Musculoskeletal System Commons^™

Overcoming Thoracic Outlet Syndrome In A Young Athlete: A Case Study, Cormia Lewis, Christina Fry, Mark Knoblauch, Layci Harrison

Clinical Practice in Athletic Training

Introduction: Thoracic Outlet Syndrome (TOS) is a rare and complex condition caused by the compression of neurovascular structures in the thoracic outlet. TOS is estimated to affect 3 to 80 individuals per 1,000,000 annually, with neurogenic TOS accounting for approximately 95% of cases. Athletes who perform repetitive overhead motions are at higher risk due to increased stress on the brachial plexus. Diagnosis can be challenging as symptoms such as pain, numbness, and weakness, often mimic other conditions such as nerve entrapment or tendon pathologies. Treatment for TOS typically begins with a conservative approach, including postural correction and strengthening, activity modification, …

Impressions And Gastrointestinal Tolerance Of An Electrolyte Hydration Beverage Among Individuals Participating In Collegiate Baseball, S. Andrew Cage, Alexander Jacobsen, Brandon Warner, Jessie Gibson, Derek Lege, Robert French

Clinical Practice in Athletic Training

Context: Performing physical activity in numerous environmental conditions often results in mild to moderate dehydration. Dehydration can be problematic for the physically active population, as it can lead to decreases in physical and cognitive performance. This places emphasis on making sure individuals are properly hydrated during exercise. One of the barriers to appropriate hydration behaviors that has been identified in physically active individuals is a dislike of available hydration options. This highlights the need for sports medicine professionals to provide physically active individuals with appealing hydration options. Currently there is a lack of research exploring the flavor appeal of hydration …

Athletic Trainers’ Motivations For And Satisfaction With Transition To The Physician Practice Setting, Abigail G. Overstreet, Nicolette A. Harris, Cailee E. Welch Bacon

Clinical Practice in Athletic Training

An increasing number of athletic trainers are transitioning from traditional settings, such as secondary schools, colleges, universities, and professional sports, to physician practice. Although research suggests athletic trainers may be changing settings in search of better working conditions, little is known about their motivations for and satisfaction with the setting transition. The objective of this research was to explore athletic trainers’ motivations for and satisfaction with transition to the physician practice setting. A qualitative design was used to collect and interpret data. Eleven certified athletic trainers (6 women, 5 men; age 1⁄4 38.5 6 10.0 years) who transitioned from a …

Trust, Culture, And Conversation: How Athletic Training Leaders Navigate High-Stakes Interactions, Nicole A. Wilkins, Ashley B. Thrasher, Ericka P. Zimmerman

Clinical Practice in Athletic Training

Introduction: Engaging in difficult conversations is central to leadership growth and requires sustained effort to refine and strengthen these skills. Leaders not only need to navigate the complexities of their role within an organization, but also the intersectionality of interpersonal dynamics, emotional intelligence, structural hierarchies, and the nuanced environments that influence how communication occurs. Furthermore, leaders must adapt to role expectations that shift across clinical, academic, and administrative contexts, adjusting their approach to engaging in conversations based on these complexities. As part of a larger research project examining difficult conversations, this portion of the study explored how leaders in athletic …

Integrating Wearable Technologies Into Athletic Training: Bridging Innovation And Clinical Practice, Michael Douglas

Clinical Practice in Athletic Training

Athletic training is entering a transformative period driven by the convergence of wearable technologies, artificial intelligence (AI), and advanced biomechanical modeling. Historically, wearable technology in sport was primarily used for performance tracking, including workload monitoring, heart rate assessment, and movement quantification. However, advances in sensor accuracy and data analytics have expanded the clinical relevance of wearable systems, allowing athletic trainers to monitor fatigue markers, movement asymmetry, and neuromuscular control patterns that inform injury risk and rehabilitation progression. Wearable sensor technologies provide objective data that can support clinical decision-making when integrated with traditional evaluation methods.¹Despite these advancements, wearable technologies present persistent …

Recurrent Lateral Patellar Dislocation After Mpfl Repair With Subsequent Tibial Tubercle Anteromedialization And Concomiant Mpfl Reconstruction, Jacob Hardy, Anthony Thomas Drazick, Joshua Pratt, Jeremy M. Burnham

