The "Genesis" of sciatic nerve injury.

In the Old Testament book of Genesis, Chapter 32, Jacob wrestled with an angel. After that encounter, Jacobs limped. Through careful understanding of the original meaning of the words in Verses 25, 31, and 32 of Genesis 32, we seek to learn what type of injury the angel might have inflicted on Jacob.

Anococcygeal Nerve and Sitting Pain: Differential Diagnosis and Treatment Results.

Background: The plastic surgeon is often asked to reconstruct the sacral area related to pilonidal cysts or a tumor, or after other surgery, such as coccygectomy. When sitting pain is not due to the pudendal or posterior femoral cutaneous nerve injury, the anococcygeal nerve (ACN) must be considered. Clinically, its anatomy is not well known.

Report on 7 Years' Experience Implementing an Undergraduate Medical Curriculum for Osteopathic Medical Students Using Entrustable Professional Activities.

Calls for changes in undergraduate medical education and the advent of the single graduate medical education accreditation system have challenged the osteopathic medical profession to maintain its identity and distinctiveness while adapting to innovations. For the osteopathic medical profession to thrive, its colleges must provide students with an educational framework that solidifies their osteopathic identity. The authors developed an integrated anatomy-clinical skills course at the University of New England College of Osteopathic Medicine, Osteopathic Clinical Skills, that used the performance benchmarks of the Entrustable Professional Activities and the Osteopathic Core Competencies for Medical Students from the American Association of Colleges of Osteopathic Medicine.

Form and Force Closure of the Sacroiliac Joints.

The principles of form and force closure were introduced to describe the complex mechanism of sacroiliac joint (SIJ) stability. Form closure refers to a theoretical stable state of a joint with close fitting articular surfaces, where no extra forces are needed to maintain the stable state of the system during loading and unloading situations. If the sacrum would fit in the pelvis with perfect form closure, no lateral compressional forces would be needed to maintain stability.

Effects of Group Fitness Classes on Stress and Quality of Life of Medical Students.

Context: Medical school can produce intense psychological distress in its students; however, there is a paucity of research exploring potential means of improving medical students' well-being.

Objective: To investigate the relationship between physical exercise and stress and quality of life (QOL) in a medical student population.

Methods: This nonrandomized, controlled, 12-week study used a survey research design.

Defining the Anatomy of the Tendinous Intersections of the Rectus Abdominis Muscle and Their Clinical Implications in Functional Muscle Neurotization.

Purpose: Little is known about the definitive course of the tendinous intersections from anterior to posterior through the rectus abdominis (RA) muscle. The implications of a full thickness intersection may have effects on the ability to neurotize the RA. We hypothesized that these tendinous inscriptions would be fully adherent to the anterior rectus sheath, but there would be an incomplete penetrance into the posterior surface, thereby allowing for muscle fibers and neurovascular structures to run the entire course of the RA muscle.

Current Diagnosis and Treatment of Superficial Fibular Nerve Injuries and Entrapment.

The superficial peroneal nerve is now known as the superficial fibular nerve (SFN). Identification and treatment of entrapment of the SFN are important topics of discussion for foot and ankle surgeons, because overlooking the diagnosis can lead to permanent nerve damage. With the proper tools and skills, surgeons are able to help patients with symptomatic SFN entrapment, patients who often present in some degree of desperation, with the peripheral nerve surgeon as a last resort.

Metabolic characteristics of keto-adapted ultra-endurance runners.

Background: Many successful ultra-endurance athletes have switched from a high-carbohydrate to a low-carbohydrate diet, but they have not previously been studied to determine the extent of metabolic adaptations.

Methods: Twenty elite ultra-marathoners and ironman distance triathletes performed a maximal graded exercise test and a 180 min submaximal run at 64% VO2max on a treadmill to determine metabolic responses. One group habitually consumed a traditional high-carbohydrate (HC: n=10, %carbohydrate:protein:fat=59:14:25) diet, and the other a low-carbohydrate (LC; n=10, 10:19:70) diet for an average of 20 months (range 9 to 36 months).

The functional coupling of the deep abdominal and paraspinal muscles: the effects of simulated paraspinal muscle contraction on force transfer to the middle and posterior layer of the thoracolumbar fascia.

The thoracolumbar fascia (TLF) consists of aponeurotic and fascial layers that interweave the paraspinal and abdominal muscles into a complex matrix stabilizing the lumbosacral spine. To better understand low back pain, it is essential to appreciate how these muscles cooperate to influence lumbopelvic stability. This study tested the following hypotheses: (i) pressure within the TLF's paraspinal muscular compartment (PMC) alters load transfer between the TLF's posterior and middle layers (PLF and MLF); and (ii) with increased tension of the common tendon of the transversus abdominis (CTrA) and internal oblique muscles and incremental PMC pressure, fascial tension is primarily transferred to the PLF.

Quantitative assessment of the ischiofemoral space and evidence of degenerative changes in the quadratus femoris muscle.

Background: Injuries to the quadratus femoris (QF) muscle have only recently appeared in the medical literature with the increasing use of advanced imaging in assessing musculoskeletal complaints in the gluteal region. Both strains of the QF muscle and impingement of the QF muscle within the ischiofemoral (IF) space can appear similar on imaging, and normative data of the IF space is important in establishing guidelines for defining these conditions.

