Tendons, Raideur Tissulaire, Prévention des Blessures & Charge ACWR

PURPOSE: We investigated the effects of seated versus prone leg curl training on hamstrings muscle hypertrophy and susceptibility to eccentric exercise-induced muscle damage. METHODS: Part 1: Twenty healthy adults conducted seated leg curl training with one leg (Seated-Leg) and prone with the other (Prone-Leg), at 70% one-repetition maximum (1RM), 10 repetitions per set, 5 sets per session, 2 sessions per week for 12 wk. Magnetic resonance imaging (MRI)-measured muscle volume of the individual and whole hamstrings was assessed pre- and posttraining. Part 2: Nineteen participants from part 1 and another 12 untrain…

Regimented resistance training (RT) has been shown to promote increases in muscle size. When engaging in RT, practitioners often emphasize the importance of appropriate exercise technique, especially when trying to maximize training adaptations (e.g., hypertrophy). This narrative review aims to synthesize existing evidence on what constitutes proper RT exercise technique for maximizing muscle hypertrophy, focusing on variables such as exercise-specific kinematics, contraction type, repetition tempo, and range of motion (ROM). We recommend that when trying to maximize hypertrophy, one should employ a ROM that emph…

Goto, M, Chikako, M, Hirayama, T, Terada, S, Nirengi, S, Kurosawa, Y, Nagano, A, and Hamaoka, T. Partial range of motion exercise is effective for facilitating muscle hypertrophy and function through sustained intramuscular hypoxia in young trained men. J Strength Cond Res 33(5): 1286-1294, 2019-The acute response to and long-term effects of partial range of motion exercise (PRE) and full range of motion exercise (FRE) of elbow extensors were compared in young trained men. The PRE was expected to increase the intramuscular hypoxic environment, which was theorized to enhance muscular hypertrophy. Forty-four resist…

One of the most striking adaptations to exercise is the skeletal muscle hypertrophy that occurs in response to resistance exercise. A large body of work shows that a mammalian target of rapamycin complex 1 (mTORC1)-mediated increase of muscle protein synthesis is the key, but not sole, mechanism by which resistance exercise causes muscle hypertrophy. While much of the hypertrophy signaling cascade has been identified, the initiating, resistance exercise-induced and hypertrophy-stimulating stimuli have remained elusive. For the purpose of this review, we define an initiating, resistance exercise-induced and hypert…

BACKGROUND: Maximizing the hypertrophic response to resistance training (RT) is thought to be best achieved by proper manipulation of exercise program variables including exercise selection, exercise order, length of rest intervals, intensity of maximal load, and training volume. An often overlooked variable that also may impact muscle growth is repetition duration. Duration amounts to the sum total of the concentric, eccentric, and isometric components of a repetition, and is predicated on the tempo at which the repetition is performed. OBJECTIVE: We conducted a systematic review and meta-analysis to determine w…

The present study compared two unilateral arm curl resistance exercise protocols with a different starting and finishing elbow joint angle in the same ROM for changes in elbow flexors strength and muscle thickness of the trained and non-trained arms. Thirty-two non-resistance trained young adults were randomly assigned to one of the three groups: extended joint training (0°-50°; EXT, n = 12); flexed joint training (80°-130°; FLE, n = 12); and non-training control (n = 8). The exercise training was performed by the dominant arms twice a week for 5 weeks with gradual increases in the training volume over 10 trainin…

Although the effects of short versus long inter-set rest intervals in resistance training on measures of muscle hypertrophy have been investigated in several studies, the findings are equivocal and the practical implications remain unclear. In an attempt to provide clarity on the topic, we performed a systematic literature search of PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, and Physiotherapy Evidence Database (PEDro) electronic databases. Six studies were found to have met the inclusion criteria: (a) an experimental trial published in an English-language peer-reviewed journal; (b) the study compar…

Manipulating joint range of motion during squat training may have differential effects on adaptations to strength training with implications for sports and rehabilitation. Consequently, the purpose of this study was to compare the effects of squat training with a short vs. a long range of motion. Male students (n = 17) were randomly assigned to 12 weeks of progressive squat training (repetition matched, repetition maximum sets) performed as either a) deep squat (0-120° of knee flexion); n = 8 (DS) or (b) shallow squat (0-60 of knee flexion); n = 9 (SS). Strength (1 RM and isometric strength), jump performance, mu…

The purpose of this study was to investigate the time course of changes in human tendon properties and metabolism during resistance training and detraining. Nine men (21-27 years) completed 3 months of isometric plantar flexion training and another 3 months of detraining. At the beginning and on every 1 month of training and detraining periods, the stiffness, blood circulation (blood volume and oxygen saturation), serum procollagen type 1 C-peptide (P1P; reflects synthesis of type 1 collagen), echointensity (reflects collagen content), and MRI signal intensity (reflects collagen structure) of the Achilles tendon …

Several lines of evidence support that dopaminergic neurotransmission plays a role in creative thought and behavior. Here, we investigated the relationship between creative ability and dopamine D2 receptor expression in healthy individuals, with a focus on regions where aberrations in dopaminergic function have previously been associated with psychotic symptoms and a genetic liability to schizophrenia. Scores on divergent thinking tests (Inventiveness battery, Berliner Intelligenz Struktur Test) were correlated with regional D2 receptor densities, as measured by Positron Emission Tomography, and the radioligands …