Clinical Practice in Athletic Training

Introduction: Patellar instability is a common knee pathology, particularly among adolescents and young adults, with reported incidence rates ranging from 7 to 77 per 100,000 person-years. Following an initial patellar dislocation, recurrence rates have been reported as high as 86%, particularly in patients with underlying anatomic risk factors. Identification of the multifactorial contributors to patellar instability is critical to guide appropriate management and prevent recurrent episodes. Common pathoanatomic factors associated with recurrent instability include trochlear dysplasia, patella alta, lateralized tibial tubercle, coronal or torsional malalignment, and abnormal patellar shift. This case report describes a patient who presented with a chronic …

Improving Entry-Level Athletic Training Student Confidence In Emergency Care: A Pilot Study, Michele Pye, Cade Watts, John Hunt, Kimberly Pritchard

Clinical Practice in Athletic Training

Introduction: Immediate and emergency care is essential to athletic training education and clinical practice. Athletic training students (ATS) may have limited exposure to emergencies during their clinical experiences, which can undermine their confidence. AT educators can improve ATS confidence and clinical reasoning using a simulation-based, learner-centered SNAPPS approach. SNAPPS consists of Summarizing the history and findings, Narrowing and Analyzing the differential diagnoses, Probing peers about uncertainties or confusion, Planning management, and Selecting case-related knowledge gaps for self-directed learning. This empowers students to control the learning environment while adding realism to encounters. The purpose of this pilot study was to determine …

Performance On The Timed Single-Leg Step-Down Test Is Correlated With Hip And Knee Biomechanics As Measured By 3d Markerless Motion Capture, Ghislain Aminake, Anthony Drazick, Christ Focht, Chloe Roy, Emily Clark, Savannah Knighton, Edward Austin, Jeremy Burnham

Clinical Practice in Athletic Training

Introduction: The timed single-leg step-down (SLSD) test is widely used in clinical and sports settings to assess lower extremity function and injury risk, yet the specific biomechanical determinants of performance on this test remain poorly understood. The purpose of this study is to investigate the relationship between performance on the timed SLSD test and hip and knee biomechanics captured by a markerless 3-D motion-analysis system. Methods: Twenty (20) healthy high school athletes with no recent history of lower extremity injury completed a 60-second timed single leg step down test. The number of quality SLSD repetitions (REPS) constituted their SLSD score. …

Bilateral Congenital Radioulnar Synostosis - Case Report, Derek A. Diangelis, Matthew J. Hudson

Advances in Clinical Medical Research and Healthcare Delivery

A 2-year-old male presented to an orthopedic outpatient office due to a supination defect in both of his upper limbs. X-rays of the affected limbs revealed fusion of the proximal radioulnar joints indicating congenital radioulnar synostosis (CRUS). CRUS is abnormal development of the upper limbs occurring during weeks 3—7 of embryological development. Causes of CRUS include genetic syndromes and spontaneous mutations. Treatment options include nonoperative and surgical treatments, however, treatment is controversial due to a lack of clinical evidence. Proposed screening methods could help improve detection rates and improve clinical management. This report aims to increase awareness of CRUS and …

Direct Effects Of Capsaicin On Voltage-Dependent Calcium Channels Of Mammalian Skeletal Muscle, Dmytro Isaev, Tatiana Prytkova, Badarunnisa Mohamed, Mohamed Omar Mahgoub, Keun-Hang Susan Yang, Murat Oz

Pharmacy Faculty Articles and Research

Capsaicin, a naturally occurring polyphenol, is known to affect energy expenditure and muscle fatigue and modulate contractions in skeletal muscle. The L-type Ca²⁺ channels are known to be an important ion channel involved in the various muscle functions and the effect of capsaicin on the skeletal L-type Ca²⁺ channels is currently unknown. In this study, the effects of capsaicin and capsaicin analogs on depolarization-induced Ca²⁺ effluxes through L-type Ca²⁺ channels in transverse tubule membranes from rabbit skeletal muscle and L-type Ca²⁺ currents recorded using the whole-cell patch clamp technique in rat myotubes were examined. Capsaicin, …

The Impact Of Heavy Resistance Training On Type Ii Muscle Fibers Throughout Female Reproductive Stages, Lily G. Colberg

Scripps Senior Theses

Type II muscle fibers, also known as fast-twitch muscle fibers, are reliant on aerobic glycolysis and are crucial for high-force contractions, mobility, and rapid movements, such as fast reflexes. Heavy resistance training has been found to increase type II muscle fiber concentration in young, middle-aged, and elderly individuals. However, there have been few studies conducted on female-only sample populations. In women, the impact of heavy resistance training on type II muscle fibers is affected by the progressive decline of estrogen that defines the transition throughout the four female reproductive stages: premenopause, perimenopause, late-transition menopause, and postmenopause. Menopausal estrogen depletion causes …

Sexually Dimorphic Effects Of Gpnmb Modulation On Vertebral Bone Mass Regulation And Intravertebral Disc Health, Hakem Altawil, Fayez Safadi

Williams Honors College, Honors Research Projects

Osteoporosis and vertebral degeneration are major contributors to musculoskeletal morbidity, yet the molecular mechanisms regulating vertebral bone and intervertebral disc (IVD) homeostasis remain incompletely understood. GPNMB (osteoactivin) has been identified as a regulator of bone remodeling, though its role in spine health is unclear. This study evaluated the effects of GPNMB deficiency on lumbar vertebral bone microarchitecture and IVD integrity in a sex-dependent context.

