Rehabilitation of Soft Tissue Injuries of the Hip and Pelvis.

The athlete's hip is complex when it comes to the surrounding musculature-approximately 21 different muscles can cross the hip and pelvis region, all synchronously working to maintain pelvic stability and functional hip activities. Commonly injured muscle groups for high-level athletes include flexors, adductors, abductors, and/or proximal hamstring musculotendinous complex. These muscle groups work in harmony; however, each has an independent function and propensity for injury. Rehabilitation phases for each injury group can be broken down into 3 phases: acute management, strengthening, and return-to-sport or return-to-competition phase. Specific rehabilitation principles and modalities are described for each injury group.

The Impact of an Ultrasound Curriculum on the Accuracy of Resident Joint Line Palpation.

BACKGROUND: Ultrasound education has been used as a tool to help improve physical examination skills. However, its utility in increasing accuracy of joint line palpation has yet to be investigated. OBJECTIVE: To evaluate the accuracy of resident palpation and identification of the lateral knee joint line before and after introducing a musculoskeletal ultrasound (MSUS) curriculum. DESIGN: Cohort study. SETTING: A physical medicine and rehabilitation (PM&R) residency program at an academic institution. PARTICIPANTS: Seventeen PM&R residents. INTERVENTIONS: Residents underwent a knee-focused MSUS workshop. MAIN OUTCOME MEASURES: Distance from needle placement to joint line confirmed with ultrasound. RESULTS: All residents demonstrated improved accuracy in lateral knee joint line palpation after completing a knee-focused MSUS workshop, with statistically significant (P < .05) improvement in postgraduate year (PGY) 2 (P = .02), PGY-3 (P = .04), and across all residents (P = .001). CONCLUSIONS: MSUS education significantly improved lateral knee joint line palpation accuracy in resident physicians.

Treatment of tendinopathies with platelet-rich plasma.

Pain and dysfunction related to tendinopathy are often refractory to traditional treatments and offer a unique challenge to physicians, because no gold standard treatment exists. Injectable biologics may represent a new modality in conjunction with a multifaceted treatment approach. Platelet-rich plasma (PRP) injections are not associated with the systemic or tendon degradation risks of corticosteroids or the inherent risks of surgery. Studies are promising but have not been replicated with high-powered evidence at the clinical level. Further evidence to expand understanding of the role of PRP in the treatment of tendinopathy is needed.