Achilles Tendon Doppler Flow May Be Associated With Mechanical Load Among Active Athletes.

Am J Sports Med. 2008 Jul 1.

Malliaras P, Richards PJ, Garau G, Maffulli N.
Brunel University.
BACKGROUND: Tendon Doppler flow may be associated with tendon pain in symptomatic patients, but the relationship between Doppler flow and pain among athletes who are still competing is unclear. HYPOTHESIS: Among active athletes, Doppler flow may partly reflect tendon adaptation to increased mechanical load and/or asymptomatic tendinopathy. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: The Achilles tendons of 61 badminton players (24 elite, 37 recreational) were examined with gray-scale and color Doppler ultrasound. Achilles tendon pain and activity level (badminton training, badminton playing, badminton years) were measured. RESULTS: Doppler flow was not associated with current Achilles tendon pain but was associated with an increased anteroposterior tendon diameter (an indicator of tendinopathy) (P = .02). Athletes who had been playing badminton for longer were more likely to have Doppler flow (P < .01), and there was a trend toward an association between a greater number of badminton playing hours per week and Doppler flow (P = .07). CONCLUSION: Achilles tendon Doppler flow appears to be a sign of asymptomatic tendinopathy rather than pain among active athletes. The association between weekly badminton hours and badminton years and Doppler flow suggests that Doppler flow may be a response to mechanical load in this cohort.

Magnetic resonance imaging appearance of the shoulder after subacromial injection with corticosteroids can mimic a rotator cuff tear.

Arthroscopy. 2008 Jul;24(7):846-9. Epub 2007 Apr 24
Borick JM, Kurzweil PR.
Southern California Center for Sports Medicine, Long Beach, California, USA. jayborick@hotmail.com
Subacromial injections have been used to treat rotator cuff problems. Previous studies have noted the difficulty in performing accurate injections into this area. In addition, one must also question the effects that misplaced corticosteroids could have on the surrounding tissues. In this case, a 51-year-old woman presented with several weeks of left shoulder pain and was diagnosed with rotator cuff tendonitis. After a subacromial injection with betamethasone and lidocaine, the patient noted 3 weeks of near complete pain relief, followed by a return of her symptoms. A magnetic resonance imaging scan obtained 7 weeks after the injection showed a full-thickness tear of the supraspinatus tendon. Five weeks later, the patient underwent arthroscopic evaluation of the shoulder and subacromial decompression. The rotator cuff tendons were noted to be intact and normal in appearance. The patient eventually had full resolution of her symptoms. Six months postoperatively, she underwent a new scan that showed a normal supraspinatus tendon. Apparently, the subacromial injection penetrated the anterior half of the supraspinatus tendon, causing a transient effect and signal change. One should use caution in the interpretation of magnetic resonance imaging scans of the shoulder soon after the injection of corticosteroids.

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10th Scientific Meeting Sport + Exercise Medicine QMUL - 12th September Skeel Lecture theatre

Friday 12 September 2008

The Centre for Sport and Exercise Medicine (CSEM) at Queen Mary, University of London (QMUL)

Venue - Skeel Lecture Theatre

Contact barryghill@hotmail.com Mob: 07968 586 855

TENTH SCIENTIFIC MEETING IN SPORTS & EXERCISE MEDICINE & REUNION

MORNING SESSION

0930 Registration and Commercial Exhibition

1000 Welcome & Introduction – Mr J B King

CHAIR: Dr T Crisp

1010 P1 Metatarsal fractures in Professional Football. Dr G Steinbergs

1020 P2 Establishing practical guidelines for exercise in Type I Diabetics

1030 P3 An experimental design to assess relationship in ability to perform a timed, eyes closed, single leg stance test, with 7 without quarter squat. Ms L Barnes

1040 P4 The effect of cryotherapy on dynamic unilateral balance in healthy adults. Ms S Cru

1050 P5 A cohort study to investigate hydration status of professional rugby union players. Ms M Sturley.

1100 P6 A pilot observational study of vertical pressure distribution and blister formation on the hand of sitting volleyball players. Dr JM Zhang

1110 P7 A comparative study of Achilles tendon stiffness. Dr S Ahmad

1120 Refreshments and Commercial Exhibition

CHAIR: Dr R Carbon

1150 P8 Comparison of 2 verbal cues used to initiate an isolated transversus abdominis muscle contraction in normal subjects. Mr N Lynne

1200 P9 The effect of exercise on self-esteem and physical self-perception in obese children of Tower Hamlets. Ms C McCall

1210 P10 Test-Retest reliability of repeated single leg squat until volitional quadriceps fatigue. Ms A Ogles

1220 P11 Retrospective audit of patients who have undergone Cheilectomy & Akin’s osteotomy to reduce Hallux Valgus deformity. Dr H Oshiba

1230 P12 Correlation between changes in neovascularisation and clinical severity in patients with resistant Achilles Tendinopathy. Dr J Humphrey

1240 KEYNOTE SPEECH: OBESITY – A SPORTS PHYSICIAN’S PROBLEM. Dr Z Iqbal

1300 Buffet Lunch and Commercial Exhibition

AFTERNOON SESSION

CHAIR: Dr I Beasley

1400 P14 Evaluation of physical balance ability of patients with CFS/ME. Mr N Dyer

1410 P15 Effect of specific weight bearing ankle stretch on functional outcome following an acute lateral ankle sprain. Mr P Howarth

1420 P16 Return to play after musculoskeletal injury in the English Rugby Premiership League & National League One. Dr J Noakes

1430 P17 Injury type and rate in Junior Elite Hockey players in England. Ms L O’Flynn

1440 P18 High volume distension arthrography with steroid and steroid alone, in the treatment of adult idiopathic adhesive capsulitis of the shoulder. Dr R Findlay

1450 P19 Ultrasound detection of injuries in the paediatric severe ankle sprain. Dr A Pillai

1500 P20 Pedometer determined physical activity levels in secondary school children in Tower hamlets. Dr T Margham

1510 P21 Improving the ability of medical; students to communicate complex ideas in writing. Dr C Chung

1520 Refreshments and Commercial Exhibition

CHAIR: Dr J D Perry

1550 P22 Application of surface EMG to assess muscle recruitment patterns in novice & experienced rowers. Ms C Sharpe

1610 P23 TBA

1630 KEY NOTE SPEECH – MOUNTAIN MEDICINE – Dr R Casserley

1700 John King Prize (SPONSORED BY DJO) presentation & CLOSE

PUB CRAWL CONFERENCE & REUNION MEAL IN THE OCTAGON, QUEEN MARY