International Journal of Sports Physical Therapy最新文献

{"title":"Author Response - Letter to the Editor Concerning:\"A Biomechanical Review of the Squat Exercise: Implications for Clinical Practice.\"","authors":"Rachel K Straub, Christopher M Powers","doi":"10.26603/001c.161270","DOIUrl":"https://doi.org/10.26603/001c.161270","url":null,"abstract":"","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 5","pages":"459-461"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Pain on Rotator Cuff Muscle Size and Function: A Case-Control Study with Ultrasound Assessment of Cross-Sectional Area and Tendon Thickness.","authors":"Dirk Kokmeyer, Lori Thein Brody, Jace Brown, Shane Koppenhaver, Charles Thigpen","doi":"10.26603/001c.160558","DOIUrl":"https://doi.org/10.26603/001c.160558","url":null,"abstract":"<p><strong>Background: </strong>Rotator cuff weakness is common in patients with shoulder pain, but the underlying causes are unclear when tendons are structurally intact. Atrophy is well established after full-thickness tears, but it is uncertain whether rotator cuff muscle cross-sectional area (CSA) differs in painful shoulders without rupture. Distinguishing structural atrophy from pain-related inhibition has important implications for rehabilitation.</p><p><strong>Purpose: </strong>The purpose of this study was to compare supraspinatus (SS) and infraspinatus (IS) CSA and SS tendon thickness between painful and asymptomatic shoulders. Secondary aims were to evaluate the influence of limb dominance on CSA, strength, and endurance, and to examine relationships between CSA, strength, and endurance.</p><p><strong>Study design: </strong>Cross-sectional case-control study.</p><p><strong>Methods: </strong>Twenty-four participants (12 with unilateral shoulder pain recruited from an outpatient orthopedic clinic, 12 age- and sex-matched asymptomatic community-based controls) were enrolled. Participants in the shoulder pain group presented with chronic symptoms and MRI-confirmed intact rotator cuff tendons. Exclusion criteria included prior surgery or MRI-confirmed full-thickness tears. Demographics and patient-reported outcomes were collected. Ultrasound was used to measure the CSA of the SS and IS tendons and the SS tendon thickness. Isometric strength of the external rotators (ER) and full can was assessed with handheld dynamometry, and endurance with the Posterior Shoulder Endurance Test (PSET). Mixed-model ANOVAs examined group × dominance effects on CSA, tendon thickness, strength, and endurance outcomes; ANCOVA and regression explored the contributions of pain and CSA.</p><p><strong>Results: </strong>CSA and tendon thickness did not differ between groups or sides (all p >0.19). Painful dominant shoulders showed significantly lower ER (p = 0.003), full can strength (p = 0.003), and endurance (p = 0.021) compared with contralateral and control shoulders. Adjusting for pain eliminated group differences in strength, with pain accounting for 36-56% of the variance. Regression showed that SS CSA predicted full can strength and IS CSA predicted ER strength, but neither predicted endurance. PSET deficits persisted after adjusting for pain.</p><p><strong>Conclusion: </strong>Rotator cuff CSA and tendon thickness were preserved in individuals with shoulder pain, yet strength and endurance deficits were evident. Weakness was more closely related to pain-mediated inhibition than structural atrophy, while endurance appeared to be influenced by scapular stabilizer function. These findings suggest that early rehabilitation may emphasize pain reduction and neuromuscular control before progressive strengthening.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 5","pages":"527-541"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Guidelines and Decision Tree for Dry Needling Musculoskeletal Conditions: A Consensus Statement.","authors":"Tyler Waterway, Jonathon Beougher, Robert Butler, Kelby Church, Gray Cook, Susan Falsone, Brian Hortz, Tyler Opitz, Phillip J Plisky, Edo Zylstra, RobRoy Martin","doi":"10.26603/001c.161025","DOIUrl":"https://doi.org/10.26603/001c.161025","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Dry needling (DN) is commonly used to address pain and movement-related impairments, with the goal of improving range of motion, muscle performance, and functional movement. Despite its growing use, techniques and procedural parameters vary widely and lack standardization in both research and clinical practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;The purpose of this modified Delphi study was to develop consensus statements to guide clinicians and researchers in the application of DN for use in individuals with musculoskeletal dysfunction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;A modified Delphi technique was