A dissertation submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Science in Physiotherapy Johannesburg, 2017 / This research makes a meaningful contribution to the development of effective injury prevention strategies among adolescent cricket pace bowlers. This dissertation, specifically investigated two screening procedures, the Functional Movement Screen (FMS) and ultrasound measured abdominal wall muscle thickness, both of which aim to predict injury among the general and sporting population. More specifically, the dissertation investigated the applicability of these screening procedures to adolescent cricket pace bowlers. Adolescent pace bowlers are prone to injury due to the high load and complex nature of the bowling action as well the risk factors associated with the adolescent growth spurt. Studies related to the validity of the FMS in terms of the prediction of injuries among various sporting disciplines have been conducted but none among cricket pace bowlers. Studies related to the association between abdominal wall muscle morphometry (i.e. thickness at rest and during the performance of abdominal drawing in manoeuvre (ADIM), as measured by ultrasound imaging (USI), and injury among professional and amateur cricket pace bowlers have had conflicting results and limited research related to abdominal muscle morphometry among the adolescent pace bowlers exist. Adolescent pace bowlers that were injury free at the start of the season were recruited for this study. Details related to the nature of past injuries as well as injuries sustained during the season were monitored and recorded over a three month period. Included in this dissertation are three original papers. The first two investigated the association between prospective in-season injury and the two above mentioned screening procedures. The third investigated the concurrent validity of FMS overhead deep squat (DS) when observer rating was compared to kinematic analysis. The first paper (Chapter 4) investigated the association between muscle morphometry of transverse abdominis (TA), internal oblique (IO) and external oblique (EO), as measured by USI, at the start of the season and in-season injury. Results indicated that non-dominant internal oblique is thicker than dominant IO (p=0.01, effect size (ES) =0.65) in injury free pace bowlers but that non-dominant and dominant internal oblique (p=0.47; ES=0.24) is symmetrical in injured pace bowlers. Based on these findings we concluded that asymmetry in IO thickness may play a protective role against injury rather than being a predisposing risk factor to injury. The second paper (Chapter 5) investigated the association between pre-season total FMS score and in-season injury among adolescent pace bowlers. Results indicated that there was no significant difference in total pre-season FMS scores of bowlers that sustained injuries during the season and those that remained injury free (p=0.58). Also, a total FMS score of 14 (the score previously found to be an accurate cut-off score) does not provide the sensitivity needed to assess injury risk among adolescent pace bowlers. It was therefore concluded that the FMS was not associated with in-season injury among adolescent pace bowlers and that the usefulness of this tool in the prediction of injuries among these cricketers is doubtful Paper 3 (Chapter 7) investigated the concurrent validity of the overhead DS included in the FMS when observer rating is compared to kinematic analyses. The FMS attempts to systematically score the quality of movements, among other the DS, based on specific criteria. The developers of the FMS suggest that specific mechanics related to the DS differ between levels of scoring. There were significant differences in the degree to which the torso was flexed forward, away from the vertical (p=0.03), where groups 3 and 2 (i.e. those participants who scored a rating of 3 and 2 respectively for the performance of the DS) remained more upright compared to Group 1. There was also a significant difference in the degree to which the femur passed the horizontal line (p=0.05) between the three groups. At the point of deepest descent, the femurs of Groups 3 and 2 were below the horizontal while that of Group 1 remained above. The findings of this part of the study suggest that, while raters correctly identified differences in biomechanics between groups for two of the scoring criteria (femur below horizontal and feet remaining flat on floor or board) , they did not rate the groups correctly for the remaining criteria. The concurrent validity of the observer rating of the FMS DS is therefore questionable. In conclusion, the high load nature and complexity of the pace bowling action together with the intrinsic risk factors related to the adolescent growth spurt, expose school boy cricket pace bowlers to injury. The ability of these screening procedures to accurately identify individuals at risk of sustaining injuries are therefore of the utmost importance. Despite the popularity of the FMS, the concurrent validity of this screening tool and its lack of association with in- season injury among adolescent pace bowlers brings the use of FMS into question. Symmetry, not asymmetry, of the IO and under-, not over-activation of the dominant TA muscles were associated with in-season injuries among pace bowlers. All of the above conflicting findings pose uncertainty regarding the applicability of these screening procedures to injury prediction among adolescent cricket pace bowlers. / MT2017

A Dissertation Submitted to the Department of Physiology, University of the Witwatersrand,Johannesburg for the Degree of Master ot Science / Extensive disruption of muscle fibres has been shown to occur after short term eccentric exercise where high mechanical forces are generated. This study tested whether downhill running acts as a stimulus for inducing eccentric damage, and results in greater muscle damage and deterioration in muscular performance than an equal workload of uphill running. The study aimed at determining whether an adaptation or training effect takes place such that the muscle is more resistant to the damaging effects of a repeated bout of the same exercise. In. addition, the study aimed at determining whether the lower muscle volumes and forces of muscular contractions in females compared to males, makes females less susceptible to the damaging effects of eccentric contraction.(Abbreviation abstract) / Andrew Chakane 2019

A double-blind, placebo controlled research technique was used to determine the effects of two non-steroidal anti-inflammatory drugs, meclofenamate and diclofenac, in combination with physiotherapy treatment, on the rate and extent of healing of acute hamstring muscle tears. Sixty patients were recruited and treated at No's 1 and 2 Military Hospitals in Voortrekkerhoogte and Wynberg, Cape Town, respectively. Patients were randomly allocated to one of three treatment groups: meclofenamate, diclofenac and placebo. Patient assessments were performed on days 1, 3 and 7 of the 7-day study period. These assessments included pain assessment (visual analogue scale), swelling measurement (thigh circumference measurement at the site of the muscle tear) and muscle performance test (Cybex isokinetic dynamometer and data reduction computer). All patients received physiotherapy treatment on all 7 days of the study. This comprised early rest, ice, compression and elevation (RICE), and later, ultrasound and deep transverse friction massage. An intensive regime of strengthening and stretching exercises was used throughout the study, beginning with stretching and isometric exercises gradually moving onto isotonic exercises and aerobic exercise including swimming, running and cycling. No competitive sport was allowed during the study period. Statistical significance was determined using the analysis-of-variance (ANOVA) test with an acceptance level of p<0.05. No differences in pain, swelling or muscle performance were demonstrated between the three treatment groups. In terms of the pain and swelling assessments, the injuries did not appear to be very severe. Accordingly, the groups were divided into severe and non-severe sub-groups and statistical significance was determined using the ANOVA test with an acceptance level of p<0.05. A significant difference was found in the severe hamstring injury sub-group. In this group, pain reduction was greater in the placebo group than in the meclofenamate group on day 7. There were no other significant differences found in this sub-group analysis. Relatively few side effects were encountered, and those encountered were mild. No patients were withdrawn from the study as a result of these adverse events. Drowsiness and gastro-intestinal disturbance were the most common side effects reported. In conclusion, the study found that no benefit was gained from the use of meclofenamate or diclofenac in combination with physiotherapeutic modalities as compared to the use of physiotherapeutic modalities on their own. Thus, the widespread use of NSAIDs in the treatment of acute muscle injuries may not be justified.