Neer impingement sign, HawkinseKennedy impingement test, Patte maneuver as well as Jobe supraspinatus test, are highly reproducible and therefore reliable to use in clinical practice to identify patients with sub- acromial pain with an impingement phenomenon, but the maneuvers are limited as structural discriminators > from Johansson et al.; Manual Therapy 14 (2009) 231-239
Wednesday, January 5, 2011
SA Impingement tests
Neer impingement sign, HawkinseKennedy impingement test, Patte maneuver as well as Jobe supraspinatus test, are highly reproducible and therefore reliable to use in clinical practice to identify patients with sub- acromial pain with an impingement phenomenon, but the maneuvers are limited as structural discriminators > from Johansson et al.; Manual Therapy 14 (2009) 231-239
Thessaly Test for meniscus
The Thessaly test revealed a sensitivity of 90.3%, specificity of 97.7%, positive predictive value of 98.5%, negative predictive value of 86.0%, likelihood ratio for a positive test of 39.3, likelihood ratio for a negative test of 0.09, and diagnostic accuracy of 88.8%. The Thessaly test is a valid and reproducible phy...sical examination technique for predicting meniscal tears. The Thessaly test shows promise as an easily performed maneuver that may have better diagnostic accuracy than traditional tests > from Harrison et al.; Clinical Journal of Sports Medicine 19 (2009) 9-12.The accuracy of the Thessaly test in patients with combined ACL and meniscus injuries: The Thessaly test had a sensitivity of 79%, specificity of 40%, positive predictive value of 56%, negative predictive value of 66%, positive likelihood ratio of 1.33, negative likelihood ratio of 0.51%, and overall accuracy of 60%. We concluded that the Thesally test has a low specificity in patients with combined ACL and meniscal injuries and can not be recommended as a diagnostic test in this setting > from Mirzatolooei et al.; The Knee 17 (2010) 221-223
Check the video out: http://www.youtube.com/watch?v=84pZh0n_rMg
Check the video out: http://www.youtube.com/watch?v=84pZh0n_rMg
Tuesday, January 4, 2011
Empty Can and Full can tests
The ‘empty can’ (EC) and ‘full can’ (FC) tests have been promoted as being able to isolate activity to supraspinatus and are therefore diagnostic of supraspinatus dysfunction. While both EC and FC tests activated supraspinatus to levels approximately 90%, eight other shoulder muscles tested including other rotator cuff... muscles (infraspinatus and upper subscapularis), scapular positioning muscles (upper, middle and lower trapezius, and serratus anterior), and abduction torque producing muscles (anterior and middle deltoid) were activated to similarly high levels. In addition, supraspinatus and posterior deltoid were activated to similarly high levels in the EC test. Therefore, these tests should not be interpreted as definitive tests for the clinical diagnosis of supraspinatus pathology > from Boettcher et al.; Journal of Science and Medicine in Sport 12 (2009) 435–439
Monday, January 3, 2011
To stretch or not to stretch? That is the question.
Stretching is a very individual thing. Genetically and physiologically, we have different tissue types that make us up, that mean some people are naturally more flexible or 'stretchy' for want of a better word than others. Often it can be a case of trial and error during training sessions that determines whether you are someone that performs better following a stretching session, or recovers better by stretching after. Here are some general guidelines from recent studies on the effects of stretching:
1. Stretching at 80% of your maximum range of motion significantly decreases tension in the muscles being stretched, whereas stretching at full range often makes the muscle contract
2. Initial stretches at slow speeds are beneficial as they cause less resistance in the stretched muscle
3. The most economical time to hold a stretch is between 20 to 30 seconds. Anything less than doesn't seem to give any change in muscle length, anything longer doesn't seem to show extra benefit.
4. The greatest reduction in muscle tension when stretching takes place during the first stretch. The ideal number of repetitions to stretch is not currently known. So make sure the first one is an effective one!
5. If you already have a sufficient range of motion for the activities that you do in a sport, then the need to stretch beforehand is not always essential. In activities that require a greater range of motion eg. Ballet and karate, participants should perform some pre-stretching to achieve that required movement range.
