Lower limb stress fractures are common injuries in runners. In terms of treatment, much of the me... more Lower limb stress fractures are common injuries in runners. In terms of treatment, much of the medical literature has focused primarily on rest and cessation of running, but little has been written about the rehabilitation and functional progression of runners following a lower limb stress fracture. This article reviews the scientific evidence behind common rehabilitation concepts used for runners recovering from these injuries and also discusses sport-specific training modalities such as deep water running and antigravity treadmill training. Overall this article is intended to be a practical resource for clinicians to guide runners in functional rehabilitation and return to running following lower limb stress injury.
Physical medicine and rehabilitation clinics of North America, 2005
Foot and ankle injuries are common in runners. Treatment is becoming more evidence-based for the ... more Foot and ankle injuries are common in runners. Treatment is becoming more evidence-based for the most common of these conditions; however, further research is needed to determine the best treatments for injuries that are encountered less commonly.
Physical medicine and rehabilitation clinics of North America, 2004
Shoulder stiffness is a common but poorly understood disorder of the glenohumeral joint. Many ter... more Shoulder stiffness is a common but poorly understood disorder of the glenohumeral joint. Many terms are used to describe a stiff shoulder, including frozen shoulder and adhesive capsulitis. This article reviews the terminology, classification, diagnostic options, and management options of shoulder stiffness. Conservative measures,emphasizing a four-quadrant stretching program, typically produce effective treatment outcomes. Operative interventions, which may be required for the small percentage of patients who fail conservative therapy, are also presented.
Participation in contact sports exposes the athlete to a risk of cervical spine injury. Temporary... more Participation in contact sports exposes the athlete to a risk of cervical spine injury. Temporary neurological injuries manifesting as radiating arm pain or paresthesias, such as transient quadriparesis and stingers, present unique challenges for the sports medicine physician and will be reviewed in detail. The initial management of these conditions must recognize signs and symptoms of spinal cord injury and prevent further neurological sequelae. Evaluation will often include advanced imaging of the cervical spine in addition to serial neurological examinations. This review concludes with rational return-to-play guidelines for contact sport athletes.
The diverse exercise goals of the aging population present several challenges to physicians. Wher... more The diverse exercise goals of the aging population present several challenges to physicians. Whereas some Masters athletes aim to set personal time records, sedentary elderly persons may look to exercise to help maintain independence and combat functional decline. This review article examines the common cardiovascular and neuromuscular physiological changes associated with aging and how regular exercise is used to improve physiological parameters and functional abilities. Exercise precautions specific to the elderly population are discussed. Exercise recommendations for persons with osteoarthritis and after joint arthroplasty also are presented.
A 27-year-old runner presented to our sports medicine clinic with 4 months of medial foot pain af... more A 27-year-old runner presented to our sports medicine clinic with 4 months of medial foot pain after an eversion ankle sprain. Initial radiographs were negative for fracture. Her symptoms improved but plateaued after 1 month. She was unable to continue running and noticed a new prominence at her right medial foot. Results of a physical examination showed pes planus, a prominent navicular in her right foot and mild weakness of inversion at the right ankle. Magnetic resonance imaging showed bone edema adjacent to a navicular synchondrosis, which confirmed a diagnosis of type 2 accessory navicular with synchondrosis injury. The patient was treated conservatively with a progressive rehabilitation course.
Objective: This self-directed learning module highlights tendinopathy associated with sports and ... more Objective: This self-directed learning module highlights tendinopathy associated with sports and performing arts. It is part of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. Using a case vignette format, this article specifically focuses on the etiology, pathophysiology, clinical presentation, diagnostic imaging, and management recommendations for tendinopathy. The goal of this article is to allow the learner to better describe the pathophysiology and diagnostic imaging characteristics of tendinopathy, and to formulate an appropriate nonsurgical management algorithm for tendinopathies.
Objective: This self-directed learning module highlights common conditions associated with specif... more Objective: This self-directed learning module highlights common conditions associated with specific populations. It is part of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. Using a case vignette format, this article specifically focuses on the osteoarthritis and cardiac safety in the senior athlete, hip problems in the pediatric athlete, classification of athletes with disabilities, and the female triad and exercise during pregnancy in female athletes. The goal of this article is to assist the learner in developing an understanding of issues related to specific athletic populations.
Objective: This self-directed learning module highlights medical coverage of sports events and ar... more Objective: This self-directed learning module highlights medical coverage of sports events and artistic performances. It is part of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. Using a case vignette format, this article specifically focuses on performance anxiety, exercise-associated collapse, exercise-induced asthma, transient quadriparesis, stingers/burners and anterior glenohumeral joint dislocations. The goal of this article is to improve the learner's ability to formulate and implement an appropriate evaluation and treatment algorithm for certain conditions associated with sports and performing arts events.
Objective: This self-directed learning module highlights select spine and neurological injuries i... more Objective: This self-directed learning module highlights select spine and neurological injuries in athletes and performing arts injuries. It is part of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. Using a case vignette format, this article specifically focuses on sports-induced concussion, stingers and transient myelopathy, and buttock pain in athletes, and hand dystonia and hand numbness in musicians. The goal of this article is to facilitate the learner's ability to diagnose and treat spine and neurologic injuries in athletes and performing artists.
