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Piriformis syndrome (PS) is a neuromuscular condition caused by the entrapment of the sciatic nerve at the level of the piriformis muscle (PM) and can cause significant discomfort and disability.PS is often misdiagnosed due to its overlapping symptoms with other lumbar and sciatic issues, and, as such, diagnosing PS remains challenging despite recent invasive and non-invasive diagnostic methods. Diagnostic musculoskeletal ultrasound (MSK US) offers a non-invasive, cost-effective alternative for the identification and evaluation of PS, providing dynamic, realtime imaging of the PM and adjacent structures. This article reviews the applications, advantages, and procedural insights of MSK US in the diagnosis of PS, emphasizing its relevance in rehabilitation settings. We discuss the technical aspects of ultrasound use, interpretation of findings, and integration into clinical practice, aiming to enhance the diagnostic accuracy and therapeutic outcomes for patients with suspected PS. [ABSTRACT FROM AUTHOR]

Gluteus medius tendon pathology, encompassing tendinopathy and tears, is a significant source of lateral hip pain and functional impairment. Traditional diagnostic approaches have relied on clinical examination and magnetic resonance imaging (MRI). However, the advent of diagnostic musculoskeletal ultrasound MSKUS has transformed the evaluation process. Musculoskeletal ultrasound MSKUS has emerged as a highly valuable diagnostic tool in the evaluation of gluteus medius tendon pathology, offering a non-invasive, cost-effective, and dynamic assessment method. This modality provides real-time visualization of soft tissue, enabling the detailed examination of tendon structure, vascularity, and associated musculature. For rehabilitation providers, understanding the application, strengths, and limitations of diagnostic MSKUS can enhance clinical decision-making, facilitate targeted therapeutic interventions, and potentially expedite the recovery process. This article reviews the application of MSKUS in diagnosing gluteus medius tendon pathology and its implications for rehabilitation practice. This should help to equip rehabilitation professionals with knowledge to better integrate this diagnostic tool into their clinical repertoire. [ABSTRACT FROM AUTHOR]

Medial collateral ligament (MCL) injuries are prevalent in sports and other physical activities and constitute a significant cause of knee pain and dysfunction. Traditional diagnostic modalities such as magnetic resonance imaging (MRI) are often utilized for their detailed visualization capabilities. However, musculoskeletal ultrasound (MSK-US) has emerged as a pivotal diagnostic tool in the evaluation of MCL injuries due to its non-invasive nature, cost-effectiveness, and dynamic imaging capabilities. This article reviews the utility and advantages of MSK-US in diagnosing MCL injuries, with a specific focus on its implications for rehabilitation providers. We discuss the technical aspects of ultrasound (US) imaging, including the sonographic appearance of MCL injuries across various grades, and compare its diagnostic accuracy with other imaging modalities such as MRI. Additionally, the role of US in monitoring the healing process and guiding rehabilitation strategies is explored. This review emphasizes the practical application of MSK-US in clinical settings, offering rehabilitation providers a comprehensive understanding of how US can be integrated into patient management protocols to enhance outcomes in patients with MCL injuries. [ABSTRACT FROM AUTHOR]

Cubital tunnel syndrome (CTS), is a frequently encountered condition in clinical settings, typically arising from static or dynamic compression of the ulnar nerve. CTS is characterized by the irritation of the ulnar nerve within the cubital tunnel and is a common neuropathic condition that can significantly impact functional abilities and quality of life. This article explores the utility of diagnostic musculoskeletal ultrasound (MSK-US) in the evaluation of the cubital tunnel and the ulnar nerve. The cubital tunnel syndrome, a common entrapment neuropathy of the ulnar nerve, often presents diagnostic challenges. Traditionally, nerve conduction studies and electromyography have been the primary diagnostic tools used to diagnose CTS. Given the superficial nature of the ulnar groove and its adjacent structures, MSK-US imaging known for its non-invasive nature and high-resolution imaging capabilities, has become an increasingly valuable tool in the assessment and management of various musculoskeletal conditions. This article reviews the technical aspects of MSK-US, its advantages in visualizing the ulnar nerve and related structures, and its implications in clinical practice for rehabilitation providers. By integrating MSK-US in the evaluation of CTS, rehabilitation professionals can enhance diagnostic accuracy, tailor interventions, and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Accurately diagnosing pectoralis major injuries, particularly in athletes, often presents a challenge for healthcare practitioners. Although pectoralis muscle injuries are relatively uncommon, the diagnosis of a tear may be overlooked without careful screening by a thorough physical examination of both the injured and uninjured sides. While magnetic resonance imaging (MRI) has traditionally held the gold standard, musculoskeletal ultrasound (MSKUS) has emerged as a viable alternative. This article delves into the power of MSKUS in evaluating and diagnosing pectoralis major injuries, highlighting its dynamic capabilities, real-time visualization, and cost-effectiveness in comparison to MRI. By equipping healthcare professionals with a thorough understanding of MSKUS's potential, this article aims to empower them to confidently diagnose and manage pectoralis major injuries, ultimately improving patient outcomes and facilitating a faster return to function. [ABSTRACT FROM AUTHOR]

