Epigenetics of concussion: A systematic review.

Background: Concussion is the most common neurological disorder affecting millions of people globally each year. Identifying epigenetic mechanisms influencing concussion incidence, severity and recovery could provide diagnostic and prognostic insight into this injury.

Objectives: This systematic review aims to identify the epigenetic mechanisms underpinning concussion.

The Comparative Effect of Different Timings of Whole Body Cryotherapy Treatment With Cold Water Immersion for Post-Exercise Recovery.

Despite several established benefits of Whole Body Cryotherapy (WBC) for post-exercise recovery, there is a scarcity of research which has identified the optimum WBC protocol for this purpose. This study investigated the influence of WBC treatment timing on physiological and functional responses following a downhill running bout. An additional purpose was to compare such responses with those following cold water immersion (CWI), since there is no clear consensus as to which cold modality is more effective for supporting athletic recovery.

Tendon and Ligament Genetics: How Do They Contribute to Disease and Injury? A Narrative Review.

A significant proportion of patients requiring musculoskeletal management present with tendon and ligament pathology. Our understanding of the intrinsic and extrinsic mechanisms that lead to such disabilities is increasing. However, the complexity underpinning these interactive multifactorial elements is still not fully characterised.

The role of vancomycin-soaking of the graft in anterior cruciate ligament reconstruction.

Approximately 1% of anterior cruciate ligament reconstruction (ACLR) procedures develop septic arthritis despite intravenous antibiotic prophylaxis and other preventive measures. Infection is most commonly due to contamination during autograft harvest and preparation by introducing bacteria into the knee during graft insertion. Pre-soaking ACL grafts in 5 mg/mL vancomycin ("vancomycin wrap") has been utilised to eradicate such bacterial contamination.

The Effect of Repetitive Whole Body Cryotherapy Treatment on Adaptations to a Strength and Endurance Training Programme in Physically Active Males.

Despite its potential merit in sport and exercise recovery, the implications of repetitive Whole Body Cryotherapy (WBC) during training programmes require further review due to the possibility of repetitive cold interfering with long term adaptations. This study investigated the impact of two weekly 3 min WBC sessions (30 s at -60°C, 150 s at -120°C) on adaptations to a 6 week strength and endurance training programme. Sixteen male participants (mean ± SD age 33.

Vitamin D and the athlete-patient: state of the art.

Vitamin D deficiency is common in athletes. The conventional measurement of vitamin D levels provides a general indicator of body stores. However, there are nuances in its interpretation as values of 25(OH)D do not correlate absolutely with the amount of 'bioavailable' vitamin to the cells.

The Effects of Age and Body Fat Content on Post-Downhill Run Recovery Following Whole Body Cryotherapy.

This study explored the effects of age and body fat content on responses to whole body cryotherapy (WBC) following a downhill running bout. Forty-one male participants (mean ± SD age 42.0 ± 13.

Functional COL1A1 variants are associated with the risk of acute musculoskeletal soft tissue injuries.

Studies have reported the association of the COL1A1 Sp1 binding site variant (rs1800012) with the risk of acute musculoskeletal soft tissue injuries. Interaction with the COL1A1 promoter variant (rs1107946) has also been proposed to modulate acute injury risk. Conversely, neither of these loci have been associated with chronic musculoskeletal soft tissue phenotypes.

Variability within the human iNOS gene and Achilles tendon injuries: Evidence for a heterozygous advantage effect.

Objectives: The aim of this case control genetic association study was to explore whether two variants within the inducible nitric oxide synthase (iNOS) gene, rs2779249 (C/A) and rs2248814 (A/G), influenced the risk of Achilles tendinopathy in a British population.

Design: Candidate gene, case control association study.

Method: We recruited 145 individuals diagnosed with Achilles tendon pathology and 132 asymptomatic controls.

Vitamin D and foot and ankle trauma: An individual or societal problem.

Background: Vitamin D deficiency is a worldwide health concern. Hypovitaminosis D may adversely affect recovery from bone injury. The authors aimed to perform an audit of the Vitamin D status of patients in three centres in the United Kingdom presenting with foot and ankle osseous damage.

Vitamin D levels in 577 consecutive elective foot & ankle surgery patients.

Background: Vitamin D deficiency is a global concern impacting upon large communities and certain disease populations. It can adversely affect the outcome of orthopaedic operations. We aimed to perform an audit of the Vitamin D status of patients in two centres in the United Kingdom undergoing elective foot and ankle surgery.

Human Genetic Variation, Sport and Exercise Medicine, and Achilles Tendinopathy: Role for Angiogenesis-Associated Genes.

