iii mtn workshop - b·debate · 2016-07-14 · jordi puigdellivol orthopaedic surgeon and senior...
TRANSCRIPT
Introduction Tissue engineering has been a topic of extensive research over the last years. The ability of human body to regenerate tissue loss such as cartilage, tendon and muscle is limited leading often to chronic injuries. In recent years there have been rapid developments in the use of several novel approaches to muscular and tendinous injuries - growth factors, platelet-rich plasma (PRP) or mesenchymal stem cells (MSCs) to name a few for accelerated healing of injury.The advances made in cellular biology, genetics and recombinant technology has initiated the development of new techniques and new therapeutic strategies allowing treatment of many pathological conditions providing restoration of tissue continuity and function. Those approaches have been used with success and the technology is now being developed for orthopaedics and sports medicine applications for repair of soft tissues such as muscle, tendon and ligament following acute traumatic or overuse injury, and animal studies have demonstrated clear benefits in terms of accelerated healing. Although, in some of those new techniques and new therapeutic strategies minimal clinical evidence is currently available, their use has increased, given its safety as well as the availability of new techniques many controlled clinical trials are underway. Should we approach tissue engineering cautiously until high-level clinical evidence supporting the new techniques and new therapeutic strategies’ e�cacy is available? On another area related to the approaches to muscular and tendinous injuries, we find studies performed using a focused model of injury causation and prevention strictly from a biomechanical perspective. One could argue this model would be equivalent to the failure of a machine or structure - a result from a transfer of energy to the tissue taking into consideration the mechanical properties of human tissue, such as stiffness (stress–strain relation), ultimate strength, and critical stress, and ultimately governing how the body responds to physical loads. Is this approach too simplistic? Biomechanics, one of the disciplines in the field of Human Movement and Exercise Science from a research perspective may be seen to have a disagreeing approach to muscular and tendinous injuries. Clinical biomechanics involving research in several areas such as neuromuscular control, tissue mechanics, and movement evaluation during rehabilitation from either injury or disease will be discussed, with the primary aim to show the role of biomechanics in sports science and sports medicine. Scientists, medical researchers, biomechanics and practitioners working in the field of sports injury prevention tend to have very tangible objectives and focus on identifying and solving specific injury risks. There is an uncertainty, however, that “solving” one problem may not simply create another or that “solving” one problem may be done with only one approach. As the field of the muscular and tendinous injuries matures, it is worth considering whether theories and models can be developed that have more general application to a range of injury issues. There is a need for an integrated perspective on sports injury that is inclusive of medical and biomechanical factors.
III MTN WORKSHOPMUSCLE INJURIES AND REPAIR:CURRENT TRENDS IN RESEARCH September, 27th-28th, 2011
Futbol Club Barcelona StadiumAv. Arístides Maillol, s/n 08028 Barcelona
Program
Tuesday, 27th Wednesday, 28th
8:45 Hotel pick up - bus transfer 8:45 Hotel pick up - bus transfer
9:00 Registration
9:00
Update in regenerative therapies in the muscle and tendon Johnny Huard Richard Lieber Nicola Maffulli Chairs: María José Martínez; Lluís Orozco; Robert Soler Discussion panel:Ramon Cugat; José López Calbet; Mario Marotta; Jordi Puigdellivol; LLuís Til
9:30 Welcome
9:45 MuscleTech Network, moving forward Gil Rodas Francesc X. Roca
10:00 Key note lectures Thomas M. Best Johnny Huard Willem van Mechelen
11:00 Coffee break 11:00 Coffee break
11:30
Presentation of the magazine FEM Xavier Gassó Evaluating strength tests as elements of injury prediction Thomas M. Best Pierre Portero Chair: Joaquim Chaler Discussion panel: Rosa Angulo-Barroso; Xavier Balius; Angel Sánchez; Antoni Turmo
11:30
Scientific evidence and clinical validation of the F.C. Barcelona Clinical Practice Guide of tendon injuries Henning Langberg Nicola Maffulli Per Tesch Chairs: Daniel Medina; Ricard Pruna Discussion panel: Angel Cotorro; Ramon Cugat; Alfons Mascaró, Jordi Puigdellivol
13:00 Lunch 13:00 Lunch
14:00
Injuries in the adolescent stage Nikos Malliaropoulos Per Tesch Pierre Portero Chair: Xavier Valle Discussion panel: Manuela González; José Antonio Gutiérrez; Mauricio Mónaco; Jordi Puigdellivol; Lluís Til
14:00
Update in muscle and tendon injury and repair biomarkers Walter Herzog Henning Langberg Richard Lieber José López Calbet Chairs: Roser Cussó; Ginés Viscor Discussion panel: Jordi Ardevol; Josep Cadefau; Franchek Drobnic; Xavier Yanguas 15:30 Coffee break
15:45
Prognostic value of ultrasound and MRI in muscle and tendon injuries Carl Askling Nikos Malliaropoulos Xavier Alomar Ramon Balius Chairs: Ramon Balius; Ma Isabel Miguel Discussion panel: Manuela González; Jordi Puigdellivol; Marta Rius; LLuís Til
16:00
Conslusions and closing remarks of the "3rd MuscleTech Network Workshop on Muscle and Tendon" Carles Pedret Gil Rodas
18:30 Visit to FCB, Stadium and Museum 16:30 Bus to the FCB sport city
20:00 Dinner at FCB 16:45 Visit to FCB sport city
22:30 Bus to the hotel 18:00 Bus to the Hotel
Program Tuesday, September 27th ____________________________________________________________________________ 9:00 Registration 9:30 Welcome
9:45 MuscleTech Network, moving forward
Gil Rodas Scientific Director of MuscleTech Network, Senior Researcher and Sports Medicine Specialist at the Medical Services Futbol Club Barcelona Francesc X. Roca Coordinator Manager of MuscleTech Network and Senior Researcher on Medicinal Chemistry at LEITAT Technological Centre
10:00 Key note lectures
Challenges and Dilemmas in Muscle-Tendon Research and Implementation to Clinical Practice Thomas M. Best Professor and Pomerene Endowed Chair, Department of Family Medicine, Professor of Biomedical Engineering and Biostatstics, Director, Division of Sports Medicine, Co-Medical Director, The OSU Sports Medicine Center, Team Physician, OSU Athletic Department, The Ohio State University, President, American College of Sports Medicine. Regenerative Medicine based on Adult Stem Cells for Musculoskeletal Tissue Regeneration & Repair Johnny Huard Henry J. Mankin Professor and Vice-chair for Musculoskeletal Cellular Therapeutics in the Department of Orthopaedic Surgery and in the Departments of Microbiology and Molecular Genetics, Pathology and Physical Medicine, Bioengineering, and Rehabilitation. Director of the Stem Cell Research Centre of Children’s Hospital of Pittsburgh. Deputy Director of the McGowan Institute for Regenerative Medicine, United States of America
Cost-Effective Secondary Prevention of Musculo-skeletal Problems; Myth or Reality? Willem van Mechelen Head of the Department of Public and Occupational Health of VU University Medical Centre and Co- Director EMGO+ Institute of VU University Medical Centre, Chairman of the Research Centre Body@Work TNO VU University Medical Centre and Director of the spin-off company Evalua Nederland B.V. ('Ltd').
11:00 Coffee break 11:30 Presentation of the magazine FEM – Forum Egarsat del Múscul
Xavier Gassó , Director of Health Management at “Mútua d’accidents EGARSAT”
11:40 Evaluating strength tests as elements of injury prediction
The assessment of muscle strength and especially the knowledge of the relationship between agonist and antagonist muscles allow the analysis of the muscle state. It is postulated that knowledge in this way allows us to understand the risk of muscle-tendinous injuries. In this regard, isokinetic studies have been really important because they study the muscle strength performed in a determined range of motion and velocity, allowing observing the presence of injuries or imbalances between muscle groups. However there is still controversy as to whether it measures the real movement of the athlete when performing their various sporting gestures. Other methods of analysis have emerged in recent years, seeking to be more specific and decisive in finding athletes with a high risk of lesion and who could benefit from prevention programs specifically designed according to their morpho-functional deficits. What we should discuss is which are the best methods for assessing the risk of injury and how can they be applied.
Core Training for Hamstring/Groin Problems – Myths And Evidence For Injury Prediction and Prevention Thomas M. Best Professor and Pomerene Endowed Chair, Department of Family Medicine, Professor of Biomedical Engineering and Biostatstics, Director, Division of Sports Medicine, Co-Medical Director, The OSU Sports Medicine Center, Team Physician, OSU Athletic Department, The Ohio State University, President, American College of Sports Medicine.
