Physical Therapy in Sport RSS feed: Current Issue. Physical Therapy in Sport is an international peer-reviewed journal that provides a forum for the publication of research and clinical practice material relevant to the healthcare professions involved in sports medicine. The journal publishes material that is indispensable for day-to-day practice and continuing professional development. Physical Therapy in Sport covers topics dealing with the diagnosis, treatment, and prevention of injuries, as well as more general areas of sports medicine and related sports science. The journal publishes original research, case studies, reviews, masterclasses, papers on clinical approaches, and book reviews, as well as occasional reports from conferences. Papers are double-blind peer-reviewed by our international advisory board and other international experts, and submissions from a broad range of disciplines are actively encouraged. http://www.physicaltherapyinsport.com/?rss=yesElsevier Inc.en © 2011 Published by Elsevier Inc. All rights reserved. Physical Therapy in Sport1466-853X131February 2012 © 2011 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.physicaltherapyinsport.com/article/PIIS1466853X11001283/abstract?rss=yesEditorial Board10.1016/S1466-853X(11)00128-3Physical Therapy in Sport 13, 1 (2012)2012-02-01Physical Therapy in Sport2012-02-01131S1466-853X(11)X0005-6iihttp://www.physicaltherapyinsport.com/article/PIIS1466853X11001192/abstract?rss=yesWelcome to the first issue of 2012, and as this heralds the start of an Olympic year, this is a special issue dedicated to research in high performance and professional sport. Working at the top level in sport is often the pinnacle of a clinician’s career and it can be one of the most rewarding experiences. However, working at this level can also raise many additional challenges to clinicians including working long hours under intense conditions, pressure from management and coaches in making decisions about players ability to train and play, responsibilities to the athlete and athlete confidentiality, working within your scope of practice, working in isolated situations in different locations both nationally and internationally, to name but a few. Sport has also become increasingly litigious and clinicians need to be aware of the rules and codes of the sport they are working with. Contraventions of professional or sporting rules of conduct could have serious implications for those concerned. One such example is the incident that has become known as ‘Bloodgate’. For those of you not familiar with this episode, it was during a quarter final game of the 2009 Heineken cup between Harlequins and Leinster. The important thing to note here is that in rugby union if a player is bleeding they are temporarily substituted whilst the blood injury is dealt with off the pitch. It was a very tight game and at a critical moment when a kick had been awarded, Harlequins faked a blood injury on a player in order to bring on a specialist kicker. The physiotherapist responsible for bringing on and giving the blood capsule to the player was suspended and subsequently struck off the professional register and had to go to the high court to appeal the ban. Eventually the physiotherapist was re-instated but only after a long legal battle. Ironically the doctor involved who, after the opposition suspected of faking the injury actually cut the players lip to try and disguise the fact and later denied doing so, was not struck off their respective professional register and only given a warning. The case raises many ethical and moral issues for all of us working in sport and the sometimes blurred lines between right and wrong. The commercial and personal pressures to succeed in sport can wrongly influence the surrounding team. One of the competencies for sports physiotherapists defined by the IFSP is the promotion of fair play and anti-doping practices. However in a piece of research looking at the perceptions of elite rowers in this issue, the athletes did not identify this as a role for sports physiotherapists. Is it time to revisit the list of competencies for sports physiotherapists or do we need to more clearly define what these roles are?Working in high performance and professional sportZoe Hudson10.1016/j.ptsp.2011.12.002Physical Therapy in Sport 13, 1 (2012)2012-02-01Physical Therapy in Sport2012-02-01131S1466-853X(11)X0005-6Editorial12http://www.physicaltherapyinsport.com/article/PIIS1466853X11000460/abstract?rss=yesAbstract: Overuse related tendon pain is a significant problem in sport and can interfere with and, in some instances, end an athletic career. This article includes a consideration of the biology of tendon pain including a review of tendon anatomy