Entheses (insertion sites, osteotendinous junctions, osteoligamentous junctions) are sites of stress concentration at the region where tendons and ligaments attach to bone. Consequently, they are commonly subject to overuse injuries (enthesopathies) that are well documented in a number of sports. In this review, we focus on the structurefunction correlations of entheses on both the hard and the soft tissue sides of the junction. Particular attention is paid to mechanical factors that influence form and function and thus to exploring the relationship between entheses and exercise. The molecular parameters indicative of adaptation to mechanical stress are evaluated, and the basis on which entheses are classified is explained. The application of the 'enthesis organ' concept (a collection of tissues adjacent to the enthesis itself, which jointly serve the common function of stress dissipation) to understanding enthesopathies is considered and novel roles of adipose tissue at entheses are reviewed. A distinction is made between different locations of fat at entheses, and possible functions include space-filling and proprioception. The basic anchorage role of entheses is considered in detail and comparisons are explored between entheses and other biological 'anchorage' sites. The ability of entheses for self-repair is emphasized and a range of enthesopathies common in sport are reviewed (e.g. tennis elbow, golfer's elbow, jumper's knee, plantar fasciitis and Achilles insertional tendinopathies). Attention is drawn to the degenerative, rather than inflammatory, nature of most enthesopathies in sport. The biomechanical factors contributing to the development of enthesopathies are reviewed and the importance of considering the muscle-tendon-bone unit as a whole is recognized. Bony spur formation is assessed in relation to other changes at entheses which parallel those in osteoarthritic synovial joints.
The current manuscript has been adapted from the official position statement of the UK Strength and Conditioning Association on youth resistance training. It has subsequently been reviewed and endorsed by leading professional organisations within the fields of sports medicine, exercise science and paediatrics. The authorship team for this article was selected from the fields of paediatric exercise science, paediatric medicine, physical education, strength and conditioning and sports medicine.
We conclude that intermuscle differences in hamstring moment arms about the hip and knee may be a factor contributing to the greater propensity for hamstring strain injuries to occur in the BF muscle.
Reactive oxygen species (ROS) are chemically reactive molecules that are naturally produced within biological systems. Research has focused extensively on revealing the multi-faceted and complex roles that ROS play in living tissues. In regard to the good side of ROS, this article explores the effects of ROS on signalling, immune response and other physiological responses. To review the potentially bad side of ROS, we explain the consequences of high concentrations of molecules that lead to the disruption of redox homeostasis, which induces oxidative stress damaging intracellular components. The ugly effects of ROS can be observed in devastating cardiac, pulmonary, neurodegenerative and other disorders. Furthermore, this article covers the regulatory enzymes that mitigate the effects of ROS. Glutathione peroxidase, superoxide dismutase and catalase are discussed in particular detail. The current understanding of ROS is incomplete, and it is imperative that future research be performed to understand the implications of ROS in various therapeutic interventions.
Regular participation in organized youth sports does not ensure adequate exposure to skill- and health-related fitness activities; and sport training without preparatory conditioning does not appear to reduce risk of injury in young athletes. Recent trends indicate that widespread participation in organized youth sports is occurring at a younger age, especially in girls. Current public health recommendations developed to promote muscle strengthening and bone building activities for youth aged 6 and older, along with increased involvement in competitive sport activities at younger ages, has increased interest and concern from parents, clinicians, coaches and teachers regarding the optimal age to encourage and integrate more specialized physical training into youth development programs. This review synthesizes the latest literature and expert opinion regarding when to initiate neuromuscular conditioning in youth and presents a how to integrative training conceptual model that could maximize the potential health-related benefits for children by reducing sports-related injury risk and encouraging lifelong regular physical activity.
The biceps femoris is the most commonly injured hamstring muscle and the semitendinosus is the second most commonly injured. Although hamstring injuries often involve one muscle injured proximally, multiple muscles were involved in 33% of athletes (5/15) and the injuries were distal in 40% of athletes (6/15). All intramuscular injuries occurred at the musculotendinous junction, either at the ends of the muscle or within the muscle belly.
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