Here we report on the effect of combining endurance training with heavy or explosive strength training on endurance performance in endurance-trained runners and cyclists. Running economy is improved by performing combined endurance training with either heavy or explosive strength training. However, heavy strength training is recommended for improving cycling economy. Equivocal findings exist regarding the effects on power output or velocity at the lactate threshold. Concurrent endurance and heavy strength training can increase running speed and power output at VO2max (Vmax and Wmax, respectively) or time to exhau…

BACKGROUND: A number of resistance training (RT) program variables can be manipulated to maximize muscular hypertrophy. One variable of primary interest in this regard is RT frequency. Frequency can refer to the number of resistance training sessions performed in a given period of time, as well as to the number of times a specific muscle group is trained over a given period of time. OBJECTIVE: We conducted a systematic review and meta-analysis to determine the effects of resistance training frequency on hypertrophic outcomes. METHODS: Studies were deemed eligible for inclusion if they met the following criteria: …

Brandão, L, de Salles Painelli, V, Lasevicius, T, Silva-Batista, C, Brendon, H, Schoenfeld, BJ, Aihara, AY, Cardoso, FN, de Almeida Peres, B, and Teixeira, EL. Varying the order of combinations of single- and multi-joint exercises differentially affects resistance training adaptations. J Strength Cond Res 34(5): 1254-1263, 2020-Our study aimed to compare the effects of multi-joint (MJ) and single-joint (SJ) exercises, either isolated or in combination, and in different orders, on cross-sectional area (CSA) of the pectoralis major (PM) and different heads of the triceps brachii (TB), as well as on the one-repetiti…

Longo, AR, Silva-Batista, C, Pedroso, K, de Salles Painelli, V, Lasevicius, T, Schoenfeld, BJ, Aihara, AY, de Almeida Peres, B, Tricoli, V, and Teixeira, EL. Volume load rather than resting interval influences muscle hypertrophy during high-intensity resistance training. J Strength Cond Res 36(6): 1554-1559, 2022-Interset rest interval has been proposed as an important variable for inducing muscle mass and strength increases during resistance training. However, its influence remains unclear, especially when protocols with differing intervals have equalized volume. We aimed to compare the effects of long (LI) vs. …

This study aimed to evaluate the inter-rater and intra-rater reliability of a weight-bearing dorsiflexion (DF) lunge in 13 healthy subjects. Our raters with varying clinical experience tested all subjects in random order. Two of the raters repeated the measurements one week later. Two methods were used to assess the DF lunge: (i) the distance from the great toe to the wall and (ii) the angle between the tibial shaft and the vertical using an inclinometer. The average of three trials was used in data analysis. Intra-rater intraclass correlation coefficients (iccs) ranged from 0.97 to 0.98. Inter-rater ICC values w…

It has been suggested that deep squats could cause an increased injury risk of the lumbar spine and the knee joints. Avoiding deep flexion has been recommended to minimize the magnitude of knee-joint forces. Unfortunately this suggestion has not taken the influence of the wrapping effect, functional adaptations and soft tissue contact between the back of thigh and calf into account. The aim of this literature review is to assess whether squats with less knee flexion (half/quarter squats) are safer on the musculoskeletal system than deep squats. A search of relevant scientific publications was conducted between Ma…

PURPOSE: Acute high-intensity unaccustomed eccentric exercise performed by naive subjects is accompanied by disturbances in muscle damage biomarkers. The aim of the study was to investigate whether a causal relationship indeed exists between eccentric exercise and muscle damage. METHODS: Twenty-four men randomly assigned into a concentric only or an eccentric-only training group and performed 10 weeks of isokinetic resistance exercise (one session/week of 75 maximal knee extensors actions). Physiological markers of muscle function and damage (i.e., range of motion, delayed onset muscle soreness, isometric, concen…

BACKGROUND: Weight-training sports, including weightlifting, powerlifting, bodybuilding, strongman, Highland Games, and CrossFit, are weight-training sports that have separate divisions for males and females of a variety of ages, competitive standards, and bodyweight classes. These sports may be considered dangerous because of the heavy loads commonly used in training and competition. OBJECTIVES: Our objective was to systematically review the injury epidemiology of these weight-training sports, and, where possible, gain some insight into whether this may be affected by age, sex, competitive standard, and bodyweig…

INTRODUCTION: The benefits of preexercise muscle stretching have been recently questioned after reports of significant poststretch reductions in force and power production. However, methodological issues and equivocal findings have prevented a clear consensus being reached. As no detailed systematic review exists, the literature describing responses to acute static muscle stretch was comprehensively examined. METHODS: MEDLINE, ScienceDirect, SPORTDiscus, and Zetoc were searched with recursive reference checking. Selection criteria included randomized or quasi-randomized controlled trials and intervention-based tr…

PURPOSE: To review the principles of neural plasticity and make recommendations for research on the neural bases for rehabilitation of neurogenic speech disorders. METHOD: A working group in speech motor control and disorders developed this report, which examines the potential relevance of basic research on the brain mechanisms involved in neural plasticity and discusses possible similarities and differences for application to speech motor control disorders. The possible involvement of neural plasticity in changes in speech production in normalcy, development, aging, and neurological diseases and disorders was co…

