Thilo Hotfiel

• Dr., MD
• Friedrich-Alexander-University Erlangen-Nürnberg

This study evaluates the corneal applicability of a refractive ultraviolet femtosecond laser in postmortal human donor eyes and ex vivo porcine eyes. Refractive lenticule extraction and flap creation were attempted in 10 human donor eyes and 80 ex vivo porcine eyes with and without abrasion of the corneal epithelium. The postmortem interval ranged...

Summary Injury and exercise during training and competition are associated with mechanical and metabolic stress. This results in a (patho-) physiological and immunological reaction that can have a physiological (increased endurance and performance) or pathophysiological effect (overuse, misload, misuse, injuries). In this context, heat and cold the...

The term Delayed Onset Muscle Soreness (DOMS) refers to a complex injury entity which is based on ultrastructural injury patterns. The injury is usually harmless and heals within a few days without sequelae. However, at the time of the manifestation there are (sometimes considerable) performance limitations and the risk of possible secondary injuri...

Background: Musculoskeletal pain is a non-negligible multifaceted condition affecting more than 30% of the global population. Superficial heat therapy (HT), through increasing tissue temperatures, plays a role in increasing local metabolism and function and relieving pain. Knee (KP) and sports pain represent two relevant fields of superficial HT ap...

Background: Musculoskeletal pain is a non-negligible multifaceted condition affecting more than 30% of the global population. Superficial heat therapy (HT) through increasing tissues temperatures plays a role in increasing local metabolism and function and relieving pain. Knee pain and sports represent two relevant fields of superficial HT applicat...

Purpose: To elucidate whether it is feasible to use porcine eyes from scalded, abattoir-acquired animals for refractive femtosecond laser research. Methods: An infrared laser (FS 200) and an ultraviolet laser (prototype version) were tested for their applicability on scalded pig eyes. Fifty porcine eyes were divided into two equally-sized groups...

The article highlights newer aspects of strength training after knee trauma that need to be considered in the future. Recent findings on muscle contraction (three-filament theory) and the importance of eccentric training for prevention and rehabilitation are discussed. The altered central, spinal, and peripheral neuromuscular activation patterns wi...

Purpose The aim of this systematic review was to investigate tendon-specific microRNAs (miRNAs) as biomarkers for the detection of tendinopathies or degenerative tendon ruptures. Also, their regulatory mechanisms within the tendon pathophysiology were summarized. Methods A systematic literature research was performed using the PRISMA guidelines. T...

Purpose: Microvascular blood flow (MBF) and its intramuscular regulation are of importance for physiological responsiveness and adaptation. The quantifiable in-vivo monitoring of MBF after cycling or systemic cold-water exposure may reveal new insights into capillary regulatory mechanisms. This study aimed to assess the role of exercise and cold t...

Purpose: To examine a series of papers from top ranked orthopaedic journals with respect to the number of citations over a 10-year observation period to identify factors that lead to high citation rates. Methods: The Web of Science database was consulted to identify all published papers from the first-year term of 2010 (January-May) from four to...

B S T R A C T Introduction: Foam Rolling (FR) as a technique of self-massage has become a widely used intervention in clinical and sports practice. It is assumed that FR leads to an increased intramuscular microvascular blood flow (MBF), and therefore is commonly recommended as a warm-up or regeneration method. However, no data validate the effects...

The proximal hamstring complex is a highly vulnerable area that is especially prone to injury. Proximal hamstring tendinopathies (PHTs) remain challenging in diagnosis, treatment, rehabilitation, and prevention due to a large variety of different injuries, slow healing response, persistent symptoms, and functional impairments. PHTs are often misdia...

Background: In sports games, epidemiological data show that groin pain is relatively common and can lead to repeated loss of time. Consequently, it is essential to be aware of the evidence-based prevention strategies. The aim of this systematic review was to examine risk factors and prevention strategies for groin pain and to rank them based on th...

Background Early diagnosis of muscle injuries is indispensable in order to initiate appropriate treatment and to facilitate optimal healing.PurposeThe aim of this review is to provide an update on imaging of muscle injuries in sports medicine with a focus on ultrasound and magnetic resonance imaging (MRI) and to present experimental approaches in a...

Background: This study aimed to investigate the effects of different shoulder orthoses on the neuromuscular activity of superficial and deep shoulder muscles during activities of daily living (ADL) and physiotherapeutic exercises. Methods: Ten participants with healthy shoulders (31 ± 3 years, 23.1 ± 3.8 kg/m2) were randomized to receive a "shou...

