Rotator cuff strength is not augmented by blood flow restriction training.

OBJECTIVE: Blood flow restriction (BFR) training utilizes a tourniquet applied to the upper or lower extremities (UE or LE) to occlude blood flow while exercising. BFR training may help augment strength in muscles that are proximal to BFR cuff application. However, prior studies have failed to demonstrate augmented strength gains in the rotator cuff when the tourniquet is applied to the UE. The purpose of this study was to evaluate if a protocol consisting of LE exercises, performed with BFR, followed by rotator cuff exercises was superior in augmenting strength, and cross-sectional area (CSA) of the rectus femoris, in untrained subjects when compared to a non-BFR training group. DESIGN: Randomized controlled trial. SETTING: University. PARTICIPANTS: Thirty-five subjects (mean age 25.8 ± 1.6 y) randomized to a BFR or non-BFR group. MAIN OUTCOME MEASURES: Muscular strength measured via hand held dynamometer and the CSA of the dominant rectus femoris was measured by diagnostic ultrasound. RESULTS: Both groups experienced significant gains in LE and rotator cuff strength. Strength increased in the BFR group by 11.6% for the supraspinatus, 34.1% for shoulder ER, 23.4% for the quadriceps, and 17.1% for the hamstrings. Strength increased in the non-BFR group by 7.3% for the supraspinatus, 20% for shoulder ER, 12.8% for the quadriceps, and 10.7% for the hamstrings. However, there were no differences in strength gains between groups. Neither group experienced a significant increase in CSA for the rectus femoris. CONCLUSION: The BFR protocol used in this study did not augment strength for the rotator cuff in subjects who also performed LE exercises under occlusion.

Blood Flow Restriction Training for the Rotator Cuff: A Randomized Controlled Trial.

CONTEXT: Blood flow restriction (BFR) training utilizes a tourniquet, applied to the proximal portion of one or more extremities, to occlude blood flow during exercise. Significant gains in strength and cross-sectional area can be achieved in muscles, both distal and proximal to BFR cuff application. PURPOSE: To compare strength gains of the rotator cuff and changes in tendon size in subjects who performed side-lying external-rotation exercise with or without BFR. METHODS: Forty-six subjects (mean age 25.0 [2.2] y) were randomized to either a BFR + exercise group or to the exercise-only group. Subjects performed 4 sets of the exercise (30/15/15/15 repetitions) at 30% 1-repetition maximum 2 days per week for 8 weeks. RESULTS: Subjects in both groups experienced strength gains in the supraspinatus and the external rotators (P = .000, P = .000). However, there was no difference in strength gains between groups for the supraspinatus (P = .750) or the external rotators (P = .708). Subjects in both groups experienced increases in supraspinatus tendon thickness (BFR P = .041, exercise only P = .011). However, there was no difference between groups (P = .610). CONCLUSIONS: Exercise with BFR applied to the proximal upper extremity did not augment rotator cuff strength gains or tendon thickness when compared with subjects who only exercised. This study did demonstrate that performing multiple sets of high repetitions at a low load led to significant increases in rotator cuff strength and tendon size in the dominant upper extremity.

Prevalence of Patellar Tendinopathy and Patellar Tendon Abnormality in Male Collegiate Basketball Players: A Cross-Sectional Study.

CONTEXT: Patellar tendinopathy (PT) is a degenerative condition known to affect athletes who participate in sports such as basketball and volleyball. Patellar tendinopathy is a challenging condition to treat and may cause an athlete to prematurely retire from sport. The prevalence of PT in male collegiate basketball players is unknown. OBJECTIVE: To determine the prevalence of PT and patellar tendon abnormality (PTA) in a population of male collegiate basketball players. DESIGN: Cross-sectional study. SETTING: National Collegiate Athletic Association Divisions II and III, National Association of Intercollegiate Athletics, and Northwest Athletic Conference male collegiate basketball teams were assessed in a university laboratory setting. PATIENTS OR OTHER PARTICIPANTS: Ninety-five male collegiate basketball players (age = 20.0 ± 1.7 years). MAIN OUTCOME MEASURE(S): A diagnostic ultrasound image of an athlete's patellar tendon was obtained from each knee. Patellar tendinopathy was identified based on a player's symptoms (pain with palpation) and the presence of a hypoechoic region on an ultrasonographic image. RESULTS: A majority of participants, 53 of 95 (55.8%), did not present with pain during palpation or ultrasonographic evidence of PTA. Thirty-two basketball players (33.7%) displayed ultrasonographic evidence of PTA in at least 1 knee; 20 of those athletes (21.1%) had PT (pain and tendon abnormality). Nonstarters were 3.5 times more likely to present with PTA (odds ratio = 3.5, 95% confidence interval = 1.3, 9.6; P = .017) and 4 times more likely to present with PT (odds ratio = 4.0, 95% confidence interval = 1.1, 14.8; P = .038) at the start of the season. CONCLUSIONS: One in 3 male collegiate basketball players presented with either PT or PTA. Sports medicine professionals should evaluate basketball athletes for PT and PTA as part of a preseason screening protocol.

COMPARISON OF NON-CONTACT AND CONTACT TIME-LOSS LOWER QUADRANT INJURY RATES IN MALE COLLEGIATE BASKETBALL PLAYERS: A PRELIMINARY REPORT.

BACKGROUND: Male collegiate basketball (BB) players are at risk for musculoskeletal injury. The rate of time-loss injury in men's collegiate BB, for all levels of National Collegiate Athletic Association (NCAA) competition, ranges from 2.8 to 4.3 per 1000 athletic exposures (AE) during practices and 4.56 to 9.9 per 1000 AE during games. The aforementioned injury rates provide valuable information for sports medicine professionals and coaching staffs. However, many of the aforementioned studies do not provide injury rates based on injury mechanism, region of the body, or player demographics. HYPOTHESIS/ PURPOSE: The purpose of this study is two-fold. The first purpose of this study was to report lower quadrant (LQ = lower extremities and low back region) injury rates, per contact and non-contact mechanism of injury, for a cohort of male collegiate basketball (BB) players. The second purpose was to report injury risk based on prior history of injury, player position, and starter status. STUDY DESIGN: Prospective, descriptive, observational cohort. METHODS: A total of 95 male collegiate BB players (mean age 20.02 ± 1.68 years) from 7 teams (NCAA Division II = 14, NCAA Division III = 43, NAIA = 21, community college = 17) from the Portland, Oregon region were recruited during the 2016-2017 season to participate in this study. Each athlete was asked to complete an injury history questionnaire. The primary investigator collected the following information each week from each team's athletic trainer: athletic exposures (AE; 1 AE = game or practice) and injury updates. RESULTS: Thirty-three time-loss LQ injuries occurred during the study period. The overall time-loss injury rate was 3.4 per 1000 AE. Division III BB players had the highest rates of injury. There was no difference in injury rates between those with or without prior injury history. Guards had a significantly greater rate of non-contact time-loss injuries (p = 0.04). CONCLUSIONS: Guards experienced a greater rate of LQ injury than their forward/center counterparts. Starters and athletes with a prior history of injury were no more likely to experience a non-contact time-loss injury than nonstarters or those without a prior history of injury. These preliminary results are a novel presentation of injury rates and risk for this population and warrant continued investigation. LEVEL OF EVIDENCE: 2.