Effects of technological running shoes versus barefoot running on the intrinsic foot muscles, ankle mobility, and dynamic control: a novel cross-sectional research.

BACKGROUND: Technological running shoes have become increasingly popular, leading to improvements in performance. However, their long-term effects on foot musculature and joint mobility have not been thoroughly studied. OBJECTIVE: To compare the activation of the intrinsic foot muscles between runners wearing technological footwear and barefoot runners. Secondary objectives included assessing ankle dorsiflexion (DF) range of motion (ROM) and dynamic postural control in both groups. METHODS: A cross-sectional study was conducted involving 22 technological footwear runners and 22 barefoot runners. Ultrasonography was used to measure the thickness of the plantar fascia (PF) and the quadratus plantae (QP), abductor digiti minimus (ADM), abductor hallucis (AH), and flexor hallucis longus (FHL) muscles. Ankle mobility and dynamic postural control were also recorded. RESULTS: Ultrasonography measurements showed statistically significant differences for PF thickness (mean difference [MD]: -0.10 cm; 95% CI: -0.13, -0.05 cm), QP cross-sectional area (CSA) (MD: -0.45 cm2; 95% CI: -0.77, -0.12 cm2), ADM CSA (MD: -0.49 cm2; 95% CI: -0.70, -0.17 cm2), and FHL thickness (MD: 0.82 cm; 95% CI: 0.53, 1.09 cm), with all measurements being lower in the group wearing technological footwear compared to the barefoot runners. Ankle DF ROM was also significantly greater for the barefoot runners (MD: -5.1°; 95% CI: -8.6, -1.7°). CONCLUSIONS: These findings suggest potential implications for the foot musculature and ankle mobility in runners using technological footwear.

Physical manifestations of stress in women. Correlations between temporomandibular and pelvic floor disorders.

INTRODUCTION: Stress is characterized as a challenging occurrence that triggers a physiological and/or behavioral allostatic response, alongside the demands typically encountered throughout the natural course of life. A sustained state of stress gives rise to secondary effects, including insomnia and neck pain. Also, the risk of musculoskeletal problems in the cervical and lumbar spine can be increased due to a sustained state of stress. The present study main objective is to study the association between orofacial and pelvic floor muscles in women in Spain. METHODOLOGY: An observational, cross-sectional, retrospective analytical study was designed and carried out in the laboratories of the European University of Madrid. Sixty-five participants were recruited with a mean age of 29.9 ± 7.69. Measurements were taken by myotonometry on natural oscillation frequency (Hz), dynamic stiffness (N/m), elasticity (N/m2), mechanical stress relaxation time (ms) and creep, for the following muscles: right and left masseter, right and left temporalis and central fibrous nucleus of the perineum (CFPF). On the other hand, the subjects completed the following questionnaires: perceived stress scale (PSS-14), anxiety scale (STAI), self-reported bruxism questionnaire (CBA), Fonseca Anamnestic Index and the Pittsburgh Sleep Quality Scale (PSQI). RESULTS: Significant correlations were found in several parameters between the right temporalis and CFPF (p<0.05). Highlighting the correlation between TMDs and lubrication r = -0.254 (p = 0.041) and bruxism with pain in sexual intercourse r = 0.261 (p = 0.036). CONCLUSION: The results support the proposed hypothesis. To the author's knowledge, this is the first study which relates both locations, and it is suggested to continue with the research and expand the knowledge of it.

Effects of combined treatment with transcranial and peripheral electromagnetic stimulation on performance and pain recovery from delayed onset muscle soreness induced by eccentric exercise in young athletes. A randomized clinical trial.

