Achilles Pain, Stiness, and Muscle Power Deficits: Achilles Tendinitis

Total Page:16

File Type:pdf, Size:1020Kb

Achilles Pain, Stiness, and Muscle Power Deficits: Achilles Tendinitis Clinical Guidelines CHRISTOPHER R. CARCIA, PT, PhDHE8HEOB$C7HJ?D"PT, PhD@;<<>EK9A"PT, PhD:7D;A$MKA?9>" MD Achilles Pain, Sti!ness, and Muscle Power Deficits: Achilles Tendinitis Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability, and Health from the Orthopaedic Section of the American Physical Therapy Association J Orthop Sports Phys Ther. 2010:40(9):A1-A26. doi:10.2519/jospt.2010.0305 RECOMMENDATIONS$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$ A2 INTRODUCTION$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$A3 METHODS$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$A3 CLINICAL GUIDELINES: Impairment-Function-Based Diagnosis $$$$$$$$$$$$$$$$$$ A7 CLINICAL GUIDELINES: Examinations$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$ A11 CLINICAL GUIDELINES: Interventions$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$A16 SUMMARY OF RECOMMENDATIONS$$$$$$$$$$$$$$$$$$$$$$$$$$$$$ A21 AUTHOR/REVIEWER AFFILIATIONS AND CONTACTS$$$$$$A22 REFERENCES$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$ A23 H;L?;M;HI0Heo7bjcWd"C:IWdZhW9khm_d"8IYF^oi_e"F^:7dj^edo:[b_jje"FJ"F^:@e^d:[M_jj":FJ7cWdZW<[hbWdZ":FJ >[b[d[<[Whed"FJ@eoCWY:[hc_Z"FJ"F^:@Wc[iM$CWj^[ied":FJJ^ecWi=$CYFe_bFJ"F^:F^_b_fCY9bkh["FJ"F^: Ij[f^[dH[_iY^b":FJFWkbI^[a[bb["C:"F^:7$Hkii[bbIc_j^"@h"FJ";Z:B[ib_[JehXkhd":FJ@Wc[iPWY^Wp[mia_":FJ <ehWkj^eh"YeehZ_dWjeh"WdZh[l_[m[hWøb_Wj_edii[[[dZe\j[nj$(&'&Ehj^efW[Z_YI[Yj_ed7c[h_YWdF^oi_YWbJ^[hWfo7iieY_Wj_ed7FJ7"?dY"WdZj^[Journal of Orthopaedic & Sports Physical Therapy$J^[Ehj^efW[Z_YI[Yj_ed"7FJ7"?dY"WdZj^[Journal of Orthopaedic & Sports Physical TherapyYedi[djjej^[h[fheZkY_d]WdZ Z_ijh_Xkj_d]j^_i]k_Z[b_d[\eh[ZkYWj_edWbfkhfei[i$7ZZh[iiYehh[ifedZ[dY[je@ei[f^@$=eZ][i":FJ"?9<FhWYj_Y[=k_Z[b_d[i9eehZ_dWjeh"Ehj^efW[Z_YI[Yj_ed"7FJ7 ?dY"(/(&;Wij7l[dk[Iekj^"Ik_j[(&&"BW9heii["M?+*,&'$;#cW_b0_Y\6ehj^efj$eh] 40-09 Guidelines-Achilles Tendinopathy.indd 1 8/18/10 11:22 AM Achilles Tendinopathy: Clinical Practice Guidelines Recommendations* H?IA<79JEHI0 For specific groups of individuals, clinicians ;N7C?D7J?EDÅF>OI?97B?CF7?HC;DJC;7IKH;I0 When evaluat- should consider abnormal ankle dorsiflexion range of mo- ing physical impairment over an episode of care for those with tion, abnormal subtalar joint range of motion, decreased ankle Achilles tendinopathy, one should consider measuring dorsi- plantar flexion strength, increased foot pronation, and abnor- flexion range of motion, subtalar joint range of motion, plantar mal tendon structure as intrinsic risk factors associated with flexion strength and endurance, static arch height, forefoot Achilles tendinopathy. Obesity, hypertension, hyperlipidemia, alignment, and pain with palpation. (Recommendations based and diabetes are medical conditions associated with Achilles on moderate evidence.) tendinopathy. Clinicians should also consider training errors, environmental factors, and faulty equipment as extrinsic risk ?DJ;HL;DJ?EDIÅ;99;DJH?9BE7:?D=0 Clinicians should consider factors associated with Achilles tendinopathy. (Recommenda- implementing an eccentric loading program to decrease pain tion based on moderate evidence.) and improve function in patients with midportion Achilles ten- dinopathy. (Recommendation based on strong evidence.) :?7=DEI?I%9B7II?