6. Target your pre-stretching to the muscle groups known to be at risk for a particular sport eg. Hamstring strains in soccer, rotator cuff strains in tennis
7. There is evidence that stretching before an exercise session reduces the incidence of muscle strains, but not the incidence of overuse injuries.
8. Stretching after 'warm-up' is likely to be better than stretching when cold, as it seems to offer less resistance to stretch in a muscle.
If you're not sure whether you are someone that needs to stretch or not, get some professional advice from your physiotherapist, trainer or coach. Just remember what I said at the beginning, it can be a very individual thing depending on your body type, age and the exercise you are about to participate in, so make sure you're properly assessed before any recommendations are made.
References:
Decoster, L.C., Cleland, J., Altieri, C., Russell, P. The effects of hamstring stretching on range of motion: a systematic literature review. Journal of Orthopaedic & Sports Physical Therapy 2005: 35 (6):377-387
McHugh, P., Cosgrove, C.H. To stretch or not to stretch: the role of stretching in injury prevention and performance. Scandinavian Journal of Medicine and Science in Sports. 2010: 20: 169-181
McNair, P. Acute responses to stretches with isokinetic dynamometers. SportEX Medicine 2007: 34 (Oct):6-9
1. Stretching at 80% of your maximum range of motion significantly decreases tension in the muscles being stretched, whereas stretching at full range often makes the muscle contract
2. Initial stretches at slow speeds are beneficial as they cause less resistance in the stretched muscle
3. The most economical time to hold a stretch is between 20 to 30 seconds. Anything less than doesn't seem to give any change in muscle length, anything longer doesn't seem to show extra benefit.
4. The greatest reduction in muscle tension when stretching takes place during the first stretch. The ideal number of repetitions to stretch is not currently known. So make sure the first one is an effective one!
5. If you already have a sufficient range of motion for the activities that you do in a sport, then the need to stretch beforehand is not always essential. In activities that require a greater range of motion eg. Ballet and karate, participants should perform some pre-stretching to achieve that required movement range.
6. Target your pre-stretching to the muscle groups known to be at risk for a particular sport eg. Hamstring strains in soccer, rotator cuff strains in tennis
7. There is evidence that stretching before an exercise session reduces the incidence of muscle strains, but not the incidence of overuse injuries.
8. Stretching after 'warm-up' is likely to be better than stretching when cold, as it seems to offer less resistance to stretch in a muscle.
If you're not sure whether you are someone that needs to stretch or not, get some professional advice from your physiotherapist, trainer or coach. Just remember what I said at the beginning, it can be a very individual thing depending on your body type, age and the exercise you are about to participate in, so make sure you're properly assessed before any recommendations are made.
References:
Decoster, L.C., Cleland, J., Altieri, C., Russell, P. The effects of hamstring stretching on range of motion: a systematic literature review. Journal of Orthopaedic & Sports Physical Therapy 2005: 35 (6):377-387
McHugh, P., Cosgrove, C.H. To stretch or not to stretch: the role of stretching in injury prevention and performance. Scandinavian Journal of Medicine and Science in Sports. 2010: 20: 169-181
McNair, P. Acute responses to stretches with isokinetic dynamometers. SportEX Medicine 2007: 34 (Oct):6-9
Rhomboids
Rhomboids
Rhomboid Major
Structure
The rhomboid major arises from the spinous processes of the thoracic vertebrae T2 to T5 as well as the supraspinous ligament. It inserts on the medial border of the scapula, from about the level of the scapular spine to the scapula's inferior angle. The rhomboid major is considered a superficial back muscle. It is deep to the trapezius, and is located directly inferior to the rhomboid minor. As the word rhomboid suggests, the rhomboid major is diamond-shaped. The major in its name indicates that it is the larger of the two rhomboids.
INNERVATION AND BLOOD SUPPLY
The rhomboid major, like the rhomboid minor, is innervated by the ventral primary ramus via the dorsal scapular nerve (C5). Both rhomboid muscles also derive their arterial blood supply from the dorsal scapular artery.