Lateral ankle sprains, predominantly involving the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL), constitute a significant portion of sports-related injuries, with a notable rate of recurrence and progression to chronic instability. Precise diagnosis and effective treatment of the ATFL and CFL injuries are crucial in preventing long-term complications. Musculoskeletal (MSK) diagnostic ultrasound has emerged as a pivotal tool in the rehabilitation sector, particularly in assessing lateral ankle ligament injuries. This article will highlight its benefits over traditional diagnostic methods and the emerging role of MSK diagnostic ultrasound as a superior tool for accurate, cost-effective, and comprehensive assessment of these injuries. We discuss the technology's ability to provide objective, real-time imagery, facilitating accurate diagnosis, treatment planning, and injury monitoring emphasizing the need for a standardized approach to ultrasound evaluation to improve diagnostic accuracy and patient outcomes. [ABSTRACT FROM AUTHOR]

Context: Both health professionals and consumers use menthol-based topical analgesics extensively for the temporary relief of pain from musculoskeletal ailments or injury. However, there are no reports of differences in the pain pressure threshold (PPT) or the relative effectiveness of topical analgesics to reduce pain in the upper and lower body muscles and tendons. The objective of this study was to investigate whether differences existed in PPT and relative pain attenuation associated with a menthol-based topical analgesic over a variety of upper and lower body muscles and tendons. Design: Randomized allocation, controlled, intervention study. Methods: Sixteen participants (10 females and 6 males) were tested on their dominant or nondominant side. The order of specific muscle/tendon testing was also randomized, which included upper body (middle deltoid, biceps brachii, and lateral epicondylar tendon) and lower body locations (quadriceps, hamstrings, gastrocnemius, lumbosacral erector spinae muscles, and patellar and Achilles tendons). The PPT was monitored before and 15 minutes following the application of a menthol-based topical analgesic. Results: A menthol-based topical analgesic increased PPT (decreased pain sensitivity) overall (P = .05; 11.6% [2.4%]; d = 1.05) and PPT was higher (P < .0001; 31.5%-44.2%; d = 1.03-1.8) for lower versus upper body locations. Conclusions: Health professionals and the public can be assured of similar reductions in pain sensitivity independent of the location of application of a menthol-based topical analgesic. [ABSTRACT FROM AUTHOR]

The acromioclavicular joint (ACJ), a key element in shoulder movement and stability, is prone to various injuries such as sprains, dislocations, and osteoarthritis, typically resulting from physical trauma or wear and tear. Accurate and timely diagnosis is paramount for effective treatment and rehabilitation. Musculoskeletal (MSK) ultrasound has emerged as a pivotal diagnostic tool due to its ability to visualize soft tissues and provide real-time imaging. This non-invasive tool is also invaluable for monitoring healing progress and the evolution of osteoarthritic changes. This article reviews the application of MSK ultrasound in the evaluation of ACJ injuries, highlighting its advantages, specific applications, and recent technological advancements that enhance its diagnostic capabilities. [ABSTRACT FROM AUTHOR]

