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Variability of Regional Quadriceps Architecture in Trained Men Assessed by B-Mode and Extended-Field-of-View Ultrasonography

Dustin J. Oranchuk, André R. Nelson, Adam G. Storey, and John B. Cronin

, preferentially increasing distal MT and force production at long muscle lengths. 1 , 3 , 4 , 11 , 12 Two-dimensional B-mode ultrasonography is a commonly used technique to assess MT and PA, and to calculate FL. In addition to ultrasonography, the extended field-of-view (EFOV) technique, where a panoramic view of

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Is There a Decrease in the Acromiohumeral Distance Among Recreational Overhead Athletes With Rotator Cuff–Related Shoulder Pain?

Fábio Carlos Lucas de Oliveira, Amanda L. Ager, and Jean-Sébastien Roy

shoulder abduction in both symptomatic and asymptomatic shoulders, using standardized ultrasonography parameters. Although painful symptoms are most often reported between 70° and 110° of arm elevation, 23 there is a known difficulty in visualizing, simultaneously, both structures that define the AHD

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Comparison of Pain Measures Between Tendons of Elite Basketball Players With Different Sonographic Patterns

Josep C. Benítez-Martínez, Pablo Martínez-Ramírez, Fermín Valera-Garrido, Jose Casaña-Granell, and Francesc Medina-Mirapeix

.1177/03635465020300040701 12130402 10.1177/03635465020300040701 6. Khan KM , Cook JL , Kiss ZS , et al . Patellar tendon ultrasonography and jumper’s knee in female basketball players: a longitudinal study . Clin J Sport Med . 1997 ; 7 ( 3 ): 199 – 206 . PubMed ID: 9262888 doi:10.1097/00042752-199707000-00009 10

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Relationship Between Dual-Energy X-Ray Absorptiometry, Ultrasonography, and Anthropometry Methods to Estimate Muscle Mass and Muscle Quality in Older Adults

Márcio Beck Schemes, Simone de Azevedo Bach, Carlos Leonardo Figueiredo Machado, Rodrigo Rabuski Neske, Cláudia Dornelles Schneider, and Ronei Silveira Pinto

( Newman et al., 2006 ; Pinto et al., 2014 ) and has also been linked to an increased mortality risk in this population ( Newman et al., 2006 ). Regarding methods to estimate muscle mass, dual-energy X-ray absorptiometry (DXA) ( Abe et al., 2015 ), ultrasonography (US; Thiebaud et al., 2019 ), and

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Biomechanics of the Median Nerve During Stretching as Assessed by Ultrasonography

Jacinto Javier Martínez-Payá, José Ríos-Díaz, María Elena del Baño-Aledo, David García-Martínez, Ana de Groot-Ferrando, and Javier Meroño-Gallut

The objective of this observational cross-sectional study was to investigate the normal motion of the median nerve when stretched during a neurodynamic exercise. In recent years, ultrasonography has been increasingly accepted as an imaging technique for examining peripheral nerves in vivo, offering a reliable and noninvasive method for a precise evaluation of nerve movement. Transverse motion of the median nerve in the arm during a neurodynamic test was measured. A volunteer sample of 22 healthy subjects (11 women) participated in the study. Nerve displacement and deformation were assessed by dynamic ultrasonography. Excellent interobserver agreement was obtained, with kappa coefficient of .7–.8. Ultrasonography showed no lateral motion during wrist extension in 68% of nerves, while 73% moved dorsally, with statistically significant differences between sexes (ORlat = 6.3; 95% CI = 1.4–27.7 and ORdor = 8.3; 95% CI = 1.6–44.6). The cross-sectional area was significantly greater in men (3.6 mm2). Quantitative analysis revealed no other statistically significant differences. Our results provide evidence of substantial individual differences in median nerve transverse displacement in response to a neurodynamic exercise.

