This paper assesses a specific connective tissue insufficiency induced hamstring injury occurring in the late swing/early stance phase of sprinting and jumping activities. A literature review related to hamstring injury demonstrates that eccentric muscle action is capable of producing very high forces within the series elastic component (SEC) of the hamstrings in this phase of sprinting. These high forces have been shown to be related to hamstring injury. The utilization of eccentric exercise training regimens can prevent this injury by strengthening the SEC, resulting in a musculotendinous structure theoretically capable of both generating and withstanding higher eccentric and concentric forces. A clinical approach utilizing an eccentric exercise regimen designed to strengthen the hamstrings in the late swing/early stance phase is outlined. A pilot study investigating the exercise indicates it is a valid method of preventing and rehabilitating the hamstring injury in terms of the positions at risk while sprinting, the angular velocities achieved, and the torques produced.
Abstract A questionnaire was administered to 224 patients who had undergone 246 operations for duodenal ulcer to see how well this correlated with Visick grading and to provide insight into the patients' feelings about the results of their surgery. The patients were divided into three groups by Visick grade: good (grade I, n = 70), satisfactory (grades II and IIIs, n = 104) and poor (grades IIIu and IV, n = 72). The distribution of questionnaire responses in each group was statistically different (P < 0·01). Dividing the questionnaire responses into three corresponding groups, 72 per cent of patients assigned themselves to the same group as their Visick grade. Three observations were made regarding the Visick system: recurrent ulceration is over-scored and should be included only if symptomatic; grading should acknowledge a wider range of symptoms related to ulcer disease and its treatment; only three grades are necessary.
Summary A case of skin necrosis at the sites of injection of subcutaneous heparin is described. The patient went on to develop heparin-induced thrombocytopenia and pulmonary embolism. Review of the previously described cases of heparin-associated skin necrosis reveals that this sequence of events is not uncommon.
'%3e%3cpath fill='%23012169' d='M0 0v30h60V0z'/%3e%3cpath stroke='%23fff' stroke-width='6' d='m0 0 60 30m0-30L0 30'/%3e%3cpath stroke='%23C8102E' stroke-width='4' d='m0 0 60 30m0-30L0 30' clip-path='url(%23b)'/%3e%3cpath stroke='%23fff' stroke-width='10' d='M30 0v30M0 15h60'/%3e%3cpath stroke='%23C8102E' stroke-width='6' d='M30 0v30M0 15h60'/%3e%3c/g%3e%3c/svg%3e)
'/%3e%3cpath d='M200 752.362h200v300H200z' style='fill:%23fff;fill-opacity:1;stroke:none' transform='translate(0 -752.362)'/%3e%3cpath d='M400 752.362h200v300H400z' style='fill:%23ff883e;fill-opacity:1;stroke:none' transform='translate(0 -752.362)'/%3e%3c/svg%3e)
