Dear Mel,
Funny you should write this. A few weeks ago a doctor in the
clinic I work in referred me a patient with patella tendinitis who
plays rugby union. Upon briefly consulting with the doctor he
informed me that he had told the patient that he needed
quads strengthening exercises. When I saw the patients quads
and looked at resisted contraction and muscle bulk, there was no
problem with strength or muscle bulk.
I have a possible explanation for this. A few years ago we had
a lecture from an orthopaedic surgeon that followed in a discussion
on anteverted NOF. He claimed that elite athletes tend to have
an anteverted NOF, and that the compensatory tibial rotations
produced by this gave them better athletic ability. It makes sense
to me that this same advantage is also an anatomical alignment that
also relates to injury eg. altered patella tracking, varus tibia,
hyperpronation, plantarflexed first ray etc.
Does the list think it conceivable that this could be the link in the
study that mel posted?
Comments.......
Scott Epsley
Physiotherapist
Brisbane, Australia.
--
On Tue, 1 Feb 2000 08:21:07 Mcsiff wrote:
>It is commonly accepted that all musculoskeletal injuries automatically lead
>to a decrease in laboratory and sporting measures of athletic performances.
>This, however may not necessarily be true in all cases, as emerges from the
>following study.
>
>Lian O et al Characteristics of the leg extensors in male volleyball players
>with jumper's knee
>Am J Sports Med 1996 May-Jun; 24(3):380-5
>
>The aim of this study was to examine the performance ability of the leg
>extensor apparatus in a group of athletes with jumper's knee and to compare
>the results with those of a matched control group without knee symptoms.
>Patient and control groups were selected from a population of 141
>well-trained male Norwegian volleyball players, of which 39% satisfied the
>diagnostic criteria for jumper's knee. The testing program consisted of a
>standing jump, a countermovement jump, a 15-second rebound jump test, a
>standing jump with a 20-kg load, and a standing jump with a load
>corresponding to one-half of the subject's body weight. Jump height and power
>were measured using a contact mat connected to an electronic timer. The
>results of the patient group were significantly higher than those of the
>control group for the countermovement jump (15% increase), power during
>rebound jump (41%), work done in standing jump (12%) and countermovement jump
>(22%), and the difference between countermovement jump and standing jump
>(effect of adding eccentric component).
>
>Athletes with jumper's knee demonstrated better performance in jump tests
>than uninjured athletes, particularly in ballistic jumps involving eccentric
>force generation.
>---------------------------------------------------------------
>
>Several years ago, I presented similar findings at the 1995 S African Sports
>Medicine Congress (Mar 22-, Durban, SA) in a paper called "Limitations of
>Isokinetic Testing and Rehabilitation". In it I showed isokinetic knee
>extension and flexion tests of weightlifters and powerlifters with
>peripatellar pain syndrome or chondromalacia patellae which revealed in
>several cases that athletes could produce greater torque with their injured
>knees than their healthy knees. I also noted no consistent correlation
>between maximal squat weight and isokinetic measures of torque decrease or
>discrepancy.
>
>Interestingly, several of the lifters whom I tested could execute heavy
>squats with little or moderate pain, but they experienced high levels of pain
>during seated isokinetic leg extension testing and were not able to produce
>torques that would be expected from such powerful athletes. Thus, it may
>well be that individual experience and perception of pain may play a central
>role in determining the outcome of laboratory and functional sporting tests.
>
>Findings such as these cited above suggest that clinical tests and standard
>beliefs about the effect of non-immobilising injuries may need to be
>seriously re-examined. Has anyone else noticed this sort of apparent
>contradiction among their athletes or laboratory subjects?
>
>Mel Siff
>
>Dr Mel C Siff
>Denver, USA
>[log in to unmask]
>
>
>
>
MailCity. Secure Email Anywhere, Anytime!
http://www.mailcity.com
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|