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S F E Praet, J H Ong, C Purdam, M Welvaert, G Lovell, L Dixon, J E Gaida, J Anglim, S Manzanero, N Vlahovich, D Hughes, G Waddington
OBJECTIVES: The role of neovascularisation in tendinopathy is still poorly understood, potentially due to technical limitations of conventional power Doppler ultrasound. This study aimed to investigate the association between contrast-enhanced ultrasound (CEUS) microvascular volume (MV), Victorian Institute of Sports Assessment-Achilles (VISA-A) scores and intrinsic Achilles tendon tenderness, as well as two different Power Doppler modes. DESIGN: Cross-sectional study...
May 15, 2018: Journal of Science and Medicine in Sport
Paula C Charlton, Benjamin Raysmith, Martin Wollin, Simon Rice, Craig Purdam, Ross A Clark, Michael K Drew
OBJECTIVES: Determine whether clinically feasible tests of isometric lower limb strength and range of motion (ROM) in Australian Football (AF) athletes are useful in Periodic Health Examinations to identify persistent deficits following hamstring strain injury (HSI). DESIGN: Case-control. METHODS: Thirty-seven male, semi-professional AF athletes (mean±SD; age, 20.2±2.9years; height, 1.7±0.5m; mass, 81±9.2kg) participated, ten athletes (37%) reported HSI within the previous three seasons of competition...
April 3, 2018: Journal of Science and Medicine in Sport
Paula C Charlton, Benjamin Raysmith, Martin Wollin, Simon Rice, Craig Purdam, Ross A Clark, Michael K Drew
OBJECTIVES: To evaluate strength and flexibility measures pre- and post- Australian Football (AF) competition to determine their potential utility as secondary prevention measures. DESIGN: Cohort study. SETTING: Semi-professional AF club. PARTICIPANTS: Ten male AF athletes (mean ± SD; age, 21.3 ± 2.2 years; height, 186.1 ± 6.3 cm; weight, 83.5 ± 8.6 kg). MAIN OUTCOME MEASURES: Maximal unilateral isometric knee flexion strength performed in 45 degrees of hip flexion and 30 degrees of knee flexion, flexibility measures of hip and knee extension and ankle dorsiflexion...
May 2018: Physical Therapy in Sport
Ebonie Rio, Craig Purdam, Michael Girdwood, Jill Cook
OBJECTIVE: To investigate the effectiveness of an isometric squat exercise using a portable belt, on patellar tendon pain and function, in athletes during their competitive season. DESIGN: Case series with no requirements to change any aspect of games or training. The object of this pragmatic study was to investigate this intervention in addition to "usual management." A control or sham intervention was considered unacceptable to teams. SETTING: In-season...
November 27, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Rodrigo Scattone Silva, Craig R Purdam, Angela M Fearon, Wayne A Spratford, Claire Kenneally-Dabrowski, Peter Preston, Fábio V Serrão, James E Gaida
PURPOSE: This study aimed to verify the immediate effects of altering sagittal plane trunk position during jump landings on lower limb biomechanics, patellar tendon force, and pain of athletes with and without patellar tendinopathy. METHODS: Twenty-one elite male athletes were categorized into three groups: athletes with patellar tendinopathy (TG; n = 7), asymptomatic athletes with patellar tendon abnormalities (n = 7), and asymptomatic athletes without tendon abnormalities (CG; n = 7)...
December 2017: Medicine and Science in Sports and Exercise
Elisabeth A Garratt, Tarani Chandola, Kingsley Purdam, Alex M Wood
Children living in low-income households face elevated risks of behavioral problems, but the impact of absolute and relative income to this risk remains unexplored. Using the U.K. Millennium Cohort Study data, longitudinal associations between Strengths and Difficulties Questionnaire scores and absolute household income, distance from the regional median and mean income, and regional income rank were examined in 3- to 12-year-olds (n = 16,532). Higher absolute household incomes were associated with lower behavioral problems, while higher income rank was associated with lower behavioral problems only at the highest absolute incomes...
July 2017: Child Development
Elisabeth A Garratt, Tarani Chandola, Kingsley Purdam, Alex M Wood
PURPOSE: Parents face an increased risk of psychological distress compared with adults without children, and families with children also have lower average household incomes. Past research suggests that absolute income (material position) and income status (psychosocial position) influence psychological distress, but their combined effects on changes in psychological distress have not been examined. Whether absolute income interacts with income status to influence psychological distress are also key questions...
