A wall squat exercise increased PPTs compared with quiet rest; however, the relative and absolute reliability of the EIH response was poor. Future research is warranted to investigate the reliability of EIH in clinical pain populations.

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Background Osgood Schlatter disease (OSD) is the most common knee condition in adolescent athletes aged 9‐16. Without evidence to guide clinical practice, it is unclear how OSD is managed. The aim of this study was to investigate how international healthcare professionals (general practitioners, physiotherapists, rheumatologists, sports and exercise medicine doctors, and orthopedic surgeons) diagnose and manage OSD. Methods This mixed‐method study used a convergent parallel design. A quantitative questionnaire and semi‐structured interview covered prognosis, diagnosis, treatment, and return to play of adolescents with OSD. For quantitative data, those who reported likely/very likely considered “for” and unlikely/very unlikely “against” (for specific diagnostic/management strategy). Qualitative data analysis used a phenomenological approach. Results Two hundred and fifty‐one healthcare professionals completed the questionnaire. The most common diagnostic criterion was pain at the tibial tuberosity (97% for). The most common treatments were patient education (99%) and exercise therapy (92%). Other treatment options were more heterogeneous, for example, pain medication (31% for and 34% against). Managing training load (97%), pain intensity (87%), and psychological factors (86%) were considered the most important factors influencing the return to activities. Several themes emerged from the interviews (on N = 20) including imaging, pain management, family, and psychosocial factors influencing prognosis. Conclusion Diagnosis criteria of OSD were relatively well agreed upon, whereas the triangulation of qualitative and quantitative data showed heterogeneity of treatments. Psychosocial factors including family were highlighted as critical in the management of OSD.

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Background The underlying mechanisms for shoulder pain (SP) are still widely unknown. Previous reviews report signs of altered pain processing in SP measured using quantitative sensory testing (QST). Evidence suggests that QST might hold predictive value for SP after intervention, yet it is not known whether QST profiles can be modulated in response to different treatments. Therefore, this systematic review and meta-analysis aimed to assess if QST-parameters can be modified by interventions for patients with SP. Methods Three databases were searched to identify eligible studies. Eligible studies had a prospective design, with at least one QST variable as an outcome in conjunction with an intervention measured before and after intervention. Studies that involved SP caused by spinal or brain injury and studies looking at combined chronic neck/shoulder pain were excluded. Results 19 studies investigating SP were eligible for inclusion for this review. Pressure pain threshold (PPT) was the most frequently used QST-parameter investigating local and widespread hyperalgesia. A meta-analysis was performed with data from 10 studies with a total of 16 interventions. Results demonstrated an overall acute effect (<24 hours after intervention) of interventions in favour of local decreased pain sensitivity and of remote decreased pain sensitivity comparing PPTs before and after interventions. Conclusions This study demonstrates that interventions such as exercise and manual therapy can modulate PPTs acutely both locally and remotely in patients with shoulder pain. Further research investigating the acute and long-term modulatory ability of these interventions on other QST-parameters is needed in patients with shoulder pain.