BACKGROUND: Numerous antioxidant and anti-inflammatory agents have been identified in tart cherries. OBJECTIVE: To test the efficacy of a tart cherry juice blend in preventing the symptoms of exercise induced muscle damage. METHODS: This was a randomised, placebo controlled, crossover design. Fourteen male college students drank 12 fl oz of a cherry juice blend or a placebo twice a day for eight consecutive days. A bout of eccentric elbow flexion contractions (2 x 20 maximum contractions) was performed on the fourth day of supplementation. Isometric elbow flexion strength, pain, muscle tenderness, and relaxed elb…

This study was planned to investigate the influence of sports background on leg muscle coordination during vertical jumps (concentric and drop jumps). Five different athlete groups were chosen as subjects: jumpers in athletics, swimmers, soccer players and poor and good vertical jumpers. Motor versatility was used as an additional inclusion criterion. Interest centred on the comparison of two different movement models: the jumping model (jumpers) and the kicking model (swimmers). The jumpers performed the most powerful vertical jumps. Proportional IEMG activity showed that their catapult innervation did not follo…

Hypertrophy and strength are two common long-term goals of resistance training that are mediated by the manipulation of numerous variables. One training variable that is often neglected but is essential to consider for achieving strength and hypertrophy gains is the movement tempo of particular repetitions. Although research has extensively investigated the effects of different intensities, volumes, and rest intervals on muscle growth, many of the present hypertrophy guidelines do not account for different movement tempos, likely only applying to volitional movement tempos. Changing the movement tempo during the …

The moment arm of a muscle represents its leverage or torque-producing capacity, and is indicative of the role of the muscle in joint actuation. The objective of this study was to undertake a systematic review of the moment arms of the major muscles spanning the glenohumeral joint during abduction, flexion and axial rotation. Moment arm data for the deltoid, pectoralis major, latissimus dorsi, teres major, supraspinatus, infraspinatus, subscapularis and teres minor were reported when measured using the geometric and tendon excursion methods. The anterior and middle sub-regions of the deltoid had the largest humer…

Thirty-four untrained women participated in a 6-week program to investigate slow-speed versus "normal" speed resistance-training protocols. Subjects were divided into: slow-speed (SS), normal-speed/traditional-strength (TS), normal-speed/traditional muscular endurance (TE), and non-exercising control (C) groups. Leg press, squats, and knee extensions were performed 2 days/week for the first week and 3 days/week for the remaining 5 weeks (~2 min rest). The SS group performed 6-10 repetitions maximum (6-10RM) for each set with 10 s concentric (con) and 4 s eccentric (ecc) contractions. The TS and TE groups performe…

PURPOSE: Recent studies have found age-related BOLD signal changes in several areas of the human brain. We investigated whether such changes also occur in brain areas involved in the processing of motor action observation and imagery. METHODS: Functional magnetic resonance imaging with an experimental paradigm in which motor acts had to be observed and/or imagined from a first person perspective was performed in twenty-six subjects. RESULTS: In line with previous work action observation and imagery induced BOLD signal increases in similar areas, predominantly in the premotor and parietal cortex. In contrast to yo…

Creatine is one of the most popular nutritional ergogenic aids for athletes. Studies have consistently shown that creatine supplementation increases intramuscular creatine concentrations which may help explain the observed improvements in high intensity exercise performance leading to greater training adaptations. In addition to athletic and exercise improvement, research has shown that creatine supplementation may enhance post-exercise recovery, injury prevention, thermoregulation, rehabilitation, and concussion and/or spinal cord neuroprotection. Additionally, a number of clinical applications of creatine suppl…

INTRODUCTION: The hamstring muscles play a crucial role in sprint running but are also highly susceptible to strain injuries, particularly within the biceps femoris long head (BFlh). This study compared the adaptations in muscle size and strength of the knee flexors, as well as BFlh muscle and aponeurosis size, after two eccentrically focused knee flexion training regimes: Nordic hamstring training (NHT) vs lengthened state eccentric training (LSET, isoinertial weight stack resistance in an accentuated hip-flexed position) vs habitual activity (no training controls: CON). METHODS: Forty-two healthy young males co…

Isometric training is used in the rehabilitation and physical preparation of athletes, special populations, and the general public. However, little consensus exists regarding training guidelines for a variety of desired outcomes. Understanding the adaptive response to specific loading parameters would be of benefit to practitioners. The objective of this systematic review, therefore, was to detail the medium- to long-term adaptations of different types of isometric training on morphological, neurological, and performance variables. Exploration of the relevant subject matter was performed through MEDLINE, PubMed, …

BACKGROUND: Few interventions reduce patellar tendinopathy (PT) pain in the short term. Eccentric exercises are painful and have limited effectiveness during the competitive season. Isometric and isotonic muscle contractions may have an immediate effect on PT pain. METHODS: This single-blinded, randomised cross-over study compared immediate and 45 min effects following a bout of isometric and isotonic muscle contractions. Outcome measures were PT pain during the single-leg decline squat (SLDS, 0-10), quadriceps strength on maximal voluntary isometric contraction (MVIC), and measures of corticospinal excitability …

