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REVIEW ARTICLE |
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Common stress fractures in runners: An analysis  |
p. 1 |
Angelo V Vasiliadis DOI:10.4103/1319-6308.197457 Stress fractures are common injuries in both professional and recreational runners. This type of injury occurs more frequently in the lower extremities and can be caused by a number of both extrinsic and intrinsic factors. A wide variety of stress fracture locations have been reported in the literature, but the tibia is most frequently involved followed by the metatarsals, the fibula, the tarsal navicular, and the femur bone. Marathon training and average weekly running distances over 64 km have been consistently demonstrated as factors in the development of a stress fracture. Recent changes in the training regimen, prior injury, and running or training on hard terrain, such as trail running, are among additional considerations when evaluating runners with stress fractures. |
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ORIGINAL ARTICLES |
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Obesity degrees and their relationships with weakness of musculoskeletal system among the obese housewife |
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Mohammed Zerf DOI:10.4103/1319-6308.197458 Background: Obesity is associated with a range of disabling musculoskeletal conditions in adults. Objective: Our aimed in this study was to examine the correlation between Obesity degrees and weakness musculoskeletal system in class obese I, II, and III housewife. Methods: For the propose, our sample was selected by intentional method represented in 30 women, their homogeneity was calculate based on the age sex and questionnaire PA-R, tested Based on the index Ruffier-Dickson, body shape (ABSI), the body mass (BMI) as medical test and the vertical jump as field test to estimate the impact of Obesity degrees on weakness musculoskeletal system. Results: Thus, the analyses statistics we confirm: (a) Class obese level predicts the weakness of musculoskeletal system in class obese, which is related to the overweight level and high heartbeat during the effort. (b) There is a strong positive relationship between the increase body fat, the level of the index Ruffier-Dickson and the relative risks ABSI & BMI, in the opposite of the jumping -power which confirms in one hand the health risk based on the values anaerobic power and the weakness of musculoskeletal system based on the level of the values power leg. Conclusion: Obesity degrees predicts the weakness of musculoskeletal. |
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Does balance training balance the functional aspects of ankle instability? |
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Zafar Azeem, Kalpana Zutshi DOI:10.4103/1319-6308.197463 Background and Purpose: Ankle sprains are the reigning top most priority in the management and prevention of sports injuries. However, the repetitive nature of the injury makes it difficult to prevent as the functional deficits disturb the kinesthetic sense and thereby functional movement performance indicators of sportsmen. Balance training is considered as the mainstay of preventive strategy for ankle sprains though limited evidence seems to suggest the actual mode of training. This study was aimed to study the efficacy of wobble board training and a new functional balance training program on athletes with recurrent ankle sprains and reported functional deficits in the injured or affected leg. Materials and Methods : The training was carried out for 30 recreational athletes with a history of "giving away" and atleast 1 ankle sprain during the past 6months. Static and dynamic postural control were assessed using measures of balance in static and dynamic mode. Results: The results of the study showed that both training programs showed equal benefits in improving the static and dynamic postural control though functional training had more impact due to its functional nature of movements. Conclusion: The findings from our study pointed toward the greater need to involve function oriented movement approach to prevent sporting injuries as frequent and common as ankle sprains. |
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Fixation of anterior cruciate ligament avulsion fractures with arthroscopic suture bridge technique |
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Umesh Jadhav, Dhaval Gotecha DOI:10.4103/1319-6308.197465 Purpose: Numerous techniques for treatment of anterior cruciate ligament (ACL) avulsion fractures have been described in literature from closed reduction to definitive fixation, both open and arthroscopically assisted fixation. The present study aims to evaluate the clinical outcome of arthroscopic suture bridge fixation technique. Methods: The present retrospective study includes 31 patients with documented ACL avulsion fractures between 2008 and 2015. They all underwent arthroscopic suture bridge fixation by the same lead operating surgeon. The inclusion criteria were a displaced ACL avulsion fracture (Meyer and McKeever Types 3 and 4), with a minimum completed follow-up of 18 months. All patients were assessed with a preoperative magnetic resonance imaging to confirm the fracture. Results: Radiographs taken postoperatively showed that all avulsed fragments reduced were maintained and healing was evident in all cases by the end of 3 months. Clinically, no symptoms of instability were called for and no signs of ACL deficiency were elicited. Range of motion measurement showed a mean extension deficit of 2° (0-4) and a mean flexion deficit of 3° (1-6) when compared with the unaffected knee. The average Lysolm knee score was 98 (96-100). Conclusion: The present study demonstrated arthroscopic suture bridge fixation as a successful surgical intervention procedure for treatment of ACL avulsion fractures. |
