B Clinicians should include patient age, body mass index, pain coping strategies, report of instability, history of previous sprain, ability to bear weight, pain with weight bearing, ankle dorsiflexion range of motion (ROM), medial jointline tenderness, balance, and ability to jump and land (as safely tolerated) in their initial assessment, because of their role in influencing the clinical course and estimation of time to accomplish the goals of an individual with an acute lateral ankle sprain (LAS). CLINICAL COURSE -CHRONIC ANKLE INSTABILITYC Clinicians may include previous treatment, number of sprains, pain level, and self-report of function in their evaluation, as well as an assessment of the sensorimotor movement systems of the foot, ankle, knee, and hip during dynamic postural control and functional movements, because of their role in influencing the clinical course and estimation of time to accomplish the goals of an individual with chronic ankle instability (CAI). DIAGNOSIS/CLASSIFICATION -ACUTE LATERAL ANKLE SPRAINB Clinicians should use special tests, including the reverse anterolateral drawer test and anterolateral talar palpation in addition to the traditional anterior drawer test, and a thorough history and physical examination to aid in the diagnosis of a LAS. DIAGNOSIS/CLASSIFICATION -CHRONIC ANKLE INSTABILITYB When determining whether an individual has CAI, clinicians should use a reliable and valid discriminative instrument, such as the Cumberland Ankle Instability Tool or the Identification of Functional Ankle Instability, as well as a battery of functional performance tests that have established validity to differentiate between healthy controls and individuals with CAI. EXAMINATION -OUTCOME MEASURESA Clinicians should use validated patient-reported outcome measures, such as the Patient-Reported Outcomes Measurement Information System physical function and pain interference scales, the Foot and Ankle Ability Measure, and the Lower Extremity Functional Scale, as part of a standard clinical examination. Clinicians should utilize these before and 1 or more times after the application of interventions intended to alleviate the impairments of body function and structure, activity limitations, and participation restrictions associated with an acute LAS or CAI.C Clinicians may use the Pain Self-Efficacy Questionnaire in the acute and postacute periods after a LAS to assess effective coping strategies for pain, and the 11-item Tampa Scale of Kinesiophobia and the Fear-Avoidance Beliefs Questionnaire to assess fear of movement and reinjury and fear-avoidance beliefs in those with CAI. EXAMINATION -PHYSICAL IMPAIRMENT MEASURESA Clinicians should assess and document ankle swelling, ROM, talar translation, talar inversion, and single-leg balance in patients with an acute LAS, postacute LAS, or CAI at baseline and 2 or more times over an episode of care. Clinicians should specifically include measures of dorsiflexion, using the weight-bearing lunge test, static single-limb balance on a firm surface with eyes...

Background: In swimmers, the great number of stroke repetitions and force generated through the upper extremity, leaves the shoulder uniquely vulnerable to injury. Numerous high school swimmers experience shoulder pain, muscle shortening, and/or weakness leading to poor swim mechanics. Purpose: The purposes of this study were to examine the effects of a six week dry land intervention program on the 1) flexibility of the shoulder girdle, 2) muscular strength of the shoulder girdle and core, and 3) swim performance in high school aged competitive swimmers. Methods: 32 high-school swimmers were divided into control (N = 16) and intervention (N = 16) groups. Measurements for shoulder strength, core strength and swim times were measured. The intervention group completed a dry-land home exercise program three times a week for six weeks. Results: A MANOVA comparing flexibility, strength and swim times for pre-and post-test measurements by control and intervention group, revealed a significant group by time interaction. Post-hoc tests revealed a significant improvement in core strength in the intervention group (F = 15.847, p = .000). Conclusion: A 6-week dry land exercise program was effective in improving core strength, however, shoulder flexibility, strength and swim performance remained unchanged in this group.

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Purpose:The purpose of this investigation was to determine the effects of a 6-week, standardized, groupbased plyometric training program on force generating potential of knee extensors, hip abductors, and hip extensors and reactive strength as measured by the reactive strength index in a sample of adolescent female basketball players. Methods: Seventeen female basketball players completed the study, 13 to 16 years of age (average of 14 years). Isometric force production of knee extensors, hip abductors, and hip extensors was measured with the hand-held MicroFet3 dynamometer. Reactive strength index was measured with the MuscleLab Ergotest infrared contact grid using depth jumps. The intervention consisted of 6 exercises performed prior to normal basketball practice twice per week for 6 weeks. Results: statistically significant improvements were observed between pre-test and post-test for all force measurements with the exception of right leg hip abduction. Reactive strength index did not significantly change. Conclusions: findings suggest the proposed plyometric training program offers sufficient stimulus to improve lower extremity force production, but not reactive strength in adolescent female athletes. More research is needed comparing the intervention to a control group and to determine an exercise dose necessary to produce changes in reactive strength index.

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