<?97J?ED0 Self-reported localized pain and perceived sti!ness in the Achilles tendon following a period of ?DJ;HL;DJ?EDIÅBEM#B;L;BB7I;HJ>;H7FO0 Clinicians should inactivity (ie, sleep, prolonged sitting), lessens with an acute consider the use of low-level laser therapy to decrease pain and bout of activity and may increase after the activity. Symptoms sti!ness in patients with Achilles tendinopathy. (Recommenda- are frequently accompanied with Achilles tendon tenderness, tion based on moderate evidence.) a positive arc sign, and positive findings on the Royal London Hospital test. These signs and symptoms are useful clinical ?DJ;HL;DJ?EDIÅ?EDJEF>EH;I?I0 Clinicians should consider findings for classifying a patient with ankle pain into the ICD the use of iontophoresis with dexamethasone to decrease pain category of Achilles bursitis or tendinitis and the associated ICF and improve function in patients with Achilles tendinopathy. impairment-based category of Achilles pain (b28015 Pain in (Recommendation based on moderate evidence.) lower limb), sti!ness (b7800 Sensation of muscle sti!ness), and ?DJ;HL;DJ?EDIÅIJH;J9>?D=0 Stretching exercises can be used muscle power deficits (b7301 Power of muscles of lower limb). to reduce pain and improve function in patients who exhibit (Recommendation based on weak evidence.) limited dorsiflexion range of motion with Achilles tendinopathy. (Recommendation based on weak evidence). :?<<;H;DJ?7B:?7=DEI?I0 Clinicians should consider diagnos- tic classifications other than Achilles tendinopathy when the ?DJ;HL;DJ?EDIÅ<EEJEHJ>EI;I0 A foot orthosis can be used to patient’s reported activity limitations or impairments of body reduce pain and alter ankle and foot kinematics while running function and structure are not consistent with those presented in patients with Achilles tendinopathy. (Recommendation based in the diagnosis/classification section of this guideline, or, when on weak evidence.) the patient’s symptoms are not resolving with interventions aimed at normalization of the patient’s impairments of body ?DJ;HL;DJ?EDIÅC7DK7BJ>;H7FO0 Soft tissue mobilization can function. (Recommendation based on expert opinion.) be used to reduce pain and improve mobility and function in patients with Achilles tendinopathy. (Recommendation based ;N7C?D7J?EDÅEKJ9EC;C;7IKH;I0 Clinicians should incor- on expert opinion.) porate validated functional outcome measures, such as the Victorian Institute of Sport Assessment and the Foot and Ankle ?DJ;HL;DJ?EDIÅJ7F?D=0 Taping may be used in an attempt to Ability Measure. These should be utilized before and after inter- decrease strain on the Achilles tendon in patients with Achilles ventions intended to alleviate the impairments of body function tendinopathy. (Recommendation based on expert opinion.) and structure, activity limitations, and participation restrictions associated with Achilles tendinopathy. (Recommendation based ?DJ;HL;DJ?EDIÅ>;;BB?<J0 Contradictory evidence exists for the on strong evidence.) use of heel lifts in patients with Achilles tendinopathy. (Recom- mendation based on conflicting evidence.) ;N7C?D7J?EDÅ79J?L?JOB?C?J7J?ED7D:F7HJ?9?F7J?EDH;IJH?9- J?EDC;7IKH;I0 When evaluating functional limitations over an ?DJ;HL;DJ?EDIÅD?=>JIFB?DJ0 Night splints are not benefi- episode of care for those with Achilles tendinopathy, measures cial in reducing pain when compared to eccentric exercise for of activity limitation and participation restriction can include patients with Achilles tendinopathy. (Recommendation based objective and reproducible assessment of the ability to walk, on weak evidence.) descend stairs, perform unilateral heel raises and single-limb hop, and participate in recreational activity. (Recommendation J^[i[h[Yecc[dZWj_ediWdZYb_d_YWbfhWYj_Y[]k_Z[b_d[iWh[XWi[Zedj^[iY_[dj_ÓY based on moderate evidence.) b_j[hWjkh[fkXb_i^[Zfh_ehje<[XhkWho(&&/$ a2 | september 2010 | number 9 | volume 40 | journal of orthopaedic & sports physical therapy 40-09 Guidelines-Achilles Tendinopathy.indd 2 8/18/10 10:18 AM Achilles Tendinopathy: Clinical Practice Guidelines Introduction 7?CE<J>;=K?:;B?D; accepted terminology, of the practice of orthopaedic physi- The Orthopaedic Section of the American