Effects of Grip Style and Contact Point on Force Production in a Tennis Forehand Groundstroke.

Modern tennis forehand grip style and ball contact points have evolved to enhance power and topspin. Different grip styles and ball contacts are recommended; however, little data are available to support one over another. Through a quantitative experimental study, we sought to determine which grip style and ball contact point produced the greatest forces at static contact.

Injections of the Hand and Wrist: Part I. Trigger Finger, First Carpometacarpal Joint Osteoarthritis, and Palmar Fibromatosis.

Family physicians are well-positioned to provide injections for patients who have pain due to hand and finger conditions, especially when initial treatments such as splinting and nonsteroidal anti-inflammatory drugs are ineffective. Corticosteroid injections can offer pain relief; however, potential risks such as infection, cartilage damage, and skin depigmentation should be discussed. Techniques and procedures for injections vary.

Sonographic Assessment of Asymptomatic Patellar and Achilles Tendons to Predict Future Pain: A Systematic Review and Meta-analysis.

Objective: Patients with clinical tendinopathy often demonstrate significant abnormalities with ultrasound (US) imaging. Tendon abnormalities likely precede pain in these patients. The purpose of this review was to systematically evaluate the available literature regarding the utility of US imaging as a method to predict Achilles and patellar tendon pain.

From Dugout to the Mound: A Tale of Platelet-Rich Performance.

Ulnar collateral ligament (UCL) tears of the elbow are prevalent injuries among throwing athletes and are associated with excessive or repeated valgus forces at the elbow. We present the case of an 18-year-old male baseball pitcher with an 18-month history of progressive right elbow pain, notably worsened during his fastball pitching. Clinical assessment revealed tenderness with dynamic stressing of the right UCL.

The Effect of Intra-articular Hypertonic Dextrose Prolotherapy on Pain, Quality of Life, and Functional Outcomes Scores in Patients With Knee Osteoarthritis.

Introduction Knee osteoarthritis is a common chronic condition leading to pain and debility. Prolotherapy is a safe and cost-effective treatment option. Our team conducted a case series to examine the effect of prolotherapy on functional measures and quality of life in patients with knee osteoarthritis.

Using Chronic Care Management Visits to Reduce the Number of Frequent Emergency Department Visits: A Pilot Study.

Background Emergency department (ED) visits are increasing in number and cost and becoming a major way patients are interacting with the healthcare system. Patients who frequently visit the ED are deemed "super-utilizers" who visit for a variety of reasons, including, but not limited to, multiple chronic medical illnesses, homelessness, and substance use disorder, but fail to have an established long-term treatment plan. Methodology We enrolled our hospital's top 50 super-utilizing patients into the Chronic Care Management Program.

Improving Patient Access to Musculoskeletal Treatments and Medical Student Musculoskeletal Education via Free Clinic Services.

Introduction Homeless patients are at higher risk for musculoskeletal conditions but have limited access to treatments. Physical therapy (PT) and osteopathic manual therapy (OMT) are treatments for acute and chronic musculoskeletal conditions. Here, we outline establishing a free specialty clinic to provide PT and OMT to underserved patients.

Strike Out: A Case Report of Glioblastoma in a Collegiate Softball Player.

A 20-year-old female, right-hand-dominant Division I softball player, presented to her pre-participation exam endorsing numbness that started in her left thumb and had progressed to involve her entire hand and left medial elbow. She had no change in her physical health over the past year prior to presentation and denied injury illness or trauma to the left upper extremity or neck. She reported no change in her softball off-season training regimen or equipment.

A Schatzker Type III Tibial Plateau Fracture in a Soccer Player: A Case Report.

The tibial plateau is an important load-bearing surface in the knee, and when fractured, there is subsequent loss of motion and stability. These fractures typically result from axial loading and twisting. Our case outlines a tibial plateau fracture in a 15-year-old soccer player.

Early Initiation of Vestibular Therapy Following Sports-Related Concussions: A Retrospective Cohort Study.

Background: Vestibular dysfunction is common following sports-related concussions (SRC). Within the current practice, it is theorized that patients with vestibular dysfunction as sequelae of sports-related concussion have a prolonged recovery time compared to those without vestibular dysfunction.