employed with nine physical therapists identified as experts in DN. The panelists participated in four rounds of questions and related discussions to reach consensus on guidelines for implementing DN as a therapeutic intervention. Additionally, the authors developed a decision tree outlining key clinical decision-making parameters, including patient candidacy, treatment dosage, target tissue selection, and post-intervention strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The panel reached consensus on all statements guiding DN interventions. Individuals experiencing musculoskeletal pain, mobility limitations, muscle performance deficits, or movement dysfunction may be appropriate candidates for DN, provided they are first evaluated for absolute contraindications, precautions, or reasons to modify or defer treatment. DN dosage including the number of needles used, anatomical regions treated, and overall treatment volume, as well as intensity and aggressiveness should be based on the patient's level of irritability and estimated tolerance for treatment. A comprehensive functional movement examination should be conducted before and after DN intervention. When neurological assessments reveal deficits, DN targeting spinal segmental structures-such as the multifidus at the corresponding nerve root levels-should be considered; peripheral structures may be targeted when impairments are identified through manual muscle testing, range of motion assessments, flexibility evaluations, pain provocation testing, or diagnosis-specific special tests. Immediately following DN treatment and reassessment, patients should perform appropriate therapeutic exercises to load the treated tissues and address movement impairments identified during reassessment. If no meaningful change is observed, clinicians should re-evaluate the working hypothesis, including movement, neurological, or regional assessment findings, and adjust treatment accordingly to better align with the primary driver of dysfunction. Clinicians should also provide education on post-treatment expectations to support post-needling response and recovery (e.g., expected soreness, activity modification) and optimize outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This consensus provides clinical guidance on the utilization of DN, including recommendations for patient selection, determin","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 5","pages":"556-567"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Countermovement Jump and Quantitative Electroencephalography Assessment in Division I Football Athletes: An Exploratory Neurophysiological Study of Return‑to‑Play Readiness.","authors":"Robert E Mangine, Bradley T Jacobs, James A Tersak, Marsha Eifert-Mangine, Corey J Rodrigo, Steven Feldman, Peter Draovitch, Raul Bermudez, Michael Mark, Audrey R Hill-Lindsay, Brian M Grawe, Abby Rogers","doi":"10.26603/001c.161023","DOIUrl":"https://doi.org/10.26603/001c.161023","url":null,"abstract":"<p><strong>Background: </strong>The countermovement jump (CMJ) is commonly used to assess neuromuscular performance in athletic populations; however, force plate-derived mechanical metrics may not fully reflect central nervous system (CNS) contributions to persistent deficits following musculoskeletal injury. Quantitative electroencephalography (qEEG) offers cortical-level measures that may complement force plate assessments and provide additional insight into neuromuscular function.</p><p><strong>Purpose: </strong>To explore neuromechanical, movement quality, and cortical activation patterns during countermovement jump performance in previously injured and non-injured Division I football athletes using an integrated force plate, functional movement, and qEEG assessment approach.</p><p><strong>Study design: </strong>Exploratory cross-sectional observational study.</p><p><strong>Methods: </strong>Ten male NCAA Division I football athletes were recruited for participation, five with history of lower extremity injury and five uninjured controls. All subjects completed a qEEG cognitive baseline then CMJ testing on a force-plate with synchronized qEEG. Outcomes included reactive strength index-modified (RSI Mod), jump height, peak landing force, reaction time, Stroop accuracy, and functional movement assessment (FMA) observations. Data were analyzed descriptively.</p><p><strong>Results: </strong>Compared with controls, previously injured athletes demonstrated lower RSI Mod (≈43% lower), reduced jump height (≈36% lower), and lower peak landing force (≈16% lower). Reaction times were modestly slower, with small interlimb differences. Stroop accuracy was comparable; however, injured athletes scored lower on sustained attention under task demands. FMA observations indicated greater single leg asymmetry and diminished step down control. qEEG sensorimotor rhythm (SMR) patterns showed greater asymmetry in motor related regions in the injured cohort, consistent with altered cortical activation.