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Ultrasound in Sports Medicine: Current Concepts and Advances

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A special issue of Medicina (ISSN 1648-9144).

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 33498

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Prof. Dr. César Calvo-Lobo

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Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain
Interests: ligaments; muscles; myofascial pain syndrome; musculoskeletal disorders; sports; tendons; ultrasonography
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Prof. Dr. Daniel López-López

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Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, 150403 Ferrol, Spain
Interests: biomechanics; quality of life; shoes; pain; epidemiology; orthopedic; podiatry; prevention and promotion of the health; rehabilitation
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Prof. Dr. David Rodríguez Sanz

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Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain
Interests: feet; ligaments; muscles; musculoskeletal disorders; sports; tendons; ultrasonography
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Prof. Dr. Ricardo Becerro de Bengoa Vallejo

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Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain
Interests: feet; ligaments; muscles; musculoskeletal disorders; reliability; sports; tendons; ultrasonography; validation
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Prof. Dr. Marta Elena Losa-Iglesias

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Co-Guest Editor

Faculty of Health Sciences, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
Interests: health care; biomechanics; quality of life; shoes; pain; epidemiology; orthopedic; podiatry; prevention and promotion of the health; rehabilitation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Ultrasound imaging is a trending tool in the sports medicine field that is becoming increasingly dynamic. Novel static and dynamic evaluations are proposed in order to improve musculoskeletal ultrasound imaging for joint, nerve, muscle, tendon, and ligament structures. New tools and software have been developed in order to obtain promising high-quality ultrasound images and novel pixel analyses.

Thus, ultrasonography may be considered a useful tool in sports medicine, permitting non-invasive, inexpensive, and portable use. Currently, morphological and functional changes may be evaluated with this tool in several structures of the locomotor system. Additionally, ultrasonography has been used as a visual biofeedback tool in order to re-educate deep muscle contraction in sports teams. In addition, metabolic altercations and body composition have been reflected in the ultrasound imaging of athletes. Further research is needed in order to offer a better understanding of ultrasound imaging in sports medicine.

According to these considerations, it is a pleasure to announce that Medicina is launching this Special Issue entitled “Ultrasound in Sports Medicine: Current Concepts and Advances”.

We encourage you and your colleagues to submit your articles reporting on this topic. Meta-analysis, reviews, or original articles such as reliability, validity, descriptive, cross-sectional, case-control, cohort, quasi-experimental, or clinical trials studies dealing with ultrasound imaging in sports medicine are particularly welcome. In addition, we warmly invite you to submit articles reporting new devices or applications of ultrasound imaging, with a special focus on pixel analysis.

Prof. Dr. César Calvo-Lobo
Prof. Dr. Daniel López-López
Prof. Dr. David Rodríguez Sanz
Prof. Dr. Ricardo Becerro de Bengoa Vallejo
Prof. Dr. Marta Elena Losa-Iglesias
Guest Editors

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Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

diagnostic imaging
joints
ligaments
muscles
nerves
musculoskeletal disorders
return to sports
sports
tendons
ultrasonography

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Published Papers (8 papers)

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Research

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9 pages, 967 KiB

Open AccessArticle

Comparison of the Acute Effects of Kinesio Taping and Sleeper Stretching on the Shoulder Rotation Range of Motion, Manual Muscle Strength, and Sub-Acromial Space in Pitchers with Glenohumeral Internal Rotation Deficit

by Chi-Ling Lo, Ya-Hsin Hsueh, Chun-Hou Wang and Hsiao-Yun Chang

Medicina 2021, 57(2), 102; https://doi.org/10.3390/medicina57020102 - 23 Jan 2021

