INTRODUCTION Mid-portion (or non-insertional) Achilles tendinopathy has been reported as one of the most common overuse injuries (Maffulli et al., 2003). It is common in those who engage in regular physical activity, which means athletes are particularly susceptible to this condition. Sports physiotherapists who treat regularly treat runners will be aware of its high incidence […]
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.
When I say optimal shoulder function what do you think? My guess for many of you it is likely ‘rotator cuff function’ (yeah, for some it may be scapulohumeral rhythm). However, you would undoubtedly agree that optimal function of the rotator cuff musculature is essential in the successful rehabilitation of the majority of shoulder pathologies. It is common in clinical practice to utilise shoulder adduction movements to guide clinical decision making, particular in subacromial impingement syndrome patients. However, a recent EMG study has challenged the validity of both these assessment and treatment decisions.
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.
The sports physiotherapist will commonly treat shoulder presentations. One of the most common presentations, particularly in an athletic population, is subacromial impingement syndrome (or external impingement). Therefore, it is essential that the sports physiotherapist be fully aware of the more common contributing factors and treatments for this condition. This article discusses the effect of posterior capsule tightness and the “Diablo Effect” on subacromial impingement syndrome.
The sports physiotherapist will frequently assess and diagnose acute knee injuries. In doing so, we will regularly rely on the results of special orthopaedic or clinical tests. However, if we are going to use these tests to make diagnoses and therefore guide our treatment decisions, it is vital that we are aware of the diagnostic accuracy of clinical tests. This article evaluates the research regarding the diagnostic accuracy of commonly used clinical tests for medial meniscus tears.
Femoroacetabular impingement (FAI) is, as the name suggests, an impingement or abutment of the chondro-labral structures between the femur and acetabulum. Whilst the diagnosis of femoroacetabular impingement has only recently gained attention, it is known that the presentation is more common in the athletic population. High activity athletes are at increased risk; particularly athletes who participate in sports which require them to frequently move into a position of internal rotation and flexion. This makes it an important diagnosis for the sports physiotherapist to be aware of current research and the best practice.