Characterization of the Passive Mechanical Properties of the Muscle-tendon Complex Using Isokinetic Dynamometers Pierre Portero Service de Rééducation Neuro-Orthopédique Hôpital Rothschild, Paris, France Chair: Joaquim Chaler Senior Researcher at EGARSAT-SUMA Intermutual and lecturer at the Psychology, Education and Sport Sciences School at Blanquerna, Universitat Ramon Llull, Barcelona, Spain.
Discussion panel members: Rosa Angulo-Barroso Senior Researcher at the Research Unit of the National Institute of Physical Education (INEF- Catalunya), Barcelona, Spain Xavier Balius Research Leader at GIRSANE - Performance and Health Research Group for High Level Sports. Head of the Biomechanics Department Representing GIRSANE, Sport Sciences Unit (Olympic Training Centre) and Health Unit (Health Consortium of Terrassa), Barcelona, Spain Angel Sánchez Senior Researcher and Rehabilitation physician at Eurosport, Barcelona, Spain Antoni Turmo Director of the Medical School of Physical Education and Sport, Universitat de Barcelona, Barcelona, Spain and Sports Medicine Specialist at the Medical Services RCD Español, Barcelona, Spain
13:00 Lunch 14:00 Injuries in the adolescent stage
It is increasingly difficult to reduce the processing time of muscle and tendon injuries. In sports medicine the tendency is to prevent these injuries. Prevention guidelines should be started at an early age. It is precisely for this reason that is basic to know the epidemiology of the different injuries at the stage of adolescence. This knowledge will allow us to design individualized treatment strategies and adequate preventive protocols. What we should discuss is precisely what are the most common injuries and what should be achieved using certain protocols.
Clinical Prognostic Values in Hamstring Injuries. Nikos G. Malliaropoulos Sports Medicine Physician-EJU Medical Committee Member, Chair European College of Sports and Exercise Physicians (ECOSEP).
Improving Health Through Better Muscle Health Per A. Tesch. Professor at the Department of Health Sciences, Mid Sweden University, Östersund and Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden.
Passive viscoelastic characteristics of the calf muscle-tendon complex in former international female gymnasts vs. control subjects
Pierre Portero Service de Rééducation Neuro-Orthopédique Hôpital Rothschild, Paris, France
Chair: Xavier Valle Senior Researcher and Lecturer at the Medical School of Physical Education and Sport, Universitat de Barcelona, Barcelona, Spain and Sports Medicine Specialist at the Medical Services Futbol Club Barcelona.
Discussion panel members: Manuela González Head of Service of the Department of Postural Imaging and Assessment at Centre for Sports Medicine of the Consejo Superior de Deportes (National Sports Council), Madrid, Spain Jose Antonio Gutierrez Senior Researcher and Sports Medicine Specialist at the Medical Services Futbol Club Barcelona Mauricio Monaco Paediatrician, Senior Researcher and Sports Medicine Specialist at the Medical Services Futbol Club Barcelona
Jordi Puigdellivol Orthopaedic Surgeon and Senior Researcher and Sports Medicine Specialist at the Medical Services Futbol Club Barcelona Lluis Til Senior Researcher at the Physiological and Functional Evaluation Department, High Performance Centre - CAR - Sant Cugat del Vallès, Spain and Senior Researcher and Sports Medicine Specialist at the Medical Services Futbol Club Barcelona
15:30 Coffee break 15:45 Prognostic value of ultrasound and MRI in muscle and tendon injuries.
It is well known the high diagnostic value of ultrasound and MRI in muscle and tendon injuries. Similarly we consider these techniques the gold standard for assessing the evolution of these lesions. At present, the improvement in image quality and the processing of the images give us even more possibilities in the world of imaging. So we can speak not only about imaging but also for prognostic assessment and treatment using ultrasound and MRI. High-speed Running Type or Stretching-type of Hamstring Injuries Makes a Difference to MRI Findings Carl M. Askling Lecturer at the Swedish School of Sport and Health Sciences, Research Leader at the Orthopaedics and Sports Medicine Group, Department of Molecular Medicine and Surgery at the Karolinska Institutet, Stockholm, Sweden
Cost-effective Prevention of Lateral Ankle Injury Nikos G. Malliaropoulos Sports Medicine Physician-EJU Medical Committee Member, Chair European College of Sports and Exercise Physicians (ECOSEP)
Longitudinal Studies of Hamstring Muscle Injuries in Athletes Xavier Alomar Director of the Diagnostic Imaging Department at Creu Blanca Clinic, Barcelona, Spain Chairs: Ramon Balius Research Leader at the High Performance Sports Research Centre (CEARE), Catalan Sports Council, Barcelona, Spain Mª Isabel Miguel Professor at the Department of Pathology and Experimental Therapeutics, Research Unit on Muscle Anatomy and Pathology, School of Medicine (Campus Bellvitge), University of Barcelona, Barcelona, Spain
Discussion panel members: Manuela González Head of Service of the Department of Postural Imaging and Assessment at Centre for Sports Medicine of the Consejo Superior de Deportes (National Sports Council), Madrid, Spain Jordi Puigdellivol Orthopaedic Surgeon and Senior Researcher and Sports Medicine Specialist at the Medical Services Futbol Club Barcelona Marta Rius Sports Medicine Specialist at “Mutualidad de Futbolistas” of the Catalan Football Federation, and Traumatology Institute at Quiron Hospital, Barcelona, Spain and Sports Medicine Specialist at the Medical Services Futbol Club Barcelona Lluis Til Senior Researcher at the Physiological and Functional Evaluation Department, High Performance Centre - CAR - Sant Cugat del Vallès, Spain and Senior Researcher and Sports Medicine Specialist at the Medical Services Futbol Club Barcelona
18:30 Visit to FCB Stadium and Museum 20:00 Dinner at FCB
Wednesday, September 28th ____________________________________________________________________________ 9:00 Update in regenerative therapies in the muscle and tendon
The reality today is that after decades of treating muscle and tendon injuries with a standard treatment, often with little scientific evidence, the appearance of a treatment with "platelet-rich plasma", stem cells and various tissue engineering techniques had opened to the world a hope to make a treatment that can improve the recovery time of muscle and tendon injuries as well as improving the rate of recurrence associated with this type of injury. While this seems a really important goal, the few published studies do not seem to find scientific evidence yet. Also we want to know the opinion of experts in this field, especially from the clinical experience and analyze the practical aspects of its application and indications.
Biological Approaches to Improve Muscle Healing After Injuries Johnny Huard Henry J. Mankin Professor and Vice-chair for Musculoskeletal Cellular Therapeutics in the Department of Orthopaedic Surgery and in the Departments of Microbiology and Molecular Genetics, Pathology and Physical Medicine, Bioengineering, and Rehabilitation. Director of the Stem Cell Research Centre of Children’s Hospital of Pittsburgh. Deputy Director of the McGowan Institute for Regenerative Medicine, United States of America
Mechanical and Biological Interaction Between Muscle Cells and the Extracellular Matrix Richard Lieber Professor of Orthopaedics and Bioengineering, Veterans Affairs Medical Centre, and Department of Orthopaedics and Bioengineering, University of California at San Diego, San Diego, United States of America. Regenerative Therapies in the Muscle and Tendon Nicola Maffulli Centre Lead and Professor of Sports and Exercise Medicine Consultant Trauma and Orthopaedic Surgeon Queen Mary University of London Barts and The London School of Medicine and Dentistry William Harvey Research Institute Centre for Sports and Exercise Medicine Mile End Hospital. Chairs: María José Martínez Specialist in Clinical Pharmacology at the Clinical Epidemiology and Public Health Department of the Iberoamerican Cochrane Centre, Institute for Biomedical Research of the Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. Lluís Orozco Regenerative Tissue Therapy Institute at the Teknon Medical Centre (ITRT), Barcelona, Spain. Robert Soler Regenerative Tissue Therapy Institute at the Teknon Medical Centre (ITRT), Barcelona, Spain.