Cited by 9 | Viewed by 4771

Abstract

Background and Objectives: Sleeper stretching (SS) can improve the shoulder’s range of motion (ROM) for pitchers with glenohumeral internal rotation deficit (GIRD). However, no evidence has proven the effect of Kinesio taping (KT) on shoulder strength and ROM. Therefore, this study compared the effects of SS and KT on shoulder rotation ROM, muscle strength, and sub-acromial distance in pitchers with GIRD. Materials and Methods: Thirty-one pitchers with GIRD were allocated into control, KT, and SS groups. Shoulder rotation ROM, muscle strength, and sub-acromial space were measured before and after treatment with SS or KT. Results: The results revealed that KT and SS significantly enhanced shoulder rotation ROM in pitchers with GIRD. External rotator strength significantly increased following KT but significantly decreased after SS. KT and SS exerted no effects on the sub-acromial space. Conclusions: KT and SS improve shoulder rotation ROM in pitchers with GIRD. In addition, KT improves shoulder external rotator strength, and SS reduces it. Full article

(This article belongs to the Special Issue Ultrasound in Sports Medicine: Current Concepts and Advances)

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13 pages, 1220 KiB

Open AccessArticle

Ultrasonographic Evaluation of the Shoulders and Its Associations with Shoulder Pain, Age, and Swim Training in Masters Swimmers

by Yuta Suzuki, Noriaki Maeda, Junpei Sasadai, Kazuki Kaneda, Taizan Shirakawa and Yukio Urabe

Medicina 2021, 57(1), 29; https://doi.org/10.3390/medicina57010029 - 31 Dec 2020

Cited by 7 | Viewed by 3250

Abstract

Background and objectives: The long head of the biceps (LHB) and rotator cuff tendinopathy is the major cause of shoulder pain in competitive swimmers. The risk of tendinopathy increases with aging; however, the structural changes of LHB and rotator cuff in populations of masters swimmers have not been well examined. The purpose of this study was to investigate the prevalence of ultrasonographic abnormalities of the shoulders in masters swimmers, and the association of pain, age, and swim training with structural changes in this population. Materials and Methods: A total of 60 subjects participated in this study, with 20 masters swimmers with shoulder pain, 20 asymptomatic masters swimmers, and 20 sex- and age-matched controls. All swimmers completed a self-reported questionnaire for shoulder pain, their history of competition, and training volume. Each subject underwent ultrasonographic examination of both shoulders for pathologic findings in the LHB tendon, rotator cuff (supraspinatus (SSP) and subscapularis (SSC)) tendons, and subacromial bursa (SAB) of both shoulders and had thickness measured. Results: The prevalence of tendinosis (LHB, 48.8%; SSP, 17.5%; SSC, 15.9%), partial tear (SSP, 35.0%), and calcification (SSC, 10.0%) were higher in swimmers than in controls. LHB and SSP tendinosis were associated with shoulder pain. Older age and later start of competition were associated with an increased risk of LHB tendinosis and SSC calcification. Earlier initiation of swimming and longer history of competition were associated with an increased risk of SSP and SSC tendinosis. The thicker SSP tendon significantly increased the risk of tendinosis and partial tear. Conclusions: A high prevalence of structural changes in the rotator cuff and biceps tendons in masters swimmers reflects the effect of shoulder symptoms, aging, and swim training. Full article

(This article belongs to the Special Issue Ultrasound in Sports Medicine: Current Concepts and Advances)

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9 pages, 1454 KiB

Open AccessArticle

Bilateral Comparisons of Quadriceps Thickness after Anterior Cruciate Ligament Reconstruction

