Shoulder & Elbow

BACKGROUND: The aim of this study was to compare the reliability and agreement between two devices - Wii Fit Balance Board (WBB) versus Hand-Held Dynamometer (HHD) to measure isometric strength during the athletic shoulder (ASH) test in healthy amateur rugby players. METHODS: Fifteen males (23.73 ± 2.8 years) completed two testing sessions. Maximal isometric contractions using the dominant arm (D) and non-dominant arm (ND) against a WBB and HHD were assessed at three angles of abduction (180°, 'I'; 135°, 'Y' and 90°, 'T'), in a prone lying position...

This systematic review aims to provide normative values for internal and external glenohumeral rotation strength in rugby players. From the inception to March 2021, the search strategy was (strength OR torque) AND shoulder AND rugby using PubMed, Scopus, Web of Science, and SPORTDiscus databases, with no language restrictions. This systematic review includes 15 articles involving 573 rugby players and presenting internal or external glenohumeral rotation strength values. Two main methods are used to assess glenohumeral rotation strength in rugby players: isokinetic and isometric methods; in the isometric method, the upper arm is abducted at either 0° or 90°...

BACKGROUND: The region where the ulnar nerve (UN) is swollen in baseball players with ulnar neuropathy is not apparent. This study investigated the UN's cross-sectional area (CSA) at each entrapment point in baseball players. We also aimed to clarify the relationship between valgus instability and the CSA of the UN. METHODS: Forty baseball players were separated into healthy and ulnar neuropathy groups. The CSA and valgus instability were measured using ultrasonography (US)...

BACKGROUND: Proprioception is vital for motor control and can be disturbed, for example, due to fatigue or injury. Clinical feasible, reliable and valid tests of shoulder proprioception are warranted. The aim was to investigate the effects of local fatigue on shoulder proprioception and the reliability of a feasible joint position sense test using an experimental repeated measures design. METHOD: Forty participants repeated a shoulder joint position sense test to assess test-retest reliability...

BACKGROUND: The objective was to identify exercise therapy dosing parameters for subacromial pain syndrome (SAPS) associated with improved pain and function outcomes (via effect sizes) and determine the extent of exercise intervention reproducibility. METHODS: An electronic search of PubMed/MEDLINE, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Cochrane Database of Systematic Reviews, and SportDiscus identified studies that used exercise therapy exclusively to treat SAPS...

OBJECTIVE: To systematically scope the literature on posterior shoulder tightness (PST) and define a therapist-instructed and therapist-administered management framework. DESIGN: Scoping review. LITERATURE SEARCH: We searched MEDLINE, EMBASE, CINAHL, Scopus and Google Scholar from inception to December 2021. STUDY SELECTION CRITERIA: Peer-reviewed studies written in English, French, Greek, Japanese or Tamil, with extractable pre- and post-intervention data...

BACKGROUND: Functional testing has recently become more and more popular to assess athletes, both for injury prevention, as well as in an objective of performance. However, the relationship between the results of these tests and performances (or injuries) or their interpretation remains unclear. OBJECTIVE: The aim of this study is to explore the usefulness, the characteristics, and the interpretation of the most frequently used upper-limb functional test. METHODS: Twenty-two experts with an excellent knowledge of upper limb functional tests and an expertise in sports medicine and/or sports training of at least 5 years were recruited...

BACKGROUND: Lateral elbow tendinopathy is one of the most common chronic and degenerative diseases which significantly affects quality of life and the activities of daily living of a person. The following is a systematic review reporting a comparison between physical therapy intervention and corticosteroid injection for the treatment of lateral elbow tendinopathy. METHOD: PubMed, Web of Science, and Embase were searched using headings related to treatment options for Lateral elbow tendinopathy...

BACKGROUND: Excessive shoulder anterior force has been implicated in pathology of the rotator cuff in little league and professional baseball pitchers; in particular, anterior laxity, posterior stiffness, and glenohumeral joint impingement. Distinctly characterized motions associated with excessive shoulder anterior force remain poorly understood. METHODS: High school and professional pitchers were instructed to throw fastballs while being evaluated with 3D motion capture (480 Hz)...

Osteochondritis dissecans of the capitellum is debilitating and is a potentially sports career-ending injury in a young and athletic population. Osteochondritis dissecans typically occurs in patients between the ages of 10 and 24 years, and boys are more commonly affected than girls. Conventional radiographs have low diagnostic accuracy, and magnetic resonance imaging (with or without contrast) or computed tomography may aid in accurate diagnosis. The primary indication for non-operative treatment is the presence of an intact cartilage cap on magnetic resonance imaging, indicating a "stable lesion...