Background: There is a common interest in finding a common consensus in the approach of athletes suffering from DOMS with the aim of accelerating recovery and thereby enhancing performance. The objective of this study was to observe the effects of a paired-associative transcranial and peripheral electromagnetic stimulation on young athletes suffering from DOMS, induced by 1 h of eccentric and plyometric exercises. Methods: Forty-eight young athletes participated in this randomized control trial: 13 were assigned to the peripheral group (P); 12 were in the control group (Cont); 11 were assigned to the transcranial group (T) and 12 were included in the paired-associative group (Comb). The Visual Analogue Scale (VAS) of pain perception and the mechanical Pressure Pain Threshold (PPT) were the tools used to analyze the symptoms of DOMS. On the other hand, the Half Squat (HS) test evaluated with an accelerometer, and the 30 m sprint velocity (30-mSP) test were used to observe the evolution of the sports performance of the lower limbs. All evaluations were performed before and after the eccentric exercise session that caused DOMS, as well as at 24-48, and 72 h afterward. Results: The AS group improved the symptoms of the induced DOMS, since significant positive differences were observed in the VAS and PPT compared to the other groups (p < 0.001). In addition, the AS group showed a significant improvement in the HS and the 30-mSP tests (p < 0.001). Based on the results a treatment with both peripheral and transcranial electromagnetic stimulation improves recovery and performance in athletes at 72 h, although these data would need to be verified in future research with a larger sample size. Conclusion: Paired-associative electromagnetic stimulation improved DOMS symptomatology, velocity, and sports performance in the lower limbs.

Current understanding of the diagnosis and management of the tendinopathy: An update from the lab to the clinical practice.

Tendinopathy is labeled by many authors as a troublesome, common pathology, present in up to 30% medical care consultations involving musculoskeletal conditions. Despite the lasting interest for addressing tendon pathology, current researchers agree that even the exact definition of the term tendinopathy is unclear. Tendinopathy is currently diagnosed as a clinical hypothesis based on the patient symptoms and physical context. One of the main goals of current clinical management is to personalize treatment approaches to adapt them to the many different needs of the population. Tendons are complex structures that unite muscles and bones with two main objectives: to transmit forces and storage and release energy. Regarding the tensile properties of the tendons, several authors argued that tendons have higher tensile strength compared with muscles, however, are considered less flexible. Tendinopathy is an accepted term which is used to indicated a variety of tissue conditions that appear in injured tendons and describes a non-rupture damage in the tendon or paratendon, which is intensified with mechanical loading Even when the pathoetiology of tendinopathy is unclear, there is a wide array of treatments available to treat and manage tendinopathy. Although tendinitis usually debuts with an inflammatory response, the majority of chronic tendinopathies do not present inflammation and so the choosing of treatment should vary depending on severity, compliance, pain and duration of symptoms. The purpose of this article is to review and provide an overview about the currently research of the tendon diagnosis, management and etiology.

Current advances and novel research on minimal invasive techniques for musculoskeletal disorders.

The present review summarized the current advances and novel research on minimal invasive techniques for musculoskeletal disorders. Different invasive approaches were proposed in the physical therapy field for the management of musculoskeletal disorders, such as ultrasound-guided percutaneous needle electrolysis, dry needling, acupuncture and other invasive therapy techniques, discussing about their worldwide status, safety and interventional ultrasound imaging. Indeed, dry needling may be one of the most useful and studies invasive physical therapy applications in musculoskeletal disorders of different body regions, such as back, upper limb, shoulder, arm, hand, pelvis, lower limb, neck, head, or temporomandibular joint, and multiple soreness location disorders, such as fibromyalgia. In addition, the assessment and treatment by acupuncture or electro-acupuncture was considered and detailed for different conditions such as plantar fasciitis, osteoarthritis, spasticity, myofascial pain syndrome, osteoporosis and rheumatoid arthritis. As an increasing technique in physical therapy, the use of ultrasound-guided percutaneous needle electrolysis was discussed in injuries of the musculoskeletal system and entrapment neuropathies. Also, ultrasound-guided percutaneous neuromodulation was established as a rising technique combined with ultrasound evaluation of the peripheral nerve system with different clinical applications which need further studies to detail their effectiveness in different musculoskeletal conditions. Thus, invasive physical therapy may be considered as a promising approach with different novel applications in several musculoskeletal disorders and a rising use in the physiotherapy field.

Current advances and research in ultrasound imaging to the assessment and management of musculoskeletal disorders.