Discussion panel members: Ramon Cugat Orthopaedic Surgeon, Head of the Orthopaedic Unit at the “Mutua Montañesa”, Head of Service of “Mutualidad de Futbolistas” of the Catalan Football Federation at the Trauma Institute Quiron Garcia Cugat Foundation and Senior Researcher and Sports Medicine Specialist at the Medical Services Futbol Club Barcelona. José A. López Calbet Professor of the Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain. Mario Marotta Researcher at the Paediatric Surgery, Orthopaedics and Bioengineering Laboratory at the Research Institute “Institut de Recerca Hospital Universitari Vall d'Hebron”, Barcelona, Spain. Jordi Puigdellivol Orthopaedic Surgeon and Senior Researcher and Sports Medicine Specialist at the Medical Services Futbol Club Barcelona. LluÍs Til Senior Researcher at the Physiological and Functional Evaluation Department, High Performance Centre - CAR - Sant Cugat del Vallès, Spain and Senior Researcher and Sports Medicine Specialist at the Medical Services Futbol Club Barcelona.
11:00 Coffee break
11:30 Scientific evidence and clinical validation of the F.C.Barcelona Clinical Practice Guide of
tendon injuries F.C. Barcelona is one of the pioneering clubs in medical research and the application of scientifically validated protocols for prevention and treatment of injuries to its athletes. In the 2nd MuscleTech Network, the guide “Clinical practice of muscle injury” published at the journal Apunts Medicina de l’Esport was presented. We are currently in the process of validation of the Clinical Practice Guide of tendon injuries. To do this we have to put into discussion the different sections of the guidance that range control of risk factors, diagnosis, treatment and secondary prevention.
Connective Tissue, Fibroblasts and Myofibroblasts - Structure, Function and Responses to Mechanical and Physiological Stimuli Henning Langberg Associate Professor and lecturer at the Institute of Sports Medicine, Bispebjerg Hospital, School of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Prevention and Management of Tendon Injuries Nicola Maffulli Centre Lead and Professor of Sports and Exercise Medicine Consultant Trauma and Orthopaedic Surgeon Queen Mary University of London Barts and The London School of Medicine and Dentistry William Harvey Research Institute Centre for Sports and Exercise Medicine Mile End Hospital. Combining Aerobic and Resistance Exercise: Can Muscle Comply? Per A. Tesch Professor at the Department of Health Sciences, Mid Sweden University, Östersund and Department of Physiology & Pharmacology, Karolinska Institutet, Stockholm, Sweden.
Chairs: Daniel Medina Senior Researcher and Sports Medicine Specialist at the Medical Services Futbol Club Barcelona. Ricard Pruna Senior Researcher and Sports Medicine Specialist at the Medical Services Futbol Club Barcelona.
Discussion panel members: Angel Cotorro Senior Researcher and Medical Director of the Medical Services of the Royal Spanish Tennis Federation. MAPFRE Tennis Medicine Centre, Barcelona, Spain. Ramon Cugat Orthopaedic Surgeon, Head of the Orthopaedic Unit at the “Mutua Montañesa”, Head of Service of “Mutualidad de Futbolistas” of the Catalan Football Federation at the Trauma Institute Quiron Garcia Cugat Foundation and Senior Researcher and Sports Medicine Specialist at the Medical Services Futbol Club Barcelona. Alfons Mascaró Senior Researcher and Sports Physiotherapist Specialist. Jordi Puigdellivol Orthopaedic Surgeon and Senior Researcher and Sports Medicine Specialist at the Medical Services Futbol Club Barcelona.
13:00 Lunch 14:00 Update in muscle and tendon injury and repair biomarkers.
The signalling pathway occurring after injuries, the effect of nerve activity in adult skeletal muscle, and specifically the pathways which control muscle growth and fibre type specification will be subjects in the limelight during this session. Amongst them, the study of biological markers of myoconnective injuries can help and be complementary to the imaging studies of muscle and tendon injuries. The determination of serum proteins may have a diagnostic and prognostic value of muscle and tendon injuries. These studies may reveal novel injury recovery protocols and lead to the creation of a glucose reader like device rating the injury grade. The Mystery of Popping Sarcomeres Walter Herzog Associate Dean of Research, Faculty of Kinesiology, The University of Calgary and Adjunct Professor, Faculty of Medicine, Department of Surgery, The University of Calgary.
What processes are taking place in the healing tendon? Henning Langberg Associate Professor and lecturer at the Institute of Sports Medicine, Bispebjerg Hospital, School of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Cellular and Transcriptional Changes After Muscle Injury Richard Lieber Professor of Orthopaedics and Bioengineering, Veterans Affairs Medical Centre, and Department of Orthopaedics and Bioengineering, University of California at San Diego, San Diego, United States of America.
In the Search of Human Models of Muscle Damage and Reparation: Repeated Muscle Biopsies José López Calbet Professor of the Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
Chairs: Roser Cussó Professor at the Department of Physiological Sciences I. Biochemistry and Molecular Biology Unit. Metabolic Regulation and Molecular Pathology Group. School of Medicine, University of Barcelona, Barcelona, Spain. Ginés Viscor Professor at the Physiology Department, School of Biological Sciences, University of Barcelona, Barcelona, Spain.
Discussion panel members: Jordi Ardevol Senior Researcher and Sports Medicine Specialist, Orthopaedic Surgeon with specialty on Arthroscopic Surgery at the Orthopaedic Surgery and Traumatology Unit of the ASEPEYO Hospital and Clinica Diagonal, Barcelona, Spain. Josep Cadefau University of Barcelona, Barcelona, Spain. Franchek Drobnic Research Leader at GIRSANE - Performance and Health Research Group for High Level Sports Department of Sport Physiology, High Performance Centre - CAR - Sant Cugat del Vallès and Senior Researcher and Sports Medicine Specialist at the Medical Services Futbol Club Barcelona. Xavier Yanguas Senior Researcher and Sports Medicine Specialist at the Medical Services Futbol Club Barcelona
16:00 Conclusions and closing remarks of the “3rd MuscleTech Network Workshop Muscle Injuries
and Repair: Current Trends in Research”
Carles Pedret Senior researcher at the MAPFRE Medicine Tennis Centre, and Centre for Image Diagnostics, Tarragona, Spain. Gil Rodas Scientific Director of MuscleTech Network, Senior Researcher and Sports Medicine Specialist at the Medical Services Futbol Club Barcelona.
16:45 Visit to FCB Sports City
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tbol Club Ba
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Beirut (LebStandardizaorganisationagainst Neu(Health Dep Characterizisokinetic d Traditionallypower, and measuring need for mostretching pinformation be used as range of minfluences connective decrease ininactive areelements capproximatemuch of thechanges to ideal prescrfor 20-30 sundertaken dynamic) cstretches arstiffness. Wmotion and stretching iscycle is notand landing Passive visgymnasts v The purposmuscle-tendintensive trais not clearintensive trdynamometthe maximaaverage paThe area unIn addition,
PPfroprrethmce10aspr
banon). He ation (ISO), Ens as the Nauromuscular partment), th
zation of thedynamomet
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motion, it alsstiffness. Thtissues that
n tension is e less stiff than rise to leely 80 percee early gainsthe muscle.
ription for strseconds, tha
slowly to limcan influencere more likely
Whether to strstiffness of t
s diminishedt required, thgs.
