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Lindsey Eberman, Heather Mata and Leamor Kahanov

Student acquisition of psychomotor skills in athletic training is diffcult, particularly those pertaining to non-orthopedic injuries and illnesses, which are less common in our patient populations. We provide examples of lesson plans to improve physical examination of the thorax and abdomen. Each lesson (the scratch test, utilization of a noise-immune stethoscope, tactile fremitus, and intent auscultation) allows students to engage in performance of the skill and expand contextual knowledge to enhance skill acquisition and learning.

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Abby L. Cheng, John A. Merlo, Devyani Hunt, Ted Yemm, Robert H. Brophy and Heidi Prather

adolescent female soccer athletes and (2) to assess whether findings on a baseline physical examination consistent with a cam deformity are associated with future lower-body injury rate in elite adolescent female soccer athletes. We hypothesized that elite adolescent female soccer athletes would have a high

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John Cottone

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John M. Coons, Richard S. Farley, Jwa K. Kim and Jennifer L. Caputo

Edited by Kathleen Laquale

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Lauren C. Olmsted and Craig Denegar

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Luzita Vela, Timothy W. Tourville and Jay Hertel

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Kari Brody, Russell T. Baker, Alan Nasypany and Jeff Seegmiller

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Romy H. Chan and James J. Lam

Shoulder pain among overhead-sport athletes is common and often presents a challenge to clinicians in making an accurate diagnosis. A case report of a young college tennis player is presented, with emphasis on the clinical examination process leading to the diagnosis of a superior labrum anteroposterior lesion. The current literature regarding the clinical diagnosis of glenoid labrum lesion in the shoulder with respect to specific clinical tests was reviewed. It is recommended that clinicians consider glenoid labral lesions in the context of shoulder instability. Glenohumeral internal-rotation deficit should be routinely evaluated and corrected in high-performance tennis players.

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David A. Krause, Mathew D. Neuger, Kimberly A. Lambert, Amanda E. Johnson, Heather A. DeVinny and John H. Hollman

Context:

Hip-muscle impairments are associated with a variety of lower-extremity dysfunctions. Accurate assessment in the clinical setting can be challenging due to the strength of hip muscles relative to examiner strength.

Objective:

To examine the influence of examiner strength and technique on manual hip-strength testing using a handheld dynamometer.

Design:

Repeated measures.

Setting:

Research laboratory.

Participants:

30 active adults (age 24 ± 1.4 y).

Interventions:

Three examiners of different strength performed manual muscle tests (MMT) in 2 different positions for hip extension, abduction, and external rotation using a MicroFet handheld dynamometer. Examiner strength was quantified via a 1-repetition-maximum leg press and chest press with a Keiser A420 pneumatic resistance machine.

Main Outcome Measures:

Intrarater reliability (ICC3,1), interrater reliability (ICC2,1), and measured torque values.

Results:

Intrarater reliability for all measurements ranged from .82 to .97. Interrater reliability ranged from .81 to .98. Main effects for hip extension revealed a significant difference in torque values between examiners and between techniques. For the short-lever hip-abduction and seated hip-external-rotation tests, there was a significant difference between examiners. There was no significant difference in measured torque values between examiners with the long-lever hip-abduction or the prone hip-external-rotation tests.

Conclusions:

MMT of the hip may be performed with high reliability by examiners of different strength. To obtain valid MMT measurements of hip muscles, examiners must consider their own strength and testing techniques employed. The authors recommend a long-lever technique for hip abduction and a prone position for testing hip external rotation to minimize the influence of examiner strength. Both positions appear to provide mechanical advantages to the examiner compared with the alternative techniques. The authors are unable to recommend a preferred hip-extension-testing technique to minimize the influence of examiner strength.

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Erin Macaronas, Shannon David and Nicole German

Because of this, collections may be mistaken for neoplasms. 1 In addition, physical examination reveals a soft fluctuant area of deformity, which may be mobile. 1 , 2 Moreover, presentation of Morel-Lavallée lesions may occur days, months, and even years after the initial trauma. 1 , 4 Possible