Acute ankle sprain is the most common lower limb injury in athletes and accounts for 16%-40% of all sports-related injuries. It is especially common in basketball, American football, and soccer. The majority of sprains affect the lateral ligaments, particularly the anterior talofibular ligament. Despite its high prevalence, a high proportion of patients experience persistent residual symptoms and injury recurrence. A detailed history and proper physical examination are diagnostic cornerstones. Imaging is not indicated for the majority of ankle sprain cases and should be requested according to the Ottawa ankle rules. Several interventions have been recommended in the management of acute ankle sprains including rest, ice, compression, and elevation, analgesic and anti-inflammatory medications, bracing and immobilization, early weight-bearing and walking aids, foot orthoses, manual therapy, exercise therapy, electrophysical modalities and surgery (only in selected refractory cases). Among these interventions, exercise and bracing have been recommended with a higher level of evidence and should be incorporated in the rehabilitation process. An exercise program should be comprehensive and progressive including the range of motion, stretching, strengthening, neuromuscular, proprioceptive, and sport-specific exercises. Decision-making regarding return to the sport in athletes may be challenging and a sports physician should determine this based on the self-reported variables, manual tests for stability, and functional performance testing. There are some common myths and mistakes in the management of ankle sprains, which all clinicians should be aware of and avoid. These include excessive imaging, unwarranted non-weight-bearing, unjustified immobilization, delay in functional movements, and inadequate rehabilitation. The application of an evidence-based algorithmic approach considering the individual characteristics is helpful and should be recommended.

Purpose: Despite numerous studies which have been done regarding soccer injuries worldwide, there is lack of available data considering the epidemiology of injuries in the Iranian soccer premier league, although it is the most popular sport in the country. The main goal of this research was to determine the incidence of physical injuries in the studied population, considering other characteristics such as site, type and mechanism as well.Methods: Twenty one adult male professional soccer players (age 24±3), members of a team (Tehran-Pas) participating in Iranian premier league, were followed during a 4-month period. The injury characteristics and exposure times were recorded by the team physician during all the matches and training sessions. Results:The total exposure time was 2610 playing hours (2352 h of training versus 258 h of competition). Eighty six percent of the injuries were acute. Incidence of acute injuries was 16.5 (95% CI: 12-22) per 1000 hours of playing (11.5 per 1000 hrs of training and 62 per 1000 hrs of competition). The most common types of injuries were strains followed by contusions, each of which constituted 30% of acute injuries. More than 80% of injuries occurred in lower limbs, especially in thigh and groin regions. Nearly 60% of acute injuries occurred in dominant side of the body, and collision was the reason of about half of the acute injuries. Severity of more than 70% of the injuries was minor. On average each injury had led the player being off the field for about 10 days. Conclusion:The incidence of injury in this research is in range of numbers obtained in important international tournaments but the rate of injuries during training sessions is higher than comparable studies.

Context: Growing evidence highlights the importance of physical activity as a critical element for the prevention and control of diabetes. However, there is no clinical practice guideline focusing on the different aspects of exercise in patients with diabetes, especially for the Iranian population. Objective: We aimed to prepare and adopt a clinical practice guideline to provide well-defined, simple, and concise responses to certain questions related to physical activity and exercise in all patients with diabetes, including type 1, 2, and gestational diabetes mellitus (GDM). Evidence Acquisition: A multidisciplinary team of experts in various fields (sports medicine specialists, endocrinologists, and cardiologists) developed the guideline. This group did the task in four stages: (1) identifying and refining the subject area using 17 clinical questions; (2) appraising evidence through a systematic review of the literature; (3) extracting recommendations from evidence and grading them as A, B, C, or D based on the quality, quantity, and consistency of existing evidence; and (4) subjecting the guideline to external review and finally selecting the recommendations with high scores of appropriateness and agreement. The final version was evaluated and approved by the National Deputy for Curative Affairs - Ministry of Health and Medical Education and has also been endorsed by the Iran Endocrine Society (IES) and Iranian Association of Sports and Exercise Medicine (IASEM). Results: The guideline consists of 52 recommendations addressing 17 important questions concerning different aspects of exercise prescription in Iranian patients with diabetes. Conclusions: The guideline provides evidence-based information that may help physicians to prescribe exercise for Iranian patients with diabetes safely and effectively.

Background: Carpal tunnel syndrome (CTS) is the most prevalent form of peripheral neuropathy. There are various treatments for carpal tunnel. Objectives: In this study, we evaluated the effect of electroacupuncture and exercise on pinch and grip strength and wrist range of motion in patients with mild to moderate CTS. Methods: Sixty patients with carpal tunnel syndrome were evaluated in this study, only five of whom were male. In this study, patients were divided into three groups. The control group consisted of 20 patients who only used splints in the second group, in addition to splints, special exercises were administered, and the third group, electroacupuncture, and brace were prescribed for 12 sessions of 40-minute duration. study time was 6 weeks. The parameters of pinch force, grip force, ROM (flexion and extension) were evaluated at baseline and after the treatment. Results: In this study, 55 women and 5 men with an average age of 49.23 ± 8.96 were enrolled. At the final follow up, significant improvements in all parameters were found in third groups (P < 0.05), except flexion of the wrist in the control group (P = 0.098). Our findings indicate that exercise therapy had more effect on ROM of flexion than acupuncture and acupuncture had more effect on pinching than exercise therapy but the effect sizes were weak. Also, the efficacy of splint alone was less than intervention groups in all parameters. Conclusions: Results of this study demonstrated that adding exercise or acupuncture to nocturnal splinting, the functional improvement is more in patients with mild to moderate carpal tunnel syndrome and these interventions could be adopted in the management of these patients.

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