October 2016: Social Psychiatry and Psychiatric Epidemiology
Suzi Edwards, Julie R Steele, Deirdre E McGhee, Craig R Purdam, Jill L Cook
This study aimed to explore how asymptomatic athletes with a patellar tendon abnormality (PTA), who are at high risk of developing patellar tendinopathy, alter their landing technique and net patellar tendon loads generated in response to fatigue. Seven asymptomatic players with a PTA performed five successful vertical stop-jump trials before and after a fatigue protocol. Fatigue protocol involved participants repeatedly performing sets of 30 submaximal jump exercises on a sledge apparatus followed by 30 s rest until the task failure criteria were reached...
April 2017: Journal of Sports Sciences
J L Cook, E Rio, C R Purdam, S I Docking
The pathogenesis of tendinopathy and the primary biological change in the tendon that precipitates pathology have generated several pathoaetiological models in the literature. The continuum model of tendon pathology, proposed in 2009, synthesised clinical and laboratory-based research to guide treatment choices for the clinical presentations of tendinopathy. While the continuum has been cited extensively in the literature, its clinical utility has yet to be fully elucidated. The continuum model proposed a model for staging tendinopathy based on the changes and distribution of disorganisation within the tendon...
October 2016: British Journal of Sports Medicine
Thomas S H Goom, Peter Malliaras, Michael P Reiman, Craig R Purdam
Synopsis Proximal hamstring tendinopathy (PHT) typically manifests as deep buttock pain at the hamstring common origin. Both athletic and nonathletic populations are affected by PHT. Pain and dysfunction are often long-standing and limit sporting and daily functions. There is limited evidence regarding diagnosis, assessment, and management; for example, there are no randomized controlled trials investigating rehabilitation of PHT. Some of the principles of management established in, for example, Achilles and patellar tendinopathy would appear to apply to PHT but are not as well documented...
June 2016: Journal of Orthopaedic and Sports Physical Therapy
Ebonie Rio, Dawson Kidgell, G Lorimer Moseley, Jamie Gaida, Sean Docking, Craig Purdam, Jill Cook
Tendinopathy can be resistant to treatment and often recurs, implying that current treatment approaches are suboptimal. Rehabilitation programmes that have been successful in terms of pain reduction and return to sport outcomes usually include strength training. Muscle activation can induce analgesia, improving self-efficacy associated with reducing one's own pain. Furthermore, strength training is beneficial for tendon matrix structure, muscle properties and limb biomechanics. However, current tendon rehabilitation may not adequately address the corticospinal control of the muscle, which may result in altered control of muscle recruitment and the consequent tendon load, and this may contribute to recalcitrance or symptom recurrence...
February 2016: British Journal of Sports Medicine
Peter Malliaras, Jill Cook, Craig Purdam, Ebonie Rio
Synopsis The hallmark features of patellar tendinopathy are (1) pain localized to the inferior pole of the patella and (2) load-related pain that increases with the demand on the knee extensors, notably in activities that store and release energy in the patellar tendon. While imaging may assist in differential diagnosis, the diagnosis of patellar tendinopathy remains clinical, as asymptomatic tendon pathology may exist in people who have pain from other anterior knee sources. A thorough examination is required to diagnose patellar tendinopathy and contributing factors...
November 2015: Journal of Orthopaedic and Sports Physical Therapy
Ebonie Rio, Dawson Kidgell, Craig Purdam, Jamie Gaida, G Lorimer Moseley, Alan J Pearce, Jill Cook
BACKGROUND: Few interventions reduce patellar tendinopathy (PT) pain in the short term. Eccentric exercises are painful and have limited effectiveness during the competitive season. Isometric and isotonic muscle contractions may have an immediate effect on PT pain. METHODS: This single-blinded, randomised cross-over study compared immediate and 45 min effects following a bout of isometric and isotonic muscle contractions. Outcome measures were PT pain during the single-leg decline squat (SLDS, 0-10), quadriceps strength on maximal voluntary isometric contraction (MVIC), and measures of corticospinal excitability and inhibition...
October 2015: British Journal of Sports Medicine
Martin Wollin, Craig Purdam, Michael K Drew
OBJECTIVES: To investigate inter and intra-tester reliability of an externally fixed dynamometry unilateral hamstring strength test, in the elite sports setting. DESIGN: Reliability study. METHODS: Sixteen, injury-free, elite male youth football players (age=16.81±0.54 years, height=180.22±5.29cm, weight 73.88±6.54kg, BMI=22.57±1.42) gave written informed consent. Unilateral maximum isometric peak hamstring force was evaluated by externally fixed dynamometry for inter-tester, intra-day and intra-tester, inter-week reliability...
