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Theresa M. Spitznagle and Shirley Sahrmann


Transient abdominal pain commonly occurs during running. There is limited information to guide the physical examination and treatment of individuals with this transient pain with running (TAPR). The purposes of this report are to describe the movement-system examination, diagnosis, and treatment of 2 female adolescent athletes with TAPR and highlight the differences in their treatment based on specific movement impairments.

Study Design:

Case series.


The movement diagnosis determined for both patients was thoracic flexion with rotation. The key signs and symptoms that supported this diagnosis included (1) alignment impairments of thoracic flexion and posterior sway and ribcage asymmetry; (2) movement impairments during testing and running of asymmetrical range of motion for trunk rotation, side bending, and flexion of the thoracic spine; and (3) reproduction of TAPR.


Musculoskeletal impairments related to the trunk muscles combined with the mechanical stresses of running could contribute to TAPR. Treatment in each of the patients was focused on patient education regarding correction of alignment, muscle, and movement impairments of the extremities, thoracic spine, and ribcage. A strategy was determined for correcting motion during running to reduce or abolish the TAPR. Outcomes were positive in both patients. Differences in specific impairments in each patient demonstrate the need for specificity of treatment. These 2 patients illustrate how developing a movement diagnosis and identifying the contributing factors based on a systematic examination can be used in individuals with TAPR.

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Vincenzo Ricci and Levent Özçakar

side of the thoracic spine with moderate swelling of the paraspinal soft tissues. Active range of motion of the thoracic spine was painful especially during the rotation movements. Manual palpation of the spinous processes of the thoracic vertebrae was painless, and there were no radicular signs at the

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José Pino-Ortega, Alejandro Hernández-Belmonte, Carlos D. Gómez-Carmona, Alejandro Bastida-Castillo, Javier García-Rubio and Sergio J. Ibáñez

leg, 3 cm proximally from the lateral malleolus with a vertical alignment), 33 (2) thigh (5 cm up from the patella, on the lateral side), 39 (3) lumbar spine (over the vertebra L4), 25 and (4) thoracic spine (over the interescapular line [vertebra T5–T7]). 40 At knee and ankle, the devices were

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Margaret Schneider, Genevieve F. Dunton, Stan Bassin, Dan J. Graham, Alon Eliakim and Dan M. Cooper


Many female adolescents participate in insufficient physical activity to maintain cardiovascular fitness and promote optimal bone growth. This study evaluates the impact of a school-based intervention on fitness, activity, and bone among adolescent females.


Subjects were assigned to an intervention (n = 63) or comparison (n = 59) group, and underwent assessments of cardiovascular fitness (VO2peak), physical activity, body composition, bone mineral density (BMD), bone mineral content (BMC), and serum markers of bone turnover at baseline and at the end of each of two school semesters.


The intervention increased physical activity, VO2peak, and BMC for the thoracic spine (P values < 0.05). Bone turnover markers were not affected. In longitudinal analyses of the combined groups, improvements in cardiovascular fitness predicted increased bone formation (P < 0.01) and bone resorption (P < 0.05).


A school-based intervention for adolescent females effectively increased physical activity, cardiovascular fitness, and thoracic spine BMC.

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Harpa Helgadottir, Eythor Kristjansson, Sarah Mottram, Andrew Karduna and Halldor Jonsson Jr.

Clinical theory suggests that altered alignment of the shoulder girdle has the potential to create or sustain symptomatic mechanical dysfunction in the cervical and thoracic spine. The alignment of the shoulder girdle is described by two clavicle rotations, i.e, elevation and retraction, and by three scapular rotations, i.e., upward rotation, internal rotation, and anterior tilt. Elevation and retraction have until now been assessed only in patients with neck pain. The aim of the study was to determine whether there is a pattern of altered alignment of the shoulder girdle and the cervical and thoracic spine in patients with neck pain. A three-dimensional device measured clavicle and scapular orientation, and cervical and thoracic alignment in patients with insidious onset neck pain (IONP) and whiplash-associated disorder (WAD). An asymptomatic control group was selected for baseline measurements. The symptomatic groups revealed a significantly reduced clavicle retraction and scapular upward rotation as well as decreased cranial angle. A difference was found between the symptomatic groups on the left side, whereas the WAD group revealed an increased scapular anterior tilt and the IONP group a decreased clavicle elevation. These changes may be an important mechanism for maintenance and recurrence or exacerbation of symptoms in patients with neck pain.

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Leo Ng, Amity Campbell, Angus Burnett and Peter O’Sullivan

The trunk and pelvis kinematics of 20 healthy male and female adolescent rowers were recorded during an ergometer trial using an electromagnetic tracking system (Fastrak). The kinematics of each drive phase were collected during the 1st and 20th minute, respectively. The mean and range of the kinematics, stroke rate and stroke length were compared between genders and over time. Male rowers postured their pelvis with more posterior tilt and their thoracic spine in more flexion than female rowers (P < .05). Both genders postured their pelvis in more posterior pelvic rotation and upper trunk in more flexion over time. Male rowers were found to have a significantly shorter drive phase than female rowers (P = .001). Differences in trunk and pelvic kinematics between adolescent male and female rowers suggest potentially various mechanisms for biomechanical stress. Assessment and training of rowers should take gender differences into consideration.

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José M. Muyor, Pedro A. López-Miñarro and Fernando Alacid

The aim was to determine the relationship between hamstring muscle extensibility and sagittal spinal curvatures and pelvic tilt in cyclists while adopting several postures. A total of 75 male cyclists were recruited for this study (34.79 ± 9.46 years). Thoracic and lumbar spine and pelvic tilt were randomly measured using a Spinal Mouse. Hamstring muscle extensibility was determined in both legs by a passive knee extension test. Low relationships were found between hamstring muscle extensibility and spinal parameters (thoracic and lumbar curvature, and pelvic tilt) in standing, slumped sitting, and on the bicycle (r = .19; P > .05). Significant but low relationships were found in maximal trunk flexion with knees flexed (r = .29; P < .05). In addition, in the sit-and-reach test, low and statistically significant relationships were found between hamstring muscle extensibility for thoracic spine (r = –.23; P = .01) and (r = .37; P = .001) for pelvic tilt. In conclusion, hamstring muscle extensibility has a significant relationship in maximal trunk flexion postures with knees flexed and extended, but there are no relationships while standing or on the bicycle postures.

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Elif Turgut, Irem Duzgun and Gul Baltaci

lateral flexion and axial rotation. Research has shown that there is a significant relationship between thoracic spine and scapula position, 28 and reduced cervico-thoracic mobility were suggested as a risk factor for shoulder pain, 29 thus theoretically the intervention focused on thoracic mobility may

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Federico Jose Villalba and Melina Soledad Martínez

Surg . 2014 ; 23 ( 11 ): e275 – e282 . PubMed ID: 24925699 doi:10.1016/j.jse.2014.02.030 10.1016/j.jse.2014.02.030 24925699 14. Johnson KD , Kim KM , Yu BK , Saliba SA , Grindstaff TL . Reliability of thoracic spine rotation range-of-motion measurements in healthy adults . J Athl Train

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Hio Teng Leong and Siu Ngor Fu

adhesive tape was applied for conditions (2) and (3). With the participants in the sitting position, they were asked to fully extend their thoracic spine, with the scapula in full retraction and depression position. 14 As proposed previously, 14 , 22 tape was applied from the inferomedial one-third of