Six-month-old male and female wild-type (WT) and GPNMB knockout (KO) mice were analyzed using micro–computed tomography (µCT) of lumbar vertebrae (L4–L6) and histological assessment of the L5–L6 IVD. KO males exhibited increased bone volume fraction, bone …

The Relationship Between Phone Usage, Activity Participation, And Hand Strength, Debra Gibbs, Will Best, Raegan Adams, Amanda Finke, Rachel Pierce, Salem Swallows, Alisha Yoo

SPARK Symposium Presentations

Smartphone use among university students in the United States is steadily increasing. Longer duration of smartphone use has been associated with increased risk of smartphone addiction, reduced musculoskeletal strength, and engagement in meaningful activities. While prior research has examined these variables separately, limited evidence exists on the associations between smartphone use, hand grip and pinch strength, and extracurricular and leisure activities among U.S. university students. To address this gap, a correlational study was conducted using the Spearman rank correlation to analyze the relationship between phone use, activity participation, and hand strength. A Qualtrics survey including demographic information, phone usage, and …

The Impact Of Hot V. Cold Water Immersion On Post-Exercise Recovery, Cameron Moss, Aaron Krukemeyer

Williams Honors College, Honors Research Projects

Muscle recovery following exercise-induced soreness has been the focus of extensive research and debate, with Cold Water Immersion (CWI) and Hot Water Immersion (HWI) emerging as two of the most widely used modalities. The purpose of this study was to compare the effects of CWI and HWI on muscle recovery by determining changes in maximal force production of knee extension, range of motion (ROM) of the hip joint in flexion, extension, and abduction, and subjective muscle soreness using a validated Likert scale. Seven male recreational athletes participated in hot and cold-water immersion, and passive recovery. Despite thorough data collection, the …

Off-Label Uses Of Deucravacitinib For Inflammatory Skin Conditions: Cases And Literature Review, Alexandra Nigro, Isabel C. Silva, Benjamin Gerstein, Jasper Dayanan, Saakshi Khattri

Department Dermatology Faculty Publications

Deucravacitinib is an oral, selective, allosteric tyrosine kinase 2 (TYK2) inhibitor approved for the treatment of moderate-to-severe plaque psoriasis and psoriatic arthritis. Deucravacitinib may offer a more selective approach compared to traditional Janus kinase (JAK) inhibitors. Emerging data support the use of deucravacitinib in inflammatory dermatoses beyond psoriatic disease. We present our clinical experience using deucravacitinib off-label in patients with challenging inflammatory skin disease and contextualize our findings within the current literature. We report three female patients aged 31–63 years with refractory inflammatory skin conditions, including two with dermatomyositis and one with pityriasis rubra pilaris (PRP). All patients had persistent …

Biomechanical Integrity Of The Female Pelvic Floor: A Comparison Of Military And Civilian Women, Vladimir Egorov, Peter Takacs, Vincent Lucente, Heather Van Raalte, Joy A. Greer, Noune Sarvazyan

Department of Obstetrics & Gynecology Faculty Publications

Introduction

The health of the pelvic floor depends on the integrity of its muscles, connective tissue, ligaments, and their innervation. The female pelvic floor may be more vulnerable to repetitive heavy loads in a military environment than the male pelvic floor because of anatomical and physiological differences. The study aim was to identify and explore possible differences in the female pelvic floor conditions between active military and civilian women with similar demographics.To identify and explore possible differences in the conditions of the female pelvic floor between active military women and civilian women with similar demographics.

Materials and Methods

Military active …

Procedural-Based Contemporary Management Of Bell's Palsy Long-Term Sequelae: A Narrative Review, Robert M. Frederick, Rhorie Kerr, Eric Dobratz, William Dougherty

Department of Otolaryngology (ENT) Faculty Publications

Objective

To describe the long-term sequelae of Bell's palsy and summarize available treatment options, including recent advances, so that general otolaryngologists and other practitioners are aware of the clinical findings and available interventions.