scoelastic cvs. control s
se of this studon unit betaining from er and needs raining for 5ter was used
al angle of dossive stiffnesnder the momthe maxima
Pierre Portehysiotherapyom the Univrofessor at tesearch activhe Rothschildmovement anervical spine00 invited cos referee byrofessor at Ais involved European Neational Agenc
Disorders (Ae University
e passive mters
dynamomecharacteristassociated on on the prhe use of dymore preciseuipment to faso reduces these reductserve as a frnot known. han the tendevels simila
ent of their m in range of Structural aretching remat the first smit stress ine the degrey to influencretch for spothe individua
d. In sports whe need to s
characteristisubjects
udy was to etween formeearly childhoo
to be inves5 to 17 yead to passivelorsiflexion (Rss was calcument-angle cl voluntary to
ero is profey in Paris (19versity of Tecthe Sport Svities take pd Hospital in
nd muscle bi. He has pub
onferences (iy 15 indexedAuckland Unin several s
euromusculacy for HealthAFM), the Frof Teeside (
mechanical p
ters have bics of musclwith tissue rescription ofynamometerse stretching pacilitate imprthe tension tions in tensramework fo Studies ha
don, however to those r
maximum ranmotion occu
adaptations aains unknowstretch prov the tissuese to which e range of m
orts or not deal. If a persowhere there istretch is less
ics of the ca
examine the er internationod. The impastigated.Sevears and 6 sy stretch the
ROM) at 5°.sulated betwecurve was caorques of the
essor and ho977) and recchnology of
Science Depalace in the Nn Paris wheriomechanicsblished over including ove
d internationaniversity of Tscientific org
ar Centre). Hh Accreditatiorench Minist(UK), Royal S
properties o
been used tle. Much lesextensibility.f stretching rs to examineprescription trovements inin muscles sion occur
or the muscleave generaler, when murecorded in nge of motiour as a resultare more likewn. Current vides the mo. There is srange of m
motion while epends uponon has sufficis concentrics compared
alf muscle-te
difference inal female gact of such sen former insedentary se right calf ms-1. The maxeen 15 and 2alculated as e plantar flex
olds a PT dceived his PhCompiègneartment of tNeuro-Orthore he is in c
s with specifi60 scientific
er 40 at inteal journals. Technology (ganisations e serves als
on and Evalutry for ReseaSociety of Ne
f the muscle
o measure ss attention h Researcheroutines to ee responsesto be instituten range of m
at any partin the tend
e. The relativly found thauscle is activthe tendon. n, they oftent of reduced ely to be obsevidence suost gains, aome evidenc
motion increadynamic stre
n the type of ient range of
c muscle actto sports th
endon comp
n passive vigymnasts anstrenuous tranternational fubjects part
muscle-tendoximal passive25° of dorsiflthe average
xors and exte
degree from hD degree in (1993). He ihe Universit
opaedic Rehacharge of thec reference
c articles, 27 rnational levHe has serv(NZ) and Un(e.g. Internao as expert a
uation (HAS)arch, the Freew Zealand (
e-tendon co
variables ashas been givrs have comnhance the to stretchin
ed. Furthermmotion. Stret
ticular muscdons, contrave contributiot muscle covated; the te
When musn become acmuscle activ
served over wggests that s
and that initce that the tases or stiffetches are msport being f motion, theion primarilyat require la
plex in form
scoelastic cnd controls. aining on the female gymnticipated to n unit from r
e resistive toexion and fo of absorbedensors were
the Nationa Biomedical is currently wty Paris-Est abilitation dee researcheto muscle d book chapte
vel). He has ved as visitinniversity Sainational Orgaadvisor in m
), the Frenchench Ministry(Rutherford F
omplex usin
ssociated wven to their
mmented thasafety and t
ng can providmore, dynamotching not oncle length anactile elemenon of these tiontractile eleension in thescles are strctive. It seemvity rather thweeks of strstretches shtial stretchestype of stretfness is red
more effectiveplayed and
en the need ty and the strearge amounts
mer internati
characteristicGymnasts
musculoskenasts that hathe study.A
relaxed plantorque was meor the final 10d passive-ela also measu
al School ofEngineering
working as aCréteil. His
epartment ats on human
disease, anders and overbeen invitedng or invitednt-Joseph inanization for
many nationalh Associationy of DefenceFoundation).
g
ith strength,potential for
at there is ahe results ofde importantometers cannly improvesnd thereforents and thessues to thements whene contractileretched pastms likely thatan structuraletching. Theould be helds should betch (static oruced. Static
e in reducingthe range ofto undertakeetch-shortens of jumping
onal female
s of the calfusually start
eletal systemave stopped
An isokinetictar flexion toeasured and0% of ROM.astic energy.red. Despite
f g a s t n d r d d n r l
n e
, r a f t
n s e e e n e t t l
e d e r c g f
e n g
e
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m d c o d . .
e
similar maximal voluntary plantar flexion and dorsiflexion torques, former international gymnasts exhibited significant higher maximal passive dorsiflexion ROM (+35%), maximal passive resistive torque (+48%) and passive-elastic energy (+63%). Furthermore, former gymnasts showed significant lower passive stiffness within the 15-25° of dorsiflexion (-33%) and higher for the last 10% of ROM (+41%). Although speculative, these results suggest that long term loading during childhood have modified passive properties of the calf muscle-tendon unit of former international female gymnasts that persist several years after the cessation of sport practice. Longitudinal follow up will assist in determining whether or not passive properties of plantar flexors is genetically determined and/or able to be modified with further gymnastic training.
Physicians-Hellenic VoPhysicians-Sports andmedicine Ro Clinical Pro Muscle injusports. Accinjuries are positioning the hip andreceives innknow. Contbiceps femokicking andclassify the imaging findrange of molesion. Folloprotocol to pto differentiathe Posterioinjuries .Wephase. Opemuscles, eifound to beAccording tassess theof Prognosia proximal farea of injurat a normal less than 4 return to pla Cost-effect Injuries to tthe frequenmanagemeninversion ananterior taloligament (Cthem in thre
NMFSHLDsAGT
-ECOSEP Molley Ball Fe-ECOSEP . Exercise moyal College
ognostic va
ries are amoording to sothe commo
and relationsd knee .Longnervations frtraction injuroris, long he
d primary invseverity of tdings, time totion deficit owing a clinipredict the tiate Commonor Thigh froe as clinicianerative intervether at the in
e 12–31% Eto our clinica
e risk of re-ins the followinfree tendon, ry. Past histopacepain-freweeks from
ay timescale
tive prevent
the lateral anncy and thent, and long-nd plantar flofibular ligam
CFL) as well. ee grades, a
Nikos G. MMember, ChFellow of theScience (MHospital. DipLondon HosDirector of tsince 1986. Athens 2004Games 200Thessalonikiedical Commederation . Founding m
medicine Ase of Surgeons
lues in Ham
ong the mosome studies, nest muscleship to the gg head receirom the comries occurrinead and thevolving Semhe injury. Thto walk painbetween thecal classificame to full rehn Signs and m another S
ns have to pention is resnsertion or aEarly return al classificat
njury followinng factors haproximity of
ory of hamstee within 24 the time of inwhich is imp
tion of latera
nkle ligamene impact of-term compliexion [6]. Eiment (ATFLVarious sys
as mild .mod
Malliaropohair Europeae Faculty of MSc) in Spoploma in Sp
spital. PhD fhe Sports MChief Medic
4. Director of7. Director 2009. Cha
mittee MembFounding m
member of thsociation-BAs Ireland. Me
mstring Injur
st common, muscle inju
e injury in allground it canives innervat
mmon persong during Ru
ey heal fastemimembranoshey classify th-free. Our C
e injured andation we are habilitation aSymptoms o
Source. Rehprescribe theerved only fo
at the origin to sport &
tion Objectivg acute ham
ave been shof the injury totring injury ish of injury w
njury. Defininportant in gui
al ankle inju
nts constitutef acute ankcations. Earghty percen
L). In 20%, stems have bderate, seve
oulos Sportsan College oSports and E
orts Medicineports Medicifrom MedicaMedicine Cencal Officer of the Medicaof the Med
air of the Eurber Europeanmember of the Greek SpASEM. Μ.F.Sember of the
ries.
most misunduries accountl Sports. Ha
n serve as a tions via a t
nal nerve. Thunning at Maer comparingsus, proximahem in three
Clinical classd the healthable to dec
and to assessof a Hamstrihabilitation ise right clinicaor severe inj(avulsion). Tpoor rehabil
ve clinical finmstring muscown to requiro the ischial s the main riswas independng the severiding rehabili
ury
e 15% to 45kle ligamentrlier studies it of lateral amore violen
been used tore. In our s
s Medicine of Sports anExercise Mee - Universine (DSM) Ul School of ntre, Athleticof the Hellenal Services odical Servicropean Collen Judo Unionthe Europeaorts MedicinSEM MembGreek Traum
derstood, ant for 10 - 30mstrings funhip extensortibia portion he mechanisaximal or Neg to stretchial tendon. Ve grades, as sification is by side. Ultraide for the trs the reinjureng Strain Inj
s one of theal applicationuries, such a
The reinjure itation progr
ndings can cle strains in re a greater ctuberosity, i
sk factor for dent predictoity of the injuitation and in
% of all spot Injuries lendicate that
ankle sprain nt inversion o classify thesetting, we p
Physician-End Exercise dicine UK, ity of LondoUniversity ofAristotle Un
cs Federationnic Olympic of the First Ses World F
ege of Sportsn –EJU. Medan College oe Associatioer Faculty oma Associati
d inadequat0% of all injunction is comr, knee flexoof the sciati
sm of the injear-Maximal ng injuries oarious systemild .modera
based on estasound is usreatment, to e rate. We mjury Compar
e key points n correlated tas complete rate for ham
ram met withprovide an elite track aconvalescenncreased lenthe next injuor of being uury enable usn team plann
orts related Inads to poo85% of anklinjuries mosforce dama
e severity of tplan the initia
EJU MedicalPhysicians F. FSEM U
on Queen Mf London Q
niversity of Tn SEGAS, TTeam XXV
South EasterFinal Gran s medicine adical Commitof Sports a
on. Member oof Sports aion.
tely treated curies in spormplex. Depen
r, and externic nerve, thejury is very Speed Primoccurring in
ems have beate, severe, timating the
sed to imagedesign the r
must always kred to Those
dealing witto each hearupture of th
mstring injurieh a high riseffective cli
nd field athlent period: injngth and cro
ury. Being unnable to retus to assess ting.
njuries. Undor diagnosisle sprains inst commonly
ages the calthe injury. Tal managem
Committee(ECOSEP).
