More than half of the recreational runners studied were observed to have a medial or lateral heel whip of greater than 5 degrees. These data reveal the age, body mass index, and gender distribution of recreational runners with and without heel whips.

Background Initial protocols for return to play cardiac testing in young competitive athletes following SARS‐CoV‐2 infection recommended cardiac troponin (cTn) to screen for cardiac involvement. This study aimed to define the diagnostic yield of cTn in athletes undergoing cardiovascular testing following SARS‐CoV‐2 infection. Methods and Results This prospective, observational cohort study from ORCCA (Outcomes Registry for Cardiac Conditions in Athletes) included collegiate athletes who underwent cTn testing as a component of return to play protocols following SARS‐CoV‐2 infection. The cTn values were stratified as undetectable, detectable but within normal limits, and abnormal (>99% percentile). The presence of probable or definite SARS‐CoV‐2 myocardial involvement was compared between those with normal versus abnormal cTn levels. A total of 3184/3685 (86%) athletes in the ORCCA database met the inclusion criteria for this study (age 20±1 years, 32% female athletes, 28% Black race). The median time from SARS‐CoV‐2 diagnosis to cTn testing was 13 days (interquartile range, 11, 18 days). The cTn levels were undetectable in 2942 athletes (92%), detectable but within normal limits in 210 athletes (7%), and abnormal in 32 athletes (1%). Of the 32 athletes with abnormal cTn testing, 19/32 (59%) underwent cardiac magnetic resonance imaging, 30/32 (94%) underwent transthoracic echocardiography, and 1/32 (3%) did not have cardiac imaging. One athlete with abnormal troponin met the criteria for definite or probable SARS‐CoV‐2 myocardial involvement. In the total cohort, 21/3184 (0.7%) had SARS‐CoV‐2 myocardial involvement, among whom 20/21 (95%) had normal troponin testing. Conclusions Abnormal cTn during routine return to play cardiac screening among competitive athletes following SARS‐CoV‐2 infection appears to have limited diagnostic utility.

A 20-year-old, right-hand-dominant female collegiate tennis player presents with persistent pain over her right lateral epicondyle for the past 4 months that began when she increased activity at the start of season. She was initially diagnosed with lateral epicondylitis and tried oral antiinflammatories, physical therapy, a counterforce brace, a corticosteroid injection, and activity modification without relief. Point-of-care ultrasound demonstrated evidence of chronic tendinosis with thickening of the common extensor tendon, focal hypoechogenicity, and neovascularization. She did a trial of topical nitroglycerin patches and eccentric exercises without significant improvement. She prefers to avoid surgery and would like to know the efficacy of percutaneous needle tenotomy for her common extensor tendinosis.

Background and EpidemiologyRunning-related injuries are a major subset of musculoskeletal complaints seen in sports medicine and primary care offices. The number of runners who will suffer a running-related injury are estimated to be as many as 30% to 50% (1,2). Having an expert grasp on the key points of gait analysis can simplify assessment of gait-related complaints and also aid the performance of running athletes. AnatomyThe relevant anatomy and biomechanics of gait include the hip, knee, ankle, and joints of the foot. Neutral joint positions should be assessed with the patient in a comfortable relaxed standing posture. Neutral position presents the subtalar joint without pronation or supination, in vertical alignment from anterior superior iliac spine through patella and the second metatarsal. Normal ranges of motions for the other joints involved are as follows:

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