Study Method:  A retrospective, cohort investigation of 282 subjects with sports-related concussions with vestibular dysfunction was conducted at The Sports Medicine Concussion Clinic, Duke University.

Elbow Evaluation Via Telephone and Video Visit.

Background Elbow conditions and pathology are commonly seen in the outpatient clinic. Telephone and video visits can allow for expeditious assessment of elbow complaints, without the added challenges of commuting for a clinic-based evaluation. In the setting of a pandemic, the benefits of telemedicine are apparent, but the time and effort saved from being able to remotely evaluate musculoskeletal conditions are also useful in a non-pandemic situation.

Ultrasound Evaluation of Knee Osteoarthritis.

While radiographs and magnetic resonance imaging (MRI) have long been used in the assessment of osteoarthritis (OA), ultrasound imaging has been rapidly accepted by musculoskeletal providers in both the assessment and treatment of OA. A limiting factor in the use of ultrasound is the proper training required by the user for results to be reliable and reproducible. A standardized ultrasound protocol can potentially address this limiting factor.

Telemedicine Evaluation of Hip Ailments.

Background During the coronavirus disease 2019 (COVID-19) pandemic, telemedicine has provided new means of patient care while still allowing for physical examination and history to be obtained. Hip ailments are a common musculoskeletal problem leading to limited function. Today, we lack a standardized telemedicine hip evaluation protocol.

An Unexpected Finding in a Concussed Circus Acrobat.

Persistent post-concussive syndrome (PPCS) outlines a complex array of neurocognitive and psychological symptoms that persist in patients after a concussion. A 58-year-old female presented reporting recurrent loss of consciousness, and retrograde and anterograde amnesia following multiple concussions. She also endorsed persistent nausea, balance insufficiencies, hearing loss, and cognitive impairment.

Telemedicine Examination of the Knee.

Introduction The coronavirus disease 2019 (COVID-19) pandemic has resulted in rapid healthcare system adaptations, including the acceptance of telemedicine in primary care. In the case of knee ailments, among the most common problems encountered in primary care, telemedicine provides a literal window to observe the patient performing functional activities. Despite its potential, there is a lack of standardized protocols for data collection.

Perioperative Management in the Collegiate Athlete: An Integrated Approach.

Collegiate athletes face rigorous physical, academic, and emotional demands. While significant attention has been paid to injury prevention among young athletes in the past two decades, orthopedic injury rates remain high among collegiate athletes, and a significant number will undergo surgical management for injuries each year. In this narrative review, we describe techniques for perioperative management of pain and stress after surgery in collegiate athletes.

Evaluation of the Hand and Wrist via Telephone and Video Visit.

Background:  The COVID-19 pandemic has highlighted the utility of telemedicine, with rapid incorporation throughout 2020. Telemedicine is a timely, safe, and effective means of evaluating, triaging, and treating patient conditions, including those of the musculoskeletal system. Hand and wrist complaints are frequently encountered in the primary care setting, and some can have serious consequences if not promptly diagnosed.

Opiate Use Patterns Among Collegiate Athletes.

Objective/aim: The purpose of this study is to determine the rates of prescribed opiate use and misuse among current collegiate athletes.

Materials And Methods: This was an bservational survey study conducted at a single institution; Division I Collegiate Athletics Department. The participants in the study were current Division I Collegiate Student-Athletes.

Telehealth examination of the lumbar spine.

Background: Telehealth evaluations of musculoskeletal conditions have increased due to the stay-at-home policies enacted during the COVID-19 pandemic. Back pain is one of the most common complaints in primary care. While telehealth may never supplant in-person evaluation of back pain, it is imperative in a changing world to learn to perform this evaluation via telephone or video.

Which Factors Predict 30-Day Readmission After Total Hip and Knee Replacement Surgery?

Background The Centers for Medicare and Medicaid Services enacted the Hospital Readmissions Reduction Program to impose penalties for diagnoses with high readmission rates. Despite several elective orthopedic procedures being included in this program, readmission rates have not declined, and associated costs have reached critical levels for total knee and total hip arthroplasty. Readmissions drastically impact patient outcomes.