Objective: To assess sodium (23 Na) and quantitative proton (1 H) parameter changes in muscle tissue with magnetic resonance imaging (MRI) after eccentric exercise and in delayed-onset muscle soreness (DOMS). Methods: Fourteen participants (mean age: 25±4 years) underwent 23 Na/1 H MRI of the calf muscle on a 3 Tesla MRI system before exercise(t...

Background: There is limited information about perfusion in exercise-induced muscle injuries such as delayed-onset muscle soreness (DOMS) and the effect of compression garments as a therapeutic strategy during the regeneration phase. The purpose of this prospective, explorative study was to evaluate muscle perfusion in DOMS and to assess the effec...

In den Sportspielen können Knorpelschäden am Kniegelenk mit langen Ausfallzeiten einhergehen und zu einer progredienten Osteoarthrose führen. Demzufolge ist weiterer Forschungsbedarf zu den neuen Möglichkeiten der Entlastung und resultierenden realen Knorpelbeanspruchungen während des Trainings und der Rehabilitation nach Verletzungen notwendig. Zi...

Background Physical activity (PA) has been shown to be advantageous to one's health. Coronavirus disease 2019 (COVID-19) lockdown measures have reportedly led to substantial decrease of PA and to drastic reduction of well-being (WB). In light of this, the purpose of this review was to assess the impact of PA on WB during the COVID-19 pandemic. Mat...

Zusammenfassung Stressfrakturen und Stressreaktionen zählen zu den überlastungsbedingten Verletzungen („Overuse injuries”) und können für betroffene Sportler mit erheblichen Trainings- und Wettkampfausfällen einhergehen. Repetitive, die Belastungs- und Anpassungsfähigkeit übersteigende Lasteinwirkungen verbunden mit intrinsischen und extrinsischen...

Osteochondrosen und Osteonekrosen stellen eine heterogene Gruppe von Erkrankungen des Knochens dar, die zu einem Integritätsverlust der physiologischen Knochen- und/oder Knorpelstruktur führen können und mit typischen stadienadaptierten Umbauprozessen verbunden sind. Bei den Begriffen der Osteochondrose und Osteonekrose handelt es sich nicht um ein...

Background Contrast-enhanced ultrasound (CEUS) has been shown to be a valid measurement tool for evaluating microvascular blood flow. Until now, the assessment of periosteal tissue has been insufficiently validated, and a procedure has not yet been standardized for this purpose. The aim of the present study was to investigate periosteal femur perfu...

Injuries and overload to the hamstring muscles are frequently observed in recreational and high-performance athletes. The proximal hamstring muscle complex is in a highly vulnerable region that is likely to sustain injury in several disciplines. Proximal hamstring injuries (PHI) are responsible for a substantial loss of training and competition day...

Während der postoperativen Nachbehandlungen vieler Schultergelenkseingriffe steht die Immobilisation des Gelenks mittels Orthesen im Vordergrund. Auch kommt der passiven-assistierten Mobilisation des Gelenks (z.B. durch physiotherapeutische Eigenübungen) eine wichtige Bedeutung zu. Gegenwärtig ist jedoch der Einfluss unterschiedlicher Orthesen bzw....

To investigate below-knee compression garments during exercise and a post-exercise period of 6 h on clinical, functional, and morphological outcomes in delayed-onset muscle soreness (DOMS). Eighteen volunteers (age: 24.1 ± 3.6, BMI 22.7 ± 2.7 kg/m2) were enrolled. Measures were acquired at baseline, 6 h, and 48 h after eccentric and plyometric exer...

The aim of this prospective cohort study was to evaluate the effect of compression garments under resting conditions and after the induction of delayed-onset muscle soreness (DOMS) by MR perfusion imaging using intravoxel incoherent motion (IVIM). Magnetic resonance imaging of both lower legs of 16 volunteers was performed before and after standard...

The aim of this randomized controlled laboratory study was to evaluate the role of standardized protection, rest, ice (cryotherapy), compression and elevation (PRICE) therapy on microvascular blood flow in human skeletal muscle. Quantifiable contrast-enhanced ultrasound was used to analyze intramuscular tissue perfusion (ITP) of the rectus femoris...

Zusammenfassung Hintergrund Armdrücken ist ein beliebter Zweikampfsport, der sowohl in der Freizeit als auch im professionellen Wettkampf ausgeübt werden kann. Ziel dieser Studie ist die Vorstellung einer sportarttypischen Verletzung, ihrer Behandlung sowie des vermuteten Unfallmechanismus. Material und Methoden Es erfolgte eine retrospektive Ana...