by Joo-Hyun Lee, Soul Cheon, Hyung-Pil Jun, Yu-Lun Huang and Eunwook Chang

Medicina 2020, 56(7), 335; https://doi.org/10.3390/medicina56070335 - 3 Jul 2020

Cited by 11 | Viewed by 3059

Abstract

Background and objectives: Anterior cruciate ligament reconstruction (ACLR) often results in quadricep atrophy. The purpose of this study was to compare the bilateral thickness of each quadricep component before and after ACLR. Materials and Methods: Cross-sectional study design. In 14 patients who underwent ACLR, bilateral quadricep muscle thicknesses were measured using a portable ultrasound device, 1 h before and 48–72 h after ACLR. Two-way analysis of variance (ANOVA) was used to compare muscle thickness pre- and post-ACLR between the limbs. Results: The primary finding was that the vastus intermedius (VI) muscle was significantly smaller in the reconstructed limb after ACLR compared to that in the healthy limb (Reconstructed limb; RCL = Pre-operated (PRE): 19.89 ± 6.91 mm, Post-operated(POST): 16.04 ± 6.13 mm, Healthy limb; HL = PRE: 22.88 ± 6.07, POST: 20.90 ± 5.78 mm, F = 9.325, p = 0.009, η²p = 0.418). Conclusions: The results represent a selective surgical influence on the quadricep muscle thickness. These findings highlight the need of advanced strengthening exercises in order to restore VI thickness after ACLR. Full article

(This article belongs to the Special Issue Ultrasound in Sports Medicine: Current Concepts and Advances)

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11 pages, 693 KiB

Open AccessEditor’s ChoiceArticle

Does Function Determine the Structure? Changes in Flexor Hallucis Longus Muscle and the Associated Performance Related to Dance Modality: A Cross-Sectional Study

by Blanca De-la-Cruz-Torres, Irene Barrera-García-Martín, Mónica De la Cueva-Reguera, María Bravo-Aguilar, María Blanco-Morales, Emmanuel Navarro-Flores, Carlos Romero-Morales and Vanesa Abuín-Porras

Medicina 2020, 56(4), 186; https://doi.org/10.3390/medicina56040186 - 16 Apr 2020

Cited by 7 | Viewed by 4070

Abstract

Background and Objectives: Flexor hallucis longus pathology is one of the most common conditions of the ankle and foot in dancers, due to the high demand of dance movements performed in an extreme plantar flexion and dorsiflexion range of motion. The objectives of this study were to determine the bilateral differences between the thickness and cross-sectional area of the flexor hallucis longus muscle in dancers, to establish possible differences between dance modalities, and to analyze whether there is a correlation between ultrasonographic parameters or performance variables and the dance modality. Material and Methods: A sample of 50 (29 classical and 21 contemporary) full-time pre-professional female dancers were included in the study. The thickness and cross-sectional area of the flexor hallucis longus muscle were evaluated for both limbs using ultrasound imaging. The range of movement of the first metatarsophalangeal joint was measured using functional extension with maximal ankle plantarflexion, balance was measured in a unilateral stance with the heel raised, endurance was evaluated through a modified heel rise fatigue test, and a counter movement jump to assess the vertical jump performance was measured bilaterally. Results: There were no significant differences recorded between the dominant and non-dominant limbs for each variable, within both groups. Contemporary dancers showed a greater thickness and cross-sectional area of the flexor hallucis longus muscle than classical dancers. However, classical dancers showed an increase of balance, endurance, range of movement of the first metatarsophalangeal joint, and counter movement jump with respect to contemporary dancers. Conclusion: Bilateral symmetry was identified in all variables for both groups. The size and performance of the flexor hallucis longus muscle may be influenced by the specific nature of dance modality. Full article

(This article belongs to the Special Issue Ultrasound in Sports Medicine: Current Concepts and Advances)

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9 pages, 1185 KiB

Open AccessArticle

Comparison of Lateral Abdominal Musculature Activation during Expiration with an Expiratory Flow Control Device Versus the Abdominal Drawing-in Maneuver in Healthy Women: A Cross-Sectional Observational Pilot Study

by Vanesa Abuín-Porras, Paula Maldonado-Tello, Mónica de la Cueva-Reguera, David Rodríguez-Sanz, César Calvo-Lobo, Daniel López-López, Emmanuel Navarro-Flores and Carlos Romero-Morales

