Objective: The aim of this study is to describe the clinical management of a young male patient with sciatica symptoms that developed after an avulsion of the ischial tuberosity. This is a rare injury, but complications may occur.Clinical Feature: A 19-year-old patient developed sciatica 6 months after a football injury. The patient described his symptoms as a shooting pain from the buttock to the lateral part of the foot, along the back of his thigh and calf, sometimes accompanied by paresthesia. Physical examination showed restricted hip range of motion and a positive Bonnet's test. X-ray analysis revealed a bony overgrowth of the right ischial tuberosity.Intervention and Outcome: A treatment plan was designed to decrease the pain level, increase sacroiliac and lumbar joint mobility, and augment muscular extensibility. The patient received 20 treatments over a period of approximately 3 months. Complete recovery was observed 5 months later.Conclusion: Although many differential diagnoses were contemplated, it is most likely that changes in muscular tension and gait pattern, resulting from the ischial tuberosity avulsion, contributed to overuse of the piriformis muscle leading to a piriformis syndrome.

BACKGROUND CONTEXT: A number of recent scientific publications suggest that patients suffering from whiplash-associated disorders (WADs) exhibit sensorimotor deficits in the control of head and neck movements.PURPOSE: The main objective of the present study was to evaluate if subjects with WADs can produce isometric neck extension and flexion forces with precision, variability, and a mode of control similar to the values of healthy subjects.STUDY DESIGN: A control group study with repeated measures.PATIENT SAMPLES: Neck force production parameters and neuromuscular control were measured in 17 whiplash and 14 control subjects. The experimental group included subjects who had a history of persistent neck pain or disability after a motor vehicle accident.OUTCOME MEASURES: Pain levels were assessed on a standard 100-mm visual analog pain scale at the beginning and end of the experiment. Each whiplash subject completed the neck disability index and the short-form 36 health survey (SF-36) questionnaire before the experiment.METHODS: All subjects were asked to exert flexion and extension forces against a fixed head harness. Kinetic variables included time to peak force, time to peak force variability, peak force variability, and absolute error in peak force. Surface electrodes were applied bilaterally over the sternocleidomastoideus and paraspinal muscles. Electromyography (EMG)-dependent variables included EMG burst duration and amplitude using numerical integrated techniques.RESULTS: The average time to peak force was significantly longer for whiplash subjects than for the healthy controls. A significant increase in peak force variability was also observed in the whiplash group, and no group differences were noted for absolute error. Heightened muscular activity was seen in both paraspinal muscles, even though it only reached statistical significance for the left paraspinal muscle.CONCLUSION: Our results show that the whiplash subjects involved in the study were able to produce isometric forces with spatial precision similar to healthy controls using a motor strategy in which the time to peak force is increased. This trade-off between spatial precision and time to peak force probably reflects an adaptation aimed at limiting pain and further injuries. (c) 2007 Elsevier Inc. All rights reserved.

En l’an 2000, vingt-sept pour cent des postes de direction des écoles secondaires au Québec sont occupés par des femmes. Cet article traite des barrières limitant l’accès des femmes à un poste de direction, notamment en ce qui concerne les postes de directrice et de directeur, et de directrice et directeur adjoint dans les écoles secondaires à Montréal. Les perceptions de 28 des 58 femmes, en poste à l’automne 2000, dans les écoles secondaires de deux commissions scolaires de la grande région de Montréal par rapport aux facteurs réduisant l’accès des femmes à un poste de direction et aux caractéristiques du processus d’accès qu’elles ont-elles-mêmes vécu, sont présentées et analysées. Cette étude permet de dresser un bilan de la situation et de préciser quelles barrières se sont abaissées et quelles sont celles toujours bien présentes. En conclusion, des recommandations aux commissions scolaires du Québec sont dégagées, afin que le processus de recrutement et de sélection facilite l’accès des femmes à un poste de direction des écoles secondaires et assurent aux femmes candidates une plus grande équité.