Musculoskeletal (MSK) ultrasound has emerged as a valuable tool for sports physical therapists in the assessment and treatment of various knee pathologies. Its ability to provide high-resolution images of soft tissue and superficial bone surfaces makes it especially useful for sports physical therapists and orthopedic clinicians. Specifically, MSK-ultrasound is increasingly recognized as a potent tool for the assessment of the femoral trochlea. Its non-invasive nature and dynamic imaging capabilities make it particularly suited for visualizing the femoral trochlea, a critical component in knee function and biomechanics. The use of MSK ultrasound in the evaluating the femoral trochlea provides sports medicine professionals with a dynamic, non-invasive, and cost-effective means to diagnose, and monitor knee-related injuries. This article delves into the utility of MSK ultrasound in the anatomical and functional assessment of the femoral trochlea, elucidating its benefits, limitations, and clinical implications for athletes. [ABSTRACT FROM AUTHOR]

The article focuses on the International Journal of Sports Physical Therapy published abstracts from the thirteenth Orthopedic Summit (OSET) in Boston, U.S., from September 19-23, 2023. It mentions the sponsored by ATI Physical Therapy and Hyperice, the conference featured research abstracts on contemporary orthopedic and rehabilitation topics. It emphasizes the importance of sharing new ideas and advancements in the field and encourages authors to publish their research as full manuscripts.

Musculoskeletal (MSK) diagnostic ultrasound has become an invaluable tool in the assessment of musculoskeletal pathologies, including rotator cuff injuries, notably the supraspinatus tendon. MSK ultrasound, characterized by high-resolution and real-time imaging capabilities, presents a cost-effective, safe, and patient-friendly alternative. This modality allows precise visualization of the supraspinatus tendon's structure and function, aiding in the identification of pathological alterations, such as thickening, thinning, or disruption, critical in diagnosing conditions like tendonitis, partial tears, and ruptures. In this manuscript, we detail the diagnostic utility of MSK ultrasound in assessing supraspinatus injuries, discussing the indications, techniques, and findings relevant to the supraspinatus tendon. Moreover, we examine the advantages and limitations of this imaging modality and provide a step-by-step guide for accurate supraspinatus tendon evaluation. The evidence suggests that MSK ultrasound is a dependable and cost-effective imaging technique for diagnosing supraspinatus injuries when executed by skilled operators. [ABSTRACT FROM AUTHOR]

Musculoskeletal (MSK) ultrasound has emerged as a vital tool in diagnosing patellar tendon injuries. Traditional imaging techniques, such as X-rays and magnetic response imaging (MR)I, have certain limitations in assessing soft tissue structures or may not be easily accessible. MSK ultrasound, with its high-resolution, real-time imaging capabilities, offers a cost-effective, safe, and patient-friendly alternative. It allows for accurate visualization of the patellar tendon's structure and function, thereby facilitating the identification of pathological changes such as thickening, thinning, or disruption which aids in diagnosing conditions such as tendonitis, partial tears, and ruptures. Furthermore, MSK ultrasound serves as an invaluable tool for guiding interventions like injections, as it provides real-time imaging. This article explores the role and benefits of MSK ultrasound in diagnosing patellar tendon injuries, highlighting its cost-effectiveness, accessibility, real-time assessment capabilities, and reduced patient burden compared to other imaging modalities. Despite its numerous benefits, the need for ongoing research to enhance its utility is highlighted. As technology advances, MSK ultrasound is set to revolutionize the early detection and management of patellar tendon injuries. [ABSTRACT FROM AUTHOR]

Byline: Andrew. Robertson, Andrew J. Cameron, Brian. Joyce, Phil. Le Page, Bruce. Tulloh, Andrew. de Beaux, Peter. Lamb Introduction: There are concerns that laparoscopic sleeve gastrectomy (LSG) can cause severe [...]

MSK ultrasound is a valuable imaging technique which has become increasingly popular in recent years. This efficient technique proves beneficial in a variety of ways. MSK ultrasound effectively streamlines the process by enabling practitioners to securely and accurately image and assess structures all in one simple step. By allowing healthcare providers to access critical information quickly and conveniently, MSK ultrasound can help identify conditions early when interventions are most effective. Moreover, it may be able to shorten diagnostic times and reduce costs through more cost-effective use of resources such as imaging and laboratory testing. Furthermore, MSK ultrasound can provide additional insights into musculoskeletal anatomy and help improve patient care and outcomes. In addition, utilizing this method reduces exposure to radiation and provides enhanced patient comfort with its quick scan duration. MSK ultrasound has a high potential to provide quick and accurate diagnosis of MSK disturbances when used correctly. As clinicians become more comfortable and familiar with this technology, we will continue to see its use expand for various MSK assessments. In this commentary we'll explore how ultrasound can be used in physical therapy, specifically for musculoskeletal assessment. We'll also look at some of the potential benefits and limitations of using ultrasound in PT practice. [ABSTRACT FROM AUTHOR]