UNLABELLED: Soft tissue injuries of the hip and pelvis are common among athletes and can result in significant time loss from sports participation. Rehabilitation of athletes with injuries such as adductor strain, iliopsoas syndrome, and gluteal tendinopathy starts with identification of known risk factors for injury and comprehensive evaluation of the entire kinetic chain. Complex anatomy and overlapping pathologies often make it difficult to determine the primary cause of the pain and dysfunction. The purpose of this clinical commentary is to present an impairment-based, stepwise progression in evaluation and t…

The influence of icing on muscle regeneration after crush injury was examined in the rat extensor digitorum longus. After the injury, animals were randomly divided into nonicing and icing groups. In the latter, ice packs were applied for 20 min. Due to the icing, degeneration of the necrotic muscle fibers and differentiation of satellite cells at early stages of regeneration were retarded by ∼1 day. In the icing group, the ratio of regenerating fibers showing central nucleus at 14 days after the injury was higher, and cross-sectional area of the muscle fibers at 28 days was evidently smaller than in the nonicing …

Intense exercise is directly related to muscular damage and oxidative stress due to excessive reactive oxygen species (ROS) in both, plasma and white blood cells. Nevertheless, exercise-derived ROS are essential to regulate cellular adaptation to exercise. Studies on antioxidant supplements have provided controversial results. The purpose of this study was to determine the effect of moderate antioxidant supplementation (lemon verbena extract) in healthy male volunteers that followed a 90-min running eccentric exercise protocol for 21 days. Antioxidant enzymes activities and oxidative stress markers were measured …

A randomized-controlled single-blind trial was conducted to investigate the clinical, structural and functional effects of peritendinous corticosteroid injections (CORT), eccentric decline squat training (ECC) and heavy slow resistance training (HSR) in patellar tendinopathy. Thirty-nine male patients were randomized to CORT, ECC or HSR for 12 weeks. We assessed function and symptoms (VISA-p questionnaire), tendon pain during activity (VAS), treatment satisfaction, tendon swelling, tendon vascularization, tendon mechanical properties and collagen crosslink properties. Assessments were made at 0 weeks, 12 weeks an…

Myostatin, a negative regulator of muscle growth, has recently been found to be expressed in tendons. Myostatin-deficient mice have weak and brittle tendons, which suggest that myostatin could be important for tendon maintenance. Follistatin expression in the callus tissue after tendon transection is influenced by loading. We found that follistatin antagonises myostatin, but not GDF-5 or OP-1 in vitro. To study if myostatin might play a physiological role in soft tissue, we transected 64 rat Achilles tendons and studied the gene expression for myostatin and its receptors at four different time-points during heali…

Strength and flexibility are common components of exercise programmes; however, it is not clear how best to include both of these elements in a single training programme. It is common practice among athletes, coaches and recreational exercisers to perform a stretching routine before a strength training session. Stretching exercises are regularly recommended, even in many textbooks, with the claimed purpose of preventing injury and muscle soreness, or even enhancing performance. However, as highlighted in recent review articles, this recommendation lacks scientific evidence. Thus, the purpose of the present review…

We investigated the acute and long-term effects of low-intensity resistance exercise (knee extension) with slow movement and tonic force generation on muscular size and strength. This type of exercise was expected to enhance the intramuscular hypoxic environment that might be a factor for muscular hypertrophy. Twenty-four healthy young men without experience of regular exercise training were assigned into three groups (n = 8 for each) and performed the following resistance exercise regimens: low-intensity [ approximately 50% of one-repetition maximum (1RM)] with slow movement and tonic force generation (3 s for e…

OBJECTIVE: To demonstrate the response to a proprioceptive training model during a 1-week rehabilitation regime. The techniques were demonstrated on a college-aged female basketball player who had injured her anterior cruciate ligament (ACL) several weeks earlier. The athlete was tested, trained, and then retested during her semester break. BACKGROUND: The ACL injury has become a fairly common occurrence in the world of athletics. Knowing this, the athletic trainer is constantly searching for ways to improve the rehabilitative process. New research demonstrates that rehabilitation should be based on proprioceptio…

OBJECTIVE: To determine injury types, natures, anatomical locations, recommended amount of time missed, and injury rates during weightlifting training. DESIGN AND SETTING: We collected and analyzed medical injury records of resident athletes and during numerous training camps to generate an injury profile. SUBJECTS: Elite US male weightlifters who were injured during training at the United States Olympic Training Centers. MEASUREMENTS: United States Olympic Training Center weightlifting injury reports from a 6-year period were analyzed. Data were expressed as percentages and were analyzed via x(2) tests. RESULTS:…

The instantaneous muscle moment arms of 10 shoulder muscles including the three portions of the deltoid and the rotator cuff and scapulohumeral muscle groups during four specified glenohumeral motions were calculated. Moment arm values were derived from a plot of tendon excursion versus glenohumeral joint rotation angle during horizontal flexion along the 90 degrees elevation plane and elevation in the sagittal, scapular, and coronal planes. The deltoid had the largest moment arm in elevation. The anterior deltoid has a larger moment arm in the anterior planes, whereas the midportion is greater in the scapular an…

