Ankle injuries are a ridiculously common sports injury. Fong et al (2007) found that ankle injuries are the most common injuries in a wide variety of popular sports. It has been suggested that syndesmosis injuries account for about 11% of ankle injuries. Furthermore, ankle syndesmosis injuries (or “high” ankle sprains) have high occurrences during athletic activities, particularly those that involve twisting or cutting activities. Read on for evidence based assessment and diagnosis of ankle syndesmosis injuries.
Patellar dislocation accounts for 2 – 3% of all knee injuries, however, is the second most common cause of knee haemarthrosis (Aglietti et al., 2001). Patellar dislocation is most commonly associated with sports injuries, and therefore, is encountered commonly by the sports physiotherapist. In recent times there has been controversy on the most appropriate forms of management following primary (or first time) patellar dislocation. This post discusses evidence based management of primary patellar dislocations.
Cyclops lesions are an unfortunate sequelae of anterior cruciate ligament injury, and are most commonly seen following ACL reconstructions. The cyclops lesion is a consequence of a localised form of anterior arthrofibrosis. This results in the formation of a nodule of fibrous tissue in the anterior portion of the ACL graft (Tonin et al., 2001). The cyclops lesion sits in the anterior margin of the intercondylar notch, just above the tibial tunnel, which can become impinged between the tibia and femur upon knee extension (Bradley et al., 2000).
Patellar tendinopathy, commonly referred to as “Jumper’s Knee”, is a common overuse lower limb injury. In certain sporting populations, such as elite volleyball, the incidence can be as high as 45% (Lian et al., 2005). Thus, it is easy to see the importance of the identification of risk factors for patellar tendinopathy. Additionally, once identified such risk factors have clear implications for both the prevention and rehabilitation of this condition. This article discusses the latest research identifying risk factors for the development of patellar tendinopathy.
Cervical radiculopathy is a pathology of the cervical nerve root (Dox et al 1979), frequently associated with cervical disc herniation or another space occupying lesion (such as osteophytes), which can cause nerve root impingement and inflammation. As many of you will be aware, this can be a very painful and often debilitating condition. Although the natural history of the condition is favourable, it has been suggested that if the condition becomes chronic it can be recurring and impact negatively on physical and mental health. Therefore, it is essential that as physiotherapists we are aware of the most evidence informed diagnosis and treatment techniques for cervical radiculopathy.
Acromioclavicular injuries are common in a variety of sports, particularly those which involve heavy contact or tackling. For example, Flik et al (2005) reported the incidence of AC injuries was the third most common in men’s ice hockey. Thus, this is a common injury. Whilst in many injury cases, such as acute presentations and the higher grade AC separations, the diagnosis can be quite obvious. However, many conditions of the shoulder present with very similar clinical presentations, and thus differential diagnosis can be challenging (Meyer et al 1990). Thus, this article examines the diagnostic accuracy for clinical examination tests for acromioclavicular joint pain.
How do you make a diagnosis? I assume that you perform a subjective examination and develop competing hypotheses, and then work to support or negate these via your objective examination. Can you, however, following your physical examination tell the patient the percentage chance of them having a particular diagnosis? Is that something you might be interested in? If your answer is a resounding yes, Bayes’ Theorem and a Fagan’s Nomogram can give you the ability to do so. This post will give you the easily implementable basics of using the Fagan’s Nomogram to improve your diagnostic accuracy!
How often do you treat ankles? I know that I treat them every day, and it is likely that you do to. Osteochondral lesions are very underdiagnosed causes of ankle pain and dysfunction. The astute sports physiotherapist should be aware of the hallmarks of this diagnosis. This article aims to present an overview of the evidence based assessment and management of osteochondral lesions of the ankle.
Osteitis Pubis is a condition that many consider rare, however, it is probably more common than you may think. The incidence of groin pain, in some sports, is as high as 13% (Ekstrand and Ringbord, 2001). Thus, it is highly likely that as a sports physiotherapist you will encounter may athletes with a diagnosis of osteitis pubis. Therefore, as is frequently stated on this site, you need to be aware of the current research and evidence based practice, even in a world with limited research.
Cuboid Syndrome is defined as minor disruption or subluxation of the structural congruity of the calcaneocuboid portion of the mid-tarsal joint (Blakeslee and Morris, 1987). Now, that is quite a wordy definition which essential means the subluxation of the cuboid from its natural position. Whilst you may feel that this condition is rare, it is probably more common than you think, particularly in certain athletic populations. Therefore, for the sports physiotherapist who routinely treats foot and ankle injuries, cuboid syndrome is a condition that you must be aware of. It is frequently misdiagnosed and therefore poorly treated. If you do not look for this it is likely you won’t find it, and your athletes will suffer.