Physical Therapy cal therapists Association (APTA) has an ongoing e"ort to create evidence- Ikhob]^bg_hkfZmbhg_hkiZrhklZg]\eZbflk^ob^p^klk^`Zk]- based practice guidelines for orthopaedic physical therapy ing the practice of orthopaedic physical therapy for common management of patients with musculoskeletal impairments musculoskeletal conditions described in the World Health Organization’s International <k^Zm^ Z k^_^k^g\^ in[eb\Zmbhg _hk hkmahiZ^]b\ iarlb\Ze Classification of Functioning, Disability, and Health (ICF).135 therapy clinicians, academic instructors, clinical instructors, students, interns, residents, and fellows regarding the best The purposes of these clinical guidelines are to: current practice of orthopaedic physical therapy IJ7J;C;DJE<?DJ;DJ =^l\kb[^^ob]^g\^&[Zl^]iarlb\Zema^kZirikZ\mb\^bg\en]bg` This guideline is not intended to be construed or to serve as a diagnosis, prognosis, intervention, and assessment of out- standard of clinical care. Standards of care are determined on come for musculoskeletal disorders commonly managed by the basis of all clinical data available for an individual patient orthopaedic physical therapists and are subject to change as scientific knowledge and technol- <eZllb_rZg]]^Ög^\hffhgfnl\nehld^e^mZe\hg]bmbhglnl- ogy advance and patterns of care evolve. These parameters of ing the World Health Organization’s terminology related to practice should be considered guidelines only. Adherence to impairments of body function and body structure, activity them will not ensure a successful outcome in every patient, limitations, and participation restrictions nor should they be construed as including all proper methods B]^gmb_rbgm^ko^gmbhgllniihkm^][r\nkk^gm[^lm^ob]^g\^mh of care or excluding other acceptable methods of care aimed address impairments of body function and structure, activ- at the same results. The ultimate judgment regarding a par- ity limitations, and participation restrictions associated with ticular clinical procedure or treatment plan must be made in common
Recommended publications
  • Effects of 8 Weeks of Eccentric Training on Hamstring Flexibility and Muscular Performance Among Healthy Overweight and Obese Women
    EFFECTS OF 8 WEEKS OF ECCENTRIC TRAINING ON HAMSTRING FLEXIBILITY AND MUSCULAR PERFORMANCE AMONG HEALTHY OVERWEIGHT AND OBESE WOMEN 1AYU S MUHAMAD, 2WAN M A W YUSOFF 1,2Exercise and Sports Science Programme, School of Health Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan E-mail: [email protected], [email protected] Abstract- This study was carried out to investigate the effects of 8 weeks of eccentric training on hamstring flexibility and muscular performance among healthy overweight and obese females. Twenty participants (N = 20) were recruited among USM staff and randomly divided into two groups, exercise group (n = 10; age = 40.10 ± 5.363 years old; BMI: 33.30 ± 4.90 kg/m2) and control group (n = 10; age = 44.30 ± 6.913; BMI: 29.0 ± 4.00 kg/m2). This experimental study use comparative analysis of pre and post-training. During both pre and post-training, a few measurements were carried out, passive 90°/90° test (hamstring flexibility), vertical jump test (muscle strength) and squat test (muscle power). Participants in the exercise group performed eccentric training using thera-band on both legs three times per week for eight weeks while participants in the control group did not perform any exercise. The data collected were analysed using paired and independent t test to measure significant differences between groups and within group. As a result, the exercise group showed significant increase (p < 0.05) in both left and right hamstring flexibility after the eight weeks of intervention. However, muscle strength and power did not significantly (p > 0.05) affected by eight weeks of eccentric training.