Rat casein components (C1-, C3A-, C3B- and C4-casein) were extensively purified from rat milk, and the properties of these proteins were compared with those of other caseins including rat C2-casein. C1-casein was precipitated by a low concentration of CaCl2 (1.5 mM). Both C3A- and C3B-casein were less sensitive to Ca2+ than were C1- and C2-casein, and the presence of 20 mM CaCl2 was required at 37 degrees C for their precipitation. C4-casein was absolutely insensitive to Ca2+. This protein exhibited the ability to stabilize all of the other rat casein components against Ca2+-dependent precipitation. In addition, …

Maximal strength measured via maximal voluntary contraction is known as a key factor in competitive sports performance as well as injury risk reduction and rehabilitation. Maximal strength and hypertrophy are commonly trained by performing resistance training programs. However, literature shows that long-term, long-lasting static stretching interventions can also produce significant improvements in maximal voluntary contraction. The aim of this study is to compare increases in maximal voluntary contraction, muscle thickness and flexibility after 6 weeks of stretch training and conventional hypertrophy training. S…

KEY POINTS: Skeletal muscle stem cells (satellite cells) play a crucial role in repair and remodelling of muscle in response to exercise. Satellite cells are in close spatial proximity to muscle capillaries and therefore may be influenced by them. In this study, we describe the activation and expansion of the satellite cell pool in response to eccentric contraction-induced muscle damage in individuals with significantly different levels of muscle capillarization. Individuals with greater capillarization and capacity for muscle perfusion demonstrated enhanced activation and/or expansion of the satellite cell pool …

The pathogenesis of tendinopathy and the primary biological change in the tendon that precipitates pathology have generated several pathoaetiological models in the literature. The continuum model of tendon pathology, proposed in 2009, synthesised clinical and laboratory-based research to guide treatment choices for the clinical presentations of tendinopathy. While the continuum has been cited extensively in the literature, its clinical utility has yet to be fully elucidated. The continuum model proposed a model for staging tendinopathy based on the changes and distribution of disorganisation within the tendon. Ho…

Despite little objective support, heel-raise exercises are commonly performed using varying foot positions in an attempt to alter medial (MG) and lateral (LG) gastrocnemius involvement. This investigation compared MG and LG activation during the concentric phase (CP) and eccentric phase (EP) of the heel-raise exercise using neutral (NE), internally rotated (IR), and externally rotated (ER) foot positions. Twenty healthy subjects (10 men, 10 women; age = 23.7 ± 3.1 years) with resistance training experience performed free-weight (130-135% body mass) heel-raise exercise on a 3.81-cm block. Surface electromyography …

Abstract Cadence is one of the only variables cyclists can adjust to manage their performance and fatigue during an event. Not surprisingly, cadence has received a great deal of attention from the scientific community in an effort to identify the cadence that optimizes power output while minimizing the fatigue that is incurred. The literature appears to present conflicting results with little consensus as regards the optimal pedalling cadence. This is in large part due to the inconsistent definition of the term “optimal” cadence, which has been used to describe energetic cost, muscular stress, and perception of e…

In the literature, numerous statistical analyses are used to quantify asymmetry in gait. This study tested the effect size (ES) statistic for quantifying asymmetry in nondisabled and pathological populations. The plantar pressure peaks on eight footprint locations of 27 nondisabled subjects and 18 patients with hemiparesis were bilaterally compared. Asymmetry quantifications were performed with ES and standard statistical tests (index of asymmetry, symmetry index, and ratio index). The results show an advantage in using ES to quantify asymmetry when confidence limits are also calculated. Conversely, traditional a…

This study aimed at investigating the effects of different hand positions on the electromyographic (EMG) activity of shoulder muscles during the performance of the lat pull-down exercise. Ten healthy men performed 3 repetitions of the lat pull-down exercise using their experimentally determined 10RM (repetition maximum) weight. Four different common variations of the lat pull-down were used: close grip (CG), supinated grip (SG), wide grip anterior (WGA), and wide grip posterior (WGP). Normalized root mean square of the EMG (NrmsEMG) activity for the right posterior deltoid (PD), latissimus dorsi (LD), pectoralis …

This study investigated the relationship between delayed-onset muscle soreness and other indicators of muscle damage following eccentric exercise. Male students (n = 110) performed 12 (12ECC), 24 (24ECC), or 60 maximal eccentric actions of the elbow flexors (60ECC). Maximal isometric force, relaxed and flexed elbow joint angles, upper arm circumference, and plasma creatine kinase activity were assessed immediately before and after, and for 4 days after exercise. Muscle soreness (SOR) was evaluated by a visual analog scale (a 50-mm line, 0: no pain, 50: extremely painful) when the elbow flexors were palpated (SOR-…

OBJECTIVES: To determine in patients with acute respiratory distress syndrome (ARDS) on venovenous extracorporeal membrane oxygenation (VV ECMO) whether reducing driving pressure (ΔP) would decrease plasma biomarkers of inflammation and lung injury (interleukin-6 [IL-6], IL-8, and the soluble receptor for advanced glycation end-products sRAGE). DESIGN: A single-center prospective physiologic study. SETTING: At a single university medical center. PARTICIPANTS: Adult patients with severe COVID-19 ARDS on VV ECMO. INTERVENTIONS: Participants on VV ECMO had the following biomarkers measured: (1) pre-ECMO with low-tid…