ACTIONS
The rhomboid major helps to hold the scapula (and thus the upper limb) onto the ribcage. It also acts to retract the scapula, pulling it towards the vertebral column, and downwardly rotates the scapula with respect to the glenohumeral joint. It works collectively with the levator scapulae to elevate the medial border of the scapula.
Origin
spinous processes of the T2 to T5 vertebrae
Insertion
medial border of the scapula, inferior to the insertion of rhomboid minor muscle
Artery
dorsal scapular artery
Nerve
dorsal scapular nerve (C4 and C5)
Actions
Retracts the scapula and rotates it to depress the glenoid cavity. It also fixes the scapula to the thoracic wall.
Antagonist
Serratus anterior muscle
Origin
spinous processes of the T2 to T5 vertebrae
Insertion
medial border of the scapula, inferior to the insertion of rhomboid minor muscle
Artery
dorsal scapular artery
Nerve
dorsal scapular nerve (C4 and C5)
Actions
Retracts the scapula and rotates it to depress the glenoid cavity. It also fixes the scapula to the thoracic wall.
Antagonist
Serratus anterior muscle
Muscles connecting the upper extremity to the vertebral column. (Rhomboideus major visible at upper center right, near shoulder.)
Latin
musculus rhomboideus major
Gray's
subject #121 434
Origin
spinous processes of the T2 to T5 vertebrae
Insertion
medial border of the scapula, inferior to the insertion of rhomboid minor muscle
Artery
dorsal scapular artery
Nerve
dorsal scapular nerve (C4 and C5)
Actions
Retracts the scapula and rotates it to depress the glenoid cavity. It also fixes the scapula to the thoracic wall.
Antagonist
Serratus anterior muscle
Rhomboid Major
Structure
The rhomboid major arises from the spinous processes of the thoracic vertebrae T2 to T5 as well as the supraspinous ligament. It inserts on the medial border of the scapula, from about the level of the scapular spine to the scapula's inferior angle. The rhomboid major is considered a superficial back muscle. It is deep to the trapezius, and is located directly inferior to the rhomboid minor. As the word rhomboid suggests, the rhomboid major is diamond-shaped. The major in its name indicates that it is the larger of the two rhomboids.
INNERVATION AND BLOOD SUPPLY
The rhomboid major, like the rhomboid minor, is innervated by the ventral primary ramus via the dorsal scapular nerve (C5). Both rhomboid muscles also derive their arterial blood supply from the dorsal scapular artery.
ACTIONS
The rhomboid major helps to hold the scapula (and thus the upper limb) onto the ribcage. It also acts to retract the scapula, pulling it towards the vertebral column, and downwardly rotates the scapula with respect to the glenohumeral joint. It works collectively with the levator scapulae to elevate the medial border of the scapula.
Origin
spinous processes of the T2 to T5 vertebrae
Insertion
medial border of the scapula, inferior to the insertion of rhomboid minor muscle
Artery
dorsal scapular artery
Nerve
dorsal scapular nerve (C4 and C5)
Actions
Retracts the scapula and rotates it to depress the glenoid cavity. It also fixes the scapula to the thoracic wall.
Antagonist
Serratus anterior muscle
Origin
spinous processes of the T2 to T5 vertebrae
Insertion
medial border of the scapula, inferior to the insertion of rhomboid minor muscle
Artery
dorsal scapular artery
Nerve
dorsal scapular nerve (C4 and C5)
Actions
Retracts the scapula and rotates it to depress the glenoid cavity. It also fixes the scapula to the thoracic wall.
Antagonist
Serratus anterior muscle
Muscles connecting the upper extremity to the vertebral column. (Rhomboideus major visible at upper center right, near shoulder.)
Latin
musculus rhomboideus major
Gray's
subject #121 434
Origin
spinous processes of the T2 to T5 vertebrae
Insertion
medial border of the scapula, inferior to the insertion of rhomboid minor muscle
Artery
dorsal scapular artery
Nerve
dorsal scapular nerve (C4 and C5)
Actions
Retracts the scapula and rotates it to depress the glenoid cavity. It also fixes the scapula to the thoracic wall.
Antagonist
Serratus anterior muscle
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