Effects of osteopathic manipulative treatment of the pivots on lower limb function in young professional football players.

INTRODUCTION: The most frequent injuries in professional soccer players are those pertinent to the lower limbs. In particular, strains of the hamstrings and ligamentous injuries of the knee. Therefore, preventive measures are aimed to reduce such events. We aimed to investigate if an osteopathic manipulative treatment (OMT) of the pivots could improve lower limb function in young professional football players. METHODS: Thirty-eight young male professional football players were recruited (mean age 17.8 ± 0.44 years). These were randomly assigned to an OMT or control group (n = 20 and 18, respectively). Both groups underwent osteopathic evaluation. A sit-and-reach test, a vertical jump test, a hand-grip strength test, a cervical ROM test and a balance evaluation were also performed. RESULTS: A significant improvement (p < 0.01) was observed between pre and post measures in the OMT for dysfunctional assessment of the pivots. However, only L3 and C2 also differed from the control group post evaluation (p < 0.0001). No differences were present for any functional measure in the control group. Only the sit-&-reach of the OMT increased significantly (p < 0.001). Static balance with open eyes in the OMT, but not in the control group, improved during post evaluation (p < 0.01). CONCLUSION: The OMT of the pivots was able to increase the sit-and-reach measure, improve postural control with open eyes and improve dysfunctional patterns of the lumbosacral and upper cervical spine in young professional football players.

The efficacy of muscle energy techniques in symptomatic and asymptomatic subjects: a systematic review.

Background: Muscle energy techniques are applied to reduce pain and increase range of motion. These are applied to a variety of pathological conditions and on asymptomatic subjects. There is however limited knowledge on their effectiveness and which protocol may be the most beneficial. Objective: The aim of this review is to determine the efficacy of muscle energy techniques (MET) in symptomatic and asymptomatic subjects. Design: Systematic Review. Methods: A literature search was performed using the following database: Cochrane Library, MEDLINE, NLM Pubmed and ScienceDirect. Studies regarding MET in asymptomatic and symptomatic patients were considered for investigation. The main outcomes took into account range of motion, chronic and acute pain and trigger points. Two trained investigators independently screened eligible studies according to the eligibility criteria, extracted data and assessed risk of bias. Randomized control trials (RCT's) were analyzed for quality using the PEDro scale. Results: A total of 26 studies were considered eligible and included in the quantitative synthesis: 14 regarding symptomatic patients and 12 regarding asymptomatic subjects. Quality assessment of the studies through the PEDro scale observed a "moderate to high" quality of the included records. Conclusions: MET are an effective treatment for reducing chronic and acute pain of the lower back. MET are also effective in treating chronic neck pain and chronic lateral epicondylitis. MET can be applied to increase range of motion of a joint when a functional limitation is present. Other techniques seem to be more appropriate compared to MET for trigger points.