January 2016: Journal of Science and Medicine in Sport
Tom A Ranger, Wendy M Braybon, Craig R Purdam, Jill L Cook
CONTEXT: Lateral epicondylalgia, pain at the lateral elbow, is commonly associated with extensor carpi radialis brevis tendinopathy. The radial head, which abuts the extensor tendons and is elliptical in shape, may affect the extensor tendons during pronation of the forearm. Cadaverous studies have shown that the radial head may act as a cam in pronation, to offer a mechanical advantage to the common extensor tendon and to mitigate load on the origin of the extensor carpi radialis brevis tendon...
February 2015: Journal of Sport Rehabilitation
Ebonie Rio, Lorimer Moseley, Craig Purdam, Tom Samiric, Dawson Kidgell, Alan J Pearce, Shapour Jaberzadeh, Jill Cook
Tendon pain remains an enigma. Many clinical features are consistent with tissue disruption-the pain is localised, persistent and specifically associated with tendon loading, whereas others are not-investigations do not always match symptoms and painless tendons can be catastrophically degenerated. As such, the question 'what causes a tendon to be painful?' remains unanswered. Without a proper understanding of the mechanism behind tendon pain, it is no surprise that treatments are often ineffective. Tendon pain certainly serves to protect the area-this is a defining characteristic of pain-and there is often a plausible nociceptive contributor...
January 2014: Sports Medicine
Sean Docking, Tom Samiric, Ebonie Scase, Craig Purdam, Jill Cook
Tendons are designed to absorb and transfer large amounts of tensile load. The well organised, strong yet flexible, extracellular matrix allows for this function. Many tendons are also subject to compressive loads, such as at the entheses, as the tendon wraps around bony protuberances or from internal compression during tensile loading or twisting. Tendinopathy, the clinical syndrome of pain and dysfunction in a tendon is usually the result of overload. However, it is not only the tensile overload that should be considered, as it has been shown that compressive loads change tendon structure and that combination loads can induce tendon pathology...
January 2013: Muscles, Ligaments and Tendons Journal
Suzi Edwards, Julie R Steele, Craig R Purdam, Jill L Cook, Deirdre E McGhee
PURPOSE: Fatigue may contribute to knee joint injuries, such as patellar tendinopathy, by increasing joint loading and altering lower limb landing technique, which in turn may increase tissue loading. This study aimed to investigate the effect of lower limb muscle fatigue on the landing technique and patellar tendon loads generated during the horizontal and vertical landing phases of a stop-jump task. It was hypothesized that muscle fatigue would increase patellar tendon loading and alter the landing technique displayed during the horizontal, but not the vertical, landing phase of the stop-jump task...
February 2014: Medicine and Science in Sports and Exercise
J L Cook, C R Purdam
Managing tendinopathy in season is a challenge for all sports medicine practitioners. Many of the strategies employed to treat tendinopathy in a rehabilitation setting are not suitable because of the time taken to recover. Management strategies that control pain and maintain performance are required. These include load management, both reducing aggravating loads and introducing pain-relieving loads, medications and adequate monitoring to detect a deteriorating tendon. Other interventions such as intratendinous injection therapies and other direct tendon modalities can be provocative at worst and without effect at best...
April 2014: British Journal of Sports Medicine
Alex Scott, Sean Docking, Bill Vicenzino, Håkan Alfredson, Richard J Murphy, Andrew J Carr, Johannes Zwerver, Kirsten Lundgreen, Oliver Finlay, Noel Pollock, Jill L Cook, Angela Fearon, Craig R Purdam, Alison Hoens, Jonathan D Rees, Thomas J Goetz, Patrik Danielson
In September 2010, the first International Scientific Tendinopathy Symposium (ISTS) was held in Umeå, Sweden, to establish a forum for original scientific and clinical insights in this growing field of clinical research and practice. The second ISTS was organised by the same group and held in Vancouver, Canada, in September 2012. This symposium was preceded by a round-table meeting in which the participants engaged in focused discussions, resulting in the following overview of tendinopathy clinical and research issues...
June 2013: British Journal of Sports Medicine
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