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Matt Hausmann, Jacob Ober, and Adam S. Lepley

Clinical Scenario Ankle sprains are the most prevalent athletic-related musculoskeletal injury treated by athletic trainers, often affecting activities of daily living and delaying return to play. 1 Most of these cases present with pain and swelling in the ankle, resulting in decreased range of

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Luzita Vela, Timothy W. Tourville, and Jay Hertel

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Kazunori Nosaka, P.▀ Sacco, and K.▀ Mawatari

This study investigated the effect of a supplement containing 9 essential and 3 non-essential amino acids on muscle soreness and damage by comparing two endurance exercise bouts of the elbow fexors with amino acid or placebo supplementation in a double blind crossover design. The supplement was ingested 30 min before (10 h post-fasting) and immediately after exercise (Experiment 1), or 30 min before (2-3 h after breakfast), immediately post, and 8 more occasions over 4-day post-exercise (Experiment 2). Changes in muscle soreness and indicators of muscle damage for 4 days following exercise were compared between supplement conditions using two-way ANOVA. No significant differences between conditions were evident for Experiment 1; however, plasma creatine kinase, aldolase, myoglobin, and muscle soreness were significantly lower for the amino acid versus placebo condition in Experiment 2. These results suggest that amino acid supplementation attenuates DOMS and muscle damage when ingested in recovery days.

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Selvin Balki and Hanım Eda Göktas¸

effects of KT techniques with lymphatic correction and muscle facilitation on pain, swelling, joint range, and muscle strength after orthopedic surgeries. 10 , 14 – 17 Ten-day application of KT with lymphatic correction has been found efficient on control of the leg swelling after the limb lengthening

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Kyle Southall, Matt Price, and Courtney Wisler

, disrupting the perforating vessels and causing visible swelling. 1 , 3 While this injury is relatively rare in traditional athletic settings, making up approximately 1% of reported injuries, those that have been reported in the literature have been located in the lower extremity. 1 , 3 – 6 The presented

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Erin Macaronas, Shannon David, and Nicole German

lesions occurring around the knee have also been reported. 2 – 4 An analysis by lesion site shows incidence rates as follows: greater trochanter/hip 30.4%, thigh 20.1%, pelvis 18.6%, knee 153.7%, and calf/lower leg 1.5%. 1 Morel-Lavallée lesions often present with pain and swelling at the site of injury

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Gina E. McAlear and Jennifer K. Popp

massage, toe curls, and seated heel raises; however, the patient had a sudden and dramatic increase in pain, swelling, redness, paresthesia, skin temperature asymmetry, and hyperesthesia (Figure  2 ) of the plantar and dorsal aspects of the foot and could not tolerate weight- bearing. There was

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Erik A. Wikstrom, Cole Mueller, and Mary Spencer Cain

were provided, no consistency was noted among the included papers. Table 2 Return-to-Sport Criteria From the 11 Published Expert Opinion Papers Included in This Investigation Domain (percent agreement) Assessment techniques Criterion thresholds Pain/swelling 27 – 29 , 31 , 34 , 37 (54.5%) Pain  Ability

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Andrew L. McDonough and Joseph P. Weir

The purpose of this case study was to investigate reflex inhibition of the quadriceps femoris in a subject with postsurgical edema of the left knee. The subject was a 45-year-old male with a traumatic knee injury with resultant edema who underwent elective arthroscopic surgery. Reflex inhibition was assessed by H-reflex elicitation in the femoral nerve and surface electromyography of the quadriceps. To assess the degree of edema, direct circumferential measurements were taken. On the first presurgical visit, the left knee demonstrated mild edema with a decrease in H-reflex amplitudes. Two days after surgery, a further reduction in amplitudes and more swelling were demonstrated followed by an increase in amplitudes and a reduction in edema on the 28th postoperative day. These findings document a relationship between reflex inhibition and joint swelling that was previously described in experimental models where joint edema was simulated.

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Thomas Koesterer, Aaron Blanchard, and Patrick Donnelly

Objective:

To present a unique case of meralgia paresthetica.

Background:

A 21-year-old male collegiate lacrosse player fell, twisted his right leg, and felt a “pop” in his hip. Objective fndings included: antalgic gait, mild palpable swelling, and tenderness to touch with limited range of motion due to pain. Joint stability tests were negative.

Differential Diagnosis:

Right hip abductor strain, hip sprain, trochanteric bursitis, or labral tear.

Treatment:

The physician’s findings included deep hip pain that increased with hip scouring and pain with active and passive motion. The physician’s diagnosis was hip sprain; treatment was to continue with ice and begin active progression for return to play. The athlete was treated over the next several days with warm whirlpools, stretching, and a hip fexor wrap. Ten days postinjury, the athlete played in a game, but in the fourth quarter came off the field stating he couldn’t feel his thigh. The orthopedic physician evaluated the athlete and provided a differential diagnosis of right hip fexor strain and hip capsule sprain with numbness, possibly due to meralgia paresthetica. The physician ordered treatment to continue and began a regimen of 600 mg of ibuprofen three times per day and noted the athlete could continue to play.

Uniqueness:

The athlete did not show any symptoms of meralgia paresthetica for 10 days post initial injury. The meralgia paresthetica was most likely caused by swelling resulting from the hip sprain, in which the swelling compressed the lateral femoral cutaneous nerve (LFCN) against the inguinal ligament.

Conclusions:

Meralgia paresthetica may occur as a result of trauma and subsequent swelling of the inguinal region. A thorough evaluation of the hip must be conducted to ensure no motor neuron involvement is associated with the paresthesia symptoms.