Currently evidence-based practice has given scientific weight to the physical therapist profession; it is essential that all medical professional and physical therapists know the usefulness of new tools that optimize the effectiveness of their interventions and allow the growing of the scientific knowledge base. The use of ultrasound imaging (USI) by physiotherapists has evolved in recent years, consolidating as an increasingly standardized technique, low cost compared to other imaging techniques, quickly of execution, feasible and reliable tool. USI offers a wide range of opportunities in clinical practice as well as in different research areas. Therefore, ultrasound has been currently used as a diagnostic tool by physicians and in recent years there has been an expansion of the use of ultrasound equipment by non-physicians professionals such as physical therapist or physical trainers, who incorporates USI as a means of assessing musculoskeletal system architecture and composition, musculoskeletal changes in dysfunction, pain or injury conditions, as an interventional technique assisting echo-guided procedures or using the visual real-time information as a biofeedback in control motor approaches, as guiding tool in clinical decisions as well as to improve the understanding of tissue adaptations to exercise or movement. The purpose of this article is to review and provide an overview about the currently research of the USI applications and their benefits for the diagnosis and management in individuals with musculoskeletal conditions.

Quantitative Ultrasound Imaging Differences in Multifidus and Thoracolumbar Fasciae between Athletes with and without Chronic Lumbopelvic Pain: A Case-Control Study.

New trends in ultrasound imaging are focused on exploration of morphology and muscle quality. The main goal of the study was to evaluate the first-order descriptor and echostructure of lumbar multifidus at the L4 vertebral level in athletes with and without chronic lumbopelvic pain (CLPP). A case-control study was performed in 15 semiprofessional athletes with CLPP and 15 without (healthy athletes). Lumbar multifidus echointensity and echovariation were measured for muscle quality assessment. Echostructure was used to evaluate lumbar multifidus cross-sectional area (CSA) at resting and during muscle contraction, respective differences during both phases (CSADif.), activation patterns, and thoracolumbar fasciae morphology and thickness. Significant differences with a large effect size were observed in quantitative data from CLPP and healthy athletes for left lumbar multifidus CSADif. and thoracolumbar fasciae morphology. Categorical data showed statistically significant differences with a small-to-moderate effect size for lumbar multifidus activation pattern and thoracolumbar fasciae morphology. Athletes with CLPP showed a reduced CSA difference between lumbar multifidus contraction and at resting and higher disorganization of thoracolumbar fasciae morphology compared to healthy athletes. These findings suggest the importance of dynamic exploration of the lumbar region and connective tissue in sports performance and injury prevention.

Ultrasonography Comparison of the Plantar Fascia and Tibialis Anterior in People With and Without Lateral Ankle Sprain: A Case-Control Study.

OBJECTIVE: The purpose of the present study was to evaluate the thickness of the plantar fascia (PF) at the insertion of the calcaneus and the midfoot and forefoot fascial locations, in addition to the thickness of the tibialis anterior, by ultrasound imaging in individuals with and without lateral ankle sprain (LAS). METHODS: A sample of 44 participants was recruited and divided in 2 groups: 22 feet with a prior diagnosis of grade 1 or 2 LAS (case group) and 22 feet without this condition (healthy group). The thickness and cross-sectional area were evaluated by ultrasound imaging in both groups. RESULTS: Ultrasound measurements of the PF at the calcaneus, midfoot, and forefoot showed statistically significant differences (P < .05), with a decrease in thickness in the LAS group relative to the healthy group. For the thickness and cross-sectional area of the tibialis anterior, no significant differences (P < .05) were observed between groups. CONCLUSION: The thickness of the PF at the calcaneus, midfoot, and forefoot is reduced in individuals with LAS relative to the healthy group.

Does Function Determine the Structure? Changes in Flexor Hallucis Longus Muscle and the Associated Performance Related to Dance Modality: A Cross-Sectional Study.

