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The following electronic only articles are published in conjunction with this issue of BJSM.

Hip fracture-dislocation in football: a report of two cases and review of the literature

E Giza, K Mithoefer, H Matthews, et al

Soccer is the world’s most popular sport, with over 200 million participants world wide. Fractures account for only 4–9% of acute injuries, and hip fracture-dislocation is extremely uncommon. However, the potentially serious long term sequelae of this injury means that team doctors should be alert to it. Two cases are here reported of traumatic hip fracture-dislocation in recreational soccer players sustained by low energy mechanisms. Prompt reduction and fixation are important to produce a stable and congruent joint.

(Br J Sports Med 2004;38:e17)

Effect of submaximal contraction intensity in contract-relax proprioceptive neuromuscular facilitation stretching

B Feland, H N Marin

Objective: To determine if submaximal contractions used in contract-relax proprioceptive neuromuscular facilitation (CRPNF) stretching of the hamstrings yield comparable gains in hamstring flexibility to maximal voluntary isometric contractions (MVICs).

Method: Randomised controlled trial. A convenience sample of 72 male subjects aged 18–27 was used. Subjects qualified by demonstrating tight hamstrings, defined as the inability to reach 70° of hip flexion during a straight leg raise. Sixty subjects were randomly assigned to one of three treatment groups: 1, 20% of MVIC; 2, 60% of MVIC; 3, 100% MVIC. Twelve subjects were randomly assigned to a control group (no stretching). Subjects in groups 1–3 performed three separate six second CRPNF stretches at the respective intensity with a 10 second rest between contractions, once a day for five days. Goniometric measurements of hamstring flexibility using a lying passive knee extension test were made before and after the stretching period to determine flexibility changes.

Results: Paired t tests showed a significant change in flexibility for all treatment groups. A comparison of LS means showed that there was no difference in flexibility gains between the treatment groups, but all treatment groups had significantly greater flexibility than the control group.

Conclusion: CRPNF stretching using submaximal contractions is just as beneficial at improving hamstring flexibility as maximal contractions, and may reduce the risk of injury associated with PNF stretching.

(Br J Sports Med 2004;38:e18)

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