and histopathology, risk factors for tendon pain, semantics of tendon pathology, and the pathogenesis of tendon pain. Evidence is presented to guide the physical therapist in clinical decision-making regarding the examination of and intervention strategies for athletes with tendon pain.Tendinopathy in athletesMark Reinking10.1016/j.ptsp.2011.06.004Physical Therapy in Sport 13, 1 (2012)2011-08-05Physical Therapy in Sport2011-08-05131S1466-853X(11)X0005-6Masterclass310http://www.physicaltherapyinsport.com/article/PIIS1466853X11000411/abstract?rss=yesAbstract: Objectives: To examine muscle cross-sectional areas (CSA) and symmetry of lumbar multifidus (LM) muscles in elite weightlifters.Design: Cross-sectional observational studySetting: Neuromuscular and Pain Research Unit.Participants: Thirty-one elite weightlifters (15 males) participated in the study, representing the population of Thai weightlifters eligible for national selection.Main outcome measures: Resting CSA of the LM muscle were assessed bilaterally at 4 lumbar vertebral levels using ultrasound imaging. The between side differences (relative to the side of the preferred hand) were used to determine the asymmetry.Results: The between side differences (relative to the preferred hand) of the LM muscle CSA were less than 3% for all vertebral levels and suggested symmetry between sides (p > .05). No difference was found between weightlifters with unilateral or bilateral pain symptoms.Conclusion: This study provides new information on resting CSA for the LM muscle in elite weightlifters. Future studies could investigate other aspects of neuromotor control of the LM muscle to determine if there are impairments which could be addressed in an attempt to decrease the high prevalence of LBP in this population.Multifidus muscle size and symmetry among elite weightliftersPatraporn Sitilertpisan, Julie Hides, Warren Stanton, Aatit Paungmali, Ubon Pirunsan10.1016/j.ptsp.2011.04.005Physical Therapy in Sport 13, 1 (2012)2011-06-13Physical Therapy in Sport2011-06-13131S1466-853X(11)X0005-6Original Research1115http://www.physicaltherapyinsport.com/article/PIIS1466853X11000125/abstract?rss=yesAbstract: Objective: The purpose of this study was to (i) explore the perceptions of elite Irish rowers on the role of sports physiotherapy during their sports career, (ii) to compare their information to the International Federation of Sports Physiotherapists (IFSP) competencies and standards and (iii) to use the information gathered to highlight issues regarding quality of sports physiotherapy services, and how these services could be enhanced.Design: Participants completed a short open-ended questionnaire that evaluated the service provided by sports physiotherapists. Participant anonymity was protected and they were encouraged to be honest and critical of their experiences.Results: Thirteen Irish rowers preparing for the 2008 world championships or the 2008 Olympic Games, with a minimum of nine years rowing experience and participation in international competitions within the 12 months prior to the study beginning participated in the study. Against the competencies and standards of the IFSP this elite group of athletes had a clear understanding of the role of the sports physiotherapist. They identified nine of the eleven competencies recommended by the IFSP for auditing a sports physiotherapist, and advocated the use of sports physiotherapists in all areas that could improve their performance. Reasons as to why the athletes missed two of the competencies are discussed.An exploration of the perspectives of elite Irish rowers on the role of the sports physiotherapistAidan Woods, Catherine B. Woods10.1016/j.ptsp.2011.02.004Physical Therapy in Sport 13, 1 (2012)2011-04-13Physical Therapy in Sport2011-04-13131S1466-853X(11)X0005-6Original Research1621http://www.physicaltherapyinsport.com/article/PIIS1466853X11000113/abstract?rss=yesAbstract: Objective: The main objective is to determine whether there are differences in the relative isokinetic and electromyographic responses between the internal rotator (IR) muscles on the dominant and non-dominant sides of tennis players during performance of an isokinetic fatigue protocol.Main outcome measures: Ten male tennis players were recruited for this isokinetic and electromyographic study. Participants performed 35 concentric maximal voluntary actions, carrying out internal rotations of both shoulders at an angular velocity of 120° s−1. Maximal torque (T(45°)Max), torque decrease (T(45°)), Root Mean Square normalised (RMSnorm) and Neuromuscular Efficiency (NME) parameters were analysed.Results: Although an increased T(45°)Max was observed on the dominant side compared to the non-dominant side, the progression of