K. Master ofMary-LondonQueen Mary-Thessaloniki.Thessaloniki,VIII Olympicsrn EuropeanProux IAAF
and Exercisettee Membernd Exerciseof the Britishnd Exercise
conditions inrt. Hamstringnding on legnal rotator ofe short headimportant to
mary involveDancing or
een used toaccording toknee active
e the musclerehabilitationkeep in minde Referred toh Hamstring
aling processhe hamstringes has beenk of reinjurenical tool toete. In termsury involvingoss-sectionalnable to walkurn to play inthe expected
erestimating, unsuitablevolve forced
y involve thecaneofibular
They classifyment of ankle
e . f
n -. , s n F e r e h e
n g g f
d o e r o o e e n d o g s g n e o s g l
k n d
g e d e r y e
sprain according to pain, ability to bear weight, range of motion (ROM), oedema (EDE), and stress radiographs. In addition, we routinely measure active ROM, and quantify the presence of EDE by the figure-of-eight method. We had the clinical impression that the grading of ankle sprains in athletes. Could be enriched by further sub grouping.Recently, we proposed a new classification system into 4 categories (I, II, IIIA, IIIB). Our Clinical classification based on estimating the ankle active range of motion deficit between the injured and the healthy side The extent of the acute swelling was measured in cm by using the figure of eight method and AD ankle radiographic stress evaluation. Following a clinical classification we are able to decide for the treatment, to design the rehabilitation protocol to predict the time to full rehabilitation and to assess the reinjure rate. Defining the severity of the injury enable us to assess the expected return to play timescale which is important in guiding rehabilitation and in team planning. Rehabilitation is one of the key points dealing with Ankle Ligament Injuries. Treating ankle sprains in elite athletes is a challenge for both the physician and the patient. The pressing question when managing such an injury is how to shorten the time required for full and safe return to sports. One of the main key points for rehabilitation is to induce the proper application of therapeutic intervention, according to the healing process phases. The reinjure rate for Ankle Ligament Injuries has been found to be 10%–73 % Early return to sport & poor rehabilitation program met with a high risk of reinjure According to our clinical classification Objective clinical findings can provide an effective clinical tool to assess the risk of re-injury following Ankle Ligament Injuries in elite track and field athletes. From our study regarding re injury rate of Ankle Ligament Injuries we conclude that Athletes with a grade I or II lateral ankle sprain are at higher risk of experiencing a re injury. Low-grade acute lateral ankle sprains result in a higher risk of re injury than high-grade acute lateral ankle sprains. The results of our study provide cost-effectiveness and general applicability predictive criteria for the evaluation of patients with acute lateral ankle sprain, and may be useful for further studies on this topic.
High-speed Hamstring slocation andand the anahamstrings probably neplay again wrehabilitatiorehabilitatioacute hamsinjury type lengtheningtype is mainjunction. In tissue of theacute hamsnoticed thacomparing injury locatioIn the presewhere the lengtheningincluded leninjuries. Behamstring tein athletes anticipated but can prolocation and
CoDS2resin
d running ty
strains are ad size. A maatomy is commuscles. Dif
eeds full funcwithout 100%
on period. Alon time and sstring strainsoccurs durin
g of the hamsnly located tocontrast; thee semimembstring strainsat different ihamstring son can give ently ongoinaim is to c
g exercises, wngthening ex
efore the athest without aincluded in and it has b
obably be avd size.
Carl Asklingof Sport and Department oSweden. He 2008. He is esearch thaoccer/track a
njuries.
ype or stretc
a heterogeneajority of the mplex, characfferent sport
ctional recove% restored full these parasafe return tos, which are ng high-speestrings, sucho the long h
e stretching-tbranosus. Ins in elite fooinjury situatitrains typicaimportant infg study (Askcompare twowith respect xercises sho
hletes are alany remainin
the study. become increvoided to a
g is a reseaHealth Scienof Moleculadefended hisupported bt deals withand how to
ching-type o
eous group, strains are locterized by os put differenery after injuunction. Eveameters mako sport difficu
best distinged running an as; high kicead of biceptype is locatea prospectiv
otball (n=80)ions can re
ally sustainedformation abokling CM. et o different rto time loss ortens the relowed to ret
ng symptomsTaken toget
easingly knowlarge degre
rcher and lences and ther Medicine is Thesis, “H
by The Swedh different toptimize the
of hamstring
especially iocated in theoverlapping tnt demands
ury before con psychologke the progult to predict.guished by thnd the other
cking, sliding ps femoris aned close to thve randomize), track and
esult in diffed by sprinteout the injuryal) on acute
rehabilitationand return toehabilitation turn to full t
s or signs of ther, hamstrwn how diffi
ee, provided
cturer in Spoe Section of and Surger
Hamstring mdish Centre types of acue rehabilitatio
g injuries ma
in terms of te proximal patendons and on the hams
ompeting agaical aspects nosis after aThere are athe different r occurs duritackle and s
nd typically ihe ischial tubed ongoing sfield (n=50
erent types rs versus day prognosis. e hamstring n protocols, o sports, we period sign
training and injury. So fa
ring injuries cult they aresound know
orts MedicineOrthopaedic
y, Karolinskmuscle strain”
for Sport Rute hamstrinon period an
akes a diffe
the different art of the hamstructural in
strings, for eain, but a foo
on an indiviacute hamstt least two diinjury situating moveme
sagittal split. nvolves the
berosity and study (Asklin) and other of hamstrinancers. The strains (170i.e. convenhave observ
nificantly in bcompetition
ar we have oare more c
e to treat. Rewledge abou
e at the Swecs and Spor
ka Institutet, ” at Karolins
Research in ng strains ind how to pr
erence to MR
t types of injmstring muscnterrelations example the otball player idual level catring strains istinctly diffeions. The mo
ents leading The high-spproximal mutypically invo
ng CM. et al) sports (n=4
g strains; foinjury situat
0 elite athletentional exercved that the both types on they shoulonly noticed ocommon thaecurrences aut the injury
edish Schoolrts Medicine,
Stockholm,ska Institutethis ongoingn especiallyrevent these
RI findings
juries, injurycles/tendonsbetween theelite sprintercan possiblyan affect the
in terms ofrent types ofost commonto extensive
peed runninguscle-tendonolves tendondealing with
40) we haveor example,tion and the
es included),cises versusprotocol thatof hamstringd perform aone re-injuryn previously
are common,type, injury
l , , t g y e
y s e r y e f f
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has made smuscle-deritreatment pconditions icartilage. Csuffering frosuffering froNational Insprivate and Dr. Huard wChancellor’sprestigious Regenerati Members omuscle of myogenic acharacteristderived stedifferentiatethat of othemicroenviroresistance tlocal enviroapplicationsthe genetic and anti-angthese variotechnology results on hstem cell-ba Biological A Muscle injuproduction aat the originhealing of mformation othe capacitymuscle injuand losartandecorin are Gamma-inte
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Clinical trial om urinary iom cardiac istitutes of Hepublic found
was recognizs DistinguisKappa Delta
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of my laboratnormal mice
and stem celltics similar tm cells (MD
e toward varir myogenic c
onment they to oxidative onmental cus designed tomodification
giogenic factous tissues.
to delay aghuman muscased gene th
Approaches
uries are extand re-injury
nal site of injumuscle injurf fibrotic tissy to differentury in vivo. Vn can improvmolecules t
erferon, sura
ptember ___________
ohnny HuOrthopaedic Microbiology Medicine andCenter of ChiMcGowan Ins
ittsburgh TisCook Myositeontinues to etem cell to imreclinical ad
cells. He isaddress Du
eletal and causing muscncontinencenjury. Dr. Huealth, the Dedations. He zed by Univehed Resear
a Award in 20
e based on A
tory have isoe on the bal marker expto those of DSCs). MDSous lineagescells, can im
are transpand inflamm
ues. I will do improve pen of MDSCs tors and how I will also ing in an an
cle derived stherapy and ti
s to Improve
tremely comy frequently aury. Gene theries. Transfosue that limitsiate into a mVarious inhibve muscle rethat can be eamin and los
28th ___________
ard PhD, iSurgery anand Molec
Rehabilitatildren’s Hosp
stitute for Regssue Enginee, Inc, a bexpand the pmprove the hvances in ths currently uuchenne muardiac musclle derived s and this stuard’s reseaepartment ofhas publishe
ersity of Pittsrch Award. 004.