The shoulder is an area that can be prone to a variety of injuries, including subscapularis tendon tears. The subscapularis muscle is one of the four muscles that make up the rotator cuff in the shoulder and plays an essential role in stabilizing the shoulder joint while at the same time facilitating internal rotation of the humerus. Injuries to the subscapularis can occur due to trauma, overuse, or degeneration, leading to pain, weakness, and limited mobility. When injury occurs, subscapularis tendon tears are often difficult to diagnose and evaluate due to their location deep within the shoulder joint. While traditional imaging techniques like radiographs, and magnetic resonance imaging may give us insight into the structures present, they do not always provide detailed enough information for clinicians. Ultrasound has become increasingly popular in musculoskeletal (MSK) rehabilitation as it allows for direct visualization of soft tissue abnormalities like tendinopathies or subtle rotator cuff tear patterns. In this Ultrasound Bites article, we will discuss how MSK ultrasound can be used in the evaluation of subscapularis tendon pathology with a specific focus on its utility in the physical therapy clinic. MSK ultrasound is a non-invasive imaging modality that uses high-frequency sound waves to create real-time images of soft tissues, including muscles, tendons, and ligaments. This non-invasive imaging method provides clear and highly detailed images of the soft tissues in the shoulder area, allowing for a more precise diagnosis. Specifically, MSK ultrasound is a valuable tool in the evaluation of subscapularis injuries by allowing for a detailed assessment of the muscle's structure and function. This technique can accurately identify the extent and severity of subscapularis damage, which is essential for effective treatment. By using MSK ultrasound, clinicians can assess both the structure and function of the subscapu- [ABSTRACT FROM AUTHOR]

CONTEXT. Environmental factors are suggested to play a major role in physical activity CPA) and other obesity-related behaviors, yet there is no national research on the relationship between disparity in access to recreational facilities and additional impact on PA and overweight patterns in US adolescents. OBJECTIVE. In a nationally representative cohort, we sought to assess the geographic and social distribution of PA facilities and how disparity in access might underlie population-level PA and overweight patterns. DESIGN, SETTING, AND PARTICIPANTS. Residential locations of US adolescents in wave I (1994-1995) of the National Longitudinal Study of Adolescent Health (N = 20 745) were geocoded, and a 8.05-km buffer around each residence was drawn (N = 42 857 census-block groups [19% of US block groups]). PA facilities, measured by national databases and satellite data, were linked with Geographic Information Systems technology to each respondent. Logistic-regression analyses tested the relationship of PA-related facilities with block-group socioeconomic status (SES) (at the community level) and the subsequent association of facilities with overweight and PA (at the individual level), controlling for population density. MAIN OUTCOME MEASURES. Outcome measures were overweight (BMI [greater than or equal to] 95th percentile of the Centers for Disease Control and Prevention/National Center for Health Statistics growth curves) and achievement of [greater than or equal to] 5 bouts per week of moderate-vigorous PA. RESULTS. Higher-SES block groups had a significantly greater relative odds of having 1 or more facilities. Low-SES and high-minority block groups were less likely to have facilities. Relative to zero facilities per block group, an increasing number of facilities was associated with decreased overweight and increased relative odds of achieving [greater than or equal to] 5 bouts per week of moderate-vigorous PA. CONCLUSIONS. Lower-SES and high-minority block groups had reduced access to facilities, which in turn was associated with decreased PA and increased overweight. Inequality in availability of PA facilities may contribute to ethnic and SES disparities in PA and overweight patterns. Key Words environment, health disparities, adolescence, environmental health. population-based studies Abbreviations PA--physical activity SES--socioeconomic status GIS--Geographic Information Systems SIC--Standard Industrial Classification MVPA--moderate-vigorous physical activity MET--metabolic equivalent CDC--Centers for Disease Control and Prevention NCHS--National Center for Health Statistics OR--odds ratio CI--confidence interval, UNDERSTANDING THE CAUSES of health disparities is critical for improving health and reducing social inequality. Inequality in obesity and its underlying factors, in particular physical activity (PA) and inactivity, contribute [...]