    [Show full text]
  • Accentuated Eccentric Training: Effects on Horizontal Jump Distance and Muscle Strength Among Young Adults
    MOJ Yoga & Physical Therapy Research Article Open Access Accentuated eccentric training: effects on horizontal jump distance and muscle strength among young adults Abstract Volume 3 Issue 3 - 2018 Accentuated eccentric loading is a training method in which greater load is applied during 1 1 eccentric phase in comparison to concentric phase of a coupled eccentric‒concentric action. Nizar Abdul Majeedkutty, Pang Shi Yiing, 2 The aim of this study was to evaluate the training effects of accentuated eccentric load Anila Paul countermovement jump on horizontal jump distance and muscle strength of lower extremity 1Department of Physiotherapy, University Tunku Abdul Rahman, among young adults. This study was designed as a randomized controlled trial with pretest Malaysia and post‒test model. The subjects were randomly categorized into a control group (n=15) 2Department of Physiotherapy, Medical Trust College of that underwent body‒mass countermovement jump and an intervention group (n=15) Physiotherapy, India submitted to Accentuated Eccentric Training. 30 subjects including 16 males and 14 females participated in the four‒week long training. Accentuated Eccentric Training group showed Correspondence: Nizar Abdul Majeedkutty, Department of significant improvement in horizontal jump distance and maximum muscle strength of lower Physiotherapy, University Tunku Abdul Rahman, Malaysia, Tel extremities. An increase in horizontal jump distance (+13.15%) and 5RM squat strength was 0060163702375, Email [email protected] noted (+23.14%) after four weeks of training. In conclusion, it would appear that Accentuated Eccentric Training enhance athletic performance in young adults. Application of accentuated Received: May 04, 2018 | Published: June 12, 2018 eccentric loading could be further investigated for its effects on agility and exercise induced muscle damage in athletes of different sports.
    [Show full text]
  • Eccentric Training in the Treatment of Tendinopathy
    Eccentric training in the treatment of tendinopathy Per Jonsson Umeå University Department of Surgical and Perioperative Sciences Sports Medicine 901 87 Umeå, Sweden Copyright©2009 Per Jonsson ISBN: 978-91-7264-821-0 ISSN: 0346-6612 (1279) Printed in Sweden by Print & Media, Umeå University, Umeå Figures 1-3,5: Reproduced with permission from Laszlo Jòzsa and Pekka Kannus Human Tendons Figures 4,6-7: Images by Gustav Andersson Figure 8: Reproduced with permission from Sports Medicine,´The Rotator Cuff: Biological Adaption to its Environment´Malcarney et al, 2003 Figures 9-21: Photos by Peter Forsgren and Jonas Lindberg All previously published papers were reproduced with permission from the publisher Eccentric training in the treatment of tendinopathy “No pain, no gain” Benjamin Franklin (1758) Dedicated to my family – Eva, Willy and Saga Per Jonsson Contents Abstract 7 Abbreviations 8 Original papers 9 Introduction/Background 10 The normal tendon 11 Anatomy 11 Collagen fibre orientation 12 Internal architecture 12 General innervation 13 General biomechanical forces in tendons 14 Metabolism 15 Disuse/immobilisation 15 Exercise/remobilisation 15 The Achilles tendon 17 Anatomy 17 The myotendinous junction (MTJ) 18 The osteotendinous junction (OTJ) 18 Tendon structure 19 Circulation 19 Innervation 19 Biomechanics 20 Achilles tendinopathy 20 Definitions 20 Epidemiology 21 Aetiology 21 Intrinsic risk factors 21 Extrinsic risk factors 22 Pathogenesis 23 Histology 24 Pain mechanisms 24 Clinical symptoms 25 Clinical examination 25 Differential
    [Show full text]
  • Eccentric Exercise in Ischemic Cardiac Patients and Functional Capacity