Background and Objectives: Flexor hallucis longus pathology is one of the most common conditions of the ankle and foot in dancers, due to the high demand of dance movements performed in an extreme plantar flexion and dorsiflexion range of motion. The objectives of this study were to determine the bilateral differences between the thickness and cross-sectional area of the flexor hallucis longus muscle in dancers, to establish possible differences between dance modalities, and to analyze whether there is a correlation between ultrasonographic parameters or performance variables and the dance modality. Material and Methods: A sample of 50 (29 classical and 21 contemporary) full-time pre-professional female dancers were included in the study. The thickness and cross-sectional area of the flexor hallucis longus muscle were evaluated for both limbs using ultrasound imaging. The range of movement of the first metatarsophalangeal joint was measured using functional extension with maximal ankle plantarflexion, balance was measured in a unilateral stance with the heel raised, endurance was evaluated through a modified heel rise fatigue test, and a counter movement jump to assess the vertical jump performance was measured bilaterally. Results: There were no significant differences recorded between the dominant and non-dominant limbs for each variable, within both groups. Contemporary dancers showed a greater thickness and cross-sectional area of the flexor hallucis longus muscle than classical dancers. However, classical dancers showed an increase of balance, endurance, range of movement of the first metatarsophalangeal joint, and counter movement jump with respect to contemporary dancers. Conclusion: Bilateral symmetry was identified in all variables for both groups. The size and performance of the flexor hallucis longus muscle may be influenced by the specific nature of dance modality.

Ultrasound imaging features of the Achilles tendon in dancers. Is there a correlation between the imaging and clinical findings? A cross-sectional study.

OBJECTIVES: To analyze the prevalence of tendon pathology and performance associated in pre-professional classic dancers with no history of Achilles tendon (AT) pain. DESIGN: A cross-sectional study was conducted. PARTICIPANTS: Twenty-nine classic ballet dancers without AT pain (58 tendons) were recruited. The tendons were classified (normal, abnormal) using ultrasound imaging (USI). Cross-sectional area (CSA) and thickness of flexor hallucis longus (FHL) muscle were measured using USI. Range of movement (ROM) of the first metatarsophalangeal join, balance test, endurance test and vertical jump were measured (bilaterally) as performance variables. RESULTS: More than a half (62%) of the participants had at least one abnormal tendon, with 45% of the dancers in the abnormal group having bilateral abnormalities. Dancers with AT pathology had significantly more years of dancing and number of weekly pointe hours than those with no pathology on US imaging. No significant differences between the groups were identified for the rest of the variables. Dancing years were moderately correlated with AT thickness. CONCLUSIONS: Asymptomatic classic dancers had a high incidence of tendon pathology. Increased dancing years was associated with pathology in the AT. Nevertheless, these abnormalities may not affect dance performance.

The Influence of Running on Foot Posture and In-Shoe Plantar Pressures.

BACKGROUND: Running can be considered a high-impact practice, and most people practicing continuous running experience lower-limb injuries. The aim of this study was to determine the influence of 45 min of running on foot posture and plantar pressures. METHODS: The sample comprised 116 healthy adults (92 men and 24 women) with no foot-related injuries. The mean ± SD age of the participants was 28.31 ± 6.01 years; body mass index, 23.45 ± 1.96; and training time, 11.02 ± 4.22 h/wk. Outcome measures were collected before and after 45 min of running at an average speed of 12 km/h, and included the Foot Posture Index (FPI) and a baropodometric analysis. RESULTS: The results show that foot posture can be modified after 45 min of running. The mean ± SD FPI changed from 6.15 ± 2.61 to 4.86 ± 2.65 (P < .001). Significant decreases in mean plantar pressures in the external, internal, rearfoot, and forefoot edges were found after 45 min of running. Peak plantar pressures in the forefoot decreased after running. The pressure-time integral decreased during the heel strike phase in the internal edge of the foot. In addition, a decrease was found in the pressure-time integral during the heel-off phase in the internal and rearfoot edges. CONCLUSIONS: The findings suggest that after 45 min of running, a pronated foot tends to change into a more neutral position, and decreased plantar pressures were found after the run.