The monotonous and strenuous shoulder moving pattern during throwing may result in microtrauma and fibrous adhesions between the layers of fascia among athletes. In the last decade, self myofascial release (SMR) has gained good reputation as a way to treat these adhesions. However, there is limited data demonstrating the effects on upper body performance among athletes. PURPOSE: The purpose was to examine the effects from an acute bout of upper body SMR or from dynamic stretch (DS), on shoulder range of motion (ROM), throwing velocity and throwing accuracy. Also to examine correlations between shoulder ROM and throwing velocity/accuracy and between playing experience (PE) and changes in throwing velocity/accuracy and ROM. METHODS: 20 elite male handball players (age 20 ± 5 years, weight 84 ± 9 kg) were included in the study. The study had an experimental cross-over design in which participants first performed baseline measures. They also performed SMR and DS in two different trials. The trials were supervised and separated by 14 days. During SMR, the athletes performed a series of foam rolling exercises during two minutes for the muscles surrounding the shoulder joint. The same muscles were stretched for two minutes during the DS trial. Directly after foam rolling and DS, shoulder ROM, throwing velocity and throwing accuracy were measured using a gravity reference goniometer, radar gun and a high speed videocamera. ANOVA with repeated measures and t-tests were used to analyze differences between and within groups. RESULTS: There were no statistically significant differences in either shoulder ROM, throwing velocity or throwing accuracy between the three trials. There was a moderate correlation between shoulder extension and mean accuracy (r = 0.62; p = 0.004) after DS. When dividing the group into high and low experienced players, among the players in the PE-low group, the most experienced players elicited the greatest increase in peak throwing velocity after DS (r = 0.58; p = 0.10). Change in peak accuracy showed moderate but conflicting correlations after SMR (r = -0.53; p = 0.09) and DS (r = 0.50; p = 0.11) for the players in the PE-high group, indicating a better result after SMR. CONCLUSION: An acute bout of upperbody SMR does not affect ROM and does not improve throwing velocity or throwing accuracy compared to baseline or DS among elite male handball players. Nor could any correlation between ROM and throwing velocity or throwing accuracy be observed. The associations between PE and throwing performance was inconclusive. Further studies is needed to define if PE should be taken into consideration when using SMR or DS in order to improve throwing performance.

Background: Self-myofascial release is widely used by athletes but the scientific evidence of its supposedly positive effects is limited. This study was conducted to investigate the effects of foam rolling as a warm-up routine in comparison with a dynamic stretching routine and how it may affect the jumping performance among subjects familiar with weight training. Aim: The aim of this study was to investigate the acute effect of foam rolling vs. a standardized dynamic stretch warm-up routine on jumping performance. Method: Twelve subjects, mean (SD) age 25.1 (± 3.0) years, participated in a randomized, controlled, crossover study. All subjects completed a standardized foam rolling (FR) and a dynamic stretch (DS) warm-up routine on separate days of testing. Squat jump (SJ), counter movement jump (CMJ) and loaded counter movement jump (L-CMJ) all performed bilaterally and unilaterally were conducted to investigate the acute effect of the two warm-up routines. A dependent T-test was used to investigate differences between the warm-up routines. Results: A statistical significant difference in favor of the DS was found for SJ performed bilaterally among males (p = 0.009). The mean (SD) jumping height for SJ FR was 35.6 (± 4.7) cm and for SJ DS 37.9 (± 5.2) cm. The male group also improved more in L-CMJ performed on the right leg with an external load of 54kg after DS compared to FR. No other statistical significant differences were found between the two interventions. A near statistical significant difference was found for SJ performed bilaterally for the total sample (p = 0.057) also in favor of the DS. The mean (SD) jumping height for SJ FR was 29.3 (± 8.7) cm and for SJ DS 30.5 (± 9.9) cm. Conclusion: Findings from this study supports a dynamic stretch warm-up routine prior to performing high intensity bilateral plyometrics instead of a foam rolling warm-up routine. However the data was inconsistent and more research with larger sample sizes is needed to further investigate the possible effects of foam rolling as a warm-up routine on jumping performance performed both bilaterally and unilaterally.