Anterior cruciate ligament injuries are a prominent issue in the field of sports medicine, especially for the female athlete. Extensive research has been performed that acknowledges the disparity in anterior cruciate ligament injury rates between male and female athletes and the high prevalence of risk factors specific to females. The underlying causes of anterior cruciate ligament injuries are widespread and are important to consider when approaching injury prevention. For example, prevention techniques aim to correct neuromuscular imbalances and improve biomechanical deficits, which are some of the most signifi…

AIM: This study characterised the decoupling of internal-to-external workload in marathon running and investigated whether decoupling magnitude and onset could improve predictions of marathon performance. METHODS: The decoupling of internal-to-external workload was calculated in 82,303 marathon runners (13,125 female). Internal workload was determined as a percentage of maximum heart rate, and external workload as speed relative to estimated critical speed (CS). Decoupling magnitude (i.e., decoupling in the 35-40 km segment relative to the 5-10 km segment) was classified as low (< 1.1), moderate (≥ 1.1 but < 1.2)…

BACKGROUND: Athletes maintain a balance between stress and recovery and adopt recovery modalities that manage fatigue and enhance recovery and performance. Optimal TST is subject to individual variance. However, 7-9 h sleep is recommended for adults, while elite athletes may require more quality sleep than non-athletes. METHODS: A total of 338 (elite n = 115, 74 males and 41 females, aged 23.44 ± 4.91 years; and sub-elite n = 223, 129 males and 94 females aged 25.71 ± 6.27) athletes were recruited from a variety of team and individual sports to complete a battery of previously validated and reliable widely used q…

BACKGROUND: Central arterial stiffness and brain hypoperfusion are emerging risk factors of Alzheimer's disease (AD). Aerobic exercise training (AET) may improve central arterial stiffness and brain perfusion. OBJECTIVE: To investigate the effects of AET on central arterial stiffness and cerebral blood flow (CBF) in patients with amnestic mild cognitive impairment (MCI), a prodromal stage of AD. METHODS: This is a proof-of-concept, randomized controlled trial that assigned 70 amnestic MCI patients into a 12-month program of moderate-to-vigorous AET or stretching-and-toning (SAT) intervention. Carotid β-stiffness …

OBJECTIVE: Hallux valgus, the lateral deviation of the great toe, can result in poor balance, impaired mobility and is an independent risk factor for falls. This research aims to compare the prevalence of hallux valgus in subpopulations of medieval Cambridge, England, and to examine the relationship between hallux valgus and fractures to examine the impact of impaired mobility and poor balance caused by this condition. MATERIALS: 177 adult individuals from four cemeteries located in Cambridge, England. METHODS: Human remains were macroscopically and radiographically assessed. RESULTS: Hallux valgus was identified…

Active exoskeletons are promising devices for improving rehabilitation procedures in patients and preventing musculoskeletal disorders in workers. In particular, exoskeletons implementing human limb's weight support are interesting to restore some mobility in patients with muscle weakness and help in occupational load carrying tasks. The present study aims at improving weight support of the upper limb by providing a weight model considering joint misalignments and a control law including feedforward terms learned from a prior population-based analysis. Three experiments, for design and validation purposes, are co…

The impact of a carbohydrate-electrolyte solution with sodium alginate and pectin for hydrogel formation (CES-HGel), was compared to a standard CES with otherwise matched ingredients (CES-Std), for blood glucose, substrate oxidation, gastrointestinal symptoms (GIS; nausea, belching, bloating, pain, regurgitation, flatulence, urge to defecate, and diarrhea), and exercise performance. Nine trained male endurance runners completed 3 hr of steady-state running (SS) at 60% V˙O2max, consuming 90 g/hr of carbohydrate from CES-HGel or CES-Std (53 g/hr maltodextrin, 37 g/hr fructose, 16% w/v solution) in a randomized cros…

BACKGROUND: Athletes commonly consume insufficient fluid and electrolytes just prior to, or during training and competition. Unlike non-athletes or athletes who do not engage in frequent rigorous and prolonged training sessions, "hard trainers" may require additional sodium and better benefit from a hydration plan tailored to their individual physiology. The purpose of this randomized cross-over study was to determine whether a hydration plan based off of an athlete's sweat rate and sodium loss improves anaerobic and neurocognitive performance during a moderate to hard training session as well as heart rate recov…

Contusion injuries in skeletal muscle commonly occur in contact sport and vehicular and industrial workplace accidents. Icing has traditionally been used to treat such injuries under the premise that it alleviates pain, reduces tissue metabolism, and modifies vascular responses to decrease swelling. Previous research has examined the effects of icing on inflammation and microcirculatory dynamics following muscle injury. However, whether icing influences angiogenesis, collateral vessel growth, or myofiber regeneration remains unknown. We compared the effects of icing vs. a sham treatment on the presence of neutrop…

