Background: Chronic lateral epicondylitis (LE), also known as tennis elbow, affects 1–3% of the population, primarily those over 40 years old. Most cases resolve with conservative treatments, but some require more advanced interventions. Extracorporeal shockwave therapy (ESWT) has emerged as a non-surgical treatment option, utilizing either low- or high-energy levels to alleviate pain and improve function. Objective: This study aimed to compare the efficacy of low-energy versus high-energy ESWT in the treatment of chronic LE, focusing on pain relief and functional improvement. Methods: A retrospective observational study was conducted including patients treated for chronic LE between 2021 and 2024. Participants were divided into two groups: low-energy ESWT (0.10 mJ/mm²) and high-energy ESWT (0.20 mJ/mm²). Both groups received 2400 pulses at a frequency of 6 Hz once a week for three weeks. Pain and functional outcomes were measured using a visual analog scale (VAS) and the Patient-Rated Tennis Elbow Evaluation Questionnaire (PRTEE) at the baseline, three months (T1), and six months (T2) post-treatment. Results: Forty-six patients participated, with 24 in the low-energy group and 22 in the high-energy group. Baseline demographics and clinical characteristics were similar across groups. At T1 and T2, the low-energy group showed significantly greater reductions in the VAS scores (T1: 4.45 ± 0.8 vs. 3.6 ± 1.7, p = 0.04; T2: 3.2 ± 1.2 vs. 2.1 ± 1.1, p = 0.004) and PRTEE scores (T1: 34.3 ± 6.9 vs. 26.8 ± 11.9, p = 0.03; T2: 25.3 ± 6 vs. 17.6 ± 9, p = 0.005). Significant treatment–time interactions were observed for both the VAS and PRTEE scores, indicating sustained improvements in the low-energy group. Conclusions: Low-energy ESWT was more effective than high-energy ESWT in treating chronic LE, providing greater and longer-lasting pain relief and functional improvement. These findings suggest that low-energy ESWT should be preferred in clinical practice for managing this condition. Future research should focus on larger sample sizes and randomized controlled trials to confirm these results and explore the underlying mechanisms of differential efficacy between energy levels.

Background: The rehabilitative treatment of muscle injuries is mostly conservative, but it does not always follow precise protocols. Appropriate physiotherapy, exercises, and training are essential components of the rehabilitation and reconditioning of injured muscles. The purpose of this review is to assess the good rehabilitative practices in the treatment of patients affected by muscle injuries. Methods: We performed research on Medline and Cochrane Database. Guidelines focusing on the rehabilitative treatment of muscle injuries were evaluated for inclusion. Statements about non-rehabilitative treatments were also reported only for the guidelines that mainly focused on rehabilitative treatments. Results: Eight guidelines meeting the inclusion criteria were included in the review. Results were framed into a narrative overview. Two of them mainly focused on hamstring rehabilitation, the others focused on several muscular districts. Conclusions: Conservative treatment of muscle injuries is currently the gold standard, with good results in terms of both rehabilitation times and post-injury sports performance. However, there is not a complete agreement on the type of exercises and the timing of rehabilitation when these should be performed. More research is needed to draw conclusions about the use of physical therapy instruments and other rehabilitation approaches and techniques.

Background/Objectives: Tendinopathies represent a prevalent musculoskeletal condition characterized by load-dependent pain, stiffness, weakness, and impaired functionality. Current treatment includes therapeutic exercise, physical modalities and injective therapy. Hyaluronic acid (HA) is a fundamental component of the extracellular matrix and plays a crucial role in tissue hydration, elasticity, and lubrication. This study aims to evaluate the effectiveness of ultrasound-guided injections of HA in improving pain symptoms and functionality in patients with supraspinatus tendinopathy. Methods: Patients with a confirmed diagnosis of supraspinatus tendinopathy, verified through ultrasound imaging, were included in the study. Patients underwent 3 ultrasound guidance injections (1/week) of Sodium Hyaluronate (Hyalotend, 20 mg/2 mL). Patients were evaluated at the baseline, 1 month (T1), 3 months (T2), 6 months (T3), and 1 year (T4) after the first injection through the VAS, the QuickDASH and the SF-12. Results: Twenty-four patients were enrolled. As regards the VAS there was a statistically significant reduction (p < 0.01) of averages of values over time. The scores collected through the QuickDASH questionnaire have a statistically significant variation over time (p < 0.001). The values collected through the SF-12 Mental Component Summary (MCS) questionnaire show a highly statistically significant variation over time (p < 0.005). The values collected through the SF-12 Physical Component Summary (PCS) questionnaire show a statistically highly significant change over time (p < 0.001). Conclusions: Our results suggest that HA (Hyalotend) injections could represent a viable therapeutic option for patients with supraspinatus tendinopathy in the short, medium, and long term. Further studies with larger patient samples and a control group are needed to better investigate the effects and the modalities of administration of HA in tendinopathies.

Introduction: Adaptive polyarticulated myoelectric hands aim to improve grasp versatility and intuitiveness of use; however, objective clinical and biomechanical evidence supporting their functional impact remains limited. Case presentation: A 75-year-old right-hand-dominant male with a long-standing transradial traumatic amputation and over 30 years of experience with a myoelectric tridigital prosthesis underwent experimental evaluation of an adaptive polyarticulated myoelectric hand (Adam’s Hand^®). Methods: Assessment included patient-reported outcome measures (Orthotics and Prosthetics User Survey—Upper Extremity Functional Status (OPUS-UEFS), Trinity Amputation and Prosthesis Experience Scales–Revised (TAPES-R), Disabilities of the Arm, Shoulder and Hand questionnaire (DASH), Short Form Health Survey 36 (SF-36)), standardized performance-based functional tests (Minnesota Manual Dexterity Test (MMDT), Box and Block Test (BBT), Southampton Hand Assessment Procedure (SHAP)), and laboratory-based biomechanical evaluation using optoelectronic motion capture and surface electromyography during Pointing, Hand-to-Mouth, and Grasping tasks. The adaptive prosthesis was tested after rapid artificial intelligence-based calibration, without structured training. Results: Patient-reported outcomes reflected high satisfaction and adaptation to the habitual prosthesis. Performance-based tests favored the habitual device in speed and dexterity, whereas the adaptive hand enabled additional grasp patterns. Biomechanically, the adaptive hand was smoother and faster during reaching, but less stable during grasping. Compensatory trunk and shoulder movements occurred with both devices, with a trend toward less compensation during reaching with the adaptive hand. Conclusions: This case highlights a task-dependent biomechanical profile of an adaptive polyarticulated myoelectric hand under first-use conditions. Rapid calibration may support immediate use for reaching, while optimal grasp control appears to require structured training.