Adult Stem
olated variouasis of the
pression profsatellite cell
SCs exhibit ls, both in vitrprove tissue lanted into.
matory stressdiscuss the eripheral nerv
to express ow these types
outline in mnimal model tem cells, whssue engine
e Muscle He
mmon and hare attributederapy may porming grows muscle heyofibroblast-
bitors of TGFegeneration aexpressed bysartan repres
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is the Henrnd hold secular Genetion. He is tpital of Pittsbgenerative M
eering Initiatibiotechnologypossibilities ohealing of vahe isolation, using those uscular dystrle injuries asstem cells htem cell techarch programf Defense, Med over 200 sburgh ChanHe was als
Cells for Mu
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files. Althougs, we also ong-term prro and in vivregeneratio This surv
s and their ause of MD
ve, bone andosteogenic ps of modificamy presenta
of accelerahich we belie
eering to impr
ealing after
have a high d to the deveprove useful fwth factor-beealing after s-like lineage F- β1, includand force pry cells and dsent drugs w
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ry J. Mankicondary aptics, Bioengthe current
burgh. Dr. HuMedicine (MIR
ve (PTEI). y company.
of regenerativarious tissueidentificatiofindings to
rophy (DMDs well as the
has been inihnology is a
m is funded bMuscular Dys
manuscriptsncellor Mark so the recip
usculoskele
ns of myogesion charactgh most of thhave identif
roliferation avo. The trann mainly throivability appbility to secr
DSCs in gend articular caproteins (BMations can enation new reated aging (peve will openrove tissue r
Injuries
tendency toelopment of rfor the devel
eta 1 (TGF-βsevere injuryin vitro and cing relaxin,
roduction by delivered to mwith other cl
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n Professor pointment iineering, PDirector of tuard is also RM) and an AFinally, Dr.
.Dr. Huard’sve medicine e of the musn and chara
explore anD) and a vare regeneratiotiated for thlso being ex
by a variety strophy Assos in peer revA. Nordenbepient of the
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o reoccur. Bregenerationopment of te
β1) plays a k. Muscle Stecan contributdecorin, gamlimiting mus
muscle via ginical indicat
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r in the Dein the dep
Pathology anthe Stem Cea Deputy DiAssociate DHuard is co
s main resethrough the
sculoskeletalacterization ond develop riety of muson of bone ahe treatmentxplored to trof sources i
ociation, as wviewed journaerg, as a rece Orthopaed
Regeneratio
m the postnoliferation bepulations have populationf-renewal ratof MDSCs, inbility to highly
due to thene factors in
and tissue ng. Further, angiogenic f
cells ability toned with adunally, I will pes for the us
Both limitation-restrictive fiechniques tokey role in tem Cells hate to scar formma-interferscle fibrosis. gene therapytions and ar
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epartment ofartments ofnd Physicalell Researchrector of theirector of theo-founder ofearch focususe of adult system. Heof post-natalcutting-edgesculoskeletaland articulart of patientsreat patientsncluding the
well as otherals. In 2003,cipient of thedic Society’s
on & Repair
natal skeletalehavior, andve displayedn of muscle-tes and cann contrast toy survive their increasedresponse toengineering
I will discussfactor VEGFo regenerateult stem cellpresent newse of muscle
ons in forceibrotic tissueimprove the
inducing theave exhibitedrmation afterron, suraminRelaxin and
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f f l
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w e
e e e e d r n d . y
available for clinical use. However, due to the potential side-effects of some of these agents, further research must be performed in order to determine clinical safety. Ex vivo gene therapy techniques may provide a method to deliver inhibitors of TGF-β1 to injured muscle. The proteoglycan, decorin, appears to be beneficial, not only for reducing fibrosis, but also for improving muscle regeneration. Delivery of MDSCs expressing decorin or a viral vector carrying decorin to injured muscle may help to improve long-term outcomes by reducing muscle fibrosis and hence the recurrence of injury. The protein, myostatin has been shown to inhibit muscle growth and enhance the deposition of fibrosis. Follistatin has been shown to inhibit myostatin and produces muscle hypertrophy and improves muscle strength. In this talk, we will review the current knowledge concerning the use of gene therapy and tissue engineering applications based on muscle stem cells to improve the recovery of skeletal muscle after injuries and disease.
Surgery andbiology toolmechanisticmechanical honored by Joint Surgethe Internat(Borelli AwaAffairs and Mechanica Skeletal mustudies sugcells and ECto understancharacterizeinteractionsresponse. and confoca Cellular an
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Richard LieMedical CentCalifornia at SPh.D. in Biophat was appU.C. San DieVice-Chair ocharacterizedwho study barticles in jouThe Journal rthopaedics tand gene exmuscles in
n recognitionan Academy s Andry Awarnge of Scho
search laboratitutes of Hea
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mposite tissury to musclen the tremenell-ECM inten. We have
nstrate that thes are base
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skeletal muscontractions ar
unique andechanics anst events as
h strain resultan causes wc the effectsroteins give iding of the dons that hav
eber Profestre, and DepSan Diego, Sphysics fromlied to mechego in 1985 of the Depd by its inteiomechanicsurnals ranginof Cell Bioland Related
xpression pawhich gene
n of the clinicof Orthopae
rd) the Amerolars (Fulbrigatory is suppalth.
ction Betwee
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his interface ed on quantit
nges After M
cles (i.e., “ecre common id have dramnd biology ofssociated witts in relativelaves of mus
s seen in humnsights into ldamage mece a rational s
ssor of Orthpartment of San Diego, U
m U.C. Davisanical studiewhere he h
partment of rdisciplinary
s and Orthopng from the vlogy to thosd Research. atterns in mues are introdcal impact oedic Surgeonrican Collegeght Fellowshported prima
en Muscle C
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stresses thahampered b
series of biocan remodetative electro
Muscle Injury
ccentric contn everyday m
matic biologif eccentric ch injury are ly rapid brea
scle-specific gmans. In adload bearingchanism mayscientific bas
hopaedics anOrthopaedic
United Statess in 1982 dees of single mas spent his
Orthopaednature—an
paedic Surgvery basic s
se more app More rece
uscles subjecuced to musf his basic s
ns (Kappa Dee of Sports Mhip) and the arily by gran
Cells and the
edded in thee mechanicaat exist at thaby the fact thaomechanical el dynamicallon microsco
y
tractions”) prmovements acal consequ
contraction-inmechanical kdown or reogene expresddition, the u and transm
y improve ousis.