Lower limb stress fractures are common injuries in runners. In terms of treatment, much of the me... more Lower limb stress fractures are common injuries in runners. In terms of treatment, much of the medical literature has focused primarily on rest and cessation of running, but little has been written about the rehabilitation and functional progression of runners following a lower limb stress fracture. This article reviews the scientific evidence behind common rehabilitation concepts used for runners recovering from these injuries and also discusses sport-specific training modalities such as deep water running and antigravity treadmill training. Overall this article is intended to be a practical resource for clinicians to guide runners in functional rehabilitation and return to running following lower limb stress injury.
Physical medicine and rehabilitation clinics of North America, 2005
Foot and ankle injuries are common in runners. Treatment is becoming more evidence-based for the ... more Foot and ankle injuries are common in runners. Treatment is becoming more evidence-based for the most common of these conditions; however, further research is needed to determine the best treatments for injuries that are encountered less commonly.
Physical medicine and rehabilitation clinics of North America, 2004
Shoulder stiffness is a common but poorly understood disorder of the glenohumeral joint. Many ter... more Shoulder stiffness is a common but poorly understood disorder of the glenohumeral joint. Many terms are used to describe a stiff shoulder, including frozen shoulder and adhesive capsulitis. This article reviews the terminology, classification, diagnostic options, and management options of shoulder stiffness. Conservative measures,emphasizing a four-quadrant stretching program, typically produce effective treatment outcomes. Operative interventions, which may be required for the small percentage of patients who fail conservative therapy, are also presented.
Participation in contact sports exposes the athlete to a risk of cervical spine injury. Temporary... more Participation in contact sports exposes the athlete to a risk of cervical spine injury. Temporary neurological injuries manifesting as radiating arm pain or paresthesias, such as transient quadriparesis and stingers, present unique challenges for the sports medicine physician and will be reviewed in detail. The initial management of these conditions must recognize signs and symptoms of spinal cord injury and prevent further neurological sequelae. Evaluation will often include advanced imaging of the cervical spine in addition to serial neurological examinations. This review concludes with rational return-to-play guidelines for contact sport athletes.
The diverse exercise goals of the aging population present several challenges to physicians. Wher... more The diverse exercise goals of the aging population present several challenges to physicians. Whereas some Masters athletes aim to set personal time records, sedentary elderly persons may look to exercise to help maintain independence and combat functional decline. This review article examines the common cardiovascular and neuromuscular physiological changes associated with aging and how regular exercise is used to improve physiological parameters and functional abilities. Exercise precautions specific to the elderly population are discussed. Exercise recommendations for persons with osteoarthritis and after joint arthroplasty also are presented.
A 27-year-old runner presented to our sports medicine clinic with 4 months of medial foot pain af... more A 27-year-old runner presented to our sports medicine clinic with 4 months of medial foot pain after an eversion ankle sprain. Initial radiographs were negative for fracture. Her symptoms improved but plateaued after 1 month. She was unable to continue running and noticed a new prominence at her right medial foot. Results of a physical examination showed pes planus, a prominent navicular in her right foot and mild weakness of inversion at the right ankle. Magnetic resonance imaging showed bone edema adjacent to a navicular synchondrosis, which confirmed a diagnosis of type 2 accessory navicular with synchondrosis injury. The patient was treated conservatively with a progressive rehabilitation course.
Objective: This self-directed learning module highlights tendinopathy associated with sports and ... more Objective: This self-directed learning module highlights tendinopathy associated with sports and performing arts. It is part of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. Using a case vignette format, this article specifically focuses on the etiology, pathophysiology, clinical presentation, diagnostic imaging, and management recommendations for tendinopathy. The goal of this article is to allow the learner to better describe the pathophysiology and diagnostic imaging characteristics of tendinopathy, and to formulate an appropriate nonsurgical management algorithm for tendinopathies.
Objective: This self-directed learning module highlights common conditions associated with specif... more Objective: This self-directed learning module highlights common conditions associated with specific populations. It is part of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. Using a case vignette format, this article specifically focuses on the osteoarthritis and cardiac safety in the senior athlete, hip problems in the pediatric athlete, classification of athletes with disabilities, and the female triad and exercise during pregnancy in female athletes. The goal of this article is to assist the learner in developing an understanding of issues related to specific athletic populations.
Objective: This self-directed learning module highlights medical coverage of sports events and ar... more Objective: This self-directed learning module highlights medical coverage of sports events and artistic performances. It is part of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. Using a case vignette format, this article specifically focuses on performance anxiety, exercise-associated collapse, exercise-induced asthma, transient quadriparesis, stingers/burners and anterior glenohumeral joint dislocations. The goal of this article is to improve the learner's ability to formulate and implement an appropriate evaluation and treatment algorithm for certain conditions associated with sports and performing arts events.
Objective: This self-directed learning module highlights select spine and neurological injuries i... more Objective: This self-directed learning module highlights select spine and neurological injuries in athletes and performing arts injuries. It is part of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. Using a case vignette format, this article specifically focuses on sports-induced concussion, stingers and transient myelopathy, and buttock pain in athletes, and hand dystonia and hand numbness in musicians. The goal of this article is to facilitate the learner's ability to diagnose and treat spine and neurologic injuries in athletes and performing artists.
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