Revista de medicina deportiva y estudios de dopaje

We report the case of a 57 year old female patient presenting with longstanding diffuse ankle pain. SPECT-CT was useful in making the diagnosis of an intraosseous ganglion of the posterior talus. The patient was treated with posterior arthroscopic debridement of the cyst via a two portal approach and grafting with an injectable synthetic bone graft substitute (PRO-DENSE®). The patient experienced rapid relief of pain and made a quick recovery. The surgical technique is discussed as well as a review of the current literature.

Study Background: Hamstrings strains are very common in soccer players and their rehabilitation involves a demanding process which may be considerably time consuming depending on the severity of the injury. Traditional treatment for these injuries includes conservative forms of treatment such as gentle massage, passive stretching, electrotherapy and functional exercises during training. The aim of this case study was to evaluate the effectiveness of an aggressive rehabilitation program in the treatment of grade I hamstring strain in a professional athlete.

Methods: A 30 year old professional soccer player clinically diagnosed with grade I hamstrings’ strain underwent a 15 days aggressive rehabilitation program. This included aggressive massage techniques with cups, instruments and stripping techinques, cryostretching/cryokinetics exercises, core strengthening and supervised functional exercises in the field.

Results: The applied aggressive rehabilitation techniques reduced the conventional time of the athlete’s absence from sports participation by almost 50%. In addition, further relapses in the following period were prevented.

Conclusion: This case study provides some evidence that aggressive physiotherapy techniques can reduce the absence from sports participation after hamstrings strain. Implementation and testing of these techniques in large randomised control studies is necessary for securing firm conclusions regarding their effectiveness in muscle strain rehabilitation.

Intense exercise is a physiological stress capable of inducing damage in the exercised muscle group. As a consequence of this exercise-induced micro lesion, there is an increase in the interaction of leukocytes (neutrophils and monocytes/macrophages) with muscle endothelial cells and their transmigration into skeletal muscle tissue. Mechanisms driving this physiological response are not known, but exercise-induced muscle damage may be associated with a local inflammation involving leukocyte accumulation in damaged muscle tissue. Important recent findings show that this infiltration of leukocytes plays an important role in the skeletal muscle remodeling process by activating angiogenesis and hypertrophic pathways inside the skeletal muscle tissue. There are some speculations suggesting that this inflammatory process should be controlled by anti-inflammation drugs in athletes to accelerate the recovery time. Investigations of the literature in this field up to this point do not offer a sufficient body of evidence confirming the need for an anti-inflammatory drug administration to control the exercise-induced inflammation. On the other hand, anti-inflammatory drug administration as a supplemental diet could inhibit important pathways of tissue adaptative responses and block the benefits of exercise to the skeletal muscle tissue.

The massive doping schemes that surfaced in professional cycling suggest that riders’ performances, realized in the controversial ‘epo era’ (>1990), are a cut above achievements delivered by their forerunners. We examined this superior performances assumption (SPA) by conducting six historic studies, which all scrutinized archival records of winning riders’ stage race and time trial performances demonstrated in the three European Grand Tours (Tour de France, Giro d’Italia, and Vuelta a España; 1903–2013), including Lance Armstrong’s wins. Findings revealed that all riders’ wins in the epo years are no exception to the variability in speed progress observed in the three races over time and none of their achievements proved to be outliers. This also holds true for Armstrong’s performances. These findings agree with results of a meta–analysis of epo studies we conducted, indicating that the ergogenic effects of epo and blood doping on riders’ aerobic performances and associated cycling speeds are overrated. In conclusion, we argue that our observations render the SPA doubtful. They also made us realize that arguments used in contemporary discussions about effects of doping in cycling often involve psychological biases, false reasoning and fabrications. They are presented in the closing sections of this contribution.