BACKGROUND: Various reduction techniques exist to treat traumatic shoulder dislocation, but best management remains unclear. AIMS: To investigate the reduction rate of traumatic anteroinferior shoulder dislocations using two sedation-free techniques and success rates of subgroups. METHODS: A single-center study was performed analysing shoulder dislocations in a two-year period. Adult patients with anteroinferior shoulder dislocation were included...

BACKGROUND: To systematically review the literature to evaluate the outcomes following an open Latarjet (OL) procedure at a minimum 15-year follow-up. METHODS: Two independent reviewers performed a literature search using Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines using 3 databases. Only studies reporting outcomes of OL procedure with a minimum of 15 years of follow-up were included. RESULTS: Nine studies composed of 326 shoulders (78...

BACKGROUND: The purpose of this study was to systematically review the rate and timing of return to play in overhead athletes following operative management of anterior shoulder instability. METHODS: A systematic literature search based on PRISMA guidelines, utilizing the EMBASE, MEDLINE, and The Cochrane Library Databases. Eligible for inclusion were clinical studies reporting on return to play among overhead athletes following arthroscopic Bankart repair, open Latarjet procedure or Remplissage procedure...

The muscular characteristics of rugby players may make diagnosing the direction of shoulder instability and labral pathology challenging. This study aimed to assess the accuracy of clinical examination and specifically instability tests, in diagnosing the direction of shoulder instability in rugby players. One-hundred-and-forty rugby players, who had undergone a shoulder stabilization procedure, over a 55-month period, were included in this study. The mean age was 21.5 years with 137 males. Data collected included clinical examination and intraoperative findings...

BACKGROUND: Failed Latarjet procedures pose a surgical challenge due to complex anatomical issues. This systematic review investigates salvage techniques for recurrent instability following a Latarjet procedure. METHODS: A search was conducted on MEDLINE and PubMed Central following the methodology registered to International Prospective Register of Systematic Reviews. Inclusion criteria focused on identifying revision procedures following a Latarjet procedure. Exclusion criteria filtered out irrelevant studies, such as those focused on Bankart procedures...

PURPOSE: Arthroscopic Bankart repair (ABR) may be more effective than nonoperative management for patients with anterior shoulder instability following first-time dislocation. The purpose of the study was to determine the most cost-effective treatment strategy by evaluating the incremental cost-effectiveness ratio (ICER) for ABR versus nonoperative treatment. METHODS: This cost-effectiveness study utilized a Markov decision chain and Monte Carlo simulation. Probabilities, health utility values, and outcome data regarding ABR and nonoperative management of first-time shoulder instability derived from level I/II evidence...

BACKGROUND: The Latarjet procedure is an effective shoulder stabilizing surgery, however, the procedure results in an alteration of anatomy that may result in shoulder and elbow weakness. Thus, the purpose of this study was to assess post-operative shoulder and elbow strength after the Latarjet procedure. We hypothesized that shoulder and elbow strength are not affected after the procedure. METHODS: The study group consisted of patients that had undergone the arthroscopic Latarjet procedure...

BACKGROUND: Performance-based tests for patients with anterior shoulder dislocation are lacking. This study determined the reliability and validity of the supine moving apprehension test designed to assess the ability to control anterior instability loads. METHODS: Thirty-six participants were recruited (18 healthy individuals, and 18 patients following anterior shoulder dislocation). Healthy participants performed the supine moving apprehension test on 2 separate occasions to determine test-retest reliability...

BACKGROUND: Instability of the sternoclavicular joint (SCJ) is a rare problem that is often treated closed, with few published outcomes of surgical treatment with tendon graft reconstruction. METHODS: We reviewed a consecutive series of patients who underwent tendon graft reconstruction for SCJ instability over a 7-year period. Cases with acute fractures or fewer than 2 years of follow-up were excluded. Pre- and postoperative function and pain were assessed using Single assessment numeric evaluation (SANE), simple shoulder test (SST), and visual analog scale (VAS) outcome measures...

BACKGROUND: Optimal rehabilitation following arthroscopic shoulder stabilisation for traumatic anterior instability is unknown. The purpose of this study was to establish current UK practice for this patient group. METHODS: A self-administered online questionnaire was developed and distributed to UK surgeons and physiotherapists. RESULTS: 138 responses were received. Routine immobilisation was reported in 79.7% of responses with a cross-body sling being the preferred position (63...