Journal of Exercise, Sports & Orthopedics

Number 4, 2015

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Practicing Orthopedic Medicine by Physician Assistants

Authors: Wei Li *

Abstract

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Number of views: 544

Since Physician Assistant (PA) originated in the 1960s from the Duke medical center [1], it has been continuously growing as a health care profession and delivering care to general populations together with other medical professionals. The intention for creating the PA profession was to deal with the shortage problem of primary care workforce. Although the PA profession has become a vital part of the primary care, the percentage of PAs practicing in the primary care had declined from 50.2% in 1995 to 32.1% in 2013. On the other hand, the number of PAs has grown so quickly in subspecialties of both internal medicine and surgery [2]. As a surgical subspecialty, orthopedics has become the second most common specialty practiced by PAs following only to the primary care. The orthopedics employed 10.9% of the total PAs in 2013 as compared with a 6.5% in 1997. The percentage of PAs practicing in orthopedics had increased steadily from 1997 to 2006 and then maintained around the 10% level (Figure 1). The absolute number of PAs in orthopedic practice is growing more dramatically, as the total number of PAs eligible to practice medicine has been increasing almost in a linear manner in the past decade (Figure 2). With the influence of the Patient Protection and Affordable Care Act (PPACA), new PA education programs has sprang up all over the country [3] and the number of PAs are predicted to see an enormous growth in the near future. In 2002, there are 5069 PAs practicing in the orthopedic specialty, whereas the number doubled in the year of 2013 (Figure 2). By contrast, the percentage of PAs practicing in the orthopedic medicine only has a 2% increase from 8.9% in 2002 to 10.9% in 2013 (Figure 1)

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Hip and Knee Dislocations in Extreme Sports: A Six Year National Epidemiologic Study

Authors: Vani Sabesan*, Daniel J Lombardo, Vinay Sharma and Tom Valikodath

Abstract

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Objectives: Participation in extreme sports has been rapidly increasing in the United States. These sports are associated with a significant risk of injury and even mortality. Hip and knee dislocations represent high impact injuries with potentially serious complications if not treated promptly. There is currently little literature describing the epidemiology of these injuries in extreme sports. The purpose of this investigation is to evaluate the incidence rates of hip and knee dislocations in 7 popular extreme sports using a publicly available database. Methods: The National Electronic Injury Surveillance System was used to determine estimated numbers of hip and knee dislocations in 7 extreme sports, from 2007-2012. The Outdoor Foundation data was used to determine participation in these sports. Incidence rates for the various injuries were calculated. Results: There were 9,369.30 estimated knee dislocations and 742.02 estimated hip over this study period. The incidence rates of knee and hip dislocations for all seven sports were 29.12 and 2.09 per 1 million person-year. These injuries were more common among males, and most occurred in participants between 10-19 years old. Snow skiing and snowboarding had the highest rates of knee and hip dislocations respectively. Conclusions: This study provides baseline data for hip and knee dislocations in participants of extreme sports. These injuries occurred most commonly in males and 10-19 year olds. Awareness of these injuries among extreme sports participants is important as they represent serious injuries, with potentially devastating complications if not managed promptly and properly. Keywords: Extreme sports; hip dislocations; knee dislocation; epidemiology

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Hamstring Strain in Soccer Players: Things the Trainer Must Know

Authors: Atzmon Tsur*

Abstract

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Acute hamstring strain injuries are common in sports that involve sprinting, kicking, jumping or high-speed skilled movements. It is generally believed that they occur during terminal swing phase of the gait cycle. Most hamstring injuries occur along the proximal musculo-tendon junction, where the muscle fibrils intersect with the tendon. A number of potential risk factors have been proposed for hamstring strain, among them fatigue, lack of flexibility, imbalance of muscular strength with a low hamstring to quadriceps ratio, and insufficient warm-up. An emphasis on neuro-muscular control and eccentric strengthening is suggested for the successful return of the soccer player to sport. Keywords: Hamstring; Soccer Injury; Strain; Eccentric Contraction

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Can Cushioned Shoes with Anatomical Insole Correct the Impact in Runners with Recurring Shin Splint?

Authors: Carlos I De la Fuente*, Hugo Henríquez, Rodrigo Ramírez-Campillo, Mauricio Delgado, Claudio Chamorro, Sebastian Ruidiaz, Christian Campos and Giovanni Carcuro

Abstract

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Number of views: 532

Shin splint injury usually takes several weeks to recover. We determine the effect of cushioned shoes with anatomical insole on impact, over pronation and mechanical strategy to impact during running in 10 k runners, over pronators, rear foot initial contact and unilateral recurrent shin splint respect bare foot running before sport return. Fourteen runners with recurrent shin splint who underwent standardized physical therapy were included. We compared by one tailed paired t-test the variables impact, rear foot over pronation angle in midstance and mechanical strategy to impact during barefoot running condition with anatomical insole and cushioned shoes running condition (α=0.05 and 1-β=80%). The impact was reduced from 6.893 g to 6.600 g (95% CI: 6.513 g-6.686 g, p<0.001) using cushioned shoes with anatomical insole condition respect barefoot running condition. The over pronation angle in midstance was reduced from 18.50° to 16.21° (95% CI: 14.29°-18.13°, p = 0.011) using cushioned shoes with anatomical insole condition respect barefoot running condition. The mechanical strategy to impact analyzed by cross correlation coefficient between cushioned shoes with anatomical insole condition with barefoot running condition was 0.77 (95% CI: 0.74-0.81, p<0.001). Running with cushioned shoes with anatomical insole in subjects with unilateral recurrent shin splint before return sport attenuates the impact and reduces over pronation. But, doesn´t change the mechanical strategy to impact. Keywords: Shin splint; Running, Impact, Iso-inertial accelerometer

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Motor Skills, Anthropometrical Characteristics and Functional Movement in Elite Young Soccer Players

Authors: Zalai D*, Bobak P, Csáki I3, Hamar P, Myrer JW, Mitchell UH and Johnson AW

Abstract

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This study examined functional movement patterns, anthropometrical characteristics and motor skills in elite young soccer players using the well-established Functional Movement ScreenTM system (FMS™). Sixty elite male soccer players participated (age 16.7 ± 2.3 y, height 185.4 ± 5.7 cm, weight 82.8 ± 6.7 kg, BMI 24.1 ± 1.3 kg/m2 ) from four age-based teams. There were 7 Goalkeepers (GK), 17 Defenders (DEF), 27 Midfielders (MID) and 9 Forwards (FW). We measured 5 m, 10 m, and 30 m sprint times and participants’ vertical jump height and long jump distance. The FMS™ was used to measure functional movement ability. Our study indicated that 5 of the 7 measured variables were significant when considering position assignment of advanced youth soccer players. These are the 5 m sprint, 30 m sprint, BMI, vertical jump, and FMS™ score. Functional movement ability may be useful in the physical development of soccer skills and performance. A FMS™ score of ≤ 14 was found in 28% of players and asymmetry was noted in 41%, both considered an important risk factor of injury. Keywords: Functional movement screen; Soccer performance; 30 m sprint; Movement patterns