Data Sources

PubMed.

Review Methods

A literature search was performed on December 18, 2024, via PubMed using keywords such as "synkinesis," "selective myectomy," "selective neurectomy," "botulinum toxin," "intervention" in the context of "Bell's palsy" with preference for articles published within the last 5 to 10 years but inclusion of select older articles that provided necessary context for the current topic. Articles included in the review were written …

The Sequence (S) Index As A Marker Of Diminished Step-To-Step Transition Efficiency In Older Adults, Elham Alijanpour, Ashwini Kulkarni, Peter G. Adamczyk, Daniel M. Russell

Rehabilitation Sciences Faculty Publications

Introduction: Age-related declines in walking efficiency are often attributed to musculoskeletal and neuromuscular changes, yet the mechanisms underlying these inefficiencies remain poorly understood. One key contributor is the step-to-step transition (STST), during which the center of mass (CoM) is redirected between limbs. The Sequence (S) index quantifies the temporal overlap between push-off and collision forces during STST, with higher values indicating greater mechanical energy loss. This study investigated whether aging affects STST efficiency, as quantified by the S index, and examined the timing and impulse characteristics underlying observed differences.

Methods: Thirteen young and eleven older healthy adults walked at five …

Morphological Variation Of The Clavicular Rhomboid Fossa: Bilateral Asymmetry, Sexual Dimorphism, And Environmental Influences, Michaela Tucker, Skylar Hall

Williams Honors College, Honors Research Projects

Morphological variation on the clavicle, specifically the rhomboid fossa, may be impacted by age, sex, laterality, and mechanical stress. Occupational stress and loading conditions lead to bone remodeling and adaptation to change, altering the costoclavicular ligament site. A sample of 94 bilateral clavicles from individuals ages 16-40 years was analyzed using computer tomography (CT) and 3-dimensional reconstruction. Clavicles were categorized into five groups: flat, smooth, elevated, depressed, and pitted. Chi-squared analyses were used to test associations between morphology and age, side, and history of strenuous lifting. Significant differences were observed between class and sex for the leftsided clavicle group. Female …

The Development And Implementation Of A Computational Framework To Simulate Patellofemoral Joint Mechanics, Mahmood Rashedi

Master’s Theses

Anterior knee pain affects approximately 25% of adults and is associated with altered joint mechanics. Patellofemoral joint (PFJ) models vary widely in complexity, with no established gold standard. Musculoskeletal models efficiently estimate joint loading but do not capture tissue-level mechanics, whereas finite element (FE) models provide tissue-level predictions at greater computational cost. This thesis developed a workflow to evaluate relationships between musculoskeletal model-predicted PFJ loads and FE-predicted cartilage mechanics, examined the impact of altered quadriceps activation, and introduced improved computational models.

Marker trajectories and ground reaction forces were collected from four adults (2 male, 2 female) during walking and squatting. …

Magnesium-Based Metal Matrix Nanocomposite Implants And Nanobubble-Based Delivery Systems: Integrated Strategies For Bone Loss Treatment With Cytocompatibility Evaluation, Lucas José Martinho Bizuti

Honors Undergraduate Theses

This thesis intends to investigate the development of different multimodal therapeutic strategies for combating bone loss. Most specifically, this paper will emphasize the utilization of Magnesium-Based Metal Matrix Nanocomposite Implants (MMNC) and Nanobubble-Based Delivery Systems as options for future treatment focus. The effects of biodegradable magnesium implants were evaluated for cytotoxicity and cytocompatibility via Hematoxylin and Eosin, and Masson’s Trichrome staining, as well as radiological images. The Nanobubble-Based Delivery System is being developed and optimized as a delivery system to target osteoclast activity. This paper focused on optimizing experimental parameters, which include Rotational speeds for nanobubble stimulation under microgravity conditions …

Relationships Between Quadriceps Neuromuscular Function And Time From Surgery Following Acl Reconstruction Are Sex-Specific, Tatiana Restrepo

Honors Undergraduate Theses

Anterior cruciate ligament reconstruction (ACLR) is associated with persistent quadriceps dysfunction, including muscular weakness and altered spinal and cortical excitability. While recovery has been widely studied, most investigations focus on isolated domains and fixed postoperative time points. Emerging evidence suggests females often experience slower or less complete quadriceps recovery compared to males, yet the time-dependent nature of these sex-specific outcomes remains unclear. The purpose of this study is to examine whether relationships between time since ACLR and quadriceps neuromuscular outcomes differ by sex across muscular, spinal, and cortical domains. Adults aged 18–35 with a history of primary, unilateral ACLR were …

