The mechanism of hamstring injuries: a systematic review

Danielsson et al., (2020) in BioMed Central [BMC Musculoskeletal Disorders] reviewed 26 studies on the mechanism of hamstring injuries. They conclude that the stretch-type injury is caused when the hip is flexed (when you raise your knee towards the chest) and the knee is extended (straightening) towards the late swing phase of a kick or running action. As the knee approaches this straight position, during high speeds, the hamstring muscle group suddenly tries to slow the leg down, to prevent the knee from hyperextending. This excessive strain on weak or fatigued hamstrings, overloads the muscle group and causes it to fail.

Image from solutionssportstherapy 08.06.2021

Concussion in Kids

In a recent publication by the British Journal of Sports Medicine, Van Ierssel et al., (Oct 2020) report,

Concussion risk in children and adolescents aged 5–18 years?

“Previously concussed children have four times the risk of sustaining a concussion compared with those with no previous concussion history. This should be a consideration for clinicians in return to sport decision-making.”

Monie, Touskasis & Allison, 2008. Joint Position Sense of the Human Shoulder

Joint Position Sense (JPS) of the shoulder as determined by repeated repositioning tasks has been performed under different constrained testing conditions. The variability in the testing protocols for JPS testing of the gleno-humeral (G-H) joint may incorporate different movement patterns, numbers of trials used to derive a specific JPS variable and range of motion. All of these aspects may play an important role in the assessment of G-H JPS testing. When using a new instrument for assessing JPS all of these issues need to be examined to document the optimal testing protocols for subsequent clinical assessments. By undertaking these minor studies future clinical trials may be more optimally assessed to determine if there are differences between dominant and non-dominant arms as well as the presence of JPS changes in performance associated with pathology and rehabilitation.

This study used a 3-dimentional tracking system to examined gleno-humeral (G-H) JPS  using 2 open kinetic chain (OKC) movement patterns. The ‘conventional’ 90 degree abducted, externally rotated movement was compared to the hypothetically more functional D2 movement pattern used in proprioceptive neuromuscular fascilitatory techniques. These two patterns were tested at different ranges (low and high). Two cohorts (n=12, n=16) of normal healthy athletic males aged 17-35 years, performed matching tasks of both left and right arms. The second cohort (n=16) were assessed with and without strapping the G-H joint with sports tape. Accuracy (overall bias) and precision (variability) scores were determined for progressively greater numbers of trials.

The findings of the study show that estimates of JPS accuracy and precision become more stable from data derived from 5 to 6 matching trials. There were no statistical differences between sides [95%CI » ± 1.5cm]. The accuracy but not precision improved as subjects approximated the ‘high’ end of range in the ‘conventional’ or D2 pattern.  Furthermore, no systematic differences were detected at different ranges of movement or movement patterns with or without the application of sports tape.

These findings provide a guide to the number of trials that optimise the testing of the G-H joint and also suggest that in normal controls the magnitude of differences between sides and movement patterns is similar. These findings also indicate that sports tape applied to the shoulder may not significantly change the JPS performance in healthy, athletic males.

Myofascial Trigger Point Dry Needling

Acupuncture or Dry Needling? Same needle, different goal.

After decades of research and hundreds of pain trials, including thousands of patients, there is still insufficient evidence for the use of acupuncture (BMJ, 2018;360:k970). However, diagnosis by a Physiotherapist and Dry Needling for Myofascial Trigger points, is deemed safe & effective (Unverzagt et al., 2015). 

#precisionphysiotherapy #dryneedling #acupuncture #physiotherapy 

#myofascialtriggerpoint #trp #triggerpoint #muscletherapy


The Spine of a Child

The spine of a child is changeable, like a green bamboo.

If it is put in slouched/abnormal positions often enough, over the years, ligaments will stretch, muscles will tighten and posture will change. Unfortunately, when the spine matures by the late teens, the changes are irreversible.

For a posture check, including scoliosis screening and simple (kid friendly) exercises, visit us at

#precisionphysiotherapy #posturecheck #postureexercises #hunchback #kyphosis #spinehealth