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Ultrasonographic Evaluation of the Shoulder in Elite Wheelchair Tennis Players

In-Ho Jeon, Hemanshu Kochhar, Jong-Min Lee, Hee-Soo Kyung, Woo-Kie Min, Hwan-Sung Cho, Ho-Wug Wee, Dong-Joo Shin, and Poong-Taek Kim


Wheelchair tennis has been identified as a high-risk sport for shoulder injury, so understanding shoulder pathology in these athletes is important.


This study investigated the incidence and pattern of shoulder injuries in wheelchair tennis players using high-resolution ultrasonography.


Descriptive study.


International Wheelchair Tennis Open.


33 elite-level wheelchair tennis players.

Outcome Measures:

Wheelchair tennis players completed a self-administered questionnaire, and shoulders of each athlete were investigated using high-resolution ultrasonography (linear probe 7.5 MHz).


The most common pathology in the dominant shoulder was acromioclavicular pathology, in 21 players (63.6%). Full-thickness rotator-cuff tears involving the supraspinatus were found in 8 dominant shoulders and 6 nondominant shoulders. There were no correlations between identified shoulder pathology and the different variables studied, such as age, training time per day, length of wheelchair use, and length of career as a wheelchair tennis player.


High prevalence of rotator-cuff and acromioclavicular pathology was found by ultrasonographic examination in the elite wheelchair tennis players in both dominant and nondominant shoulders. A high index of suspicion of these pathologies in wheelchair athletes is required.

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Biomechanical Behavior of Muscle-Tendon Complex during Dynamic Human Movements

Senshi Fukashiro, Dean C. Hay, and Akinori Nagano

This paper reviews the research findings regarding the force and length changes of the muscle-tendon complex during dynamic human movements, especially those using ultrasonography and computer simulation. The use of ultrasonography demonstrated that the tendinous structures of the muscle-tendon complex are compliant enough to influence the biomechanical behavior (length change, shortening velocity, and so on) of fascicles substantially. It was discussed that the fascicles are a force generator rather than a work generator; the tendinous structures function not only as an energy re-distributor but also as a power amplifier, and the interaction between fascicles and tendinous structures is essential for generating higher joint power outputs during the late pushoff phase in human vertical jumping. This phenomenon could be explained based on the force-length/velocity relationships of each element (contractile and series elastic elements) in the muscle-tendon complex during movements. Through computer simulation using a Hill-type muscle-tendon complex model, the benefit of making a countermovement was examined in relation to the compliance of the muscle-tendon complex and the length ratio between the contractile and series elastic elements. Also, the integral roles of the series elastic element were simulated in a cyclic human heel-raise exercise. It was suggested that the storage and reutilization of elastic energy by the tendinous structures play an important role in enhancing work output and movement efficiency in many sorts of human movements.

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Talofibular Interval Changes After Acute Ankle Sprain: A Stress Ultrasonography Study of Ankle Laxity

Theodore Croy, Susan Saliba, Ethan Saliba, Mark W. Anderson, and Jay Hertel


Quantifying talocrural joint laxity after ankle sprain is problematic. Stress ultrasonography (US) can image the lateral talocrural joint and allow the measurement of the talofibular interval, which may suggest injury to the anterior talofibular ligament (ATFL). The acute talofibular interval changes after lateral ankle sprain are unknown.


Twenty-five participants (9 male, 16 female; age 21.8 ± 3.2 y, height 167.8 ± 34.1 cm, mass 72.7 ± 13.8 kg) with 27 acute, lateral ankle injuries underwent bilateral stress US imaging at baseline (<7 d) and on the affected ankle at 3 wk and 6 wk from injury in 3 ankle conditions: neutral, anterior drawer, and inversion. Talofibular interval (mm) was measured using imaging software and self-reported function (activities of daily living [ADL] and sports) by the Foot and Ankle Ability Measure (FAAM).


