Context: In competitive swimming, many swimmers experience low back pain (LBP). Lumbar hyperextension may cause LBP, and tight hip-flexor muscle may cause lumbar extension during swimming. Objective: The purpose of this study was to clarify the features of the elastic moduli of the muscles and the lumbar extension when swimmers with LBP perform a dolphin kick (DK). Design: Cross-sectional study. Setting: Single center. Other Participants: Eleven male college swimmers were enrolled as the LBP group (who have LBP when swimming and during a lumbar extension), and 21 male college swimmers were recruited as the control group (no LBP). Interventions: The elastic moduli of the psoas major, iliacus, teres major, latissimus dorsi, pectoralis major, and pectoralis minor were measured through ultrasonic shear wave elastography. The lumbar and hip extension angles during a DK were measured using a video camera. The passive hip extension and shoulder-flexion range of motion (ROM) were measured using a goniometer. Main Outcome Measures: Muscle elastic moduli and lumbar extension angles during DK. Results: The characteristics, muscle elastic moduli, DK motion, and ROM were compared between the 2 groups. LBP group demonstrated significantly higher elastic modulus of the psoas major and lower modulus of pectoralis minor compared with the control group. Also, LBP group showed greater lumbar extension during a DK and less hip extension ROM than the control group. Conclusions: The higher elastic modulus of the psoas major and greater lumbar extension during a DK may be related to the LBP in swimmers.
Gakuto Kitamura, Hiroshige Tateuchi and Noriaki Ichihashi
Hiroshige Tateuchi, Noriaki Ichihashi, Masahiro Shinya and Shingo Oda
Patients with hip osteoarthritis (OA) have difficulty with mediolateral postural control. Since the symptom of hip OA includes joint pain, which mostly occurs upon initial movement, patients with hip OA might have disabling problems with movement initiation. This study aimed to identify the movement strategy during the anticipatory postural adjustments in the lateral step motion in patients with hip OA. We studied 18 female subjects with unilateral hip OA and 10 healthy subjects, and measured temporal, kinetic, and kinematic variables. Patients with hip OA required a longer duration of anticipation phase than the control subjects, the total duration of lateral stepping was not different between the groups. Displacement of the center of mass to the supporting (affected) side during the anticipation phase was not different between the two groups. These findings suggest that, in patients with hip OA, the center of mass slowly moved to the affected side. Furthermore, patients with hip OA showed greater shift of the trunk to the supporting side than did the control subjects. These movement characteristics might contribute to the achievement of both protection of the affected hip joint and quickness in the subsequent lateral step in patients with hip OA.
Masatoshi Nakamura, Tome Ikezoe, Takahiro Tokugawa and Noriaki Ichihashi
Hold–relax stretching (HRS) and static stretching (SS) are commonly used to increase joint range of motion (ROM) and decrease muscle stiffness. However, whether there are differences between acute effects of HRS and SS on end ROM, passive torque, and muscle stiffness is unclear. In addition, any differences between the mechanisms by which HRS and SS lead to an increase in end ROM are unclear.
To compare the acute effects of HRS and SS on the passive properties of the gastrocnemius muscle–tendon unit (MTU), end ROM, passive torque, and muscle stiffness in vivo and to investigate the factors involved in increasing end ROM.
Crossover experimental design.
30 healthy men (21.7 ± 1.2 y) with no history of neuromuscular disease or musculoskeletal injury involving the lower limbs.
Both HRS and SS of 30 s were repeated 4 times, lasting a total of 2 min.
Main Outcome Measures:
End ROM, passive torque, and muscle stiffness were measured during passive ankle dorsiflexion using a dynamometer and ultrasonography before and immediately after HRS and SS.
The results showed that end ROM and passive torque at end ROM significantly increased immediately after both HRS and SS, whereas muscle stiffness significantly decreased. In addition, the percentage change in passive torque at end ROM on use of the HRS technique was significantly higher than that after use of the SS technique. However, the percentage change in muscle stiffness after SS was significantly higher than that with HRS.
These results suggest that both HRS and SS can effectively decrease muscle stiffness of the gastrocnemius MTU and that HRS induces a change in the passive torque at end ROM—ie, sensory perception—rather than changing muscle stiffness.
Kosuke Fujita, Masatoshi Nakamura, Hiroki Umegaki, Takuya Kobayashi, Satoru Nishishita, Hiroki Tanaka, Satoko Ibuki and Noriaki Ichihashi
Context: A recent review or article reported that thermal agents (TA) or physical activity (PA) can increase range of motion (ROM) and that the combination of TA with stretching is superior to performing stretching only. However, since ROM is affected by the psychological factors, it is questionable whether these studies measured the effect of these interventions on muscle flexibility. By measuring muscle stiffness, the authors attempted to evaluate the effect these interventions on muscle flexibility. Objective: To compare the individual effects of TA and PA on muscle flexibility, as well as their effectiveness when combined with static stretching (SS). Design: Crossover trial. Setting: University research laboratory. Participants: 15 healthy men without a history of orthopedic disease in their lower limbs. Interventions: 15 minutes of 3 different conditions: hot pack as TA, pedaling exercise as PA, and the control group with no TA or PA intervention, followed by 3 min of SS for the hamstrings. Main Outcome Measures: Joint angle and passive torque of the knee during passive elongation were obtained prior to interventions, after 3 kinds of intervention, and after SS. From these data, muscle-tendon-unit (MTU) stiffness of the hamstrings was calculated. Results: Although knee-joint ROM increased with both TA and PA (P < .05), there were no significant differences in MTU stiffness between pre- and postintervention measurements for either of the interventions (TA, P = .477; PA, P = .377; control, P = .388). However, there were similar significant decreases in MTU stiffness between postintervention and post-SS for all conditions (P < .01). Conclusions: TA and PA did not decrease MTU stiffness, and combining these interventions with SS did not provide additional decreases in MTU stiffness compared with performing SS alone.
Masatoshi Nakamura, Tome Ikezoe, Hiroki Umegaki, Takuya Kobayashi, Satoru Nishishita and Noriaki Ichihashi
Static stretching (SS) is commonly performed in a warm-up routine to increase joint range of motion (ROM) and to decrease muscle stiffness. However, the time course of changes in ankle-dorsiflexion (DF) ROM and muscle stiffness during a routine SS program is unclear.
To investigate changes in ankle-DF ROM, passive torque at DF ROM, and muscle stiffness during a routine SS program performed 3 times weekly for 4 wk.
A quasi-randomized controlled-trial design.
The subjects comprised 24 male volunteers (age 23.8 ± 2.3 y, height 172.0 ± 4.3 cm, body mass 63.1 ± 4.5 kg) randomly assigned to either a group performing a 4-wk stretching program (SS group) or a control group.
Main Outcome Measures:
DF ROM, passive torque, and muscle stiffness were measured during passive ankle dorsiflexion in both groups using a dynamometer and ultrasonography once weekly during the 4-wk intervention period.
In the SS group, DF ROM and passive torque at DF ROM significantly increased after 2, 3, and 4 wk compared with the initial measurements. Muscle stiffness also decreased significantly after 3 and 4 wk in the SS group. However, there were no significant changes in the control group.
Based on these results, the SS program effectively increased DF ROM and decreased muscle stiffness. Furthermore, an SS program of more than 2 wk duration effectively increased DF ROM and changed the stretch tolerance, and an SS program more than 3 wk in duration effectively decreased muscle stiffness.