</p><p><strong>Conclusion: </strong>Medically cleared Division I football athletes with history of lower extremity injury demonstrated concurrent neuromechanical, movement quality, and neurophysiological differences during CMJ performance compared with uninjured controls. These descriptive findings suggest that a multimodal assessment approach may help identify potential CNS contributions to residual performance differences not captured by traditional musculoskeletal criteria. Given the small sample and cross sectional design, results should be considered hypothesis generating. Larger, longitudinal studies are needed before these measures can be considered for return to play (RTP) decision making.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 5","pages":"506-516"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Balance in Young Athletes With and Without Chronic Ankle Instability.","authors":"Arisa Parameyong, Jaruta Kunritt, Pimonnat Srinuanyai, Raweewan Chantarat","doi":"10.26603/001c.158522","DOIUrl":"https://doi.org/10.26603/001c.158522","url":null,"abstract":"<p><strong>Background and purpose: </strong>Chronic ankle instability is a common condition following ankle sprains. While the condition is well-documented in adult and collegiate athletes, its impact on pediatric populations, particularly those engaged in high-intensity sports, remains underexplored. This study aimed to investigate static and dynamic balance performance in young athletes between 8 and 16 years of age with and without chronic ankle instability. # Design and MethodsThirty young athletes were categorized into three groups: ten participants with no history of ankle sprains, called healthy, ten participants with a history of ankle sprain but without persistent symptoms, called copers, and ten participants with clinically diagnosed chronic ankle instability. Static balance was assessed using the Single Leg Stance Test, and dynamic balance was evaluated using the Y-Balance Test (YBT). A one-way ANOVA was analyzed to compare differences among groups, followed by post hoc tests for comparing between groups. # Results Significant group differences were found in static balance under eyes-open conditions on both firm and foam surfaces (p=0.001 and 0.039, respectively). The chronic ankle instability group demonstrated significantly poorer performance compared to the healthy and coper groups. For dynamic balance, significant differences were observed in the anterior, posterolateral reach direction, and the composite YBT score (p=0.009, 0.031, and 0.010, respectively), with the chronic ankle instability group performing significantly worse than the healthy group.</p><p><strong>Conclusion: </strong>Young athletes with chronic ankle instability exhibit impaired static and dynamic balance performance. Therefore, it is crucial to emphasize appropriate rehabilitation and recovery strategies to prevent long-term consequences and enhance physical performance in this population.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 4","pages":"379-386"},"PeriodicalIF":2.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13046456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interval Throwing Programs of Various Duration for Baseball Players Based on Biomechanical Workload Data.","authors":"Michael M Reinold, Brittany Dowling, Glenn S Fleisig, Leonard C Macrina, Kevin E Wilk, Frank J Alexander, Christopher S Ahmad, Jeffrey Dugas, James R Andrews","doi":"10.26603/001c.159340","DOIUrl":"https://doi.org/10.26603/001c.159340","url":null,"abstract":"<p><strong>Background: </strong>Interval throwing programs (ITP) are commonly used while returning from injuries in baseball players. Recent advances in the understanding of the biomechanics and workloads of throwing programs have led to the development of ITPs that allow for a precise and gradual increase in workload to the arm. UCL treatment options continue to evolve and now include various procedures using an internal brace and hybrid approach in addition to traditional reconstruction and nonoperative care. Each variation has different timelines for clinicians to follow.</p><p><strong>Purpose: </strong>The purpose of this paper is to describe four ITP variations of various durations that can be used for a variety of non-operative and postoperative injuries in baseball players. While these programs can be used for a variety of shoulder and elbow injuries, the application of these programs for UCL injuries will be explored.</p><p><strong>Study design: </strong>Cross-sectional descriptive study.