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Conservative non-surgical management of a herniated lumbar intervertebral disc (HLD) in athletes is a complex task due to the dramatic forces imparted on the spine during sport participation. The demands placed upon the athlete during rehabilitation and return to sport are unique not only from a sport specific perspective, but also regarding return to the sport strength and conditioning programs utilized for sport preparation. Many prescriptions fail to address postural and motor control faults specific to athletic development, which may prevent full return to sport after suffering a HLD or predispose the athlete to future exacerbations of a HLD. Strength exercises involving squatting, deadlifting, and Olympic power lifts are large components of the typical athlete's conditioning program, therefore some progressions are provided to address potential underlying problems in the athlete's technique that may have contributed to their HLD in the first place. The purpose of this clinical commentary is to propose a framework for rehabilitation that is built around the phases of healing of the disc. Phase I: Non-Rotational/Non-Flexion Phase (Acute Inflammatory Phase), Phase II: Counter rotation/Flexion Phase (Repair Phase), Phase III: Rotational Phase/Power development (Remodeling Phase), and Phase IV: Full return to sport. This clinical commentary provides a theoretical basis for these phases based on available literature as well as reviewing many popular current practice trends in the management of an HLD. The authors recognize the limits of any general exercise rehabilitation recommendation with regard to return to sport, as well as any general strength and conditioning program. It is vital that an individual assessment and prescription is made for every athlete which reviews and addresses movement in all planes of motion under all necessary extrinsic and intrinsic demands to that athlete.
Level of Evidence:
PMCID: PMC3812831  PMID: 24175134
Athletes; herniated lumbar disc; rehabilitation
The Editorial staff of The International Journal of Sports Physical Therapy (IJSPT) is dedicated to the review, critical appraisal, and publication of high quality scientific and clinical research, systematic reviews, meta‐analyses, and case reports. As IJSPT progresses through its' ninth year of providing high quality research evidence as well as relevant clinical commentary and suggestions for the international sports physical therapy community, we offer the following editorial.
We, along with many other prestigious journals are committed to elevating the quality of published research related to disability and rehabilitation and agree to adherence to the following reporting guidelines, which will be required by IJSPT as of January 1, 2015. Many of these guidelines are all ready in place and have been implemented by IJSPT.
This Editorial is a reprint of a previously published Editorial in The Archives of Physical Medicine and Rehabilitation, and is used with permission. (
For citation purposes, please use the original publication details: Chan L, Heinemann AW, and Roberts J, Elevating the Quality of Disability and Rehabilitation Research: Mandatory use of the Reporting Guidelines. Archives of Physical Medicine and Rehabilitation, 2014: 95: 414‐417
PMCID: PMC4127503  PMID: 25133069
Part 1 of this two‐part series (presented in the June issue of IJSPT) provided an introduction to functional movement screening, as well as the history, background, and a summary of the evidence regarding the reliability of the Functional Movement Screen (FMS™). Part 1 presented three of the seven fundamental movement patterns that comprise the FMS™, and the specific ordinal grading system from 0‐3, used in the their scoring. Specifics for scoring each test are presented.
Part 2 of this series provides a review of the concepts associated with the analysis of fundamental movement as a screening system for functional movement competency. In addition, the four remaining movements of the FMS™, which complement those described in Part 1, will be presented (to complete the total of seven fundamental movements): Shoulder Mobility, the Active Straight Leg Raise, the Trunk Stability Push‐up, and Rotary Stability. The final four patterns are described in detail, and the specifics for scoring each test are presented, as well as the proposed clinical implications for receiving a grade less than a perfect “3”.
The intent of this two part series is to present the concepts associated with screening of fundamental movements, whether it is the FMS™ system or a different system devised by another clinician. Such a fundamental screen of the movement system should be incorporated into pre‐participation screening and return to sport testing in order to determine whether an athlete has the essential movements needed to participate in sports activities at a level of minimum competency.
Part 2 concludes with a discussion of the evidence related to functional movement screening, myths related to the FMS™, the future of functional movement screening, and the concept of movement as a system.