This investigation sought to determine the effect of resistance training to failure on functional, structural and neural elbow flexor muscle adaptation. Twenty-eight males completed a 4-week familiarization period and were then counterbalanced on the basis of responsiveness across; non-failure rapid shortening (RS; rapid concentric, 2 s eccentric), non-failure stretch-shortening (SSC; rapid concentric, rapid eccentric), and failure control (C, 2 s concentric, 2 s eccentric), for a 12-week unilateral elbow flexor resistance training regimen, 3 × week using 85% of one repetition maximum (1RM). 1RM, maximal voluntar…

STUDY DESIGN: Evaluation of a new quantitative imaging technique in a prospective study design. OBJECTIVE: To assess glycosaminoglycan (GAG) content of lumbar intervertebral discs (IVDs) in healthy volunteers with chemical exchange saturation transfer (CEST). SUMMARY OF BACKGROUND DATA: Biochemical alterations of lumbar discs are present before the appearance of morphological changes. GAG loss plays a central role in these degenerative processes. METHODS: Lumbar intervertebral discs of healthy controls (26 women, 22 men; mean age 31 ± 8 years; range: 21-49 years) without lumbar back pain were examined at a 3 Tesl…

Recently, there has been a shift from static stretching (SS) or proprioceptive neuromuscular facilitation (PNF) stretching within a warm-up to a greater emphasis on dynamic stretching (DS). The objective of this review was to compare the effects of SS, DS, and PNF on performance, range of motion (ROM), and injury prevention. The data indicated that SS- (-3.7%), DS- (+1.3%), and PNF- (-4.4%) induced performance changes were small to moderate with testing performed immediately after stretching, possibly because of reduced muscle activation after SS and PNF. A dose-response relationship illustrated greater performan…

OBJECTIVE: The aim of the present study was to investigate the impact of sleep on osteoporosis. METHODS: The study used a baseline examination of the Hiroshima Sleep and Healthcare study, which was a cross-sectional and cohort study that addressed the association of sleep habits with lifestyle-related diseases. A total of 1032 participants (25-85 years of age) who underwent health examinations were included. Sleep habits, including its timing (bed time), quantity (time in bed [TIB]), and quality, were assessed using the Pittsburgh Sleep Quality Index (PSQI). The bone stiffness index (SI), a marker of osteoporosis…

BACKGROUND: Jump landing is a complex movement in sports. While competing and practicing, athletes frequently perform multi-planar jump landing. Anticipatory muscle activity could influence the amount of knee flexion and prepare the knee for dynamic weight bearing such as landing tasks. OBJECTIVES: The aim of the present study was to examine knee muscle function and knee flexion excursion as athletes naturally performed multi-direction jump landing. MATERIALS AND METHODS: Eighteen male athletes performed the jump-landing test in four directions: forward (0°), 30° diagonal, 60° diagonal, and lateral (90°). Muscles…

OBJECTIVE: Individuals frequently involved in jumping, pivoting or cutting are at increased risk of knee injury, including anterior cruciate ligament (ACL) tears. We sought to use meta-analytic techniques to establish whether neuromuscular and proprioceptive training is efficacious in preventing knee and ACL injury and to identify factors related to greater efficacy of such programs. METHODS: We performed a systematic literature search of studies published in English between 1996 and 2014. Intervention efficacy was ascertained from incidence rate ratios (IRRs) weighted by their precision (1/variance) using a rand…

Synopsis The hallmark features of patellar tendinopathy are (1) pain localized to the inferior pole of the patella and (2) load-related pain that increases with the demand on the knee extensors, notably in activities that store and release energy in the patellar tendon. While imaging may assist in differential diagnosis, the diagnosis of patellar tendinopathy remains clinical, as asymptomatic tendon pathology may exist in people who have pain from other anterior knee sources. A thorough examination is required to diagnose patellar tendinopathy and contributing factors. Management of patellar tendinopathy should f…

Running economy (RE) represents a complex interplay of physiological and biomechanical factors that is typically defined as the energy demand for a given velocity of submaximal running and expressed as the submaximal oxygen uptake (VO2) at a given running velocity. This review considered a wide range of acute and chronic interventions that have been investigated with respect to improving economy by augmenting one or more components of the metabolic, cardiorespiratory, biomechanical or neuromuscular systems. Improvements in RE have traditionally been achieved through endurance training. Endurance training in runne…

The lat pull-down is one of the most popular compound back exercises. Still, it is a general belief that a wider grip activates the latissimus dorsi more than a narrow one, but without any broad scientific support. The aim of the study was to compare 6 repetition maximum (6RM) load and electromyographic (EMG) activity in the lat pull-down using 3 different pronated grip widths. Fifteen men performed 6RM in the lat pull-down with narrow, medium, and wide grips (1, 1.5, and 2 times the biacromial distance) in a randomized and counterbalanced order. The 6RM strengths with narrow (80.3 ± 7.2 kg) and medium grip (80 ±…

[Rudavsky A, Cook J (2014) Physiotherapy management of patellar tendinopathy (jumper's knee). Journal of Physiotherapy 60: 122–129]