torque differences did not indicate differences in fatigue-resistance between the two sides. RMSnorm was also higher on the dominant side compared to the non-dominant side, without showing a fatigue effect. NME values decreased during performance of the fatigue protocol without any side effect.Conclusions: Practicing tennis induces an increased T(45°)Max on the dominant side compared to the non-dominant side, but does not appear to provoke differences in the fatigue-resistance of IR muscles. EMG analysis showed that the fatigue induced was mainly peripheral (from metabolic and ionic changes).Fatigue-resistance of the internal rotator muscles in the tennis player’s shoulder: Isokinetic and electromyographic analysisRoland Julienne, Antoine Gauthier, Damien Davenne10.1016/j.ptsp.2011.02.003Physical Therapy in Sport 13, 1 (2012)2011-04-11Physical Therapy in Sport2011-04-11131S1466-853X(11)X0005-6Original Research2226http://www.physicaltherapyinsport.com/article/PIIS1466853X11000095/abstract?rss=yesAbstract: Objectives: Successes of the professional athlete as individuals and team, across codes of football are contingent upon performance measures. The aim of the study was to examine associations between comfort and performance.Design: Prospective measures of lower limb comfort and coach rating performance criterion. Comfort and performance associations were described using Pearson’s correlation coefficient (r) or the R square value from the regression estimate.Setting: Two professional football codes in Australia.Participants: 79 professional footballers were followed for one football season, a total of 1724 player weeks.Main Outcome Measures: Study hypothesis was poor lower limb comfort is negatively correlated with good match day rated performance. Aspects of validity and responsiveness to change tested the hypothesis that lower limb comfort, affects rated performance. A validated lower limb comfort index (LLCI) was used to test comfort. Rated performance was evaluated by subjective rating criterion of experienced team coaches.Results: Poor lower limb comfort and good match day ratings were not well correlated (R2 = 0.25, P≤0.001) and usual-high comfort was correlated with usual-good performance (R2 = 0.69, P≤0.001).Conclusions: Lower limb comfort may be a sensitive measure of rated performance in football. The LLCI is the first measurement tool to show association between comfort and rated performance.Relation between lower limb comfort and performance in elite footballersMichael Kinchington, Kevin Ball, Geraldine Naughton10.1016/j.ptsp.2011.02.001Physical Therapy in Sport 13, 1 (2012)2011-04-01Physical Therapy in Sport2011-04-01131S1466-853X(11)X0005-6Original Research2734http://www.physicaltherapyinsport.com/article/PIIS1466853X10001124/abstract?rss=yesAbstract: Objectives: The purpose of this study was to gain a greater understanding of the emotions and coping strategies utilized when returning to competition following anterior cruciate ligament (ACL) reconstruction.Design: A qualitative approach, consisting of five semi-structured interviews and a pre-designed diary, was conducted concurrent with each ’player’s return to competition, allowing each to record emotional responses experienced and identify coping strategies employed.Participants: Five professional male rugby union players, who had suffered an ACL injury that required surgical reconstruction, participated in the study. Each had spent between six to twelve months in rehabilitation.Results: Content analysis was conducted on both pre- and post- return data, identifying 12 higher order themes. Confidence building; anticipation; anxiety; physical preparation; psychological preparation; and social support were prevalent pre-return to competition. Post-return higher order themes consisted of confidence building; positive performance emotions; performance anxieties; problem focused coping; social support; and dealing with fears.Conclusions: For the players in this study, gaining confidence in the injured knee joint appears to be influential, with increases in confidence provided by completing clinical and sport specific tests, and by performance accomplishments. Successful return can be enhanced further by the use of a specific goal setting program aimed at reintroducing the player to competition.Experiences of professional rugby union players returning to competition following anterior cruciate ligament reconstructionFraser Carson, Remco Polman10.1016/j.ptsp.2010.10.007Physical Therapy in Sport 13, 1 (2012)2010-12-13Physical Therapy in Sport2010-12-13131S1466-853X(11)X0005-6Original Research3540http://www.physicaltherapyinsport.com/article/PIIS1466853X10000763/abstract?rss=yesAbstract: Objectives: A 2-year retrospective audit