Bakgrund: Fotleden används dagligen och en nedsatt fotledsrörlighet kan orsaka många problem för personer i vardagen. Knäböj är en rörelse som används både i vardagen samt i träningssammanhang och kräver en god dorsalflexion i fotleden. Det är därför värdefullt att som fysioterapeut veta vilken metod som ökar dorsalflexion inför ett rehabiliteringsprogram där knäböj ingår. Syfte: Sammanställa litteraturen gällande akuta effekter av dynamisk och statisk stretching samt posterior talocrural glide på dorsalflexion i talocruralleden hos friska individer, definierat som personer utan fysiologisk sjukdom eller trauma med eventuell påverkan på fotleden. Studien syftar även till att värdera graden av evidens för behandlingarna. Metod: Litteratursökning utfördes i databasen PubMed. Slutligen inkluderades åtta studier med sammanlagt 141 deltagare. Samtliga studier kvalitetsgranskades enligt PEDro scale, därefter användes SBU:s GRADE för evidensbedömning. Resultat: Statistisk signifikant ökning på dorsalflexion för samtliga metoder med liknande utslag på rörlighet, med liten fördel för statisk stretch. Kvalitetsgranskning enligt PEDro scale visar på att fem studier anses vara av måttlig till hög kvalitet och tre anses vara av låg kvalitet. Otillräckligt vetenskapligt underlag för posterior talocrural glide, statisk och dynamisk stretch på dorsalflexion. Konklusion: Statisk stretch, dynamisk stretch och posterior talocrural glide ökar dorsalflexionen efter minst två minuters behandling. Evidensen talar för att samtliga metoder ger liknande utfall på dorsalflexionen med en liten fördel för statisk stretch, men fler studier behövs för att bekräfta resultatet. / Background: Demands are put on the ankle daily. Limited ankle range of motion can present problems during daily activities. The squat is a movement performed both in everyday life as well as in the context of training and requires ample dorsiflexion of the ankle. Therefore, it is of value to physiotherapists to know which method should be used to increase dorsiflexion in a rehabilitation protocol where the squat is included. Objective: To provide an overview of the acute effects of static and dynamic stretching as well as posterior talocrural glide in healthy individuals without physiological diseases or trauma relating to the ankle. The study will also assess the level of evidence surrounding each of these methods. Method: The database PubMed was used to search for the included studies. A total of eight studies was included in this review, with a total of 141 participants. Study quality was judged using PEDro scale, after which SBU’s GRADE was used to determine the level of evidence for each method. Result: A statistically significant increases present for each of the methods, with similar outcomes on the dorsiflexion. Assessing the quality of the included studies with PEDro scale resulted in five studies of moderate to high quality and three of low quality. Evidence supporting posterior talocrural glide, static and dynamic stretching is deemed insufficient according to SBU’s GRADE. Conclusion: Dorsiflexion is increased after two minutes of static and dynamic stretching as well as posterior talocrural glide. The evidence suggests that similar increases are present with each method, with static stretch showing a slightly higher result. However further research is required to confirm the result.

Background: Mechanical ventilation (MV) inflicts stress on the lungs, initiating or increasing lung inflammation, so-called ventilator-induced lung injury (VILI). Besides overdistention, cyclic opening-and-closing of alveoli (atelectrauma) is recognized as a potential mechanism of VILI. The dynamic stretch may be reduced by positive endexpiratory pressure (PEEP), which in turn increases the static stretch. We investigated whether static stretch modulates the inflammatory response of rat type 2 alveolar epithelial cells (AECs) at different levels of dynamic stretch and hypothesized that static stretch increases pro-inflammatory response of AECs at given dynamic stretch. - Methods: AECs, stimulated and not stimulated with lipopolysaccharide (LPS), were subjected to combinations of static (10, 20, and 30%) and dynamic stretch (15, 20, and 30%), for 1 and 4 h. Non-stretched AECs served as control. The gene expression and secreted protein levels of interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), and macrophage inflammatory protein 2 (MIP-2) were studied by real-time polymerase chain reaction (RTqPCR) and enzyme-linked immunosorbent assay (ELISA), respectively. The effects of static and dynamic stretch were assessed by two-factorial ANOVA with planned effects post-hoc comparison according to Šidák. Statistical significance was considered for p < 0.05. - Results: In LPS-stimulated, but not in non-stimulated rat type 2 AECs, compared to nonstretched cells: 1) dynamic stretch increased the expression of amphiregulin (AREG) (p < 0.05), MCP-1 (p < 0.001), and MIP-2 (<0.05), respectively, as well as the protein secretion of IL-6 (p < 0.001) and MCP-1 (p < 0.05); 2) static stretch increased the gene expression of MCP-1 (p < 0.001) and MIP-2, but not AREG, and resulted in higher secretion of IL-6 (p < 0.001), but not MCP-1, while MIP-2 was not detectable in the medium. - Conclusion: In rat type 2 AECs stimulated with LPS, static stretch increased the proinflammatory response to dynamic stretch, suggesting a potential pro-inflammatory effect of PEEP during mechanical ventilation at the cellular level.