Performance enhancement is a multibillion dollar industry, with little known about the efficacy or safety of many practices. Many sport governing bodies have banned certain equipment, supplements, and drugs, yet, some athletes use anyway. This use may pose a danger to the individual user, as well as to other participants, and can challenge the integrity of the sport. We must consider how we, as health care professionals, balance personal autonomy, individual safety, and the integrity of sport in fulfilling our social contract.
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Katherine R. Newsham
Edited by Malissa Martin
Katherine R. Newsham, Matthew D. Beekley, and Christine A. Lauber
Context:
Exercise-related medial leg pain (ERMLP) is a common complaint among athletes, and efforts toward rehabilitation are often unsuccessful.
Objective:
To evaluate the efficacy of a therapeutic intervention in ERMLP localized to soft tissue.
Design:
A quasi-experimental, nonequivalent control-group study.
Setting:
Athletic training facility.
Patients:
20 volunteer male and female athletes (18–22 y old) with ERMLP. Complete data were available for 13 participants.
Intervention:
Treatment group (TRE, n = 7) received therapeutic intervention focused on relieving muscle hypertonicity in the deep compartment of the lower leg and restoring balance of the toe flexors and extensors. Control group (CON, n = 6) received no intervention.
Main Outcome Measures:
Self-reported pain intensity, pain threshold, and extensor hallucis longus to extensor digitorum brevis (EHL:EDB) electromyography ratio.
Results:
There were no significant differences in age, duration of symptoms, or pain measures between the 2 groups at baseline. CON demonstrated no significant changes in any of the outcome measures in posttreatment testing, but significant between-groups differences were identified for pain during activity (CON mean = 6.5, 95% CI 5.05, 7.95; TRE mean = 3.5, 95% CI 1.67, 5.33; P = .01), change scores for pain during activity (CON mean = 0.33, 95% CI −1.25, 1.91; TRE mean = −3.43, 95% CI:−4.6, −2.25; P < .001), change scores in pressure threshold (CON mean = −0.25, 95% CI −0.74, 0.23; TRE mean = 0.72, 95% CI 0.22, 1.37; P = .006), and change in EHL:EDB ratios (CON mean = 0.05, 95% CI −0.22, 0.33; TRE mean = 1.07, 95% CI 0.75, 2.07; P < .046).
Conclusion:
Therapeutic interventions focused on restoring muscle balance appear to be effective in resolving ERMLP.