Background: The impact of compression on overexertion-related muscle injuries such as delayed-onset muscle soreness (DOMS) is a subject of controversy. Identifying the mechanisms, optimal conditions, and application settings under which compression therapy may alter muscle metabolism and improve recovery is crucial. The purpose of this study was to...

Rock climbing is one of the fastest-growing sports on the planet. The upcoming 2020 Olympics in Japan will be the first to feature climbing as one of its prestigious events. While research has helped climbers learn how to avoid injuries to their upper body, surprisingly little is known about the effects of climbing on the lower body. Now, for the f...

This study aimed to investigate the effects of different playing strategies on external and internal loads in female tennis players during match play. Also, the underlying effects on the technical-tactical actions and activity profiles were examined. Twelve well-trained female players (age: 25±5 years; maximum oxygen uptake: 40.9±4.3 ml/kg/min) pla...

For many years, strength training has been an integral part of rehabilitation after knee trauma. In the first part of the paper, new research results on muscle contraction, especially eccentric muscle action, are presented in rehabilitative accentuated strength training after knee trauma. It is pointed out that the strength training methodology, wh...

CrossFit is a form of high-intensity interval training and comparable to other high-intensity exercises. CrossFit exercises increase VO2max, strength, endurance, and improves the body composition (e. g. lean body mass). The injury risk in CrossFit is similar to that of other, comparable sports such as Olympic weightlifting, powerlifting and gymnast...

Background: Tissue flossing has been introduced to increase ROM and flexibility, to enhance prevention and rehabilitation, as well as to improve athletic performance; however, limited evidence exists for its efficacy. The aim of the present study was to evaluate the effects of ankle flossing on periarticular stiffness and perfusion via acoustic ra...

Objective. To prospectively evaluate current demographics, distribution and severity of rock climb-ing-related injuries after the sport’s inclusion into the Olympic program and to analyze changes in comparison to two prior study populations. Methods. In 2017-2018, we performed a single-center injury survey including 436 climbing patients with a tot...

Zusammenfassung Muskelverletzungen zählen als typische „time-loss Verletzungen” und sind regelhaft mit Einschränkungen der Spiel- bzw. Wettkampffähigkeit verbunden. Selbst milde Verletzungsformen führen zu erheblichen Einschränkungen der muskulären Kraftentfaltung und letztlich der Leistungsfähigkeit im Sport. Die Versorgung von Muskelverletzungen...

Background There is limited insight into trauma mechanisms of knee injuries in bouldering and sport climbing for both non-competitive and competitive athletes. Purpose Based on a recent rapid increase of knee injuries caused by bouldering and sport climbing, we aimed to examine traumatic mechanisms of injury, demographics, distribution and severit...

Triathlon is a sporting activity that combines swimming, cycling, and running in one single event. The athletes can compete in different disciplines including single or team races and ranging from super sprint up to long distances. Triathletes tend to train the whole year round and the training content is adapted to the aimed distances. Injuries of...

Background: Alterations in plantar loading patterns are risk factors for stress injuries of the lower limb, particularly of the foot and ankle. Epidemiological studies have revealed a higher incidence of soccer-related stress fractures of the fifth metatarsal (MT V) in younger athletes than in their adult counterparts. Objective: The aim of the...

Background There is limited insight into the mechanisms of knee injuries in rock climbing and bouldering in noncompetitive and competitive athletes. Purpose To examine the traumatic mechanisms of injury, demographics, distribution, and severity of knee injuries in affected athletes. Study Design Case series; Level of evidence, 4. Methods During...

Anterior knee pain (AKP) as a nonspecific symptom and encompasses a broad range of different symptoms and multiple underlying functional and/or structural abnormalities. AKP is a common disorder in athletes who participate in endurance sports, particularly in triathlon that involves repetitive loading of the knee. Due to an expanding participation...

Abstract Background It is frequently observed that overloading the foot can impair bone and soft tissue healing and can lead to harmful sequelae (i.e. ulcers, stress reactions) in context of pre-existing tissue disabilities. In terms of offloading, hindfoot relief devices are commonly applied as a non-operative treatment as well as after various su...

Context: Foam rolling (FR) has been developed into a popular intervention and has been established in various sports disciplines. However, its effects on target tissue, including changes in stiffness properties, are still poorly understood. Objective: To investigate muscle-specific and connective tissue-specific responses after FR in recreationa...

Introduction: With the growing enthusiasm from people of all ages about rock climbing and bouldering, adaptions and medical conditions of the older athlete have become increasingly important. We aimed to analyze injury demographics, distribution, and severity for the older rock-climbing athlete. Methods: During a 3-y period, we performed a singl...