nd Bioenginecs and Bioens of America
eveloping a tmuscle cells. s entire acadic Surgery. approach t
ery. He hauch as The
plied such antly, he has cted to high sscles in an
science studielta Award),
Medicine (FelAmerican Sts from the
e Extracellu
extracellulal and biologiat interface. at the precisand structu
ly and mounpy and simu
roduce injuryas well as spuences, it isnduced muscin nature andorganization sion. We ha
use of muscleission in ske
ur ability to p
eering, Vetengineering, Ua. Rick Liebetheory of lig He joined t
demic careerDr. Liebe
that is relevaas published
Biophysical as The Jour implementestress and inattempt to cies, Dr. Liebthe America
llow), and theSociety for B
Department
ular Matrix
ar matrix (ECical interactio Unfortunate
se structural fural studies nt a systemaultaneous bio
y and, ultimaports activities becoming cle injury. Cd are based of cytoskele
ave developees with “kno
eletal muscleprovide rehab
erans AffairsUniversity ofer earned hisht diffractionthe faculty ofr and is nowr’s work isant to those
almost 200Journal andnal of Hand
ed molecularn performingchange theirer has been
an Bone ande Council foriomechanicsof Veterans
CM). Recentons betweenely, attemptsfeatures thatof cell-ECMtic biologicalomechanical
ately, musclees. Becauseincreasingly
Current dataprimarily on
etal elementsed models ofocked out” or. Ultimately,bilitative and
s f s n f
w s e 0 d d r g r n d r s s
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M l l
e e y a n s f r , d
Regenerati New regenexample, scfactors and constructs fthe repair dconsidered recommendfactors abuunknown. Gthis technolprompt resemeasures formulationsrecommend Prevention
Tendon injucombinationabnormalitiematrix. The orthopaedicrecovery. Msurgery aimincisions in remaining vabnormal neintrinsically pathologicaminimally inand can be formation of
NPSaMaacoQDM
ive therapie
nerative thercaffolds to btenocyte-se
for rotator cudepends on to accelerate
d as best pndant in PR
Given our rudlogy to promearchers to uand clinicals and applding best pra
n and manag
uries can ben. Tendinopaes in tenocyscientific ev
c surgery minMinimally invms to excise
the tendon viable cells toeoinnervatiodifferent fro
al lesion, bunvasive strip
performed wf adhesions,
Nicola MafProfessor ofSurgeon Queand DentistrMedicine Miankle surgerankle arthroscontributed tof Sports anQueen MaryDentistry InsMedicine Mil
s in the mus
rapies havebridge masseeded scaffouff repairs ha
biologic hee muscle andractice for m
RPs have bedimentary knmote early heundertake aply approprialication proc
actice guidelin
gement of te
e acute or cathy is essenytes with disrvidence basenimize the prvasive surge
fibrotic adhto detect intro initiate cell on to interferem the classt act only tping. Percutwithout a touthis will allow
ffulli, MD, f Sports andeen Mary Unry William Hle End Hospry, Sports trascopy, minimto well over 6nd Exercise y University stitute of Heae End Hospi
scle and ten
e been recenive rotator clds to augmve been alsoaling at the d tendon heamanagementeen extensivowledge of tealing, and ppropriately pate follow ucedures, nenes.
endon injuri
chronic and ntially a failedruption of co
e for managinroblems posery representesions, remratendinous matrix respo
e with the paical ones in to denervateaneous long
urniquet. If pow the return
MS, PhD, Fd Exercise niversity of LoHarvey Resepital. Dr. Nicauma, Deformally invasiv600 publisheMedicine Cof London B
alth Sciencesital.
ndon
ntly developcuff tears anent tendon-to used to br tendon-to-baling and allot of musculvely studied the mechanisproduce imppowered lev
up. Thereforeed to be
es
caused by d healing resollagen fiberng tendinopaed by open sts new optioove areas olesions and
onse and heain sensation
present usee them. Thegitudinal tenoost-operativeto high level
FRCS (OrthMedicine Coondon Barts earch Institucola Maffulli mity correctie surgery. Hed works. Heonsultant TrBarts and Ts Education
ped to manand adjuvant to-bone healridge large gabone junctionow early retuoskeletal injin tissue re
sm of actionproved and avel I studies wre, major isaddressed
intrinsic or sponse with rs, and subsathies is limitsurgery, redu
ons for the mof failed hea
to restore valing. New s
n caused by e as they doey include eotomy is sime mobilisatios of activity i
) and Profeonsultant Trand The Lonte Centre fohas particu
on and ComHe has writtee is now Cenrauma and Ohe London Sand Centre
ge muscle abiologic moding have beap in tendonn. Platelet R
urn to elite couries. Even
egeneration, of the PRPs
accelerated with adequatssues, includ
to inform
extrinsic fachaphazard pequent increted. Minimallucing complimanagementling, and maascularity an
surgical techntendinopathy
o not attemptendoscopy, ple, requiresn is carried on the majorit
essor. Centrerauma and ndon Schoolor Sports a
ular interest mplex traumaen, been editntre Lead anOrthopaedic School of M for Sports a
and tendon dalities inclu
een used. Bion injuries. TheReach Plasmompetition, a
though sevthe key fac
s, it is challefunctional rete and relevading standaclinical stu
ctors, either proliferation oease in non-ly invasive teications and t of tendinopake multiplend possibly sniques aim toy. These prot to directly electrocoag
s only local aout early, prty.
e Lead andOrthopaedicl of Medicinend Exercisein Foot and
a, knee andtor of or hasnd Professor
Surgeon atMedicine andand Exercise
injuries. Foruding growthomechanicale success ofma (PRP) isand it is oftenveral growthctors are yetnging to useecovery. Weant outcome
ardization ofdies before
alone or inof tenocytes,-collagenousechniques inpostsurgical
pathy. Openlongitudinal
stimulate theo disrupt the
ocedures areaddress theulation, andanaesthesia,reventing the
d c e e d d s r t
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several boomany internInternationaincluding th Connectiveand physio Tendons artransmit thethat skeletaexercise thrcell activatioThe changeincreases thmuscles fibtissue with tadapt to theavoid injurymuscles antendons nesynthesis bOveruse of ergonomicsloading on overuse injtendons to tendons (coquality andclinical prac What proce Despite a hAchilles tenThe collagesmall diamethe tendonsmarkers of and markerpain produconnective higher exprsigns of fibtendinopath
HSFhteS“Truk
ok chapters national and al Federatione Research A
e tissue, fibological stim
re fibrous, tee forces geneal muscle carough quantion, muscle he in muscle he stress on
bers. This mathe risk of suese changedy. This is sund their tendeed to adaptby the fibrobf tendon tisss stressing ththe connecturies and cchanges in
onstructs) wh functional
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rs of collagencing mediattissue takes
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Henning LaSports MedicFaculty of Heholds a MSc endinopathySports MedicTendionpathesearch on
used lecturerkey-note lectin the area national scie
n of Sports PAward of the
roblasts anmuli
ension-bearierated by then adapt to citative mecha
hypertrophy, power increa the connectay lead to austaining injud by increasupported by dons. In ordet to the newblasts leadinue resulting
hat adaptatioive tissue duompared wiloading. A n
hich will allowparameters.
presented.
aking place
easing incides well as the n the tendin
er μm2. In adetermined. nthesis (Colln breakdowntors has be place in tenlated structu
s, inflammatongoing dege
angberg, Dcine – Copenealth Scienceand a PhD f. He is a specine – Copehy – from basadaptation o
r at national tures, and pof sports me
entific and prohysiotherapy
e Internationa
d myofibrob
ng elementse muscles tochanges in fuanism basedand a qualitaases the forctive tissue w
a situation wuries. It may ses in fibrob
data indicaer to maintaw situation bng to hyperin pain and
n of the tenduring physicath muscle ti
new perspecw us to test t
Though no
in the healin
ence of patiepathology leopathic areaddition an inOverall colla
lagen 1, Coln (MMP-2, Men found. I
ndinopathic teral proteins ion or wouenerative pro
DMSc, Ph.Dnhagen, Bispes, Universitfrom the Univecialist in Spoenhagen, Desic science toof connectiveand internat
published moedicine, basofessional ory. He is recipal Federation
blasts - stru
s interposedo the skeletounctional reqd on changesative mechanrces distributwithin the muwhere the for
thus be essblast activatioating a closeain this relatby increasinrtrophy, incred malfunctiondon tissue is al activity. Hissue, only
ctive of the rethe effect of
o conclusive
ng tendon?
ents with Aceading to thea has been foncreased volagen turnovllagen 3, Fib
MMP-9 and TIN summeryendons, assand factors nd healing
ocess with in
. PT, is asspebjerg Hosty of Copenhversity of Coorts Medicineenmark. He o evidence be tissue to etional conferore than 100ic science arganisations pient of seven of Sports P
ucture, funct
d between thon effecting lquirements as in muscle nism based oted from the scle as well rces on the sential for theon, increasee relationshiptionship and ng tissue streased crossn representsnot always s
However in slittle is knowesearch is thvarious intedata exists
hilles tendone disease is sound to haveume fraction
ver is increasbronectin, TeTIMP 2). No y this indicasociated withinvolved in ccan be decreased tiss
sociate profepital and Cehagen, Denmpenhagen, De and the cois head of
based rehabiexercise andences and h0 scientific p
and related aincluding as
eral internatioPhysiotherapy
tion and res
he muscles imb movemeand to increamass and fibon a change
muscles thras on the tetendons exc
e tendons to s in strengthp between cwithstand t
ength eithers-links or ins a major prosufficient to wpite of the hwn about thhat we haverventions or
s but hypoth
n problems thstill largely une a significann of cells in tsed with increnascin C, Tsigns of incr
ates that anan increase
controlling thtermined suue turnover.
