Justin M. Stanek

Differences in Scapular Upward Rotation Between Baseball Pitchers and Position Players

Background Baseball pitchers have been reported to have an increased prevalence of shoulder injury compared with position players such as infielders and outfielders. Furthermore, insufficient scapular upward rotation has been empirically linked with several of these shoulder disorders. However, the difference in scapular upward rotation between pitchers and position players is not known. Hypothesis Pitchers will have decreased scapular upward rotation of their dominant shoulders compared with position players. Study Design Descriptive laboratory study. Methods Dominant shoulder scapular upward rotation was measured with the arm at rest and at 60°, 90°, and 120° of humeral elevation among 15 professional baseball pitchers and 15 position players with no recent history of upper extremity injury. Results Independent t tests showed pitchers have significantly less scapular upward rotation at 60° (3.9°, P = .011) and 90° (4.4°, P = .009) of humeral elevation compared with position players. Conclusion Baseball pitchers have less scapular upward rotation than do position players, specifically at humeral elevation angles of 60° and 90°. Clinical Relevance This decrease in scapular upward rotation may compromise the integrity of the glenohumeral joint and place pitchers at an increased risk of developing shoulder injuries compared with position players. As such, pitchers may benefit from periscapular stretching and strengthening exercises to assist with increasing scapular upward rotation.

Physical Activity Participation and Constraints Among Athletic Training Students

CONTEXT Researchers have examined the physical activity (PA) habits of certified athletic trainers; however, none have looked specifically at athletic training students. OBJECTIVE To assess PA participation and constraints to participation among athletic training students. DESIGN Cross-sectional study. SETTING Entry-level athletic training education programs (undergraduate and graduate) across the United States. PATIENTS OR OTHER PARTICIPANTS Participants were 1125 entry-level athletic training students. MAIN OUTCOME MEASURE(S) Self-reported PA participation, including a calculated PA index based on a typical week. Leisure constraints and demographic data were also collected. RESULTS Only 22.8% (252/1105) of athletic training students were meeting the American College of Sports Medicine recommendations for PA through moderate-intensity cardiorespiratory exercise. Although 52.3% (580/1105) were meeting the recommendations through vigorous-intensity cardiorespiratory exercise, 60.5% (681/1125) were meeting the recommendations based on the combined total of moderate or vigorous cardiorespiratory exercise. In addition, 57.2% (643/1125) of respondents met the recommendations for resistance exercise. Exercise habits of athletic training students appear to be better than the national average and similar to those of practicing athletic trainers. Students reported structural constraints such as lack of time due to work or studies as the most significant barrier to exercise participation. CONCLUSIONS Athletic training students experienced similar constraints to PA participation as practicing athletic trainers, and these constraints appeared to influence their exercise participation during their entry-level education. Athletic training students may benefit from a greater emphasis on work-life balance during their entry-level education to promote better health and fitness habits.

The Effectiveness of PNF Versus Static Stretching on Increasing Hip-Flexion Range of Motion

Clinical Scenario: Stretching is applied for the purposes of injury prevention, increasing joint range of motion (ROM), and increasing muscle extensibility. Many researchers have investigated various methods and techniques to determine the most effective way to increase joint ROM and muscle extensibility. Despite the numerous studies conducted, controversy still remains within clinical practice and the literature regarding the best methods and techniques for stretching. Focused Clinical Question: Is proprioceptive neuromuscular facilitation (PNF) stretching more effective than static stretching for increasing hamstring muscle extensibility through increased hip ROM or increased knee extension angle (KEA) in a physically active population? Summary of Key Findings: Five studies met the inclusion criteria and were included. All 5 studies were randomized control trials examining mobility of the hamstring group. The studies measured hamstring ROM in a variety of ways. Three studies measured active KEA, 1 study measured passive KEA, and 1 study measured hip ROM via the single-leg raise test. Of the 5 studies, 1 study found greater improvements using PNF over static stretching for increasing hip flexion, and the remaining 4 studies found no significant difference between PNF stretching and static stretching in increasing muscle extensibility, active KEA, or hip ROM. Clinical Bottom Line: PNF stretching was not demonstrated to be more effective at increasing hamstring extensibility compared to static stretching. The literature reviewed suggests both are effective methods for increasing hip-flexion ROM. Strength of Recommendation: Using level 2 evidence and higher, the results show both static and PNF stretching effectively increase ROM; however, one does not appear to be more effective than the other.

