Todd A. McLoda

The immediate effects of muscle energy technique on posterior shoulder tightness: a randomized controlled trial.

STUDY DESIGN Randomized controlled trial. OBJECTIVES To compare a muscle energy technique (MET) for the glenohumeral joint (GHJ) horizontal abductors and an MET for the GHJ external rotators to improve GHJ range of motion (ROM) in baseball players. BACKGROUND Overhead athletes often exhibit loss of GHJ ROM in internal rotation, which has been associated with shoulder pathology. Current stretching protocols aimed at improving flexibility of the posterior shoulder have resulted in inconsistent outcomes. Although utilization of MET has been hypothesized to lengthen tissue, there are limited empirical data describing the effectiveness of such stretches for treating posterior shoulder tightness. METHODS Sixty-one Division I baseball players were randomly assigned to 1 of 3 groups: MET for the GHJ horizontal abductors (n = 19), MET for the GHJ external rotators (n = 22), and control (n = 20). We measured preintervention and postintervention GHJ horizontal adduction and internal rotation ROM, and conducted analyses of covariance, followed by Tukey honestly significant difference post hoc analysis for significant group-by-time interactions (P<.05). RESULTS The group treated with the MET for the horizontal abductors had a significantly greater increase in GHJ horizontal adduction ROM postintervention (mean ± SD, 6.8° ± 10.5°) compared to the control group (-1.1° ± 6.8°) (P = .011) and a greater increase in internal rotation ROM postintervention (4.2° ± 5.3°) compared to the group treated with the MET for the external rotators (0.2° ± 6.3°) (P = .020) and the control group (-0.2° ± 4.0°) (P = .029). No significant differences among groups were found for any other variables (P>.05). CONCLUSION A single application of an MET for the GHJ horizontal abductors provides immediate improvements in both GHJ horizontal adduction and internal rotation ROM in asymptomatic collegiate baseball players. Application of MET for the horizontal abductors may be useful to gain ROM in overhead athletes. LEVEL OF EVIDENCE Therapy, level 2b-.

Correlation of Shoulder and Elbow Kinetics With Ball Velocity in Collegiate Baseball Pitchers

CONTEXT Throwing a baseball is a dynamic and violent act that places large magnitudes of stress on the shoulder and elbow. Specific injuries at the elbow and glenohumeral joints have been linked to several kinetic variables throughout the throwing motion. However, very little research has directly examined the relationship between these kinetic variables and ball velocity. OBJECTIVE To examine the correlation of peak ball velocity with elbow-valgus torque, shoulder external-rotation torque, and shoulder-distraction force in a group of collegiate baseball pitchers. DESIGN Cross-sectional study. SETTING Motion-analysis laboratory. PATIENTS OR OTHER PARTICIPANTS Sixty-seven asymptomatic National Collegiate Athletic Association Division I baseball pitchers (age = 19.5 ± 1.2 years, height = 186.2 ± 5.7 cm, mass = 86.7 ± 7.0 kg; 48 right handed, 19 left handed). MAIN OUTCOME MEASURE(S) We measured peak ball velocity using a radar gun and shoulder and elbow kinetics of the throwing arm using 8 electronically synchronized, high-speed digital cameras. We placed 26 reflective markers on anatomical landmarks of each participant to track 3-dimensional coordinate data. The average data from the 3 highest-velocity fastballs thrown for strikes were used for data analysis. We calculated a Pearson correlation coefficient to determine the associations between ball velocity and peak elbow-valgus torque, shoulder-distraction force, and shoulder external-rotation torque (P < .05). RESULTS A weak positive correlation was found between ball velocity and shoulder-distraction force (r = 0.257; 95% confidence interval [CI] = 0.02, 0.47; r(2) = 0.066; P = .018). However, no significant correlations were noted between ball velocity and elbow-valgus torque (r = 0.199; 95% CI = -0.043, 0.419; r(2) = 0.040; P = .053) or shoulder external-rotation torque (r = 0.097; 95% CI = -0.147, 0.329; r(2) = 0.009; P = .217). CONCLUSIONS Although a weak positive correlation was present between ball velocity and shoulder-distraction force, no significant association was seen between ball velocity and elbow-valgus torque or shoulder external-rotation torque. Therefore, other factors, such as improper pitching mechanics, may contribute more to increases in joint kinetics than peak ball velocity.

Acute Lower Extremity Running Kinematics After a Hamstring Stretch

CONTEXT Limited passive hamstring flexibility might affect kinematics, performance, and injury risk during running. Preactivity static straight-leg raise stretching often is used to gain passive hamstring flexibility. OBJECTIVE To investigate the acute effects of a single session of passive hamstring stretching on pelvic, hip, and knee kinematics during the swing phase of running. DESIGN Randomized controlled clinical trial. SETTING Biomechanics research laboratory. PATIENTS OR OTHER PARTICIPANTS Thirty-four male (age = 21.2 ± 1.4 years) and female (age = 21.3 ± 2.0 years) recreational athletes. INTERVENTION(S) Participants performed treadmill running pretests and posttests at 70% of their age-predicted maximum heart rate. Pelvis, hip, and knee joint angles during the swing phase of 5 consecutive gait cycles were collected using a motion analysis system. Right and left hamstrings of the intervention group participants were passively stretched 3 times for 30 seconds in random order immediately after the pretest. Control group participants performed no stretching or movement between running sessions. MAIN OUTCOME MEASURE(S) Six 2-way analyses of variance to determine joint angle differences between groups at maximum hip flexion and maximum knee extension with an α level of .008. RESULTS Flexibility increased between pretest and posttest in all participants (F(1,30) = 80.61, P < .001). Anterior pelvic tilt (F(1,30) = 0.73, P = .40), hip flexion (F(1,30) = 2.44, P = .13), and knee extension (F(1,30) = 0.06, P = .80) at maximum hip flexion were similar between groups throughout testing. Anterior pelvic tilt (F(1,30) = 0.69, P = .41), hip flexion (F(1,30) = 0.23, P = .64), and knee extension (F(1,30) = 3.38, P = .62) at maximum knee extension were similar between groups throughout testing. Men demonstrated greater anterior pelvic tilt than women at maximum knee extension (F(1,30) = 13.62, P = .001). CONCLUSIONS A single session of 3 straight-leg raise hamstring stretches did not change pelvis, hip, or knee running kinematics.

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.

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.