The aim of the study was to explore the possible role of Trefoil Factor Family peptide 3 (TFF3) for skeletal repair. The expression of TFF3 was analyzed in human joint tissues as well as in a murine bone fracture model. Serum levels of TFF3 following a defined skeletal trauma in humans were determined by ELISA. The mRNA expression of TFF3 was analy...

Das Ellenbogengelenk weist eine komplexe Anatomie mit mehreren, das Gelenk kreuzenden neurovaskulären Strukturen auf. Die Ellbogenarthroskopie stellt weiterhin ein herausforderndes Operationsverfahren mit einer steilen Lernkurve und einem verhältnismäßig hohen Risiko für iatrogene Verletzungen dieser neurovaskulären Strukturen dar. In diesem Beitra...

Zusammenfassung Ziel der Studie war es zu untersuchen, ob im Elite-Kanusport durch das Tragen von Oberkörperkompressionsbekleidung eine Verbesserung der Leistungsfähigkeit zu erzielen ist. Für die Studie wurden 23 Elite-Athleten des Deutschen Kanuverbands (6 Frauen, 17 Männer) rekrutiert. Diese absolvierten auf einem Regattasee eine 1650 m lange Te...

Background Cold-water immersion (CWI) has become a popular preventive, regenerative and performance-enhancing intervention in various sports. However, its effects on soft tissue, including changes of intramuscular stiffness, are poorly understood. The purpose of this study was to investigate the effect of CWI on muscle stiffness. Patients/Material...

Compartment syndrome of the foot (CSF) is a surgical emergency, with high risk of morbidity and poor outcome, including persistent neurologic deficits or amputation. Uncertainty remains regarding surgical approaches, pressure monitoring values, and the extent of surgical treatment. This review provides a summary of the current knowledge and reports...

Background: Radial extracorporeal shock wave therapy (rESWT) is an effective and safe non-invasive therapeutic option for various musculoskeletal pathologies. However, data on possible application of radial extracorporeal shock waves (rESWs) on soft tissue components of fingers is still scarce. Objective: We now aimed to analyze the feasibility...

The triathlon is one of the fastest developing sports in the world due to expanding participation and media attention. The fundamental change in Olympic triathlon races from a single to a multistart event is highly demanding in terms of recovery from and prevention of exercise-induced muscle injures. In elite and competitive sports, ultrastructural...

Background: Plantar fasciitis (PF) is one of the most common causes of plantar heel pain. Objective: To evaluate the effectiveness of three different treatment approaches in the management of PF. Methods: Sixty-three patients (44 female, 19 men; 48.4 ± 9.8 years) were randomly assigned into a manual therapy (MT), customised foot orthosis (FO)...

Triathlon is a popular sport for both recreational and competitive athletes. This study investigated the rates and patterns of stress fractures in the German national triathlon squad. We developed a web-based retrospective questionnaire containing questions about the frequency of stress fractures, anatomic localisation and associated risk factors....

Non-traumatic shoulder pain is a challenge in treating overhead athletes. Also in tennis adaptations of the shoulder in the course of a sports career often lead to a significant restriction of mobility or to a shift in the range of motion in favor of external rotation and at the expense of internal rotation. At the same time, many athletes are losi...

Delayed-onset muscle soreness (DOMS) describes an entity of ultrastructural muscle damage. The manifestation of DOMS is caused by eccentric muscle contractions or unaccustomed forms of exercise. Clinical signs include impaired muscular force capacities, painful restriction of movement, stiffness, swelling, and altered biomechanics in adjacent joint...

Background Continuous passive motion (CPM) and active knee joint motion devices are commonly applied after various surgical procedures. Despite the growing use of active motion devices, there is a paucity of data comparing plantar loads between the different mobilization techniques. The aim of this study was to investigate foot loads during knee jo...

Objective: To describe the prevalence, severity, and location of ankle injuries as assessed on magnetic resonance imaging (MRI) in athletes participating in the Rio de Janeiro 2016 Summer Olympic Games. Methods: We analyzed all ankle MRIs that were acquired for suspected injury as reported by the National Olympic Committee medical teams and the...

When considering the scientific lack concerning the execution and acute effects and mechanism of foam rolling (FR), this study has evaluated the biomechanical loads by the force-time characteristics during two popular FR exercises. Additionally, the acute effects of FR on jump height and muscular stiffness were simultaneously assessed. Within a ran...

Background Muscle injuries are some of the most common injuries in sports; they have a high recurrence rate and can result in the loss of ability to participate in training or competition. In clinical practice, a wide variety of treatment strategies are commonly applied. However, a limited amount of evidence-based data exists, and most therapeutic...