology and didactics employed in this discipline equip students in the best possible way. The traditional method of teaching HA involves lectures and practical classes with previously dissected cadaveric specimens and dissection activities. Concurrently, the present era is witnessing the emergence and popularization of new digital technologies connected to the internet, among which we can highlight smartphones, quick response codes, and virtual reality devices, along with the dissemination of complementary imaging methods, such as radiography, ultrasonography, magnetic resonance imaging, and computerized tomography. From this perspective, the objective of this review is to analyze how each of these new tools integrates into the academic context, in order to diversify the teaching of HA and contribute to better understanding of the HA content during academic training, as well as the clinical applications.
Zusammenfassung
Die Ultraschalldiagnostik umfasst zahlreiche Anwendungsmöglichkeiten in der Sporttraumatologie. Der technische Fortschritt mobiler Geräte führt zu einer zunehmenden Nutzung der Sonografie als fokussierte Erstdiagnostik. Neue Verfahren wie die Elastografie und 3D-Vaskularisation umfassen vorrangig die spezialisierte Sonografie in wenigen Fragestellungen.
Die vorliegende Übersicht soll den aktuellen Stellenwert der Sonografie in der Sporttraumatologie, ihre etablierten Anwendungsgebiete und neuen technischen Fortschritte vorstellen. Dabei wird der Ultraschall sowohl in seiner Stellung zu anderen bildgebenden Verfahren als auch als alleiniges Diagnostikum bewertet.
Ultraschall kann sowohl zur Initialdiagnostik als auch als Verlaufsbildgebung angewendet werden. Hauptanwendungsgebiete sind aktuell die Diagnostik von akuten Muskel- und Sehnenverletzungen sowie Überlastungsschäden. Insbesondere der Ausschluss struktureller Muskelverletzungen ist mit dem US an ausgewählten anatomischen Regionen suffizient zu gewährleisten. Durch die kürzlich neu publizierte Leitlinie zur Fraktursonografie wurde die klinische Evidenz in diesem Bereich gestärkt, vor allem im Vergleich zum konventionellen Röntgen sowie in der Entwicklung von Algorithmen und Standards. Der zunehmende Einsatz mobiler Ultraschallgeräte mit adäquater Bildqualität machen die Sonografie zu einer ortsunabhängigen Modalität, die auch in Trainingsstätten als bildgebende Erweiterung der klinischen Untersuchung genutzt werden kann.