    G Model REHAB-1053; No. of Pages 7 Annals of Physical and Rehabilitation Medicine xxx (2016) xxx–xxx Available online at ScienceDirect www.sciencedirect.com Review Eccentric exercise in ischemic cardiac patients and functional capacity: A systematic review and meta-analysis of randomized controlled trials a, a a b c d C. Karagiannis *, C. Savva , I. Mamais , M. Efstathiou , M. Monticone , T. Xanthos a European University of Cyprus, School of Sciences, Department of Health Sciences, Nicosia, Cyprus b University of Nicosia, Department of Life and Health Sciences, Nicosia, Cyprus c University of Cagliari, Department of Public Health, Clinical and Molecular Medicine, Cagliari, Italy d European University of Cyprus, School of Medicine, Nicosia, Cyprus A R T I C L E I N F O A B S T R A C T Article history: Background: Eccentric (ECC) exercise is an ‘‘economical’’ type of exercise with low energy requirements Received 1st September 2016 and does not cause early fatigue. Therefore, it is used for cardiac patients, who have low physical activity Accepted 31 October 2016 and exercise intolerance, as an easier kind of training. Objective: This systematic review aimed to investigate the efficacy of ECC exercise for functional capacity Keywords: (FC) in patients with ischemic heart disease. Eccentric exercise Design: Systematic review. Ischemic heart disease Methods: MEDLINE via PubMed and EBSCO databases were searched for articles of randomized Functional capacity controlled trials of adults with ischemic heart disease who underwent ECC training as compared with Systematic review other forms of exercise (concentric exercise) or no exercise and assessed FC. The methodologic quality of studies was assessed by the PEDro scale.
    [Show full text]
  • Redalyc.Strength Training in Seniors: the Knowledge of Positive Aspects
    Journal of Human Sport and Exercise E-ISSN: 1988-5202 [email protected] Universidad de Alicante España GASSER, BENEDIKT; ZOSSO, MANUEL Strength training in seniors: The knowledge of positive aspects of eccentric training in elderly is sparse Journal of Human Sport and Exercise, vol. 12, núm. 3, 2017, pp. 659-667 Universidad de Alicante Alicante, España Available in: http://www.redalyc.org/articulo.oa?id=301053359010 How to cite Complete issue Scientific Information System More information about this article Network of Scientific Journals from Latin America, the Caribbean, Spain and Portugal Journal's homepage in redalyc.org Non-profit academic project, developed under the open access initiative Original Article Strength training in seniors: The knowledge of positive aspects of eccentric training in elderly is sparse BENEDIKT GASSER1 , MANUEL ZOSSO2 1Swiss Health Performance Lab., Institut für Anatomie, University of Berne, Switzerland 2Haute Ecole de Santé, Fribourg, Switzerland ABSTRACT Eccentric (lengthening) resistance training respectively muscle work requires a lower share of cardiac activity in comparison to concentric (shortening) muscle work. Especially in seniors suffering from cardiovascular diseases (still the most common cause of death in industrialized countries) this kind of activity is predisposed due to its possibility of high stimulation of musculoskeletal system only partly (20-25%) stimulating cardiovascular system. Comprehension of positive aspects was addressed for a sample of people doing regular work out while having access to concentric and eccentric training stations. 38 females (57 ± 15.7 years / 163.3 ± 19.4 cm / 63.6 ± 10.4 kg) and 36 males (57.6 ± 16.9 years / 177.4 ± 6.9 cm / 80.6 ± 8.7 kg) visiting at least once a week a fitness mall with access to eccentric and concentric training stations were asked concerning cardiovascular diseases, their corresponding risk factors and their own experience with eccentric muscle training.