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The effect of running on femoral bone mineral density |
p. 27 |
Tarek Saad Shafshak, Mohamed Mustafa Rezk, Sarah Sayed El-Tawab, Marwa Mokhtar Mohareb DOI:10.4103/1319-6308.197466 Background: Mechanical loading plays an essential role in the bone remodeling regulation. Running is a medium impact aerobic activity, which has been previously reported as exerting both positive and negative impacts on skeletal health. Aim: To study the effect of running on femoral bone mineral density (BMD), testosterone, and osteocalcin level among young male runners. Subjects and Methods: The study was carried out on 20 male runners aged between 18 and 25 years. Twenty healthy age-matched sedentary men were enrolled as a control group. BMD at the femoral neck, Ward's triangle, greater trochanter, and total femur was measured by dual-energy X-ray absorptiometry in all participants. The Z-score was selected for BMD assessment. Serum calcium, phosphorous, testosterone, and osteocalcin level were measured. Results: Runners had significantly higher BMD at all sites (P < 0.01). Runners had a higher serum osteocalcin (15.729 ± 13.722 vs. 4.980 ± 1.3724 ng/ml, P = 0.002) and lower serum testosterone level (3.844 ± 1.617 vs. 5.994 ± 2.190 ng/ml, P = 0.001). Serum level of osteocalcin and the duration of running were correlated positively with BMD among runners. Conclusion: This study confirms the positive osteogenic effect of running on BMD. |
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Normative adductor squeeze test values in Indian women cricketers and its correlation with body mass index |
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Divya Khare, Latika Datey, Abhinav Sathe DOI:10.4103/1319-6308.197467 Aim: The aim of this study was to establish the normative adductor squeeze test score in state-level cricketers and to determine the effect of body mass index on the test values of adductor squeeze test. Participants and Methods: A total of forty healthy women cricketers aged 20-28 years were selected. Results: The mean adductor strength and normative adductor squeeze test values for the state-level cricketers were established. Conclusion: With the increasing demands of cricket as a professional game, prevention of injuries and rehabilitation for player performance and to maximize player training are important. |
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Effect of traditional sitting on flexibility of hamstring and calf muscle among Arab people |
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Venkata Nagaraj Kakaraparthi, Vamsi Krishna Gannamaneni DOI:10.4103/1319-6308.197468 Purpose of the Study: The hamstring muscles are important contributors to the control of human movement and are involved in a wide range of activities from running and jumping to forward bending during sitting or standing and a range of postural control actions. [1] The sit-and-reach test (SRT) is a field test used to measure low back and hamstring muscle flexibility. Therefore, study contends that the flexibility of hamstring will get affected with Arab traditional sitting. Most of the Arab people have some shortening of hamstring muscles due to their style of sitting because of the knee flexion in Arab traditional sitting even the calf muscle also gets shortening and loss of flexibility. The purpose of this study is to assess hamstring muscle flexibility using the SRT test in Arab people who preferred traditional Arab sitting. Materials and Methods: A total of 20 male Arab people who living in Saudi Arabia (age range 20-40 years) volunteered to participate, and without any significant history of pathology of the hip, knee, or thigh were enlist for this study. A standard sit-and-reach box was used to position the subjects for the test, and the sliding ruler that is centered on the top of the box was used to take the SRT scores. Results: From the results, it has been noticed that age has P = 0.000968 which is highly significant due to which it plays significant effect. Age plays significant role in affecting the result whereas height does not play significant role in affecting the result of hamstring flexibility. Conclusion: Differences in hamstring muscle length varies according to age, weight, or style of sitting. The active person has better flexibility than who preferred traditional Arab sitting. |
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Normal cervical spine range of motion using digital inclinometer in male asymptomatic subjects of Aseer, Saudi Arabia  |
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Khalid A Alahmari DOI:10.4103/1319-6308.197469 Background: Various studies determined the normal cervical spine range of motion (ROM) of a large group of patients with diverse socioeconomic and ethnic background and varying degree of routine daily activities. The purpose of this investigation was to quantify normal cervical ROM in male asymptomatic subjects of Aseer Region, Saudi Arabia. Methodology: Two hundred and thirty-three asymptomatic subjects with age group of 10-80 years participated in the study. Digital goniometer was used to measure the ROM of the cervical spine. This tool was employed in a clinical setting to evaluate the full active ROM (AROM) of the cervical spine (i.e., flexion/extension, lateral bending, and axial rotation). All the subjects were divided into seven groups in terms of age (10-19, 20-29, 30-39, 40-49, 50-59, 60-69, and 70-80 years) and the cervical ROM was determined. Six cervical movements (i.e., flexion/extension, lateral bending, and axial rotation) of five groups were analyzed and each of the six cervical AROMs decreased significantly with age. Results: All the cervical ranges decreased as the age increased. The maximum cervical range was recorded in cervical rotation left (71.81 ± 8.75°), followed by rotation right (70.58 ± 5.83°), extension (68.42 ± 10.30°), flexion (66.96 ± 8.62°), left side bending (54.62 ± 7.13°), and right side bending (52.69 ± 7.32°). Conclusion: Normal database of normal cervical ROM from age group of 10-80 years was established in male asymptomatic population of Aseer Region, Saudi Arabia. |
