The relationship between isometric contraction durations during hold-relax stretching and improvement of hamstring flexibility.

AIM: Previous research suggests proprioceptive neuromuscular facilitation (PNF) stretching techniques produce greater increases in range of motion than static or ballistic. The purpose of this study was to determine the isometric contraction hold time that best produces gains in hip range of motion after a 3-s (3-HR), 6-second (6-HR), and 10-s (10-HR) hold-relax PNF stretch. METHODS: The experimental design was a within subjects repeated measures 2 factor (baseline and treatment) by 3 factor (3-HR, 6-HR, 10-HR) ANOVA. The dependent variable was hamstring flexibility as measured in degrees of passive hip flexion with the knee extended. Measurements were taken in a university athletic therapy clinic. Sixty active individuals without history of knee or hip injury volunteered for this study. Each subject was randomly assigned to a 3-HR, 6-HR, or 10-HR group for the hold-relax PNF stretch. All subjects were passively taken to the end range of motion 3 times and a goniometric measurement was taken. Each subject then performed the hold-relax PNF stretch 3 times with either a 3-HR, 6-HR, or 10-HR isometric contraction hold time and another goniometric measurement was taken. An average of each of these 3 trials was then calculated. RESULTS: The data analysis revealed a significant main effect difference (F(1,5 7)+/-633.97, p<.001, eta2=0.918) between the baseline and treatment measurements. There were no significant differences for the between groups (3-HR, 6-HR, 10-HR) main effect or for the interaction term. CONCLUSIONS: All 3 hold-time conditions produced significant gains in range of motion compared to baseline measurements. The application of the findings suggest that clinicians could choose any of the hold-times and produce the same result to patient hip joint flexibility.

Atraumatic osteochondral fracture and osteoarthritis in a collegiate volleyball player: a case report.

OBJECTIVE: To present the case of a collegiate athlete with an atraumatic osteochondral fracture influenced by the presence of osteoarthritis. BACKGROUND: Osteochondral fractures are fairly common occurrences in athletes, although it can be difficult to recognize such an injury in the absence of a traumatic event. Osteoarthritis is 1 condition that can increase an athlete's susceptibility to an atraumatic osteochondral fracture. However, because of the atraumatic nature of the injury, the possibility of an osteochondral fracture may be overlooked. DIFFERENTIAL DIAGNOSIS: Meniscal damage, osteochondritis dissecans, patellofemoral disorders. TREATMENT: The osteochondral fragment was surgically removed, and fibrous growth was encouraged by drilling and laser smoothing. UNIQUENESS: Osteochondral fractures are usually associated with some type of traumatic mechanism, such as a rotational and compressive force. Also, osteoarthritis is not common in young collegiate athletes. However, this 20-year-old volleyball player had no apparent injury and lacked the usual signs and symptoms (eg, locking, giving way, crepitus, loss of range of motion) associated with an osteochondral fracture. The athlete's susceptibility to an osteochondral fracture was increased by the presence of osteoarthritis. CONCLUSIONS: The athletic trainer should consider the possibility of an osteochondral fracture in an athlete with persistent effusion and pain in the absence of a traumatic mechanism of injury.

Aneurysmal bone cyst in a female collegiate field hockey player: a case report.

OBJECTIVE: To present the case of an intercollegiate field hockey player with an aneurysmal bone cyst of the femur and the clinical decision making necessary in the evaluation, management, surgical intervention, and positive outcome of this athlete. BACKGROUND: A 21-year-old field hockey player presented with signs and symptoms typical of a deep thigh contusion. She had no history of direct or indirect trauma, infection, or previous injury. DIFFERENTIAL DIAGNOSIS: Aneurysm, bone cyst, chondroma, giant cell tumor, osteochondroma, osteosarcoma, osteoid osteoma. TREATMENT: When her symptoms persisted beyond 6 months despite conservative care, she underwent radiographs, magnetic resonance imaging, and bone scan, which revealed a lesion in the right femur. At surgery, the lesion was diagnosed as an aneurysmal bone cyst, and it was excised by an incisional x-ray-guided biopsy followed by curettage and bone grafting. UNIQUENESS: The aneurysmal bone cyst presented as a typical thigh strain or deep contusion during the athlete's training and conditioning season. After all forms of conservative management proved ineffective, the athlete was referred to her physician. A detailed history and physical examination demonstrated no underlying musculoskeletal pathology coinciding with the athlete's symptoms. CONCLUSIONS: Increased clinical awareness is necessary when conservative management fails to resolve an athletic injury in an appropriate length of time. Proper diagnostic tools are essential in determining the pathology of the injury and whether surgical intervention is needed.