</p><p><strong>Methods: </strong>Elbow varus torque per throw was estimated from a 2nd order polynomial regression derived from a relationship between throwing distance and elbow varus torque, based on a dataset of 238,611 throws collected from healthy collegiate baseball pitchers. This model was then applied to construct 4 ITPs: 7-month progression for UCL reconstruction (with and without a hybrid internal brace), 5-month progression for a UCL repair with internal brace, and two short-term progressions of 12-weeks and 6-weeks for nonoperative injuries. For each program, individual throws were assigned estimated torque values to calculate cumulative workload (daily, chronic, and acute), and acute-to-chronic workload ratio (ACWR). These values were plotted over time to evaluate workload progression.</p><p><strong>Results: </strong>The 6-week program had a final chronic workload of 7.6 and stayed in the ACWR optimal range (0.7-1.3) the entire time. The 12-week program had a final chronic workload of 7.8 and stayed in the optimal ACWR range 98% of the time. The 5-month program finished with a chronic workload of 10.0 and stayed in the optimal range 95% of the program. The 7-month had a final chronic workload of 10.8, and stayed in the optimal range for 91% of the program.</p><p><strong>Conclusion: </strong>The four variations in ITPs each showed a gradual ramp-up of chronic workload over the duration of the program while maintaining within the recommended range of ACWR. These ITPs may be used to gradually build workload in baseball players returning from injuries. Due to the various lengths, the ITPs may be used as models to apply to a variety of common injuries or surgeries of the throwing shoulder and elbow.</p><p><strong>Level of evidence: </strong>Level 3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 4","pages":"428-439"},"PeriodicalIF":2.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13046452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal Number of Practice Trials for Balance and Hop Tests in Individuals with Chronic Ankle Instability.","authors":"Min Jun Kim, Jordan Read, Hongsuk Lee, J Ty Hopkins, S Jun Son","doi":"10.26603/001c.158516","DOIUrl":"https://doi.org/10.26603/001c.158516","url":null,"abstract":"<p><strong>Background: </strong>Static and dynamic balance tests and hop tests are widely used to assess lower extremity function; however, scientific evidence regarding the optimal number of practice trials remains limited.</p><p><strong>Purpose: </strong>To determine the number of practice trials necessary to achieve consistent performance on static and dynamic balance tests and hop tests in males and females.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>One hundred individuals (50 males, 50 females) with chronic ankle instability were recruited to participate in this study. Each participant performed the Star Excursion Balance Test (SEBT), the single-leg stance test using the Biodex Balance System (BBS), the triple-crossover hop (TCH) test, and the figure-of-8 hop (F8H) test across two sessions separated by two to three days. Main outcome measures included normalized reach distances in the anterior (ANT), posteromedial (PM), and posterolateral (PL) directions of the SEBT; overall stability index (OSI), anterior-posterior stability index (APSI), and medial-lateral stability index (MLSI) from the BBS; distance (m) in the TCH test; and time (s) from the F8H test. Two-way repeated measures analysis of variance was used to examine group-by-trial interactions and main effects, with pairwise comparisons and Bonferroni adjustments for post hoc analysis. Intraclass correlation coefficients, standard error of measurement, and minimal detectable change were calculated to assess reliability and performance stabilization.</p><p><strong>Results: </strong>A significant group-by-trial interaction was observed for the hop tests, but not for the SEBT and BBS. In the TCH test, males required more than six practice trials, whereas females required at least five trials. In the F8H test, males and females required at least five and three trials, respectively. For the SEBT and BBS, participants required at least four, three, and four practice trials for the ANT, PM, and PL directions, and four, two, and five trials for the OSI, APSI, and MLSI, respectively, regardless of sex.</p><p><strong>Conclusion: </strong>The number of practice trials required for the TCH and F8H tests differs between males and females. In contrast, the number of practice trials required for the SEBT and BBS is not influenced by sex. Males appear to need more practice trials than females to achieve consistent performance. Therefore, researchers and clinicians should implement sex-specific practice trial protocols for hop tests to ensure accurate data collection.</p><p><strong>Level of evidence: </strong>Level 3b.