Level of Evidence:
PMCID: PMC4127517  PMID: 25133083
Function; movement screening; movement system
To prepare an athlete for the wide variety of activities needed to participate in or return to their sport, the analysis of fundamental movements should be incorporated into screening in order to determine who possesses, or lacks, the ability to perform certain essential movements. In a series of two articles, the background and rationale for the analysis of fundamental movement will be provided. The Functional Movement Screen (FMS™) will be described, and any evidence related to its use will be presented. Three of the seven fundamental movement patterns that comprise the FMS™ are described in detail in Part I: the Deep Squat, Hurdle Step, and In‐Line Lunge. Part II of this series which will be provided in the August issue of IJSPT, will provide a detailed description of the four additional patterns that complement those presented in Part I (to complete the seven total fundamental movements): Shoulder Mobility, the Active Straight Leg Raise, the Trunk Stability Push‐up, and Rotary Stability, as well as a discussion about the utility of functional movement screening, and the future of functional movement.
The intent of this two part series is to present the concepts associated with screening of fundamental movements, whether it is the FMS™ system or a different system devised by another clinician. Such a functional assessment should be incorporated into pre‐participation screening and return to sport testing in order to determine whether the athlete has the essential movements needed to participate in sports activities at a level of minimum competency.
Level of Evidence:
PMCID: PMC4060319  PMID: 24944860
Function; movement screening; performance testing
The role of the Sports physical therapist (PT) as a part of the sports medical team at marathon-type events varies widely. The PT can assume the role of an emergency medical responder (EMR) whose primary role is the management of the athlete in emergency type situations. The role of the EMR extends beyond the care of the athlete to the care and safety of the spectators. In this role, the PT must be prepared to handle any type of emergency situation, which may occur from medical conditions to acute orthopedic/sports injuries, to medical conditions which may be found in the participants of the race or the spectators. Additional roles of the PT can be in pre-race education, pre-participation screening/physicals, and other concerns by the participant related to injury prevention. Regardless of the role assumed by the PT, prior planning is essential for the safety, security, and maximal performance of the participant and to make the race enjoyable and safe for everyone.
Level of Evidence:
PMCID: PMC3812832  PMID: 24175136
Event coverage; marathon running; race preparation
Successful production of a written product for submission to a peer‐reviewed scientific journal requires substantial effort. Such an effort can be maximized by following a few simple suggestions when composing/creating the product for submission. By following some suggested guidelines and avoiding common errors, the process can be streamlined and success realized for even beginning/novice authors as they negotiate the publication process. The purpose of this invited commentary is to offer practical suggestions for achieving success when writing and submitting manuscripts to The International Journal of Sports Physical Therapy and other professional journals.
PMCID: PMC3474301  PMID: 23091783
Journal submission; scientific writing; strategies and tips
Manuscripts have been subjected to the peer review process prior to publication for over 300 years. Currently, the peer review process is used by almost all scientific journals, and The International Journal of Sports Physical Therapy is no exception. Scholarly publication is the means by which new work is communicated and peer review is an important part of this process. Peer review is a vital part of the quality control mechanism that is used to determine what is published, and what is not. The purpose of this commentary is to provide a description of the peer review process, both generally, and as utilized by The International Journal of Sports Physical Therapy. It is the hope of the authors that this will assist those who submit scholarly works to understand the purpose of the peer review process, as well as to appreciate the length of time required for a manuscript to complete the process and move toward publication.
PMCID: PMC3474310  PMID: 23091777
Peer review; quality control; research publication
Bleeding or open wounds of the integumentary system occur frequently in athletics. Integumentary wounds vary from minor scrapes, blisters, and small punctures to more serious lacerations and arterial wounds that could threaten the life of the athlete. The Sports physical therapist (PT) must realize that integumentary wounds and subsequent bleeding can occur in many sports, and assessment and care of such trauma is an essential skill. The purpose of this “On the Sidelines” clinical commentary is to review types of integumentary wounds that may occur in sport and their acute management.
Level of Evidence:
PMCID: PMC3362987  PMID: 22666650
Athletes; bleeding; integument; wounds
This invited clinical commentary summarizes the current state of knowledge in the area of prevention of anterior cruciate ligament (ACL) injuries. ACL injuries occur with a four to six fold greater incidence in female compared to male athletes playing the same high risk sports. The combination of increased risk of ACL injury and a 10-fold increase in sports participation since the enactment of Title IX in 1972 has led to an almost epidemic rise in ACL injuries in female athletes. Examination of the mechanisms responsible for this sex disparity in ACL rupture accelerated in the last two decades. A summary of these findings and a synthesis and framework for understanding the results of the intense investigation of this research are detailed herein. This clinical commentary focuses on the current understanding, identification and interventional targeting of the primary neuromuscular and biomechanical risk factors associated with the ACL injury mechanism in high-risk individuals.
