The use of self myofascial release (SMR) via a foam roller or roller massager is becoming increasingly popular both to aid recovery from exercise and prevent injury. Our objective was to review the literature on SMR and its use for preexercise, recovery, or maintenance. PUBMED, EBSCO (MEDLINE), EMBASE, and CINAHL were searched for variations and synonyms of "self myofascial release" and "foam rolling." Data from nine studies were examined, and overall quality varied based on study protocol, muscle group targeted, and outcomes measured. Despite the heterogeneity of these studies, SMR appears to have a positive effect on range of motion and soreness/fatigue following exercise, but further study is needed to define optimal parameters (timing and duration of use) to aid performance and recovery.
Objectives-Ultrasound imaging is commonly used to teach basic anatomy to medical students. The purpose of this study was to determine whether learning musculoskeletal anatomy with ultrasound improved performance on medical students' musculoskeletal physical examination skills.Methods-Twenty-seven first-year medical students were randomly assigned to 1 of 2 instructional groups: either shoulder or knee. Both groups received a lecture followed by hands-on ultrasound scanning on live human models of the assigned joint. After instruction, students were assessed on their ability to accurately palpate 4 anatomic landmarks: the acromioclavicular joint, the proximal long-head biceps tendon, and the medial and lateral joint lines of the knee. Performance scores were based on both accuracy and time. A total physical examination performance score was derived for each joint. Scores for instructional groups were compared by a 2-way analysis of variance with 1 repeated measure. Significant findings were further analyzed with post hoc tests.Results-All students performed significantly better on the knee examination, irrespective of instructional group (F 5 14.9; df 5 1.25; P 5 .001). Moreover, the shoulder instruction group performed significantly better than the knee group on the overall assessment (t 5 -3.0; df 5 25; P < .01). Post hoc analyses revealed that differences in group performance were due to the shoulder group's higher scores on palpation of the biceps tendon (t 5 -2.8; df 5 25; P 5 .01), a soft tissue landmark. Both groups performed similarly on palpation of all other anatomic structures.Conclusions-The use of ultrasound appears to provide an educational advantage when learning musculoskeletal physical examination of soft tissue landmarks.
Treatment of musculoskeletal conditions in athletes with extracorporeal shockwave therapy (ESWT) is gaining popularity as greater evidence supports its use. ESWT protocols (describing energy flux density, number of impulses, type of shockwave (focused or radial), number/frequency/duration of treatment session, area of application, and postprocedural therapy protocols) can be adjusted in the clinical setting. Protocols vary across studies, and optimal protocols for most indications are yet to be determined. ESWT can safely be used to treat various musculoskeletal conditions in athletes, including rotator cuff tendinopathy, lateral elbow epicondlyopathy, greater trochanteric pain syndrome, hamstring tendinopathy, patellar tendinopathy, Achilles tendinopathy, other tendinopathies, plantar fasciopathy, bone stress injuries, and medial tibial stress syndrome. ESWT can be used to treat in-season athletes, as it often requires no/minimal time away from sport and may result in rapid benefits. ESWTshould be used in conjunction with physical therapy to facilitate longer-term gains in function and to optimize healing.
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