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 4","pages":"363-378"},"PeriodicalIF":2.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13046453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Examination of the Relationship Between Fear of Reinjury and Neuromuscular, Musculoskeletal, and Biomechanical Characteristics at the Time of Return to Sport following Anterior Cruciate Ligament Reconstruction.","authors":"Alessa R Lennon, Mallory S Faherty, Carolyn Killelea, Daniel T Le, Timothy C Sell","doi":"10.26603/001c.158524","DOIUrl":"https://doi.org/10.26603/001c.158524","url":null,"abstract":"<p><strong>Background: </strong>Kinesiophobia is linked to reinjury risk, decreased physical performance and a major cause of sport dropout following ACL reconstruction (ACLR). Identifying deficits based on kinesiophobia may help with the development of strategies to improve outcomes and decrease the risk of reinjury.</p><p><strong>Purpose: </strong>The purpose of this study was to compare individuals with high and low TSK-11 scores across modifiable neuromuscular, musculoskeletal, and biomechanical characteristics at the time of RTS. Study design: Cross-sectional study.</p><p><strong>Methods: </strong>Participants within two months of RTS clearance were recruited from a single academic institution between August 2018 and December 2019. Kinesiophobia was measured using the TSK-11. Lower extremity strength was evaluated using isometric and isokinetic testing. Dynamic postural stability was assessed with a double leg jump to single leg landing onto force plates, from which a dynamic postural stability index was calculated. Jump-landing biomechanics were assessed using a single leg stop jump (SLSJ), and single leg hop performance was measured with a triple hop test. Participants were categorized into low (<17) or high (≥17) kinesiophobia groups based on TSK-11 scores. Means and SD were calculated for all variables. Comparisons were made between groups in lower extremity range of motion, strength, dynamic postural stability, jump landing and single leg hop performance. Independent sample t-tests and Mann-Whitney U tests were used to compare variables between high and low kinesiophobia groups, with Cohen's d used to estimate effect sizes.</p><p><strong>Results: </strong>Twenty-seven participants (14 males, 13 females; age = 20.6 ± 6.5; pre-injury Tegner Activity Level = 7.7 ± 1.3) cleared for RTS post-unilateral ACLR volunteered for this study (10 ± 2 months post-ACLR). A significant difference was found between high and low TSK-11 groups for weight-bearing ankle dorsiflexion lunge test (p = 0.011) and single leg stop jump task maximum knee valgus angle (p = 0.007). There was no significant difference between the two groups for any other variable.</p><p><strong>Conclusion: </strong>Few differences in neuromuscular, musculoskeletal, and biomechanical function were identified between low and high TSK-11 scores at RTS. Results suggest that athletes in this cohort returning to sport have relatively low TSK-11 scores, and that higher scores may be attributed to other factors. Due to the small sample size and relatively low TSK-11 scores, further research is needed to confirm the relationship between kinesiophobia and variables commonly assessed at the time of RTS following ACLR.</p><p><strong>Level of evidence: </strong>3b.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 4","pages":"404-414"},"PeriodicalIF":2.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13046449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Lower-Leg Fascial Flossing on Flexibility and Performance in Collegiate Distance Runners: Ultrasound Evaluation of Fascial Gliding.","authors":"Yuki Nakai, Yasufumi Takeshita, Ryota Shibusawa, Katsutoshi Oe","doi":"10.26603/001c.158518","DOIUrl":"https://doi.org/10.26603/001c.158518","url":null,"abstract":"<p><strong>Background: </strong>Long-distance runners frequently experience repetitive loading that may contribute to reduced flexibility, impaired fascial gliding, and neuromuscular performance deficits, all of which may hinder recovery and increase overuse risk. Fascial flossing-a compressive myofascial technique-has gained attention as a potential intervention; however, evidence on its role in post-fatigue recovery remains limited. Hypothesis/Purpose: To determine whether lower-leg fascial flossing improves fascial gliding, flexibility, perceived tightness, and jump performance following running-induced fatigue.</p><p><strong>Study design: </strong>Randomized controlled cross-over study.