Sport and Exercise Medicine is one of the important subspecialties of 21st century healthcare contributing to improving the physical function, health, and vitality of populations while reducing the prevalence of lifestyle-related diseases. Moreover, sport and exercise are associated with injuries such as Achilles tendinopathy, which is a common tendon injury. The angiogenesis-associated signaling pathway plays a key role in extracellular matrix remodeling, with increased levels of angiogenic cytokines reported after cyclic stretching of tendon fibroblasts.

Polymorphisms within the COL5A1 gene and regulators of the extracellular matrix modify the risk of Achilles tendon pathology in a British case-control study.

Several genetic loci have been associated with risk of Achilles tendon pathology (ATP) within South African and Australian populations. The aim of this study was, therefore, to evaluate eight previously implicated genetic variants in an independent British population. A total of 130 asymptomatic controls (CON) and 112 participants clinically diagnosed with ATP comprising 87 individuals with chronic Achilles tendinopathy (TEN) and 25 with Achilles tendon ruptures (RUP) were included.

MMP3 and TIMP2 gene variants as predisposing factors for Achilles tendon pathologies: Attempted replication study in a British case-control cohort.

Variants within the MMP3 (rs679620) and TIMP2 (rs4789932) genes have been associated with the risk of Achilles tendon pathology (ATP) in populations from South Africa and Australia. This study aimed to determine whether these variants were associated with the risk of ATP in British Caucasians. We recruited 118 cases with ATP, including a subset of 25 individuals with Achilles tendon rupture (RUP) and 131 controls.

Variation within three apoptosis associated genes as potential risk factors for Achilles tendinopathy in a British based case-control cohort.

Achilles tendon pathology (ATP) is a degenerative condition which exhibits excessive tenocyte apoptosis. Tumour necrosis factor receptor 1 (TNFR1), caspase-3 (CASP3) and caspase-8 (CASP8) are important regulators of apoptosis. To date, the effects of variation within the genes for TNFR1 and CASP3 as risk factors for ATP have not been described.

The management of posterior ankle impingement syndrome in sport: a review.

A literature review has been undertaken to assess the efficacy of management of Posterior Ankle Impingement Syndrome with an emphasis on sport. The evidence is confined to Level IV and V studies. There is a lack of prospective studies on the natural history of this condition and the outcomes of conservative treatment.

Tibialis posterior tendon and deltoid and spring ligament injuries in the elite athlete.

The tibialis posterior tendon and the spring and deltoid ligament complexes combine to provide dynamic and passive stabilization on the medial side of the ankle and hindfoot. Some of the injuries will involve acute injury to previous healthy structures, but many will develop insidiously. The clinician must be aware of new treatment strategies and the level of accompanying scientific evidence regarding injuries sustained by athletes in these areas, while acknowledging that more traditional management applied to nonathletic patients is still likely to be appropriate in the setting of treatment for elite athletes.

Posterior ankle impingement syndrome: a clinical review with reference to horizontal jump athletes.

Posterior ankle impingement syndrome is the term attributed to the clinical disorder characterized by posterior ankle pain that occurs in forced plantar flexion. In this review article, we discuss the anatomy, aetiology, clinical and radiological features of posterior ankle impingement syndrome and consider the conservative and surgical management and the guidelines used for post operative rehabilitation. Finally we provide illustrative cases and review the biomechanical features of this condition in horizontal jump athletes.

Components of the transforming growth factor-beta family and the pathogenesis of human Achilles tendon pathology--a genetic association study.

Objectives: Achilles tendon pathology is a multifactorial condition for which various risk factors, including genetic factors, have been identified. Gene transfection of two members of the TGF-β family, TGF-β1 and growth/differentiation factor-5 (GDF-5), have been shown to enhance tendon repair and mechanical strength within animal Achilles tendon injury models. The objective of this study was to investigate whether two functional 5' untranslated region (UTR) single nucleotide polymorphisms (SNPs), the TGFB1 rs1800469 variant and the GDF5 rs143383 variant, were associated with ATP within an Australian ('AUS') and a South African ('SA') case-control cohort.

A functional variant within the MMP3 gene does not associate with human range of motion.

A recent heritability study has demonstrated that human range of motion (ROM) has a substantial genetic component. Furthermore, the COL5A1BstUI RFLP has now been identified as the first gene variant to be associated with human ROM. Interestingly, this variant is known to interact with a functional variant within the MMP3 gene (rs679620) to increase risk of Achilles tendinopathy.

Classification systems for hallux rigidus: a review of the literature.

Background: Hallux rigidus (HR) is one of the most common causes of forefoot pain. A number of classification systems have been developed to evaluate HR. These systems are based on either radiological parameters alone or a combination of radiological and clinical features.