Comparison of Compressive Myofascial Release and the Graston Technique for Improving Ankle-Dorsiflexion Range of Motion

CONTEXT   Restricted dorsiflexion (DF) at the ankle joint can cause acute and chronic injuries at the ankle and knee. Myofascial release and instrument-assisted soft tissue mobilization (IASTM) techniques have been used to increase range of motion (ROM); however, evidence directly comparing their effectiveness is limited. OBJECTIVE   To compare the effects of a single session of compressive myofascial release (CMR) or IASTM using the Graston Technique (GT) on closed chain ankle-DF ROM. DESIGN   Randomized controlled trial. SETTING   Laboratory. PATIENTS OR OTHER PARTICIPANTS   Participants were 44 physically active people (53 limbs) with less than 30° of DF. INTERVENTION(S)   Limbs were randomly assigned to 1 of 3 groups: control, CMR, or GT. Both treatment groups received one 5-minute treatment that included scanning the area and treating specific restrictions. The control group sat for 5 minutes before measurements were retaken. MAIN OUTCOME MEASURE(S)   Standing and kneeling ankle DF were measured before and immediately after treatment. Change scores were calculated for both positions, and two 1-way analyses of variance were conducted. RESULTS   A difference between groups was found in the standing ( F2,52 = 13.78, P = .001) and kneeling ( F2,52 = 5.85, P = .01) positions. Post hoc testing showed DF improvements in the standing position after CMR compared with the GT and control groups (both P = .001). In the kneeling position, DF improved after CMR compared with the control group ( P = .005). CONCLUSIONS   Compressive myofascial release increased ankle DF after a single treatment in participants with DF ROM deficits. Clinicians should consider adding CMR as a treatment intervention for patients with DF deficits.

Collegiate Football Players' Ankle Range of Motion and Dynamic Balance in Braced and Self-Adherent–Taped Conditions

CONTEXT   Ankle sprains are one of the most common injuries in the physically active population. Previous researchers have shown that supporting the ankle with taping or bracing is effective in preventing ankle sprains. However, no authors have compared the effects of self-adherent tape and lace-up ankle braces on ankle range of motion (ROM) and dynamic balance in collegiate football players. OBJECTIVE   To examine the effectiveness of self-adherent tape and lace-up ankle braces in reducing ankle ROM and improving dynamic balance before and after a typical collegiate football practice. DESIGN   Crossover study. SETTING   Collegiate athletic training room. PATIENTS OR OTHER PARTICIPANTS   Twenty-nine National Collegiate Athletic Association Division I football athletes (age = 19.2 ± 1.14 years, height = 187.52 ± 20.54 cm, mass = 106.44 ± 20.54 kg). INTERVENTION(S)   Each participant wore each prophylactic ankle support during a single practice, self-adherent tape on 1 leg and lace-up ankle brace on the other. Range of motion and dynamic balance were assessed 3 times for each leg throughout the testing session (baseline, prepractice, postpractice). MAIN OUTCOME MEASURE(S)   Ankle ROM for inversion, eversion, dorsiflexion, and plantar flexion were measured at baseline, immediately after donning the brace or tape, and immediately after a collegiate practice. The Y-Balance Test was used to assess dynamic balance at these same time points. RESULTS   Both interventions were effective in reducing ROM in all directions compared with baseline; however, dynamic balance did not differ between the tape and brace conditions. CONCLUSIONS   Both the self-adherent tape and lace-up ankle brace provided equal ROM restriction before and after exercise, with no change in dynamic balance.

Active duty firefighters can improve Functional Movement Screen (FMS) scores following an 8-week individualized client workout program

BACKGROUND Firefighting is a dangerous occupation that requires adequate functional movement patterns to help reduce injury risk. Structured programs for improving movement quality have not been studied in firefighters. OBJECTIVE To examine the effects of an 8-week individualized corrective exercise training program on Functional Movement Screen (FMS) scores in active duty firefighters. METHODS Fifty-six male firefighters volunteered to participate in the study. All subjects completed baseline FMS testing and scores were entered into the FMS Pro360 system, subscription-based software which generates an individualized corrective exercise workout based on each independent test score. Two, 4-week corrective exercise programs were generated for each participant based on baseline testing. Following the 8-weeks, participants completed follow-up FMS testing. RESULTS A significant increase in total FMS score (pre = 12.09±2.75, post = 13.66±2.28) was found after the program. A significant increase in stability (pre = 4.13±1.21, post = 4.55±0.83) and advanced movements (pre = 4.45±1.28, post = 5.36±1.29) were also found, however, no difference was observed in mobility tests (3.52±1.09, post = 3.75±0.90). CONCLUSIONS The results suggest an 8-week individualized corrective exercise program was effective at improving scores on the FMS. Providing corrective exercise programs specific to improving levels of dysfunction or maintaining/enhancing function, may increase firefighter preparedness and attempt to minimize injury risk.

A Subjective and Objective Process for Athletic Training Student Selection

Context: Admission decisions are made annually concerning whom to accept into athletic training programs. Objective: To present an approach used to make admissions decisions at an undergraduate ath...

Attitudes and Prevalence of Evidence-based Practice in Undergraduate Athletic Training Education Programs

Attitudes and Prevalence of Evidence-based Practice in Undergraduate Athletic Training Education Programs Evidence-based practice (EBP) has been adopted from medicine and has emerged among the various health professions and is regarded as the best approach to ensuring accurate and meaningful patient care. Previous authors have recommended the need for EBP education at the undergraduate level in athletic training education programs (ATEPs) and since that time the 5th edition educational competencies have been released and now require programs to include EBP instruction within the program.