</p><p><strong>Methods: </strong>Nationally competitive male collegiate long-distance runners were recruited from a university track and field team via institutional and verbal announcements. Participants completed a treadmill fatigue protocol followed by unilateral lower-leg fascial flossing, with the contralateral leg serving as control. Pre- and post-intervention assessments included ankle dorsiflexion range of motion (Weight-Bearing Lunge Test), perceived tightness (Visual Analog Scale), myofascial gliding via ultrasound cross-correlation analysis, and Reactive Strength Index from repeated rebound jumps. Statistical analysis was performed using a mixed-model repeated-measures analysis to examine condition × time interactions.</p><p><strong>Results: </strong>Seventeen nationally competitive male collegiate distance runners (mean age 20.1 ± 0.8 years) completed the protocol. Significant condition × time interactions were observed for all outcomes. Perceived tightness decreased in the flossed leg but increased in the control leg (p = 0.0499, partial η² = 0.101). Both legs improved dorsiflexion ROM, with greater gains in the flossed leg (p = 0.0084, partial η² = 0.085). RSI declined in the control leg, while the flossed leg maintained performance levels (p = 0.0043, partial η² = 0.109). Myofascial gliding improved only in the flossed leg (p = 0.0093, partial η² = 0.091), suggesting enhanced tissue mobility.</p><p><strong>Conclusion: </strong>Lower-leg fascial flossing enhanced flexibility, reduced tightness, and preserved jump performance after running-induced fatigue. This technique may represent a practical, low-cost, and time-efficient recovery strategy for endurance athletes and practitioners seeking to optimize post-exercise recovery.</p><p><strong>Level of evidence: </strong>Level 2.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 4","pages":"387-396"},"PeriodicalIF":2.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13046454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radial Pressure Wave and Focused Shockwave Therapy for Proximal Hamstring Tendinopathy: The Role of Patient Positioning, a Narrative Review and Clinical Commentary.","authors":"Jennifer R Arthurs, Chris T Ha, Julie L Pohlad, Joshua M Romero, Shane A Shapiro","doi":"10.26603/001c.158527","DOIUrl":"https://doi.org/10.26603/001c.158527","url":null,"abstract":"<p><strong>Background: </strong>Current literature has shown benefit of radial pressure wave (RPW) and focused shockwave (FSW) for management of proximal hamstring tendinopathy (PHT), although there remains a lack of consensus on treatment parameters and optimal patient positioning.</p><p><strong>Purpose: </strong>The purpose of this narrative review and clinical commentary is to report what has been described for patient positioning during treatment of PHT with RPW or FSW and propose an alternative side lying approach.</p><p><strong>Methods: </strong>A search was conducted of MEDLINE/PubMed and EMBASE electronic databases for studies published from January 2005 to January 2026. Key search terms included proximal hamstring tendinopathy, shockwave therapy, extracorporeal shockwave treatment, radial pressure wave, hamstring tendinosis, hamstring tendinitis, and hamstring pain. Studies were included if they evaluated RPW or FSW for the treatment of PHT.</p><p><strong>Results: </strong>Six manuscripts were identified for inclusion, two randomized controlled trials (RCT), two retrospective reviews, and two case reports; a total of 217 patients (145 female, 72 male) with PHT were treated with RPW and/or FSW. One RCT provided an in-depth description of patient positioning during shockwave treatment with the patient supine, with the hip and knee flexed, compared to other manuscripts detailing clinical focusing techniques only. One case report involving a para swimmer included a figure of treatment with the patient in a prone position. Improvement in patient reported outcomes with RPW and/or FSW was noted, with one RCT showing no differences between physiotherapy compared to RPW and FSW treatment.</p><p><strong>Conclusion: </strong>RPW and FSW have some evidence regarding their benefits for treatment of PHT but controlled studies are limited and no consensus on treatment protocols or patient positioning during treatment have been determined. The authors' preferred approach in treating PHT involves having the patient side lying with the hip and knee flexed to allow patient and clinician comfort while also creating compression of the proximal hamstring about the ischial tuberosity. It remains unclear how variance in patient positioning affects patient-reported outcomes. Future studies using RPW and FSW should include documentation of patient positioning when evaluating RPW and FSW efficacy.</p><p><strong>Level of evidence: </strong>5.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"21 4","pages":"467-476"},"PeriodicalIF":2.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13046457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}