Journal of Back and Musculoskeletal Rehabilitation - Volume 5, issue 4
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Journal of Back and Musculoskeletal Rehabilitation is a journal whose main focus is to present relevant information about the interdisciplinary approach to musculoskeletal rehabilitation for clinicians who treat patients with back and musculoskeletal pain complaints. It will provide readers with both 1) a general fund of knowledge on the assessment and management of specific problems and 2) new information considered to be state-of-the-art in the field. The intended audience is multidisciplinary as well as multi-specialty.
In each issue clinicians can find information which they can use in their patient setting the very next day. Manuscripts are provided from a range of health care providers including those in physical medicine, orthopedic surgery, rheumatology, neurosurgery, physical therapy, radiology, osteopathy, chiropractic and nursing on topics ranging from chronic pain to sports medicine. Diagnostic decision trees and treatment algorithms are encouraged in each manuscript. Controversial topics are discussed in commentaries and rebuttals. Associated areas such as medical-legal, worker's compensation and practice guidelines are included.
The journal publishes original research papers, review articles, programme descriptions and cast studies. Letters to the editors, commentaries, and editorials are also welcomed. Manuscripts are peer reviewed. Constructive critiques are given to each author. Suggestions for thematic issues and proposed manuscripts are welcomed.
Abstract: Correct diagnosis and successful treatment of running related injuries are based on a firm understanding of the biomechanics of running. The sports medicine practitioner, knowing the principles of the bone and muscular interactions of the structures involved in running, can generate specific, accurate diagnosis and detailed, individualized treatment and prevention protocols. Intrinsic biomechanical factors and extrinsic influences will be examined for their effects on running and related injuries.
Abstract: The evaluation of the injured runner emphasizes the identification of intrinsic and extrinsic risk factors in addition to establishing injury specific diagnosis. The history emphasizes identification of contributory changes in training regimen or technique. The physical examination includes a biomechanical screening to identify related imbalances in posture, alignment, strength, and flexibility. This comprehensive, running specific approach to diagnosis will assist the clinician in developing optimum rehabilitation programs.
Abstract: This article will discuss some of the common overload injuries that occur in runners. An approach to accurate diagnosis will be described in terms of tissue injuries, clinical symptoms, specific tissues overloaded, functional biomechanical deficits, and functional adaptations that occur. With this background, specific principles of rehabilitation of these disorders will be described.
Abstract: Patellofemoral pain is one of the most common knee disorders affecting runners. The vast majority of cases arc related to some degree of patellar malalignment. This article addresses how to assess both static and dynamic factors contributing to altered patellar position and lower extremity mechanics. Emphasis is given to the anatomic, soft tissue and strength deficits that must be considered for correction of patellar mal alignment and a successful rehabilitation program.
Abstract: Interest and participation in running has increased over the past several decades. There has also been a substantial increase in the incidence and prevalence of injuries associated with running. The etiology of running injuries is multifactorial. Of all the musculoskeletal injuries associated with running, lumbar spine injuries are among the least common – yet can be the most debilitating. The impact load generated during heelstrike travels up the lower extremity kinetic chain and converges on the lumbar spine. This impact load is minimized through a series of normal biomechanical actions of the joints and the soft tissues that support them.…Dysfunction at any link in the lower extremity kinetic chain can set off a cascading series of mechanical adaptations throughout the spinal axis. Similarly, spinal pain and dysfunction can create peripheral joint adaptations. These mechanical adaptations may become painful or may create a painful dysfunction at a more distant site. There are a variety of structures in the lumbar spine that can cause pain. Mechanical, vascular, biochemical, and neurochemical factors may also be involved in the production of low back pain and radiculopathy. Running stresses the normal biomechanics of the lumbar spine. Changes in normal tissue function including strength, strength balance, flexibility, and proprioception may be caused by these stresses or be the cause of them. New adaptive functional running patterns occur. A thorough rehabilitation plan that addresses all aspects of the injury requires an accurate and complete diagnosis that is made as soon as possible. The rehabilitation program is divided into acute and subacute phases. Education, physical modalities, medication, manual therapy, traction and therapeutic exercise are used to help meet the goals of the acute phase of rehabilitation. The goals of the subacute phase are met by optimizing strength, endurance, and coordination of the neuromuscular system as it affects the lumbar spine and preventing any further injury or recurrences. Running specific rehabilitation may start early in the subacute phase and then progress as the runner's spine stabilization skills improve.
Abstract: Stress fractures, were first described in military recruits but in recent years have increasingly been described in runners. In most surveys they comprise between 10 and 20% of all running injuries. The tibia is the most common site of all stress fractures although recent studies involving track and field athletes show an increased incidence of navicular stress fractures. The diagnosis is based on the clinical findings of a history of exercise-related bone pain with local bony tenderness on examination. The diagnosis is often confirmed by a typical appearance on an isotope bone scan or plain radiograph. In general, treatment consists…of relative rest from the aggravating activity until symptom-free and then graduated resumption of activity. Attention also needs to be paid to correction of possible causative factors. These include excessive training, low bone density, low calcium intake, menstrual abnormalities in females and biomechanical features such as excessive sub-talar pronation. Certain stress fractures, such as those in the navicular, require specific management, e.g. six weeks non-weight bearing cast immobilization.