Medicina 2020, 56(2), 84; https://doi.org/10.3390/medicina56020084 - 19 Feb 2020

Cited by 7 | Viewed by 3517

Abstract

Background and Objectives: The purpose of the present study was to quantify and compare lateral abdominal musculature thickness, including the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles, via rehabilitative ultrasound imaging (RUSI) during the use of the expiratory flow control device (EFCD) versus the classic abdominal drawing-in maneuver (ADIM). Materials and Methods: A cross-sectional observational pilot study. Twenty-one women were recruited and assessed the thickness of each muscle (TrA, IO, and EO) by ultrasound imaging at rest, during the ADIM, and during expiration with the EFCD. Waist circumference was also measured under the same circumstances. Results: Statistically significant differences were observed between ADIM, EFCD, and at rest condition for the thickness of the TrA (p = 0.001) and IO (p = 0.039). Moreover, statistically significant differences for TrAb at rest compared with the ADIM (p = 0.001, Cohen’s d = 2.183) and at rest and with the EFCD (p = 0.001, Cohen’s d = 2.843). In addition, between ADIM and EFCD were not statistically significant, although a moderate effect size was found (p = 0.055, Cohen’s d = 0.694). For the IO muscle thickness, significant differences were reported between the EFCD and at rest (p = 0.038), Cohen’s d = 0.081). Conclusions: Significant differences in the increase of the thickness of the TrA and IO muscles during the use of the EFCD and the ADIM with respect to rest. In addition, for the TrA, statistically significant differences were found during expiration with the EFCD with respect to the ADIM. Expiration with EFCD can be a useful method for the activation of the TrA. Full article

(This article belongs to the Special Issue Ultrasound in Sports Medicine: Current Concepts and Advances)

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11 pages, 1099 KiB

Open AccessArticle

Inter-and Intra-Examiner Reliability of Supraspinatus Muscle Tendon Palpation: A Cross-Sectional Study by Ultrasonography

by Fermin Naranjo-Cinto, Giezi Falcon-Machado, Alejandro Garrido-Marin, Francisco Jose Senin-Camargo, Maria Amalia Jacome-Pumar, Ruben Fernandez-Matias, Daniel Pecos-Martin and Tomas Gallego-Izquierdo

Medicina 2020, 56(2), 83; https://doi.org/10.3390/medicina56020083 - 18 Feb 2020

Cited by 1 | Viewed by 5078

Abstract

Background and objectives: Palpation is an inherent and basic skill of health professionals—particularly manual therapists who base their diagnosis and treatment in a clinical environment. Many authors have previously described multiple palpation positions for supraspinatus muscle tendon (SMT); however, there are no current studies that evaluate palpation concordance reliability for the SMT in this particular position. This study aimed to investigate the intra- and inter-rater reliabilities of supraspinatus muscle tendon (SMT) palpation. Materials and Methods: Thirty-six healthy participants (14 females; aged 22–35 years) were recruited. Musculoskeletal ultrasound was used to measure the SMT localization after two physiotherapists performed the SMT palpation at two different times. The distance between the two marked points was used to analyze the analysis of true agreement between examiners. Finally, we analyzed if the demographic variables influenced the palpation procedure. Results: The intra-examiner reliability showed a high percentage of concordance for examiner 1 (E.1) (first palpation procedure (P.1) = 91.7%: second palpation procedure (P.2) = 95.8%) and examiner 2 (E.2) (P.1 = 91.6%; P.2 = 97.2%) and high percentage of inter-palpation agreement for E.1 (87.5%) and E.2 (88.9%). The inter-examiner reliability showed a high total concordance for the right shoulder (E.1 = 94.4%; E.2 = 95.8%) and left shoulder (E.1 = 93.05%; E.2 = 95.05%). The agreement (%) according to both examiners was 93.05% for the right shoulder and 94.4% for the left shoulder. The agreement between both examiners and the ultrasound (% of true agreement) was 92.9% for the right shoulder and 92.8% for the left shoulder. A statistically significant association (p = 0.02) was found for weight regarding concordance reliability; this was not seen for dominant arm, age, gender, body mass index, height, and tendon depth (p > 0.05). Conclusions: The SMT palpation technique showed a high level of concordance and reproducibility. Full article

(This article belongs to the Special Issue Ultrasound in Sports Medicine: Current Concepts and Advances)

