Overhead athlete rehabilitation

PURPOSE: To determine the functional outcomes of adolescent athletes treated with arthroscopic marrow stimulation/microfracture for elbow capitellar osteochondritis dissecans (OCD). METHODS: The medical records for all patients younger than 18 years of age with capitellar OCD who underwent arthroscopic treatment at a single institution were retrospectively reviewed. The variables examined included patient characteristics, bone age, pre- and postoperative lesion grade/size and range of motion (ROM), intraoperative lesion grade/size, time to postoperative return to sport, and validated outcome scores...

SLAP lesions can be significant pain generators in the shoulder. These injuries are the most common shoulder injury in overhead athletes, as repetitive overhead motion is the most common etiology of SLAP lesions. These lesions present a diagnostic and treatment challenge to patients and physicians. Factors to consider when discussing treatment options for SLAP lesions include age, type of sports activity, level of sports participation, and degree of symptoms. Nonoperative management is the first-line treatment for most young, active patients without history of trauma, mechanical symptoms, and/or demand for overhead activities...

BACKGROUND: Improvements in motor control of the scapular muscles are important for the prevention and rehabilitation of shoulder and elbow injuries in overhead athletes. PURPOSE: To clarify scapular muscle activity during multijoint compound movement exercises using fine-wire and surface electrodes. STUDY DESIGN: Descriptive laboratory study. METHODS: Sixteen healthy men performed 5 types of exercises (cat and dog, trunk rotation, A-exercise, T-exercise, and Y-exercise)...

Thoracic outlet syndrome (TOS) involves an inconsistent set of symptoms that provides a challenge for medical providers to treat. Three categories of TOS are neurogenic, arterial, and venous. A combination of symptoms can occur and are most seen in overhead athletes. Symptoms may include pain, numbness, of an athlete to perform at their prior level of sport is impacted. Due to the variance in presentation and poor objective testing, there is not a well-defined examination process. It is suggested to perform an individualized assessment for each athlete...

Unique biomechanical factors in the overhead and throwing athlete lead to a spectrum of rotator cuff pathology, usually with progressive lateralization of the supraspinatus footprint. Initial comprehensive nonoperative management is indicated for all athletes. Progression to arthroscopic debridement, repair of concomitant injuries, and possible rotator cuff repair with a transosseous equivalent technique are the current management strategies for athletes when nonoperative management fails.

This review covers a systematic approach to rehabilitation following rotator cuff repair. Rates of return to work and return to a prior level of sports activity in patients that have undergone rotator cuff repair will be reviewed. Risk factors and predictors of a patient's inability to return to work or prior level of sports participation will be discussed. Overall, there is a high level of return to work and sports following rotator cuff repair. Heavy manual laborers are at higher risk of not returning to a prior level of work, whereas professional overhead athletes are at higher risk of not returning to their prior level of play following rotator cuff repair...

BACKGROUND: The Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow score (KJOC) is developed to evaluate the shoulder and elbow function in overhead athletes. To date, the score has not been adapted into Finnish language. The aim of this study was to perform a cross-cultural adaptation of the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow score (KJOC) into Finnish language and evaluate its validity, reliability, and responsiveness in overhead athletes. METHODS: Forward-backward translation method was followed in the cross-cultural adaptation process...

PURPOSE OF REVIEW: A critical component of any rehabilitation program following injury is a graduated exposure of pathologic or vulnerable tissue to sport-specific stressors. A foundational aspect in the return to sport process following an injury in baseball athletes is the development of an interval throwing program. A shift has occurred in recent years from generic programs to individualized progressions. The current review explores the evolution of interval throwing program construction and discusses the possibilities of the future with advancements in technology and understanding...

Background: Valgus extension overload syndrome (VEOS) of the elbow is a condition associated with overhead athletes. However, the non-surgical management of these individuals is not well documented. Purpose: To discuss the unique presentation, management, and outcomes of an adolescent baseball player with a chronic history of VEOS experienced during hitting. Case Description: A 15-year-old right-handed high school baseball catcher presented with a six-month history of right-sided ulnar elbow pain...

This study aimed to investigate the short-term effectiveness of scapular focused taping (SFT) on scapular position and kinematics during the tennis serve among professional players with and without shoulder pain. The cohort included 7 players who had no history of non-shoulder pain (NSP) and 6 players with shoulder pain (SP). All participants performed tennis flat serves while the Qualisys motion capture system recorded three-dimensional scapular kinematic data according to the International Society of Biomechanics recommendations...