    [Show full text]
  • Eccentric Exercise Interventions for Tendinopathies Daniel Lorenz, PT, DPT, ATC, CSCS, USAW Providence Medical Center, Kansas City, Kansas
    Available at: http://www.nsca-cc.org/ceus/quizzes.html Eccentric Exercise Interventions for Tendinopathies Daniel Lorenz, PT, DPT, ATC, CSCS, USAW Providence Medical Center, Kansas City, Kansas SUMMARY resulted in 30% of all running-related programs to accommodate the athletes injuries, and elbow tendon injuries can who have these conditions throughout TENDON INJURIES OR TENDINO- be as high as 40% in tennis players (26). the training cycle and during the com- PATHIES ARE A CHALLENGING People of all ages and skill levels, as petitive season. Being able to recognize AND PERPLEXING CONDITION FOR well as nonathletes can be afflicted by an ‘‘itis’’ or an ‘‘osis’’ is a crucial step STRENGTH AND CONDITIONING these conditions. Tendon pathologies because the management of the ath- PROFESSIONALS. TENDON can not only lead to lost time in sports lete’s training is vastly different. An INJURIES CAN BE DEBILITATING but also can result in long-term damage inflamed ‘‘itis’’ often has sharp localized AND RESULT IN LOST TIME FROM to tendons that can even affect daily pain with activity and in the morning SPORTS PARTICIPATION. IF LEFT function and let alone sports perfor- or after periods of long rest. Pain may UNTREATED, TENDON INJURIES mance. There is discrepancy in the actually decrease during activity but CAN PROGRESS TO AFFECT DAILY literature about how to manage these worsens at rest. On the contrary, FUNCTION. FURTHERMORE, injuries as well as the proper terminol- a chronic ‘‘osis’’ has fairly constant TENDON INJURIES AFFLICT ALL ogy to use when referring to them. pain that is more of a dull ache and AGES AND SKILL LEVELS.
    [Show full text]
  • SHOULDER EXTERNAL ROTATOR ECCENTRIC TRAINING VERSUS GENERAL SHOULDER EXERCISE for SUBACROMIAL PAIN SYNDROME: a RANDOMIZED CONTROLLED TRIAL IJSPT Eric J
    ORIGINAL RESEARCH SHOULDER EXTERNAL ROTATOR ECCENTRIC TRAINING VERSUS GENERAL SHOULDER EXERCISE FOR SUBACROMIAL PAIN SYNDROME: A RANDOMIZED CONTROLLED TRIAL IJSPT Eric J. Chaconas, PT, PhD1 Morey J. Kolber, PT, PhD2 William J. Hanney, PT, DPT, PhD1 Matthew L. Daugherty, PT, DPT1 Stanley H. Wilson, PT, EdD4 Charles Sheets, PT1 ABSTRACT Background: Shoulder pain affects up to 67% of the population at some point in their lifetime with subacromial pain syndrome (SAPS) representing a common etiology. Despite a plethora of studies there remains conflicting evidence for appropriate management of SAPS. Purpose: To compare outcomes, for individuals diagnosed with SAPS, performing a 6-week protocol of eccentric training of the shoulder external rotators (ETER) compared to a general exercise (GE) protocol. Study Design: Randomized controlled trial Methods: Forty-eight individuals (mean age 46.8 years +/–17.29) with chronic shoulder pain, and a clinical diagnosis of SAPS were randomized into either an experimental group performing ETER or a control group performing a GE program. The intervention lasted for six weeks, and outcomes were measured after three weeks, six weeks, and again at six months post intervention. Results: The primary outcome of function, measured by the Western Ontario Rotator Cuff Index, demonstrated a significant interaction effect derived from a multilevel hierarchical model accounting for repeated measures favoring the experimental group at week 3: 14.65 (p=.003), Week 6: 17.04 (p<.001) and six months: 15.12 (p=.007). After six months, secondary outcome measures were improved for Numeric Pain Rating Scale levels representing pain at worst (p=.006) and pain on average (p=0.02), external rotator (p<.001), internal rotator (p=0.02), and abductor strength (p<.001).
    [Show full text]
  • Don't Forget to VOTE!