Purpose: One purpose of this study was to quantitatively describe the IF and QF spaces.

The sacroiliac joint: an overview of its anatomy, function and potential clinical implications.

This article focuses on the (functional) anatomy and biomechanics of the pelvic girdle and specifically the sacroiliac joints (SIJs). The SIJs are essential for effective load transfer between the spine and legs. The sacrum, pelvis and spine, and the connections to the arms, legs and head, are functionally interrelated through muscular, fascial and ligamentous interconnections.

Misclassification of hybrid fast fibers in resistance-trained human skeletal muscle using histochemical and immunohistochemical methods.

Sixteen healthy untrained women participated in a 6-week progressive resistance training program to compare 2 common methods of classifying fiber types. The women were a subset from a previous study and were randomly divided into 2 groups: traditional strength training (TS, n = 9) and non-exercising control (C, n = 7). The TS group performed 3 lower limb exercises (leg press, squat, and knee extension) using 6-10 repetitions maximum 2 days per week for the first week and 3 days per week for the remaining 5 weeks (17 total workouts).

The thoracolumbar fascia: anatomy, function and clinical considerations.

In this overview, new and existent material on the organization and composition of the thoracolumbar fascia (TLF) will be evaluated in respect to its anatomy, innervation biomechanics and clinical relevance. The integration of the passive connective tissues of the TLF and active muscular structures surrounding this structure are discussed, and the relevance of their mutual interactions in relation to low back and pelvic pain reviewed. The TLF is a girdling structure consisting of several aponeurotic and fascial layers that separates the paraspinal muscles from the muscles of the posterior abdominal wall.

A description of the lumbar interfascial triangle and its relation with the lateral raphe: anatomical constituents of load transfer through the lateral margin of the thoracolumbar fascia.

Movement and stability of the lumbosacral region is contingent on the balance of forces distributed through the myofascial planes associated with the thoracolumbar fascia (TLF). This structure is located at the common intersection of several extremity muscles (e.g.

Modulation of bovine chondrocyte metabolism by free periosteal grafts in vitro.

Purpose: Autologous chondrocyte transplantation (ACT) is an established method in cartilage repair. Although long-term results show durable repair of isolated cartilage defects, some problems still remain. Since hypertrophy of the transplanted periosteum is a common problem, alternatives for periosteum are in demand.

Early-phase muscular adaptations in response to slow-speed versus traditional resistance-training regimens.

Thirty-four untrained women participated in a 6-week program to investigate slow-speed versus "normal" speed resistance-training protocols. Subjects were divided into: slow-speed (SS), normal-speed/traditional-strength (TS), normal-speed/traditional muscular endurance (TE), and non-exercising control (C) groups. Leg press, squats, and knee extensions were performed 2 days/week for the first week and 3 days/week for the remaining 5 weeks (~2 min rest).

Interactions of aging, overload, and creatine supplementation in rat plantaris muscle.

Attenuation of age-related sarcopenia by creatine supplementation has been equivocal. In this study, plantaris muscles of young (Y; 5m) and aging (A; 24m) Fisher 344 rats underwent four weeks of either control (C), creatine supplementation (Cr), surgical overload (O), or overload plus creatine (OCr). Creatine alone had no effect on muscle fiber cross-sectional area (CSA) or heat shock protein (HSP70) and increased myonuclear domain (MND) only in young rats.

No change in skeletal muscle satellite cells in young and aging rat soleus muscle.

Satellite cells are muscle stem cells capable of replenishing or increasing myonuclear number. It is postulated that a reduction in satellite cells may contribute to age-related sarcopenia. Studies investigating an age-related decline in satellite cells have produced equivocal results.

Effects of 14 days of microgravity on fast hindlimb and diaphragm muscles of the rat.

The purpose of the present study was to determine the effects of 14 days of microgravity on specific rat fast-twitch muscles, and to compare these data with previous data from rat fast-twitch muscles exposed to microgravity for 10 days (Kraemer et al. 2000). Hindlimb muscles containing predominately fast fibers [extensor digitorum longus (EDL), superficial "white" (GSW) and deep "red" (GDR) gastrocnemius] and the diaphragm (DIA) were removed from flight and ground-based control animals and analyzed for: muscle mass, fiber type distribution, cross-sectional area, and myosin heavy chain (MHC) isoform content.

Ageing influences myonuclear domain size differently in fast and slow skeletal muscle of rats.

Aim: In multinucleated skeletal muscle, a myonuclear domain is the region of cytoplasm governed by one nucleus, and myofibres are mosaics of overlapping myonuclear domains. Association of ageing and myonuclear domain is important in the understanding of sarcopenia and with prevention or combating age-related muscle declines. This study examined the effects of age, fibre type and muscle on nucleo-cytoplasmic (N/C) relationships as reflecting myonuclear domain size.

Effect of circulating growth hormone on muscle IGF-I protein concentration in female mice with growth hormone receptor gene disruption.

Growth hormone (GH) is a potent secretague for circulating insulin-like growth factor-I (IGF-I). The purpose of this study was to examine the effect of circulating GH on muscle IGF-I protein expression using GH transgenic animal models. Three different models were used: mice that overexpress bovine GH (bGH; n=10), mice without a functional GH receptor (GHR-/-; n=10), and wildtype mice (n=10).