Rehabilitation of the baseball athlete requires understanding of the unique injury profile of throwers and the pathologic conditions specific to the throwing motion. To optimize performance recovery, consideration must be given to age of the athlete, mechanics of throwing, velocity or effort of the throw, and total workload over time, with careful attention to minimize spikes in workload. Rehabilitation success of junior throwers is variable and likely relates to lack of high-level supervised throwing programs and mechanical analysis...

BACKGROUND: The Kerlan-Jobe Orthopaedic Clinic Shoulder & Elbow Score (KJOC) provides questions for the overhead athlete that can aid with determining if someone is throwing with or without pain. However, this scale was initially created for the adult baseball athlete and has not been validated for younger male demographics. HYPOTHESIS/PURPOSE: To (1) determine if the scores on the KJOC are different between those throwing with and without pain in male youth and high school-aged baseball athletes, and (2) establish a prediction score for whether a young baseball athlete is throwing with symptoms...

PURPOSE OF REVIEW: Lower extremity (LE) injuries are a common source of disability and time-loss for overhead athletes, and muscles have been found to be the predominant soft tissue structure affected. The current review highlights the orthopaedic literature examining lower extremity muscle injuries in overhead athletes in regard to epidemiology, diagnosis, and conventional and emerging treatment measures. RECENT FINDINGS: The hamstring muscles have been found to be the most commonly injured lower extremity muscle group in professional baseball, followed by the adductors, quadriceps, iliopsoas, and gastrocnemius-soleus complex...

Elbow injuries are frequently seen in throwing and overhead athletes. This review provides a framework for diagnosis, treatment, and particularly rehabilitation of common elbow pathologies, including ulnar collateral ligament injury, valgus extension overload, and medial and lateral epicondylitis. Advanced rehabilitation facilitates complete return to functional sport-specific activity and is based on objective criteria. As diagnostic and therapeutic modalities improve our understanding of elbow pathologies in the athletic patient, continued research will further elucidate objective evidence-based rehabilitation techniques...

BACKGROUND: The aim of this study was to analyze the shoulder functional profile (rotation range of motion [ROM] and strength), upper and lower body performance, and throwing speed of U13 versus U15 male handball players, and to establish the relationship between these measures of physical fitness and throwing speed. METHODS: One-hundred and nineteen young male handball players (under (U)-13 (U13) [n = 85]) and U15 [n = 34]) volunteered to participate in this study...

BACKGROUND: A common concern associated with elbow ulnar collateral ligament (UCL) reconstruction is the amount of time required for recovery and rehabilitation. For example, for Major League Baseball pitchers, the average time to return to competition ranges from 13.8 to 20.5 months. Suture tape augmentation has shown the ability to provide additional soft tissue stability across other joints in the body. By providing an additional checkrein to the UCL reconstruction while the graft is healing, it may be possible to accelerate the rehabilitation process in overhead athletes and thus effect a quicker return to sports...

Ulnar collateral ligament (UCL) injuries of the elbow are common in throwing athletes. Given that the UCL's primary function is to provide valgus stability during the deceleration phase of throwing, injury to the UCL will render throwing difficult to nearly impossible.15 Injuries will occur more so in the sports of baseball, softball, and javlineers participating in track and field.5,10,14 Data has indicated that valgus torque reaches 64 N-m and proximal forces as high as 1000 N to prevent elbow distraction...

CONTEXT: Overhead athletes place tremendous demands on the shoulder complex, which result in adaptive kinematics but potential susceptibility to injury. This study aimed to compare shoulder glenohumeral range of motion (ROM) and rotator muscles strength in bilateral and unilateral overhead sports. DESIGN: Cross-sectional study; secondary care. METHODS: Forty-two elite athletes (17.7 [4.5] y; 42.9% female), including 18 swimmers and 24 badminton players, were included...

BACKGROUND: A comprehensive examination of the kinetic chain during an overhead athlete's upper extremity assessment, such as the closed kinetic chain upper extremity stability test (CKCUEST), may help clinicians identify potential upper extremity dysfunction. HYPOTHESIS: Body position observed on dominant and nondominant hand touch during a CKCUEST trial differs between players with previous injury/pain history compared with healthy counterparts. STUDY DESIGN: Descriptive laboratory study...

BACKGROUND: Smokejumpers are required to parachute from planes, carry gear weighing more than 50 kg, and hike on steep terrain. With a majority of injuries sustained to the lower extremity, it is imperative to understand the influence a weighted pack may have on functional performance. OBJECTIVE: To examine the effects of external load on functional movements in Smokejumpers. METHODS: Using repeated measures design, ten Smokejumpers completed two trials consisting of 3 movements in weighted (50 kg) and unweighted conditions...