    ORTHOPAEDIC THE MAGAZINE OF THE �h��ica� Thera�� ORTHOPAEDIC�ractic� SECTION, APTA Don’t Forget To VOTE! VOL. 24, NO. 4 2012 If you don’T WANT TO KEEP UP WITH THE LATEST EVIDENCE, THEN EIM Isn’T FOR YOU. EIM educational opportunities are taught by faculty who are leaders in education, research, and practice and incorporate the latest evidence-based practices. • Orthopaedic and Sports Residencies • Orthopaedic Manual Physical Therapy Fellowship • Transition DPT in Musculoskeletal Management • Continuing Education Why wait? Apply today to • Executive Program in Private Practice secure a spot and the Management with optional tDPT future of your practice. • Manual Physical Therapy Certification (Can be a stepping stone to board certification!) Research not your strong point? Let the EIM PT Mobile App do it for you! For only $1.99 get the latest evidence from top PT news sources delivered directly SCAN THE CODE FOR to your mobile device. THE EIM PT MOBILE APP www.EvidenceInMotion.com/osec 1-888-709-7096 [email protected] Orthopaedic Practice Vol. 24;4:12 177 Can you afford not to make such an offer ? Due to the unusual guarantee we offer patients (see sample ad below), patients think they will pay either $41.11 or zero for their 1st ATM2® session ... Almost all leave $370, and refer their friends and family! With our indefinitely-extendable guarantee we offer clinicians, you can confidently adopt a similar business model (Call for details) Starting at only $78/month* you get all the necessary rehab equipment (ATM2®) plus all the necessary clinical training (ATM® Concept) ATM®2 Centers offers: Pain-elimination while on the ATM2 ..
    [Show full text]
  • Effects of Eccentric Contraction Duration on Muscle Strength, Power Production, Vertical Jump and Soreness Jonathan N
    University of New Mexico UNM Digital Repository Health, Exercise, and Sports Sciences ETDs Education ETDs 9-1-2015 Effects of Eccentric Contraction Duration on Muscle Strength, Power Production, Vertical Jump and Soreness Jonathan N. Mike Follow this and additional works at: https://digitalrepository.unm.edu/educ_hess_etds Part of the Health and Physical Education Commons Recommended Citation Mike, Jonathan N.. "Effects of Eccentric Contraction Duration on Muscle Strength, Power Production, Vertical Jump and Soreness." (2015). https://digitalrepository.unm.edu/educ_hess_etds/33 This Dissertation is brought to you for free and open access by the Education ETDs at UNM Digital Repository. It has been accepted for inclusion in Health, Exercise, and Sports Sciences ETDs by an authorized administrator of UNM Digital Repository. For more information, please contact [email protected]. Jonathan N. Mike Candidate Department of Health, Exercise, and Sports Sciences Department This dissertation is approved, and it is acceptable in quality and form for publication: Approved by the Dissertation Committee: Len Kravitz, Chairperson Chad Kerksick Christine Mermier Carole Conn i THE EFFECTS OF ECCENTRIC CONTRACTION DURATION OF MUSCLE STRENGTH, POWER PRODUCTION, VERTICAL JUMP AND SORENESS By JONATHAN N. MIKE B.S.; Western Kentucky University 2004 M.S.; Western Kentucky University 2005 DISSERTATION Submitted in Partial Fulfillment of the Requirements for the Degree of DOCTOR OF PHILOPSOHY Physical Education, Sports and Exercise Sciences The University of New Mexico Albuquerque, New Mexico JULY 2015 ii Acknowledgements I grandly acknowledge Dr. Len Kravitz for continuing to encourage me through the years of classroom teachings, presentations, and the writing process, and most of all, for believing in me.
    [Show full text]
  • Strength Training for You and Your Patients-Make Yourself Stronger Than Your Excuses!
    AOASM with ACOFP Sunday October 18, 2020 1 Strength Training for you and your patients-Make yourself stronger than your excuses! Vincent Disabella DO FAOASM 2 Faculty Disclosure It is the policy of the ACOFP Program Committee OMED organizers that all individuals in a position to control content disclose any relationships with commercial interests upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflict of interest (COI), and if identified, conflicts are resolved prior to confirmation of participation. Only those participants who had no conflict of interest or who agreed to an identified resolution process prior to their participation were involved in this CME activity. All faculty in a position to control content for this session have indicated they have no relevant financial relationships to disclose. The content of this material/presentation in this CME activity will not include discussion of unapproved or investigational uses of products or devices. 3 Strength Training ! Strength training: Strength training involves the performance of physical exercises which are designed to improve strength and endurance. – Contrary to popular belief it does not only mean weight lifting. – Can be done by ANYONE and can be done ANYWHERE! – Has many more benefits than just building strength. – Strength training does not promote overall fitness but is a key component of fitness. – Myth: Cardio is better than Strength Training. 4 Terms to understand and help with the dialogue ! Concentric contraction: the act of shortening a muscle. – Used to do positive work or accelerate a body part. – The flex ! Eccentric contraction: the presence of a resistive force that elongates the muscle.