Quadriceps muscle injury is a common occurrence, especially among athletes. While a careful history and a thorough physical examination are important steps in the assessment of quadriceps muscle pathology, it is still difficult to differentiate the type and severity of the pathology. Because of this difficulty, musculoskeletal ultrasound (MSK-US) is an invaluable tool in the diagnosis of quadriceps muscle or tendon injury. Utilizing this noninvasive imaging technique, medical professionals can easily diagnose and monitor muscle and tendon disorders to quickly determine the correct treatment plan for each individual case. The ability to view these structures in real-time allows identification of any present pathologies. MSK-US has become a useful component in diagnosing quadriceps muscle and tendon injuries due to its ability to clearly display the affected structures without exposing the patient to radiation or utilizing ionized contrast media. MSK-US provides valuable insight into fluid dynamics around joints and can even detect myotendinous tears that might otherwise be overlooked with the clinical examination or symptoms usually reported by patients. MSK-US can provide precise visualization of edema and can easily distinguish between benign and potentially pathological findings which make it an integral part of any holistic evaluation of quadriceps muscle and tendon injury. Additionally, it can be used to track the progress of physical therapy treatments and monitor tissue healing. This information is invaluable in ensuring an optimal outcome for any quadriceps muscle and tendon injury. Therefore, when used in combination with clinical tests, MSK-US can drastically increase the accuracy of the clinical examination. By utilizing this technology, healthcare practitioners have reliable access to more comprehensive diagnostics for musculoskeletal injuries and diseases than ever before. Clinicians are then able to tailor rehabilitation plans more effectively and ensure their patients receive proper treatment. As a result, recovery times may be shortened, and patients are able to return to their normal activities more quickly. [ABSTRACT FROM AUTHOR]

Pathology of the long head of the biceps brachii tendon (LHBT) is a common source of shoulder pain. While a careful history and a thorough physical examination are important steps in the assessment of LHBT pathology, it is still difficult to differentiate the type and severity of the pathology. Currently, the gold standard for confirming a diagnosis of LHBT pathologies is arthroscopic examination. Additionally, MRI is commonly ordered for diagnosis. Since an accurate diagnosis of pathology is critical for treatment success, musculoskeletal ultrasound (MSK US) is an attractive adjunct to the diagnostic process for long head of the biceps pathology due to it being safe, inexpensive and non-invasive. When used in combination with clinical special tests, MSK US can drastically increase the diagnostic accuracy of the clinical examination. [ABSTRACT FROM AUTHOR]

The article presents the discussion on physical therapists playing an important role in the opioid epidemic by providing non-pharmacological pain control. Topics include learning more about pain and pain management through neuroscience research; and physical therapy interventions containing therapeutic exercise, manual therapy, patient education, and modalities.

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The author reflects on the importance of integrating critical thinking in sports rehabilitation. Topics discussed include the tendency of physical therapists to rely on clinical experience and patient values instead of on clinical practice research in making clinical decisions, barriers to the application of evidence-based research to practice such as lack of time and lack of skills, and the need for clinicians to take responsibility for overcoming the barriers.

The article reports that the Point of care ultrasound, musculoskeletal ultrasound (MSK-US) and rehabilitation ultrasound imaging are similar procedures that use a non-ionizing imaging and become more inexpensive, portable, safe and able to be used quickly. Topics include considered these modalities are commonly used in various medical disciplines to assess musculoskeletal tissues as well as structures such as the heart, lungs and bladder just to name a few.

The foundation of evidence-based practice lies in clinical research, which is based on the utilization of the scientific method. The scientific method requires that all details of the experiment be provided in publications to support replication of the study in order to evaluate and validate the results. More importantly, clinical research can only be translated into practice when researchers provide explicit details of the study. Too often, rehabilitation exercise intervention studies lack the appropriate detail to allow clinicians to replicate the exercise protocol in their patient populations. Therefore, the purpose of this clinical commentary is to provide guidelines for optimal reporting of therapeutic exercise interventions in rehabilitation research. [ABSTRACT FROM AUTHOR]

