Physical therapists' role in prevention and management of patellar tendinopathy injuries in youth, collegiate, and middle-aged indoor volleyball athletes

ABSTRACTPatellar tendinopathy is highly prevalent in all ages and skill levels of volleyball athletes. To illustrate this, we discuss the clinical, biomechanical, and ultrasound imaging presentation and the intervention strategies of three volleyball athletes at different stages of their athletic career: youth, middle-aged, and collegiate. We present our examination strategies and interpret the data collected, including visual movement analysis and dynamics, relating these findings to the probable causes of their pain and dysfunction. Using the framework of the EdUReP concept, incorporating Education, Unloading, Reloading, and Prevention, we propose intervention strategies that target each athlete's specific issues in terms of education, rehabilitation, training, and return to sport. This framework can be generalized to manage patellar tendinopathy in other sports requiring jumping, from youth to middle age, and from recreational to elite competitive levels.

A mesoterapia melhora a amplitude articular em pacientes com tendinite do manguito rotador / Mesotherapy improves range of motion in patients with rotator cuff tendinitis

Há evidências publicadas sobre o efeito da mesoterapia para as doenças inflamatórias do ombro. Objetivo: Avaliar o ganho de amplitude de movimento (ADM) em pacientes com tendinopatia do manguito rotador tratados com mesoterapia. Uma série retrospectiva de casos conduzida a partir de prontuários médicos. Um serviço ambulatorial de reabilitação e ortopedia. População: 145 pacientes com diagnóstico clínico de tendinopatia do manguito rotador, com limitação da amplitude de movimento ativa. Método: Os sujeitos do estudo foram tratados com mesoterapia entre 1995 e 2008, a mesclas foram selecionadas de acordo com o perfil do paciente e sua tolerância. O efeito sobre a ADM foi qualificado como "sem melhora" ou "com melhora". A melhora da sintomatologia foi correlacionada com a idade, duração dos sintomas e drogas usadas na mesoterapia. A realização concomitante de fisioterapia também foi correlacionada com o desfecho. Os efeitos adversos foram avaliados sistematicamente. Resultados: 117 pacientes (80,7%) apresentaram melhor objetiva da ADM ou a dor. O resultado não foi influenciado pela idade, duração dos sintomas ou pela realização concomitante de fisioterapia. Apenas efeitos adversos menores foram observados. Conclusão: Este estudo sugere que a mesoterapia pode ser eficaz no tratamento da tendinopatia do manguito rotador, seja pela melhora da dor, ADM ou função global do membro superior. O impacto clínico deste estudo é que a mesoterapia pode ser associada ao tratamento fisioterapêutico padrão para melhorar ADM e dor na tendinopatia do manguito rotador.

There is published evidence on the effect of mesotherapy for inflammatory shoulder diseases. Objective: Evaluate the gain in range of motion (ROM) in patients with rotator cuff tendinopathy treated with mesotherapy. A retrospective series of cases conducted from medical records. Location: an outpatient rehabilitation and orthopedic service. 145 patients with clinical diagnosis of rotator cuff tendinopathy, with limited active range of motion. Method: The study subjects were treated with mesotherapy between 1995 and 2008, the blends were selected according to the patient's profile and tolerance. The effect on the ROM was qualified as "not improved" or "improved". The improvement in symptomatology was correlated to age, duration of symptoms, and drugs used in the mesotherapy. The concomitant application of physical therapy was also correlated with the result. The adverse effects were evaluated systematically. Results: 117 patients (80.7%) presented objective improvement of ROM or of pain. The result was not influenced by age, duration of symptoms, or by the concomitant application of physical therapy. Only smaller adverse effects were observed. Conclusion: This study suggests that mesotherapy can be efficient in the treatment of rotator cuff tendinopathy, for the improvement of pain, ROM, or global functioning of the upper limb. The clinical impact of this study is that mesotherapy can be associated with the standard physical therapy treatment to improve ROM and pain in rotator cuff tendinopathy.

Tendinopatía rotuliana y de tendón aquileano: clasificación orientada en la fisiopatología y tratamiento / Patellar and achilles tendinopathy: classification oriented in physiopathology and treatment

La patología tendinosa provoca dolor y alteración del rendimiento deportivo, la terminología es confusa y lleva a estrategias de tratamiento equivocadas. Se realiza una clasificación fisiopatológica y se presenta un protocolo de tratamiento para cada caso.

Comparison of self-report and interview administration methods based on the Brazilian versions of the Western Ontario Rotator Cuff Index and Disabilities of the Arm, Shoulder and Hand Questionnaire in patients with rotator cuff disorders

OBJECTIVE: The purpose of the present study was to compare self-report and interview administration methods using the Western Ontario Rotator Cuff Index (WORC) and Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH) in patients with rotator cuff disorders. METHODS: Thirty male and female patients over 18 years of age with rotator cuff disorders (tendinopathy or rotator cuff tear) and Brazilian Portuguese as their primary language were recruited for assessment via administration of the Western Ontario Rotator Cuff Index and and Disabilities of the Arm, Shoulder and Hand Questionnaire. A randomization method was used to determine whether the questionnaires would be self-reported (n=15) or administered by an interviewer (n=15). Pearson correlation coefficients were used to evaluate the correlation between the Western Ontario Rotator Cuff Index and and Disabilities of the Arm, Shoulder and Hand Questionnaire in each group. The t-test was used to determine whether the difference in mean questionnaire scores and administration time was statistically significant. For statistical analysis, the level of significance was set at 5 percent. RESULTS: The mean subject age was 55.07 years, ranging from 27 to 74 years. Most patients had a diagnosis of tendinopathy (n=21). With regard to level of schooling, the majority (n=26) of subjects had completed a college degree or higher. The mean questionnaire scores and administration times did not significantly differ between the two groups (p>0.05). There were statistically significant correlations (p<0.05) between Western Ontario Rotator Cuff Index and and Disabilities of the Arm, Shoulder and Hand Questionnaire, and strong correlations were found between the questionnaires in both groups. CONCLUSION: There are no differences between the Western Ontario Rotator Cuff Index and Disabilities of the Arm, Shoulder and Hand Questionnaire administration methods with regard to administration time or correlations...