essor of theentre for Heamark. HenninDenmark ando-Found of th
the researcilitation” and
d loading. Hehas more thapeer-review areas. He has a board meonal and natiy.
sponses to
and bones ent. It is wellases in loadbre size throin fibre type
rough the teendons in seceed the streprecede the
h and vascucross-sectionthe increaser by increas
ncreased tissoblem withinwithstand thehigh incidenche adaptive e been able
growth factohesis with re
he underlyinnknown. ntly increasethe tendinopreased mRN
TGF-b and Freased wounn increased ed number ohe formation upporting th
e Institute ofalthy Ageing,ng Langbergd a DMSc one Institute of
ch group onin charge of
e is a highlyan 60 invitedarticles and
as served inember for theional awards
mechanical
designed tol establisheding e.g. with
ough satellitedistribution. ndons 5 and
eries with theength of thee potential toularisation tonal areas of in load the
sed collagensue density.n sports ande increase ince of tendonresponse ofto form new
ors on tissueelevance for
g etiology of
ed number ofpathic part ofNA levels foribromodulin)
nd healing orturnover of
f cells and aof fibrils. Noe notion of
f ,
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sor at thend Departmeeden, adjunciversity, Collweden, rece1980. He convironmental e Center, FLsch’s early rend muscle mscle adaptatmuscle loss.
lth
he human bonificant loss s on healthuscle size anas results fr
Can muscle
ult in contrascise modalitied. In particuistance train
c and resista
Department ent of Physct Professor lege Stationived a PhD
ompleted hisMedicine a
L., and the esearch dea
metabolism, oions to resisDr. Tesch is
ody. As suchin muscle s
. Exercise cnd performanrom studies
e comply?
sting skeletaes in their t
ular, if precening, might nce exercise
of Health iology & Phat Ball State
, TX. Per Tein Physiolo
Post-Doc tt Natick, MAUniversity o
alt with classover more restance exercs also found
its role is crsize resultingcountermeasnce under thof athletes s
al muscle adraining routinded by aerobe attenuat
e will be pres
Sciences, Mharmacologyte Universityesch (1950) ogy from thetraining at thA., and held of Arkansas sical sports pecent years cise, muscleer of the Te
ritical in maing from disussures, based
hese conditiostill competin
daptations. nes, the com
obic exerciseted. Researcsented.
Mid Sweden, Karolinska, Muncie, INborned and
e Karolinskahe US Army
positions atfor Medical
performancehis research disuse and
esch-Övermo
ntaining vitalse, inactivity,d on spacens. Methods
ng at age 90
While manympatibility ofe, it appearsch exploring
n a N d a y t l
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The Myster AV Hill introrelationshipat different increasing mif this was without cheby experimethe notion tbecomes incorrespondicalled poppand to be re In order to asarcomere serially arraThree mainsarcomeressarcomeressarcomeresmuscles.
ry of Poppin
oduced the np. This notion
muscle lenmuscle lengtnot only a s
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njured becauing stretch o
ping sarcomeesponsible fo
address quepopping, we
anged sarcom results that
s are stables’ passive fos protects ag
Walter HeUniversity oSurgery, ThPhysical EdMSc/PhD inin BiomechaProfessor inis the Killamand Cellulabiomechani
ng Sarcome
notion that mn has been bngths gave ths. Needlesstatic but alsynamic propesingle musclele that is acse of sarcom
of the weakeere hypothesor the loss of
estions of mu developed ameres), and,will be discu (not unstab
orces increaainst injury a
erzog is Asof Calgary ahe Universitducation fromn Biomechananics and Nn Kinesiologym Memorial Cr Biomechancs and the c
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muscles are ubased on thea negative s to say thatso a dynamerties of muse fibre testinctively stretchmere instabilest sarcomesis. Popped sf force assoc
uscle injury oapproaches , for the firstussed and thble) on the se dramatic
and loss of fo
ssociate Deand Adjunct ty of Calgarm the Fede
nics from theeurosciencey, EngineerinChair at Calgnics. His res
clinical applic
unstable on te fact that co
slope, thatt any materiaic property.scles. Furthe
ng and relatinhed on the dlity, the assores to lengthsarcomeres ciated with ac
on the sarcomfor the testint time ever, that relate to t
descendingcally when aorce, rather t
ean of ReseProfessor, F
ry.Walter Heeral Technica University o
e at the Univng and Medigary and a Csearch intere
cation of mus
the so-calledonnecting thet is, maximaal with such The notion
ermore, suppng findings tdescending ociated differh beyond acare thought ctive stretchin
mere level, ang of single mthe testing othe notion ofg limb of tha muscle is than cause lo
earch, FacuFaculty of Merzog receival Institute iof Iowa, and versity of Cacine at the U
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d descendinge statically oal isometric properties wof instability
port for suchto individual limb of the rences in sactin-myosin fto be indicatng of muscle
and tackle thmyofibrils (a of mechanicaf eccentric me force-lengactivated, a
oss of force i
lty of KinesMedicine, Deved his BScn Zurich, hidid postdoctlgary. PreseUniversity of earch Chair muscle mecbiomechani
g limb of the observed ma
forces decwould be highy was adopth instability w
sarcomeresforce-length
arcomere forcfilament ovetive of structues.
e ideas of insub-cellular
ally isolated muscle injuriegth relationsand (iii) thatin eccentrica
siology, Theepartment ofc degree inis combinedtoral training
ently, he is af Calgary; hein Molecular
chanics, jointcs.
force-lengthaximal forcescreased withhly unstable,ed by many
was provided. This led torelationship
ces, and therlap; the so-ural damage
nstability andorganelle ofsarcomeres.
es are (i) thathip, (ii) thatt popping ofally damaged
e f
n d g a e r t
h s h , y d o p e -e
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ScandinaviaOne and TCollege. In the searc Prevention sound scientraining canthis is achiethese injurieshares sommuscle or pathways ininitiating thebe used to directly in hSTAT3 sigmechanismtype) strateg
JPUBUBRrmpii
an Journal oThe Journal
ch of human
of muscle ontific knowledn be applied seve remains es. However
me similitude tendon inju
nvolved in: e process ofboth cause umans. We naling path involved in gies to preve
José AntonPalmas de GUniversity ofBarcelona. SUniversity oBarcelona. PRigshospitaleresponse tomechanism bpapers in pen Spain annternational
of Medicine of Physical
n models of
r tendon injudge is availasuccessfully unknown. Litr, much morwith the ske
ries, new ea) enhancin
f reparation. a muscle inhave recentway, likely muscle repa
ent muscle d
nio López CGran Canariaf Barcelona
Specialty in Sf Barcelona
Postdoctoral et, Copenha
o exercise; by which leper reviewed nd other colevel.Memb
and ScienceActivity and
f muscle dam
uries is a mable on the efto prevent mttle is also knre is known eletal musclexperimental ng the neuroIn this prese
njury and thely shown thamediated b
aration it will amage and a
Calbet is pra. Canary Is Medical d
Sports Medica Specialty
appointmenagen, Denmobesity and
ptin and insuljournals.Thi
ountries.Morber of the ede in Sports, d Health. Me
mage and re
ajor focus inffectiveness
muscle and tenown about about how
es. To increamodels wil
ro-mechanicaentation we en study theat an early evby interleukbe easiest t
accelerate re
rofessor of Exslands, Spaindoctor (Hospcine at the Uin Rheuma
nts: The Copmark. Main d exercise, lin act on hurty six book
re than 25 ditorial boardEuropean J
ember of th
eparation: r
the preparaof preventiv
endon injuriepharmacologto reduce isase our knowl be neede
al competenwill shown h
e signaling invent after mu
kin 6 (IL-6).to elaborate eparation and
xercise Physn. Master in pital Clinic Bniversity of Mtology PhD
penhagen Mtopics of rewith emph
man skeletachapters. Abresearch g
d of: Journaournal of Ape Scientific
epeated mu
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how repeatednvolved in thuscle damag By undersstrategies phd functional r
siology, Univ Sports Scie
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Muscle Reseaesearch: ca
hasis on theal muscle. Mobout 120 invgrants at nl of Applied pplied PhysiBoard of th
uscle biopsi
etes. Howeves. It seems th
mechanism thonal strategiemage in the how to prevee the specifles and tendd muscle biohe process oge is the actistanding theharmacologirecovery.
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Physiology;ology, PLoS
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CONTACT
Laia ArnaProject DiInternatiolarnal@bioPhone: + 3 FrancescCoordinatoMuscleTeinfo@musPhone: +3
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