Background: Lateral epicondylalgia (LE) is a cumulative strain injury affecting the common extensor origin of the elbow, manifesting as lateral elbow pain. Tightness of the fascia connecting the lateral elbow area with the shoulder area was assumed as potential source of LE. Limitation in shoulder rotatory motions may be associated with painful LE elbows. Aim: To determine the difference on shoulder rotatory motions between sides of symptomatic and asymptomatic elbows. Methods: Eligible participants had at least one elbow that tested positive for Cozen, Mill, or Maudsley’s test. Using a universal goniometer, a blinded assessor measured the participants’ active and followed by passive shoulder internal and external rotation. The primary investigator tested the external rotation followed by internal rotation of the right upper extremity, then subsequently the left upper extremity of healthy participants both passively and actively Results: The assessor showed excellent intra-tester reliability in measuring active and passive shoulder rotatory motions of 20 asymptomatic right upper extremities (ICC=0.98). Twenty-seven (27) participants (3 males, 24 females) with a mean (95%CI) age of 54 (49-58) years old were enrolled in the study. The mean visual analogue scale of the patients was 6.53 (5.91- 7.13), with mean (95%CI) duration of 96 (50-142) weeks. Based on hand dominance and side of LE, significant difference was found in active and passive shoulder internal rotation (p>0.05). Conclusion Shoulder active and passive internal rotations were significantly associated with hand dominance in patients with LE. Tightness of the fascia and muscle in the shoulder and painful LE elbow may underpin the decreased shoulder rotatory motions.
Tennis Elbow ; Shoulder ; Fascia

BACKGROUND: Ankle inversion sprain is a common musculoskeletal injury due to an inward foot twist. It results in pain, swelling, limited movement, instability, and tenderness of the injured ankle. Standard physical therapy (PT) for acute ankle inversion sprain involves cryotherapy, range of motion, balance, and strengthening exercises. Biomechanical Taping (BMT) is an adjunct to PT. OBJECTIVES: To identify the short-term effects of BMT and PT on pain and function of individuals with acute ankle inversion sprains. METHODS: Two licensed physiotherapists screened the participants. Eligible participants were treated 3x/week with BMT and PT, with a day of home exercises in between treatments. Participants answered the Visual Analogue Scale (VAS) and Foot and Ankle Ability Measure (FAAM). Friedman Test was used to determine differences in prepost measurements of VAS and FAAM. RESULTS: 17 participants (10 males: 7 females) with unilateral acute ankle inversion sprains were included in the study with a mean (95% CI) age of 21 (20-22) years. BMT and PT (a) decreased VAS mean rank scores at Treatments 3 and 5 (p<0.05); (b) improved FAAM-ADL mean rank scores in Treatments 1 and 3 (p<0.05); (c) improved FAAM-Sports mean rank scores in all Treatments (p<0.05); and (d) improved in VAS, FAAM ADL and Sports scores between Treatment 1, Treatment 2 and Treatment 3 (p<0.00001). CONCLUSION BMT may be an effective adjunct to PT in improving pain and function of participants with acute ankle inversion sprains. The increased stability created by BMT may underpin the improved pain and function of participants.
Ankle Injuries ; Fascia ; Lateral Ligament, Ankle ; Pain

BACKGROUND: Myofascial Pain Syndrome (MPS) is a persistent pain on the shoulders and cervical spine related to limitation of motion (LOM), muscle weakness, and loss of function. It is a cumulative, repetitive injury causing disability among the middle-aged working population. This study will determine the differences in upper trapezius' superficial and deep fascia displacements among participants with and without MPS based on the effects of cervical active range of motion (AROM). METHODS: This is a retrospective records review study with two interlinked parts. In the reliability study, the Tracker will determine the physiotherapy interns' intertester and intratester reliability in assessing the musculoskeletal ultrasound videos. Using MedCalc Software and the Bland-Altman plot, the single measures ICC will determine the reliability. In determining clinically acceptable use of the Tracker, a <0.40 cut-off reliability will be used. In the case-control study, physiotherapy interns will assess 2,904 musculoskeletal ultrasound videos. The difference between the superficial and deep fascia displacements will be determined using paired t-test and the mean differences using an independent t-test. A significant difference between groups will be determined using a p-value of <0.05. RESULTS This study expects that cervical AROM with overpressure will displace the superficial and deep fascia of the upper trapezius, particularly among patients with MPS. Proving the correlation between LOM and altered fascia displacement will help rehabilitation professionals create new manual therapy techniques and emphasize the use of existing fascia-related treatments.