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Tariq Awan, Stephanie G. Marsh, Peter Miller and Stephen E. Lemos

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Dale J. Butterwick, Laurie A. Hiemstra, Mark R. Lafave and Krista J Carlyle

Column-editor : John M. Kaltenborn

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Stephanie J. Facchini, Brittany A. Ferguson and Johanna M. Hoch

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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.

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Jesse C. Christensen, Laura R. Goldfine and Hugh S. West

Study Design:

Prospective randomized clinical trial.

Methods and Measures:

Thirty-six patients who had a primary anterior cruciate ligament reconstruction (ACL-R) with a semitendinosus-gracilis (STG) autograft from a single orthopedic surgeon were prospectively randomized into 2 groups. Nineteen patients were randomized to the aggressive group (53% male, mean age 30.1 + 10.5 y) and 17 to the nonaggressive group (88% male, mean age 33.1 + 10.9 y). Impairment measures of anteroposterior (A-P) knee laxity, range of motion (ROM), and peak isometric force (PIF) values were obtained 12 wk postoperatively. Subjective response to the International Knee Documentation Committee knee form (IKDC) was collected 1, 12, and 24 wk postoperatively. One-way ANOVA was used to analyze differences between groups at 12 wk for A-P knee laxity, ROM, and PIF. Differences between the groups for the IKDC scores were determined using 1-way ANOVA with repeated measures 1, 12, and 24 wk postoperatively. Bonferroni adjustment was used for multiple comparisons.


There were no differences between the groups for the baseline characteristics (P > .05). There was no difference found between the groups in respect to A-P knee laxity, ROM, or PIF at 12 wk (P > .05). Further analysis also showed no significant differences in the IKDC scores between groups at 12 or 24 wk (P > .05).


No differences were found between early aggressive and nonaggressive rehabilitation after an isolated ACL-R using STG autografts for the primary outcomes of A-P knee laxity and subjective IKDC score. In addition, no differences were observed for secondary outcomes between groups for differences in ROM and PIF values.

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Sebastian Klich, Bogdan Pietraszewski, Matteo Zago, Manuela Galli, Nicola Lovecchio and Adam Kawczyński

increased pain severity and reduced function. 2 In fact, epidemiological data reported that 44% of overhead athletes suffer from shoulder dysfunctions and 29% from general pain. 3 Mechanical loadings may provoke alterations of morphological properties and viscoelasticity of tendons and muscles. 4 In this

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Herman van Werkhoven and Stephen J. Piazza

and function in distance runners have suggested that a shorter Achilles tendon moment arm conveys a performance advantage. Watanabe and colleagues 3 found distance runners to have smaller Achilles tendon moment arms than those of nonathlete controls. Several groups of investigators 4 – 7

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Bernardo Gialanella, Francesco Grossetti, Marina Mazza, Laura Danna and Laura Comini

, diabetes mellitus, lower level of sport activity, poorer preoperative range of motion, obesity, greater size of the cuff lesion, retraction of the cuff, fatty infiltration, and multiple tendons involvement have a negative impact on rehabilitation in these patients. 4 Conversely, although a large number of

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Akane Yoshimura, Robert Schleip and Norikazu Hirose

. Nevertheless, the relationship among morphological and property changes in the muscle and improvement in ROM by FR intervention remains controversial. The ultrasound device has been used to noninvasively evaluate the morphology and properties of tissues, including the muscle, tendon, fascia, and aponeurosis

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Dai Sugimoto, Benton E. Heyworth, Brandon A. Yates, Dennis E. Kramer, Mininder S. Kocher and Lyle J. Micheli

quadriceps and hamstrings muscles represent the primary dynamic stabilizers of the knee joint. Anterior shear force generated during knee extension, as well as the contact phase of landing, is mainly determined by the quadriceps muscle action via the patella tendon-tibia shaft angle. 24 , 25 During landing