Evidence-based practice requires clinicians to stay current with the scientific literature. Unfortunately, rehabilitation professionals are often faced with research literature that is difficult to interpret clinically. Clinical research data is often analyzed with traditional statistical probability (p-values), which may not give rehabilitation professionals enough information to make clinical decisions. Statistically significant differences or outcomes simply address whether to accept or reject a null or directional hypothesis, without providing information on the magnitude or direction of the difference (treatment effect). To improve the interpretation of clinical significance in the rehabilitation literature, researchers commonly include more clinically-relevant information such as confidence intervals and effect sizes. It is important for clinicians to be able to interpret confidence intervals using effect sizes, minimal clinically important differences, and magnitude-based inferences. The purpose of this commentary is to discuss the different aspects of statistical analysis and determinations of clinical relevance in the literature, including validity, significance, effect, and confidence. Understanding these aspects of research will help practitioners better utilize the evidence to improve their clinical decision-making skills. [ABSTRACT FROM AUTHOR]

Ankle sprains are common in team sports and sports played on courts, and often result in structural and functional alterations that lead to a greater reinjury risk. Specific exercises are often used to promote neuromuscular improvements in the prevention and rehabilitation of ankle injuries. This literature review summarizes the neuromuscular characteristics of common ankle sprains and the effectiveness of exercise as an intervention for improving neuromuscular function and preventing reinjury. Our review found that appropriate exercise prescription can increase static and dynamic balance and decrease injury recurrence. In particular, the addition of dynamic activities in the exercise program can be beneficial because of the anticipatory postural adjustments identified as a key factor in the injury mechanism. [ABSTRACT FROM AUTHOR]

As the older adult population increases in size, the number of older adults participating in sport activities will also likely increase proportionally with a concomitant increase in musculoskeletal injuries. Age-associated functional declines in muscle strength and the sensory systems, in addition to several other issues, contribute to reductions in balance that may increase fall risk There are a variety of ways to evaluate balance and fall-risk, and each older adult should be regularly screened in order to evaluate any changes in the ability to maintain postural stability. Balance training is a useful intervention in rehabilitation of postural stability impairments as well as in training programs for performance enhancement. One scientifically-based approach is Sensorimotor Training (SMT) which can be characterized as a progressive balance training program using labile surfaces to provide adequate and safe challenges to the older athlete's balance. SMT addresses both static and dynamic components of balance as well as the multitude of systems that control balance in order to train effective strategies and elicit automatic postural responses in order to enhance postural stability. The authors believe that SMT should become part of the regular training regimen for the aging athlete. For the sport and orthopedic healthcare professional, an understanding of the physiologic changes that occur with age, the means by which balance can be assessed, and how SMT programs can be developed and implemented is crucial in addressing the growing number of older athletes that they will see. [ABSTRACT FROM AUTHOR]

An interview with Phil Page, client director at Cardano, is presented. When asked regarding himself, Page says that he manages client relationships and specializes in the design of investment and derivative solutions that were driven by liability. He says that Cardano helps clients manage their interest rate and inflation risks. Page adds that the pension fund market is pretty bad in Great Britain, wherein, the typical pension plan funded is just about 50%.

Research is designed to answer a question or to describe a phenomenon in a scientific process. Sports physical therapists must understand the different research methods, types, and designs in order to implement evidence-based practice. The purpose of this article is to describe the most common research designs used in sports physical therapy research and practice. Both experimental and non-experimental methods will be discussed. [ABSTRACT FROM AUTHOR]

Stretching is a common activity used by athletes, older adults, rehabilitation patients, and anyone participating in a fitness program. While the benefits of stretching are known, controversy remains about the best type of stretching for a particular goal or outcome. The purpose of this clinical commentary is to discuss the current concepts of muscle stretching interventions and summarize the evidence related to stretching as used in both exercise and rehabilitation. [ABSTRACT FROM AUTHOR]

Cervicogenic headache (CGH), as the diagnosis suggests, refers to a headache of cervical origin. Historically, these types of headaches were difficult to diagnose and treat because their etiology and pathophysiology was not well-understood. Even today, management of a CGH remains challenging for sports rehabilitation specialists. The purpose of this clinical suggestion is to review the literature on CGH and develop an evidence- led approach to assessment and clinical management of CGH. [ABSTRACT FROM AUTHOR]