was conducted to evaluate injury diagnosis and treatment provision from a mobile physiotherapy unit serving the Professional Golf Association (PGA) European Tour.Design: Across two competitive seasons (2005/06), service data was collected at 36 tournaments (18 in 2005 and 18 in 2006). Service at each tournament was from Tuesday to Sunday, and equated to 216 days in total. Each approach made to the unit throughout this time was anonymously recorded as either i) a ‘contact’ where an injury diagnosis and/or treatment was provided, or ii) a ‘non-contact’ where no service was administered and players used the on-board fitness suite.Results: Across the audit period a total of 7430 approaches were made to the unit, equating to 206 per event or 34 per service day. From all approaches 6705 ‘contacts’ were documented with 2328 injuries recorded. A total of 9933 separate treatments were administered equating to 276 per event or 46 per day. Non-contacts equated to 725, representing only 9.8% of all approaches. Of the 2328 reported injuries, 66.6% (1551) were back-related, with 16.6% (385) and 16.8% (392), being related to upper and lower limbs, respectively. Of the 9933 treatments, 71.3% (7087) related to massage (40.7%), manipulation (15.6%) and stretching therapies (15.0%). As an overall trend, the total number of injury diagnoses and treatments increased across the 2-year period. The number of reported injuries rose by 25.6% (2005 = 1032; 2006 = 1296), whilst treatments rose by 17.2% (2005 = 4575; 2006 = 5359).Conclusions: This retrospective audit provides a valuable insight into a servicing mobile physiotherapy unit on a professional sporting tour. Findings reveal the specific type and location of injuries encountered by PGA European Tour players as well as the range of treatments administered. In developing effective support services to the professional player on tour, data presented will allow for a more structured injury management system based of typical injury occurrence and treatment provision.A retrospective service audit of a mobile physiotherapy unit on the PGA European golf tourMark F. Smith, Rob Hillman10.1016/j.ptsp.2010.09.001Physical Therapy in Sport 13, 1 (2012)2010-10-11Physical Therapy in Sport2010-10-11131S1466-853X(11)X0005-6Original Research4144http://www.physicaltherapyinsport.com/article/PIIS1466853X11000071/abstract?rss=yesAbstract: Objectives: To provide a concise overview of the prevalence and risk factors in the development of lumbar vertebral stress injuries in cricketers who are fast bowlers.Methods: A search of Medline, SPORTDiscus and CINAHL databases was conducted to find relevant studies pertaining to: cricket, cricket biomechanics and lumbar vertebral stress injuries. Narrative review methods were used to synthesise the data.Results: The prevalence of lumbar vertebral stress injuries in fast bowlers is high, with figures up to 67% reported. Potential risk factors identified include bowling action, overuse, age, lumbar muscle asymmetry and physical characteristics. While prospective studies provide evidence that bowling action and overuse are risk factors for developing lumbar vertebral stress injuries, to date there is limited evidence, largely from cross-sectional studies, regarding the other factors.Conclusions: This study provides an up-to-date overview of the current literature on prevalence and risk factors for lumbar vertebral stress injuries in fast bowlers. This information may assist clinicians to prevent injury through early identification of risk factors. Recommendations for future research directions include further prospective investigation of the role of age, physical characteristics and muscle asymmetry in the development of such injuries as well as gender specific risk factors.Lumbar vertebral stress injuries in fast bowlers: A review of prevalence and risk factorsM. Johnson, M. Ferreira, J. Hush10.1016/j.ptsp.2011.01.002Physical Therapy in Sport 13, 1 (2012)2011-02-23Physical Therapy in Sport2011-02-23131S1466-853X(11)X0005-6Literature Review4552http://www.physicaltherapyinsport.com/article/PIIS1466853X11000423/abstract?rss=yesThis very well presented hardback book covers in detail and with substantial evidence base the many medical facets which need to be considered in children and adolescent athletes’ performance.The Elite Young AthleteAlastair Nowell10.1016/j.ptsp.2011.04.006Physical Therapy in Sport 13, 1 (2012)2011-08-11Physical Therapy in Sport2011-08-11131S1466-853X(11)X0005-6Book Review5353http://www.physicaltherapyinsport.com/article/PIIS1466853X11001404/abstract?rss=yesDiary Dates10.1016/S1466-853X(11)00140-4Physical Therapy in Sport 13, 1 (2012)2012-02-01Physical Therapy in Sport2012-02-01131S1466-853X(11)X0005-6Diary Dates5454