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CASE REPORTS |
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Rehabilitation of posterolateral corner injuries of knee |
p. 45 |
Hariharasudhan Ravichandran, Balamurugan Janakiraman, Asmare Yitayeh, Berihu Fisseha, Subramanian Sundaram DOI:10.4103/1319-6308.197470 Injuries to the posterolateral corner (PLC) of the knee pose a significant challenge in sports rehabilitation due to their complex nature. Identifying PLC injuries are paramount in preventing chronic pain, instability, and/or surgical failure. To educate health professionals and athlete about posterior lateral corner injuries of the knee. Mr. X, 28-year-old badminton coach have been assessed with PLC injury with lateral collateral ligament (LCL) injury have been, clinically evaluated and rehabilitated efficiently. Mr. X was diagnosed with LCL injury and PLC injury, the treatment program provided for him on aspects of pain management, strengthening dynamic posterolateral structures, and increasing flexibility so he could continue his services pain-free. Cryotherapy was done before strengthening and stretching exercises. Very often PLC is forgotten during the assessment and rehabilitation of knee injuries. This study throws light into posterolateral aspect of the knee in preventing future complication of the instability of knee which may lead to disability. |
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Medial tibial stress syndrome: A case study |
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Abhinav Sathe DOI:10.4103/1319-6308.197471 Medial tibial stress syndrome (MTSS), commonly known as "shin splints," is a frequent injury of the lower extremity and one of the most common causes of exertional leg pain in athletes. Although often not serious, it can be quite disabling and progress to more serious complications if not treated properly. Often, the cause of MTSS is multifactorial and involves training errors and various biomechanical abnormalities. Few advances have been made in the treatment of MTSS over the last few decades. The current treatment options are mostly based on expert opinion and clinical experience. The purpose of this article is to let the readers know regarding conservative treatment options for MTSS and provide recommendations for sports medicine clinicians for improved treatment and patient outcomes. |
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Congenital Type I (Ia and Ib) and Type II intercalary longitudinal tibial hemimelia: A report of four cases |
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Mohd Faizan, Latif Z Jilani, Yasir Salam Siddiqui, Sohail Ahmed, Mazhar Abbas DOI:10.4103/1319-6308.197472 Congenital longitudinal tibial hemimelia is a rare disorder of lower limbs. This disorder is usually associated with skeletal and extraskeletal congenital malformation. The treatment depends on the type of tibial hemimelia. Multiple reconstructive surgeries and the availability of suitable prosthesis have an important role in treatment options. Here, we are reporting two cases of bilateral congenital Type I, one case of unilateral Type I, and one case of bilateral Type II intercalary longitudinal tibial hemimelia with one of them also had associated bilateral lobster claw hand. |
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Displaced closed avulsion of tibial tuberosity in a parkour enthusiast |
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Ganesh Singh Dharmshaktu, Irfan Khan DOI:10.4103/1319-6308.197473 Tibial tuberosity avulsion injury in isolation is a rare form of knee trauma. The associated damage to the knee extensor mechanism calls for adequate management for good functional regain. Most of the reported cases in literature consist of children and adolescent patients and the injury in adults is an uncommon pattern. Very few of the tuberosity fractures have concomitant patellar tendon avulsion. We present a case of this rare injury in a parkour learner who sustained this injury while practicing one of his stunts. The operative management and compliant physiotherapy ensured a satisfactory outcome. |
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Simultaneous bilateral femoral neck stress fractures in a young female runner: A case report and review of literature |
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Atul Mahajan DOI:10.4103/1319-6308.197474 Fatigue fractures generally appear in normal bone following increased repetitive activity or strenuous exercise, when imbalance occurs between applied force and elastic resistance. Femoral neck fatigue fractures are most common in athletes and young military recruits. They are not as common as stress fractures of the metatarsals or tibia and other bones. This paper reports bilateral stress fractures of the femoral neck in a 14-year-old girl presenting with pain in the anterior aspect of the right thigh of 3 months duration and without evidence of previous injury with low Vitamin D and elevated parathyroid hormone levels. Correction of Vitamin D levels, bed rest, and relief of weight-bearing were indicated as fractures were undisplaced. |
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