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9 pages, 1149 KiB

Open AccessArticle

Comparison of the Abdominal Wall Muscle Thickness in Female Rugby Players Versus Non-Athletic Women: A Cross-Sectional Study

by Vanesa Abuín-Porras, Mónica de la Cueva-Reguera, Pedro Benavides-Morales, Rocío Ávila-Pérez, Blanca de la Cruz-Torres, Helios Pareja-Galeano, María Blanco-Morales and Carlos Romero-Morales

Medicina 2020, 56(1), 8; https://doi.org/10.3390/medicina56010008 - 25 Dec 2019

Cited by 15 | Viewed by 4257

Abstract

Background and Objectives: Rugby players engage in demanding, high loading muscular activity in the spine. Study of the abdominal wall architecture in female rugby athletes is relevant to the possible muscular asymmetry secondary to sport practice and the relationship between the abdominal wall and the pelvic floor muscles. Activation of the transversus abdominis (TrAb) generates an increase in the bladder neck muscle. Moreover, an increased interrecti distance (IRD) is related to urinary incontinence and has a higher prevalence in athletic women. The aim of the present study was to compare and quantify, with ultrasound imaging (USI), the thickness of the transversus abdominis (TrAb), external oblique (EO), internal oblique (IO), rectus abdominis (RA), and interrecti distance (IRD) in female rugby players versus non-athletic women in order to improve upon existing knowledge about abdominal wall configuration in female athletes. Materials and Methods: A sample of 32 women was recruited at the Universidad Europea Research Lab and divided in two groups: a rugby group (n = 16) and a non-athletic women group (n = 16). The thickness of the TrAb, EO, IO, RA, and IRD were assessed by USI in both groups. Results: There were statistically significant differences for the ultrasound evaluation thickness of the right TrAb (p = 0.011; d = 0.10), EO (p = 0.045; d = 0.74), IO (p = 0.003; d = 1.32), and RA (p = 0.001; d = 1.38) showing a thickness increase for the rugby group with respect to the control group. For the IRD thickness, there were no significant differences (p > 0.05) between groups. Conclusions: An increased TrAb, IO, EO, and RA thickness may be shown in female rugby players versus non-athletic women. Nevertheless, statistically relevant differences were not found for the IRD between both groups. Full article

(This article belongs to the Special Issue Ultrasound in Sports Medicine: Current Concepts and Advances)

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11 pages, 836 KiB

Open AccessReview

Lower Limb Tendinopathy Tissue Changes Assessed through Ultrasound: A Narrative Review

by Eleuterio A. Sánchez Romero, Joel Pollet, Sebastián Martín Pérez, José Luis Alonso Pérez, Alberto Carlos Muñoz Fernández, Paolo Pedersini, Carlos Barragán Carballar and Jorge Hugo Villafañe

Medicina 2020, 56(8), 378; https://doi.org/10.3390/medicina56080378 - 28 Jul 2020

Cited by 10 | Viewed by 3982

Abstract

Tendinopathy is a common disease that affects athletes, causing pain and dysfunction to the afflicted tendon. A clinical diagnose is usually combined with imaging and, among all the existing techniques, ultrasound is widely adopted. The aim of this review is to sum up the existing evidence on ultrasound as an imaging tool and guide for treatments in lower limbs tendinopathy. Using three different databases—PubMed, MEDLINE and CENTRAL—a literature search has been performed in May 2020 combining MeSH terms and free terms with Boolean operators. Authors independently selected studies, conducted quality assessment, and extracted results. Ultrasound imaging has a good reliability in the differentiation between healthy and abnormal tendon tissue, while there are difficulties in the identification of tendinopathy stages. The main parameters considered by ultrasound imaging are tendon thickness, hypoechogenicity of tendon structure and neovascularization of the tendon bound tissue. Ultrasound-guide is also used in many tendinopathy treatments and the available studies gave encouraging results, even if further studies are needed in this field. Full article

(This article belongs to the Special Issue Ultrasound in Sports Medicine: Current Concepts and Advances)

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