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- Askling, Carl
(författare)
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Hamstring muscle strain
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Acute hamstring strains are common injuries in different sports. They are often serious, causing long rehabilitation times and a proneness for re-injury. Preliminary observations indicate that the injuries can be of at least two types, one occurring during high-speed running and the other during motions where the hamstring muscles reach extreme lengths.Aims: To investigate the possible existence of different types of acute hamstring strains in two specific athletic groups, namely sprinters and dancers, as well as the generality of these findings in other sports.Methods: In the first project, 18 sprinters and 15 dancers with acute first time hamstring strains were prospectively included. All subjects were examined, clinically and with magnetic resonance imaging (MRI), on 4 occasions after injury: at day 2-4, 10, 21 and 42. The follow-up period was 2 years. In the second project, 30 subjects from 21 different sports were prospectively included. All subjects were examined clinically and with MRI. The follow-up period lasted until the subjects returned to sport or finished their sport activity due to the injury.Results: All sprinters sustained their injuries during competitive high-speed running. In contrast, all dancers encountered their injuries during slow-speed stretching type of exercises. The initial loss of strength and flexibility was significantly greater in sprinters than in dancers. At 42 days after injury, both groups could perform more than 90% of the test values of the uninjured leg. All the sprinters’ injuries were primarily located in biceps femoris long head, whereas the dancers’ injuries were mainly (87%) involving the proximal free tendon of semimembranosus. For the sprinters, involvement of the proximal free tendon, as estimated by MRI, and proximity to the ischial tuberosity, as estimated both by palpation and MRI, were associated with significantly longer time to return to pre-injury level. In the dancers, there were no significant correlations between clinical or MRI parameters and time to return to per-injury level. The time to pre-injury level was significantly longer (median 50 weeks, range 30-76) for the dancers compared to the sprinters (16, 6-50). In the second project, all injuries occurred during movements reaching a position with combined extensive hip flexion and knee extension. They were all located close to the ischial tuberosity and 83% involved the proximal free tendon of semimembranosus. Fourteen subjects (47%) decided to end their sport activity and for the remaining 16 subjects the median time back to sport was 31 (range 9-104) weeks. There were no significant correlations between clinical and MRI parameters and time to return to sport.Conclusions: There seems to be a link between the injury situation and the two types of acute hamstring strain in sprinters and dancers with respect to clinical findings, injury location, muscles and tissues involved, and time to return to pre-injury level. Proximity of the injury to the ischial tuberosity, as estimated both by palpation and MRI, is associated with longer recovery time. Also in other sports, an injury situation where the hamstrings reach extensive lengths caused a specific injury to the proximal posterior thigh similar to that described in dancers. Due to the prolonged recovery time associated with this type of injury, correct diagnosis based on history, clinical and MRI investigation, and adequate information to the athletes are essential.
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| 2. |
- Askling, Carl M, et al.
(författare)
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Total proximal hamstring ruptures : clinical and MRI aspects including guidelines for postoperative rehabilitation.
- 2013
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 21:3, s. 515-33
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this article is to provide a state-of-the-art review for treatment of acute, total proximal hamstring tendon ruptures. For total proximal hamstring tendon ruptures, early (<2-3 w) surgical refixation minimizes muscle atrophy and facilitates a somewhat predictable time course for healing and rehabilitation. A postoperative rehabilitation program is detailed that has been used by one physical therapist for the past 7 years on over 200 patients with surgical repair for total proximal hamstring tendon rupture. One re-rupture has occurred, 7 months after surgery, following the rehabilitation program described herein. The rehabilitation program, including avoidance of postoperative bracing, appears effective for total proximal hamstring ruptures. Early surgery together with a specific rehabilitation program appears to be the treatment of choice for timely and safe return to sport and an active lifestyle. Level of evidence V.
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| 3. |
- Brun Sundblad, Gunilla M, et al.
(författare)
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Prevalence and co-occurrence of self-rated pain and perceived health in school-children : Age and gender differences.
- 2007
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Ingår i: European Journal of Pain. - : Wiley. - 1090-3801 .- 1532-2149. ; 11:2, s. 171-80
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Tidskriftsartikel (refereegranskat)abstract
- In this nationwide study, 1975 students from grades 3, 6, and 9 (ages 9, 12, and 15 at the onset of the year), were recruited from randomly selected schools, which represented different geographical areas throughout Sweden. The main aim of the study was to assess the prevalence of self-reported pain (headache, abdominal, and musculoskeletal pain) and perceived health (problems sleeping and/or if they often felt tired, lonely and sad). A second aim was to study the co-occurrence among different pain and health variables. The students, (n = 1908 distributed by grade 3: 255 girls and 305 boys, grade 6: 347 girls and 352 boys, grade 9: 329 girls and 320 boys) answered retrospectively (three months) a specially designed questionnaire. Fifty percent (50%) of the students reported that they had experienced pain, either as headache, abdominal pain or musculoskeletal pain, within the recall period. Gender differences were especially noticeable for headaches, where twice as many girls (17%, n = 159) than boys (8%, n = 80) reported that they suffered such pain at least once a week or more often. Co-occurrence among the variables was moderate (0.3-0.5). For the total of the seven variables, the perception of pain and health complaints decreased with age for boys from grades 3 to 9, while multiple complaints increased for girls.
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| 4. |
- Frohm, Anna, et al.
(författare)
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Eccentric treatment for patellar tendinopathy : a prospective randomised short-term pilot study of two rehabilitation protocols.