Tratamiento quirurgico de la tendinitis rotuliana en atletas de alto rendimiento / Surgical treatment of patellar tendonitis in high performance athletes

Introducción: El número de deportistas de alto rendimiento está en constante aumento, así como las exigencias a las que son sometidos. Algunos autores han llamado rodilla del saltador (jumper’s knee) a la tendinitis rotuliana. El objetivo de este trabajo fue evaluar el resultado del tratamiento quirúrgico en atletas de alto rendimiento con tendinitis de grado II o III de Blazina. Materiales y métodos: Incluimos en este estudio a 19 pacientes, todos atletas profesionales, operados entre 1995 y 2005, con edades comprendidas entre 20 y 31 años. Se describe la técnica quirúrgica utilizada y el tratamiento posquirúrgico. Se evaluaron los resultados de acuerdo con el retorno de los atletas a su nivel de competencia. Resultados: Se presentan 19 pacientes operados, con excelentes y buenos resultados en 16 de ellos. Dos pacientes tuvieron resultado regular y uno, malo. Las lesiones asociadas no influyeron en el resultado final. El retorno a la competencia varió entre 4 y 6 meses. Conclusiones: Se indicó cirugía a los atletas con tendinitis de grado II apremiados por su calendario deportivo y en aquellos con grado III cuando fracasó el tratamiento conservador. El tratamiento quirúrgico de la tendinitis rotuliana en los atletas de alto rendimiento, grado II o III, presenta excelentes y buenos resultados en la mayoría de los casos.

Afecções mais freqüentes do aparelho locomotor dos eqüídeos de tração no município de Belo Horizonte / Most frequent pathologies of the locomotor system in equids used for wagon traction in Belo Horizonte

Determinaram-se as enfermidades mais comuns do sistema músculo-esquelético dos animais de tração na cidade de Belo Horizonte. Foram utilizados 58 animais (42 eqüinos e 16 muares), sendo 31 machos e 27 fêmeas. O diagnóstico baseou-se no histórico e nos exames físico e radiológico. A freqüência observada para tenossinovite nos membros torácicos e pélvicos foi 55,2 por cento, para tendinite nos membros torácicos, 81,0 por cento, para tendinite nos membros pélvicos, 58,6 por cento, e para desmite do ligamento suspensório nos membros torácicos, 77,6 por cento. Para as lesões osteoarticulares, os resultados foram 13,8 por cento, 12,1 por cento, 27,6 por cento e 12,1 por cento de lesões osteoartríticas para a articulação interfalangeana distal dos membros torácicos e pélvicos e articulação interfalangeana proximal dos membros torácicos e pélvicos, respectivamente. Na articulação metacarpo-falangeana, a incidência foi 41,4 por cento e, nos membros pélvicos, 39,7 por cento. A incidência na articulação cárpica foi 62,1 por cento e, na articulação társica, 96,6 por cento. Os achados dos tecidos moles indicaram sobrecarga nos aparatos flexor e suspensório nesse tipo de atividade. Em ambos os casos, a atividade desenvolvida pelos animais parece ser a principal causa envolvida.

The most common conditions of the musculoskeletal system of draft equidae in the city of Belo Horizonte were determined. Fifty-eight animals (42 horses and 16 mules) were randomly examined, being 31 males and 27 females. Diagnosis was based on history, clinical and radiological examinations. The frequency observed for tenosynovitis in the fore and hindlimbs was 55.2 percent, 81.0 percent, for tendinitis in the forelimbs, 58.6 percent for tendinitis in the himblimbs, and 77.6 percent for suspensory ligament desmitis in the forelimbs. The results showed 13.8%, 12.1 percent, 27.6 percent and 12.1 percent of osteoarthritic lesions for distal interphalangeal joint of fore and hindlimbs and proximal interphalangeal joint of fore and hindlimbs, respectively. In the fetlock joints of the forelimbs, the incidence was 41.4 percent, and 39.7 percent in the hindlimbs. The incidence increased in the carpal joints, reaching 62.1 percent and it was even higher in the tarsal joints, reaching 96.6 percent. Findings in soft tissues indicated an overloading of both suspensory and flexor apparatus. Osteoarthritis was a common finding in draft equine, especially in tarsal joint. In both cases, the activity developed by those animals seems to be the main related cause.

Sweet's syndrome with tendinitis.

A 30 years man presented with fever and skin manifestations in the form of multiple tender, erythematous, asymmetric nodules and papules predominantly over the upper arms and back. The nodules were coalescing to form irregular sharply demarcated plaques over the forearms and thighs. There were pustules over the nodules. He also had tendoachilles tendinitis. The total leucocyte count, differential count and skin biopsy confirmed the diagnosis of Sweet's syndrome (acute febrile neutrophilic dermatosis). This patient, a case of Idiopathic Sweet's syndrome with tendoachilles tendinitis responded to oral corticosteroids.

Protocolo de investigaçäo das lesöes por esforços repetitivos (L.E.R.) / Investigacion protocol of repetitive strain injuries

Este protocolo propöe uma sistematizaçäo do tratamento das L.E.R.- Lesäo por Esforço Repetitivo. É dirigido a todos os profissionais da área de saúde que diagnosticam, tratam e reabilitam os pacientes com quadro de dor e limitaçäo funcional do membro superior.