Skeletal Muscle Myofiber Development In Non-Human Primate Offspring Deprived Of Estrogen In Utero, Phillip J. Gauronskas, Terrie J. Lynch, Eugene D. Albrecht, Gerald J. Pepe

Department of Biomedical and Translational Sciences Faculty Publications

Introduction: We previously showed that baboon offspring born to mothers deprived of estrogen during the second half of gestation exhibited insulin resistance prior to and after the onset of puberty. Moreover, the size of skeletal muscle myofibers and the number of microvessels important for delivery of insulin/glucose to myofibers were lower in near-term fetuses deprived of estrogen during pregnancy, and myofiber capillarization remained reduced in post-pubertal offspring deprived of estrogen in utero. However, it remains to be determined whether skeletal muscle size is restored to normal in animals deprived of estrogen in utero after the onset of puberty/gonadal estrogen production. …

Localization And Functional Exploration Of Leiomodin-2'S C-Terminal Binding Sites, Mason D. Summers, Madison Little, Robert P. Young, Brayan Osegueda, Alan Palma Guillen, Garry E. Smith Jr., John R. Cart, Vitold E. Galkin, Alla S. Kostyukova

Department of Biomedical and Translational Sciences Faculty Publications

Striated muscle contraction occurs through interactions between overlapping myosin-based thick and actin-based thin filaments within the sarcomere. For effective contraction to occur, the length of the thin filament must be maintained to ensure sufficient overlap with the thick filament. The proteins leiomodin and tropomodulin compete for binding at the pointed ends of thin filaments to regulate their length, using their homologous N-terminal actin and tropomyosin binding sites. Leiomodin also contains a region called the C-terminal extension, absent in tropomodulin. In this region, the cardiac isoform (leiomodin-2) contains additional actin-binding sites that enable it to bind along the sides of thin …

Osteopathic Manipulative Treatment For Pain With Medication And Opioid-Sparing Effects: A Narrative Review, Austin Buroker, Matthew A. Savallo, Ryan Relyea, Matthew Eximond, Dennis Besong

South Atlantic Division GME Research Days 2026

No abstract provided.

Don't Drink And Game: A Dual Mechanism Myelopathy Case Report, Benjamin Smith, Eyovel Eyassu, Sweta Thakur

South Atlantic Division GME Research Days 2026

No abstract provided.

Failure Rates And Patient-Reported Outcomes Are Similar Across 5 Arthroscopic, Suprapectoral Bicepts Tenodesis Fixation Techniques, Senah E. Stephens, Samantha M. Strohm, Rachael M. Shaughnessy, Katherine S. Worcester, Kevin F. Bonner

Department of Medicine Faculty Publications

Purpose

To compare failure rates and patient‐reported outcome measures (PROMs) across 5 arthroscopic, suprapectoral biceps tenodesis fixation techniques: tenodesis screw, tenodesis anchor, expanding tenodesis anchor, onlay with single all‐suture anchor, and soft tissue tenodesis in the bicipital groove with suture.

Methods

This was a retrospective cohort study approved by the Institutional Review Board, including patients age 18 years or older who underwent arthroscopic, suprapectoral biceps tenodesis between 2014 and 2024 with a minimum of 6 months of clinical follow‐up. Exclusion criteria included cervical pathology, chronic pain syndromes, revisions, and workers' compensation cases. Patients completed PROMs including pain Visual Analog Scale …

Failure Rates And Patient-Reported Outcomes Are Similar Across 5 Arthroscopic, Suprapectoral Biceps Tenodesis Fixation Techniques, Senah E. Stephens, Samantha M. Strohm, Rachael M. Shaughnessy, Katherine S. Worcester, Kevin F. Bonner

Department Surgery Faculty Publications

Purpose

To compare failure rates and patient-reported outcome measures (PROMs) across 5 arthroscopic, suprapectoral biceps tenodesis fixation techniques: tenodesis screw, tenodesis anchor, expanding tenodesis anchor, onlay with single all-suture anchor, and soft tissue tenodesis in the bicipital groove with suture.

Methods

This was a retrospective cohort study approved by the Institutional Review Board, including patients age 18 years or older who underwent arthroscopic, suprapectoral biceps tenodesis between 2014 and 2024 with a minimum of 6 months of clinical follow-up. Exclusion criteria included cervical pathology, chronic pain syndromes, revisions, and workers' compensation cases. Patients completed PROMs including pain Visual Analog Scale …