PMCID: PMC3096145  PMID: 21655382
Female; ACL injury; prevention strategies
10.  Nutritional Knowledge and Eating Behaviors of Female, Collegiate Swimmers 
Female athletes often have inadequate diets due to lack of nutritional knowledge and nutritional misconceptions. Poor nutrition may lead to an increased chance of developing the Female Athlete Triad, a trio of low energy availability, menstrual dysfunction, and low bone mass. Physical therapists, as part of a healthcare team, must be prepared to address nutritional issues, recognize signs and symptoms of the female athlete triad, and make the appropriate intervention or referral.
The purpose of this study was to determine the nutritional knowledge of female collegiate swimmers and how effectively they apply their nutritional knowledge to their everyday eating habits.
Eighty-five female collegiate swimmers from six Michigan universities completed a nutritional knowledge questionnaire and a 24-hour food recall survey. Demographic, nutritional, and statistical data were analyzed.
The mean score on nutritional knowledge test was 54.53/76 (71.75% correct). Mean total caloric intake of swimmers was 3229.10 calories per day. Ninety-five point nine percent did not meet the recommended dietary allowance (RDA) for all three macronutrients. No difference in total mean survey score existed between the three collegiate divisions.
This study suggests that athletes lack knowledge of nutrition, healthy food choices, components of a well-balanced diet, and the implications of nutrition on performance.
PMCID: PMC2953338  PMID: 21509109
nutrition; swimming; female athlete triad
11.  The Chop and Lift Reconsidered: Integrating Neuromuscular Principles into Orthopedic and Sports Rehabilitation. 
The upper extremity bilateral PNF patterns, better known as the “chop and lift” are well known to physical therapists. These patterns which utilize spiral and diagonal motions of the upper extremity can be used for both assessment and treatment of sports and orthopedic injuries. Half kneeling and tall kneeling postures fall between low-level postures such as rolling and 4-point, and high-level postures of standing and walking. Half kneeling and tall kneeling can be considered transitional postures. When the chop and lift patterns are used in conjunction with the half and tall kneeling developmental postures, the techniques are an excellent assessment of core stability/instability. Combinations of the upper extremity patterns and the developmental postures can be powerful corrective training techniques. The combined experience of the three authors is used to describe techniques for equipment setup, testing, assessment, and treatment of athletic imbalances. These techniques require and promote instantaneous local muscular activity as developmental postures and balance reactions are incorporated. The therapeutic use of both PNF and developmental patterns has been a hallmark of rehabilitation of patients with neurologic dysfunction, but can be equally and effectively applied in the sports and orthopedic rehabilitation setting.
PMCID: PMC2953333  PMID: 21509127
PNF; chop and lift patterns; reflex stabilization
12.  Using Rolling to Develop Neuromuscular Control and Coordination of the Core and Extremities of Athletes 
Rolling is a movement pattern seldom used by physical therapists for assessment and intervention with adult clientele with normal neurologic function. Rolling, as an adult motor skill, combines the use of the upper extremities, core, and lower extremities in a coordinated manner to move from one posture to another. Rolling is accomplished from prone to supine and supine to prone, although the method by which it is performed varies among adults. Assessment of rolling for both the ability to complete the task and bilateral symmetry may be beneficial for use with athletes who perform rotationally-biased sports such as golf, throwing, tennis, and twisting sports such as dance, gymnastics, and figure skating. Additionally, when used as intervention techniques, the rolling patterns have the ability to affect dysfunction of the upper quarter, core, and lower quarter. By applying proprioceptive neuromuscular facilitation (PNF) principles, the therapist may assist patients and clients who are unable to complete a rolling pattern. Examples given in the article include distraction/elongation, compression, and manual contacts to facilitate proper rolling. The combined experience of the four authors is used to describe techniques for testing, assessment, and treatment of dysfunction, using case examples that incorporate rolling. The authors assert that therapeutic use of the developmental pattern of rolling with techniques derived from PNF is a hallmark in rehabilitation of patients with neurologic dysfunction, but can be creatively and effectively utilized in musculoskeletal rehabilitation.
PMCID: PMC2953329  PMID: 21509112

Results 1-12 (12)