The talofibular interval increased with anterior-drawer stress in the involved ankle (22.65 ± 3.75 mm; P = .017) over the uninvolved ankle (19.45 ± 2.35 mm; limb × position F 1,26 = 4.9, P = .035) at baseline. Inversion stress also resulted in greater interval changes (23.41 ± 2.81 mm) than in the uninvolved ankles (21.13 ± 2.08 mm). A main effect for time was observed for inversion (F 2,52 = 4.3, P = .019, 21.93 ± 2.24 mm) but not for anterior drawer (F 2,52 = 3.1, P = .055, 21.18 ± 2.34 mm). A significant reduction in the talofibular interval took place between baseline and week 3 inversion measurements only (F 1,26 = 5.6, P = .026). FAAM-ADL and sports results increased significantly from baseline to wk 3 (21.9 ± 16.2, P < .0001 and 23.8 ± 16.9, P < .0001) and from wk 3 to wk 6 (2.5 ± 4.4, P = .009 and 10.5 ± 13.2, P = .001).


Stress US methods identified increased talofibular interval changes suggestive of talocrural laxity and ATFL injury using anterior drawer and inversion stress that, despite significant improvements in self-reported function, only marginally improved during the 6 wk after ankle sprain. Stress US provides a safe, repeatable, and quantifiable method of measuring the talofibular interval and may augment manual stress examinations in acute ankle injuries.

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Association of Muscle Strength With Muscle Thickness and Motor Unit Firing Pattern of Vastus Lateralis Muscle in Youth Athletes

Akane Yoshimura, Shun Kunugi, Tetsuya Hirono, Hiroya Nojima, Saeko Ueda, Aleš Holobar, Yukiko Mita, and Kohei Watanabe

Purpose: Contributions of neural and muscular factors to muscle strength change with growth, but such changes remain unclear in young populations. This study aimed to clarify the association between muscle strength and neural and muscular factors in youth athletes. Methods: Maximal voluntary contraction (MVC) during isometric knee extension, the motor unit firing rate (MUFR), and muscle thickness (MT) of the vastus lateralis were measured in 70 youth male soccer players (mean [SD]; chronological age = 16.3 [0.6] y, peak height velocity age = 13.1 [1.0] y). MUFR and MT were measured with high-density surface electromyography and ultrasonography, respectively. Results: For MUFR and MT, correlations with MVC were calculated and the values of different MVC groups were compared. A significant correlation between MVC and MT (r = .49, P < .01) was noted, but not MUFR (r = .03, P > .05). There was also no significant correlation between MT and MUFR (r = −.33, P > .05). In addition, comparison among groups (higher-/middle-/lower-strength groups) revealed that MT in the lower-strength group was significantly lower than in middle-and higher-strength groups (P < .01). Conclusion: In youth athletes, muscle strength is associated with muscular factors, rather than neural factors, and muscular and neural factors may independently contribute to muscle strength.

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Cross Sectional Area of the Supraspinatus Muscle and Acromio-humeral Distance in Overhead Athletes With and Without Shoulder Pain: A Cross-sectional Study

Josep C. Benitez-Martinez, Jose Casaña-Granell, Yasmin Ezzatvar de Llago, Carlos Villaron-Casales, Gemma V. Espi-Lopez, and Fernando Jimenez-Diaz


The supraspinatus muscle has an important role in the stabilization of the glenohumeral joint. Identifying abnormalities concerning its size and the subacromial space in the presence of pain may be relevant to provide more specific treatments focused on the etiology of pain.


To determinate whether painful shoulder causes changes in the supraspinatus cross-sectional area (CSA) and the acromio-humeral distance (AHD) between overhead athletes.


Cross-sectional study.


University campus and local sports clubs’ Physical Therapist room.


81 male overhead athletes were divided into 2 groups according to the presence of shoulder pain and clinical symptoms.

Main Outcome Measures:

Ultrasonography measurements of the supraspinatus CSA and the AHD in 2 groups of overhead athletes with and without pain.


In the pain group, the CSA was significantly smaller compared with the no pain group. No differences between groups were found in the AHD measurement.


Shoulder pain in overhead athletes was associated with a reduction in their supraspinatus muscle CSA, but not in the AHD. These findings suggest that muscle atrophy exists in the presence of pain. However, in active overhead athletes, the AHD is not clearly reduced in overhead athletes with shoulder pain. Further studies are needed to understand this condition.