- 2007
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Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 41:7, s. e7-
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare the efficacy and safety of two eccentric rehabilitation protocols for patients with symptomatic patellar tendinopathy. A new eccentric overload training device was compared with the present standard eccentric rehabilitation programme on a decline board. DESIGN: Prospective, randomised clinical trial. SETTING: Sports rehabilitation clinic, university sports laboratory, supplemented with home exercises. PATIENTS: 20 competitive and recreational athletes, all with clinical diagnosis of patellar tendinopathy, verified by MRI or ultrasound imaging. INTERVENTIONS: A 12-week rehabilitation period, either with bilateral eccentric overload strength training using the Bromsman device twice a week or with unilateral eccentric body load training using a decline board twice a week, supplemented with daily home exercises. OUTCOME MEASURES: The primary outcome was pain and function, assessed by the Swedish Victorian Institute of Sport Assessment for Patella (VISA-P) score. Secondary outcome measures were isokinetic muscle torque, dynamic function and muscle flexibility, as well as pain level estimations using visual analogue scale (VAS). Side effects were registered. RESULTS: Both treatment groups improved in the short term according to the VISA-P scores during the 12-week rehabilitation period. However, there were no significant differences between the groups in terms of pain and function. After a 3-month rehabilitation period, most patients could be regarded as improved enough to be able to return to training and sports. No serious side effects were detected in either group. CONCLUSION: In patients with patellar tendinopathy pain, two-legged eccentric overload training twice per week, using the new device (Bromsman), was as efficient and safe as the present standard daily eccentric one-legged rehabilitation-training regimen using a decline board.
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| 5. |
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| 6. |
- Sundblad, Gunilla Brun, et al.
(författare)
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Self-rated pain and perceived health in relation to stress and physical activity among school-students : a 3-year follow-up.
- 2008
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Ingår i: Pain. - : Ovid Technologies (Wolters Kluwer Health). - 0304-3959 .- 1872-6623. ; 136:3, s. 239-49
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this longitudinal study was to assess changes with age regarding prevalence of pain and perceived health in a student population, as well as change over time at grade level. Pain included frequency of headache, abdominal, and musculoskeletal pain and perceived health included problems sleeping and/or if they often felt tired, lonely, and sad. If gender, age (grade level), stress, physically activity were related to pain and health complaints were tested with multivariate logistic regression analysis. The students (n=1908) came from randomly selected schools throughout Sweden and attended grades 3, 6 and 9 (ages 9, 12 and 15 at the onset of the year) in 2001. Three years later, 67% (n=1276) of the same students answered a questionnaire that was constructed for the purpose of the studies. The responses given by the same students showed that girls' complaints of pain and perceived health increased with age and boys decreased. Over half (56%) of the girls and two-thirds (67%) of the boys reported no frequent complaints either year. At grade level most variables were rated the same as three years earlier by the same age group. Stress was significantly related to pain and health complaints for girls and the risk of complaints, as calculated with odds ratio, was most evident for students who were characterized as being physically inactive in 2001 and remained inactive three years later. Jointly, significant predictors, such as stress, being physically inactive, gender and grade level, explained 8-20% of the frequent complaints.
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| 7. |
- Sundblad, Gunilla, et al.
(författare)
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Injuries during physical activity in school children.
- 2005
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Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : Wiley. - 0905-7188 .- 1600-0838. ; 15:5, s. 313-23
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Tidskriftsartikel (refereegranskat)abstract
- During the spring of 2001, 1975 children, from grades 3, 6 and 9 participated in a nationwide, multidisciplinary collaboration study. The students came from randomly selected classes throughout Sweden, representing different geographical and socio-economic areas. The aim of this study was to collect and evaluate self-reported injuries and associated factors during various physical activities as recalled retrospectively for 3 months by the students. Every sixth student (n=299 or 16%) reported 306 injuries. Twice as many girls than boys were injured during physical education class. Ninth-grade students reported relatively more injuries during organized sports than during physical education class and leisure activities. There were no age or gender differences in incidence rate during leisure activities. Most injuries were minor, as 70% were back in physical activity within a week. Half of the students (50%) reported that they previously had injured the same body part. Primary care of the injured student was, with the exception of a family member, most often carried out by the physical education teacher or coach, which accentuates the importance of continuous sports medicine first aid education for this group.
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| 8. |
- Sundblad, Gunilla M Brun, et al.
(författare)
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Child-parent agreement on reports of disease, injury and pain.
- 2006
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 6, s. 276-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Studies on school students are indicating that somatic complaints and pain have increased during the past decades. Throughout this period there has been a change in methodology from proxy reports by parents to having the students themselves act as the respondents, possible explaining some of the increase in prevalence. The aim of this study was to compare the agreement of answers from students with answers given by their parents regarding the students' medical background and subjective rating of perceived health with specific focus on frequency of headache, musculoskeletal pain and tiredness. METHODS: The participating students came from eleven different schools in Sweden. The schools were a sub sample of randomly selected schools originally participating in a larger multidisciplinary base study. Those 8th grade students present at school on the test date became the subjects of the investigation. A total of 232 students answered, assisted by the test leader, a specially designed self-complete questionnaire at school. Their parents were, at the same time, contacted and 200 answered a similar mailed-out questionnaire. One hundred and eighty-six (186) corresponding student-same parent questionnaires were registered for which comparisons of answers could be made and analysis conducted. RESULTS: When a child is in good health, in absence of diseases, pain and injuries, his or her assessment matches up with their parent. Children and parents also showed agreement in cases of severe injuries and frequent (daily) complaints of knee pain. Less frequent headaches, back- and musculoskeletal pain and other complaints of minor injuries and less wellbeing, such as students' tiredness, were all under-reported and under-rated by their parents. CONCLUSION: When assessing the perceived health and wellbeing of students, their own expressions should be the basis for the data collection and analysis rather than relying entirely on parental reports.
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