Exhaustive resistance training programs that have been previously referred to as extreme conditioning protocols have increased in popularity in military and civilian populations in recent years. However, because of their highly fatiguing nature, proprioception is likely altered during such programs that would significantly affect the safety and efficacy of such programs. Therefore, the purpose of this study was to assess the alterations in movement patterns that result from extreme conditioning protocols and to evaluate if these protocols can be deemed safe and effective. Twelve men (age 24 ± 4.2 years, height 17…

Fundamental movement competency is essential for participation in physical activity and for mitigating the risk of injury, which are both key elements of health throughout life. The squat movement pattern is arguably one of the most primal and critical fundamental movements necessary to improve sport performance, to reduce injury risk and to support lifelong physical activity. Based on current evidence, this first (1 of 2) report deconstructs the technical performance of the back squat as a foundation training exercise and presents a novel dynamic screening tool that incorporates identification techniques for fun…

The purpose of this investigation was conducted to determine the acute effect of passive static stretching (PSS) of the lower-body musculature on lower-body strength in a 1 repetition maximum (1RM) squat exercise in young (18-24 years.) moderately trained men (n = 17). Two supervised warm-up treatments were applied before each performance testing session using a counterbalanced design on nonconsecutive days. The first treatment consisted of an active dynamic warm-up (AD) with resistance machines (i.e., leg extension/leg flexion) and free weights (i.e., barbell squat), whereas the second treatment added PSS of the…

Previous studies showed that the insertion of the intramuscular tendons of the deltoid muscle formed three discrete lines. The purpose of the present study was to establish a new dividing method of the deltoid muscle into various anatomical segments based on the distribution of the intramuscular tendons with their insertions (anatomical study). We further hoped to clarify the relationship between the anatomical segments and their activity pattern assessed by positron emission tomography with [¹⁸F]-2-fluoro-deoxyglucose (FDG-PET; PET study). Sixty cadaveric shoulders were investigated in the anatomical study. Thre…

An objective of a warm-up prior to an athletic event is to optimize performance. Warm-ups are typically composed of a submaximal aerobic activity, stretching and a sport-specific activity. The stretching portion traditionally incorporated static stretching. However, there are a myriad of studies demonstrating static stretch-induced performance impairments. More recently, there are a substantial number of articles with no detrimental effects associated with prior static stretching. The lack of impairment may be related to a number of factors. These include static stretching that is of short duration (<90 s total) …

BACKGROUND: The impetus for the use of patellar straps in the treatment of patellar tendinopathy has largely been based on empirical evidence and not on any mechanistic rationale. A computational model suggests that patellar tendinopathy may be a result of high localized tendon strains that occur at smaller patella-patellar tendon angles (PPTAs). HYPOTHESIS: Infrapatellar straps will decrease the mean localized computational strain in the area of the patellar tendon commonly involved in jumper's knee by increasing the PPTA. STUDY DESIGN: Controlled laboratory study. METHODS: Twenty adult males had lateral weightb…

Stretching is commonly practiced before sports participation; however, effects on subsequent performance and injury prevention are not well understood. There is an abundance of literature demonstrating that a single bout of stretching acutely impairs muscle strength, with a lesser effect on power. The extent to which these effects are apparent when stretching is combined with other aspects of a pre-participation warm-up, such as practice drills and low intensity dynamic exercises, is not known. With respect to the effect of pre-participation stretching on injury prevention a limited number of studies of varying q…

Wearing high heels (HH) places the calf muscle-tendon unit (MTU) in a shortened position. As muscles and tendons are highly malleable tissues, chronic use of HH might induce structural and functional changes in the calf MTU. To test this hypothesis, 11 women regularly wearing HH and a control group of 9 women were recruited. Gastrocnemius medialis (GM) fascicle length, pennation angle and physiological cross-sectional area (PCSA), the Achilles' tendon (AT) length, cross-sectional area (CSA) and mechanical properties, and the plantarflexion torque-angle and torque-velocity relationships were assessed in both group…

Chronic tendinopathy is a common musculoskeletal disorder that frequently affects athletes who train and compete at all levels. This Clinical Commentary presents a review of the etiology, incidence, and contributory factors related specifically to patellar tendinopathy. Examination and differential diagnosis considerations are provided, and an evidence-based, staged rehabilitation program is described.

CONTEXT: An in-season groin injury may be debilitating for the athlete. Proper diagnosis and identification of the pathology are paramount in providing appropriate intervention. Furthermore, an adductor strain that is treated improperly can become chronic and career threatening. Any one of the 6 muscles of the adductor muscle group can be involved. The degree of injury can range from a minor strain (grade 1), where minimal playing time is lost, to a severe strain (grade 3), in which there is complete loss of muscle function. Persistent groin pain and muscle imbalance may lead to athletic pubalgia. EVIDENCE ACQUIS…

The effects of static stretch on muscle and tendon mechanical properties and muscle activation were studied in fifteen healthy human volunteers. Peak active and passive moment data were recorded during plantar flexion trials on an isokinetic dynamometer. Electromyography (EMG) monitoring of the triceps surae muscles, real-time motion analysis of the lower leg, and ultrasound imaging of the Achilles-medial gastrocnemius muscle-tendon junction were simultaneously conducted. Subjects performed three 60-s static stretches before being retested 2 min and 30 min poststretch. There were three main findings in the presen…