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  • Author: Kenneth E. Games x
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Zachary K. Winkelmann, Ethan J. Roberts and Kenneth E. Games

Context: Hamstring inflexibility is typically treated using therapeutic massage, stretching, and soft tissue mobilization. An alternative intervention is deep oscillation therapy (DOT). Currently, there is a lack of evidence to support DOT’s effectiveness to improve flexibility. Objective: To explore the effectiveness of DOT to improve hamstring flexibility. Design: Randomized single-cohort design. Setting: Research laboratory. Participants: Twenty-nine healthy, physically active individuals (self-reported activity of a minimum 200 min/wk). Interventions: All participants received a single session of DOT with randomization of the participant’s leg for the intervention. The DOT intervention parameters included a 1∶1 mode and 70% to 80% dosage at various frequencies for 28 minutes. Hamstring flexibility was assessed using passive straight leg raise for hip flexion using a digital inclinometer. Patient-reported outcomes were evaluated using the Copenhagen Hip and Groin Outcome Score and the Global Rating of Change (GRoC). Main Outcome Measure: The independent variable was time (pre and post). The dependent variables included passive straight leg raise, the GRoC, and the participant’s perceptions of the intervention. Statistical analyses included a dependent t test and a Pearson correlation. Results: Participants reported no issues with sport, activities of daily living, or quality of life prior to beginning the intervention study on the Copenhagen Hip and Groin Outcome Score. Passive straight leg raise significantly improved post-DOT (95% confidence interval, 4.48°–7.85°, P < .001) with a mean difference of 6.17 ± 4.42° (pre-DOT = 75.43 ± 21.82° and post-DOT = 81.60 ± 23.17°). A significant moderate positive correlation was identified (r = .439, P = .02) among all participants between the GRoC and the mean change score of hamstring flexibility. Participants believed that the intervention improved their hamstring flexibility (5.41 ± 1.02 points) and was relaxing (6.21 ± 0.86). Conclusions: DOT is an effective intervention to increase hamstring flexibility.

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Kelly A. Brock, Lindsey E. Eberman, Richard H. Laird IV, David J. Elmer and Kenneth E. Games

Context: Several interventions are available to reduce the intensity and duration of the unwanted effects (eg, muscle soreness) associated with physical activity, such as massage, compression garments, and sequential pulse compression (SPC). Such interventions aim to increase blood flow to alleviate symptoms. However, there is a lack of evidence to support the use of SPC to alter total hemoglobin concentration (THb) in active individuals. Objective: To examine the acute effects of a single session of SPC on hemoglobin concentration compared with a control condition. Design: Single cohort, crossover design. Participants: Thirty-four physically active and healthy participants (females = 12 and males = 22) completed the study. Interventions: The authors randomly assigned participants to first receive the experimental (SPC) or control condition. Measures were recorded precondition and postcondition. Participants returned to the laboratory to complete the second condition ≥24 hours after the first condition. Main Outcome Measures: Relative changes in THb, deoxygenated hemoglobin, and oxygenated hemoglobin measures were recorded using near-infrared spectroscopy placed on the muscle belly of the medial gastrocnemius of the dominant limb. Results: SPC significantly increased THb (P < .001, d = 0.505) and oxygenated hemoglobin (P < .001, d = 0.745) change scores compared with the control condition. No statistical difference in deoxygenated hemoglobin change scores was found between the SPC and control conditions, but a medium effect size suggests potential biological significance (P = .06, d = 0.339). Conclusions: Overall, SPC increases THb to the lower-extremity and may be a viable option in the management of muscle soreness related to physical activity.

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Zachary K. Winkelmann and Kenneth E. Games

An 18-year-old, male collegiate basketball athlete complained of right testicular pain following basketball activities. The patient’s imaging denoted edema within the pubis at the insertion of the adductor longus tendon and rectus sheath aponeurosis consistent with inguinal disruption. The patient underwent conservative rehabilitation and attempted to return to participation with increased pain. Subsequently, the patient underwent surgery. Following surgical intervention, the patient underwent 6 weeks of rehabilitation with basketball-specific considerations. On conclusion, the patient was pain free and returned to activity. This case is unique due to the insidious onset, sport in which the patient participated, and failed conservative management.

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Jessica R. Edler, Kenneth E. Games, Lindsey E. Eberman and Leamor Kahanov

The tibial plateau is a critical load-bearing surface in humans. Although tibial plateau fractures represent only 1% of all fractures, proper management by all members of the health care team, including athletic trainers, physicians, and physical therapists, is required for successful patient outcomes. A 14-year-old national-level competitive female diver injured her right knee during the precompetition warm-up period. Upon evaluation by an athletic trainer, the patient was referred for imaging and examination by a physician. She was seen by an orthopedic surgeon for consultation. The patient elected for a surgical repair of the tibial plateau fracture. Following surgery she underwent an 11-week comprehensive therapeutic exercise program with athletic trainers and physical therapists. The patient’s return-to-play progression included dry land activities, platform diving, 1-m springboard diving, and 3-m springboard diving. The patient has successfully returned to competitive diving. Proper identification of tibial fractures can be difficult considering their low occurrence in youth and their similar clinical presentation to more common youth injuries such as anterior cruciate ligament ruptures. Clinicians providing immediate on-site medical care should be thorough in their clinical exam including palpation and axial loading of the joint.

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Mikayla Grindle, Kenneth E. Games, Lindsey E. Eberman and Leamor Kahanov