    [Show full text]
  • Metabolic Differences Between a Bout of Eccentric, Concentric and Traditional Resistance Exercise
    METABOLIC DIFFERENCES BETWEEN A BOUT OF ECCENTRIC, CONCENTRIC AND TRADITIONAL RESISTANCE EXERCISE A thesis submitted to the Kent State University College of Education, Health, and Human Services in partial fulfillment of the requirements for the degree of Master of Science By Stephen M. Fischer December 2016 Thesis written by Stephen M. Fischer B.S., Kent State University, 2013 M.S. Kent State University, 2016 Approved by _________________________, Director, Master’s Thesis Committee John McDaniel _________________________, Member, Master’s Thesis Committee Ellen L. Glickman _________________________, Member, Master’s Thesis Committee J. Derek Kingsley Accepted by _________________________, Director, School of Health Sciences Lynne E. Rowan _________________________, Interim Dean, College of Education, Health and Human Mark A. Kretovics Services ii FISCHER, STEPHEN M., M.S. December 2016 Exercise Physiology METABOLIC DIFFERENCES BETWEEN A BOUT OF ECCENTRIC, CONCENTRIC AND TRADITIONAL RESISTANCE EXERCISE (pp. 46) Director of Thesis: John McDaniel, Ph.D. PURPOSE: To determine the extent to which metabolic variables such as VO2(ml/kg/min), percentage of energy derived from carbohydrates (%CHO) and heart rate (HR) as well as blood glucose and lactate vary between resistance workouts comprised of solely eccentric, concentric or traditional muscle contractions. METHODS: N=12 men and women completed a traditional (TRAD), concentric (CONC), and eccentric (ECC) full-body resistance workout at 65% of a measured 1 repetition max with each condition matched for work. During each condition, the subject was fitted to a metabolic cart and metabolic variables were recorded through indirect calorimetry and heart rate monitor. Blood glucose and blood lactate were taken at five different stages.
    [Show full text]
  • Effects of Resistance Training Frequency on Muscle Function Adaptations Using a Multiple-Joint Eccentric Training Model
    Utah State University DigitalCommons@USU All Graduate Plan B and other Reports Graduate Studies 5-2019 Effects of Resistance Training Frequency on Muscle Function Adaptations Using a Multiple-Joint Eccentric Training Model Joshua Crane Utah State University Follow this and additional works at: https://digitalcommons.usu.edu/gradreports Part of the Exercise Science Commons Recommended Citation Crane, Joshua, "Effects of Resistance Training Frequency on Muscle Function Adaptations Using a Multiple-Joint Eccentric Training Model" (2019). All Graduate Plan B and other Reports. 1377. https://digitalcommons.usu.edu/gradreports/1377 This Creative Project is brought to you for free and open access by the Graduate Studies at DigitalCommons@USU. It has been accepted for inclusion in All Graduate Plan B and other Reports by an authorized administrator of DigitalCommons@USU. For more information, please contact [email protected]. EFFECTS OF RESISTANCE TRAINING FREQUENCY ON MUSCLE FUNCTION ADAPTATIONS USING A MULTIPLE-JOINT ECCENTRIC TRAINING MODEL by Joshua S. Crane A plan B research project submitted in partial fulfillment of the requirements for the degree of Master’s of Science in Health and Human Movement Approved: __________________________ __________________________ Brennan J. Thompson, Ph.D. Eadric Bressel, Ph.D. Major Professor Committee Member Edward M. Heath, Ph.D. Committee Member UTAH STATE UNIVERSITY Logan, Utah 2019 ABSTRACT Eccentric resistance training has been shown to be beneficial for improving multiple performance and health metrics. However, recommendations on eccentric training frequency have not been established. PURPOSE: To investigate the effects of volume-matched resistance training frequency comparing one versus three training days per week of isokinetic multiple-joint eccentric training on strength and lower body function adaptations during a 4-week training period.
    [Show full text]