摘要:

Rehabilitation and training of the shoulder in throwing and overhead athletes has dramatically changed during the last decade. Athletes are returning to participation in overhead sports faster than ever. There are numerous reasons for this rapid return to athletic training or competition. These reasons include increased anatomic understanding of the shoulder complex, increased understanding of the biomechanics that occur at the shoulder complex in sports, and ability to integrate this new knowledge into performance enhancement. In addition, a better understanding of the scientific and clinical concepts of plyometrics has facilitated this improvement in performance. Although there are numerous studies regarding the application of plyometrics in the lower extremities, there are very few regarding the application of plyometrics to the upper extremities. This article describes the physiologic, biomechanical, and neurophysiological basis of upper extremity plyometrics with an emphasis on clinical application.

ISSN:1062-8592    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The shoulder joint is the most mobile joint in the human body and is therefore at great risk for injury. Much of the existing literature about shoulder rehabilitation is based on a recovery-from-injury model. The current report reviews pertinent anatomy, describes the phases of throwing, and presents the essentials of a preventive shoulder program that will assist throwing athletes during the off season.

ISSN:1062-8592    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

An injured baseball pitcher must pitch to return to competition. A data-based interval throwing program for Little League baseball was previously defined by the authors. In that program, children 9 to 12 years old pitch 19.53 pitches per inning; 2.58 innings per outing; and 52.34 pitches per outing from a 46-foot mound distance. Children 13 or 14 years old pitch 19.15 pitches per inning; 2.65 innings per outing; and 58 pitches per outing from a 60-foot 6-in mound distance. Starting pitchers and high school, college, and professional team players pitch 14.93 to 16.45 pitches per inning; 5 to 6 innings per outing; and 76 to 94 pitches per outing. The integration of pitching statistics, field dimensions, performance restrictions, biomechanical studies, and a basic understanding of healing tissue have reduced the myriad of available pitchers' programs to just three programs. They are for the following groups: children 12 years old and younger; children 13 to 14 years old; and high school, college, and professional players. These programs can be used for training and conditioning and can be applied across a wide range of pathologies.

ISSN:1062-8592    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The diagnosis and treatment of superior labral tear anterior to posterior (SLAP) lesions in the throwing athlete is a challenge for the orthopedic surgeon. Subtle physical findings often plague the athlete, impeding their ability to participate in their sport. Lack of definitive findings specific to SLAP lesions in the history, physical examination, and diagnostic tests make this entity difficult to diagnose. Although magnetic resonance arthrography shows much promise, diagnostic arthroscopy remains the gold standard for identifying this lesion. The type of lesion identified at the time of arthroscopy determines the treatment. Type I and III SLAP lesions are debrided. Type II lesions and many type IV lesions are repaired. This article reviews the literature and presents the authors' current technique for the treatment of SLAP lesions.

ISSN:1062-8592    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The acromioclavicular joint is commonly involved in traumatic injuries that affect the shoulder. Treatment of these injuries has been controversial, and continues to evolve to this day. There are few injuries that have had as large a number of different procedures described as those of the acromioclavicular joint, due, in large part, to the varying degrees of injury. Procedures have changed as our understanding of the biomechanics of the joint has increased. This review focuses on the surgical management of acute and chronic acromioclavicular dislocations in the throwing athlete.

ISSN:1062-8592    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The purpose of this article is to identify interrelationships within the body during pitching, tennis, and swimming. In the pitch the body's forces are relatively low during wind-up and early cocking. If the lower extremities and trunk exhibit appropriate mechanics here, the risk of injury to the upper extremity later is minimized. One reason for tennis elbow may be that the feet have not caught up with the body during the backhand. The body's mechanics are off and the power must be generated by the small wrist extensors. In the freestyle stroke the relationship within the scapular muscles is identified. The muscles must antagonistically work together to minimize the risk of injury. If one muscle doesn't function (such as the serratus anterior), other muscles attempt to substitute (such as the rhomboids) and pathology may ensue. These examples demonstrate the clinical need to understand the mechanics of sport as well as to evaluate the patient beyond the painful anatomic area.

ISSN:1062-8592    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Traditional shoulder rehabilitation protocols have typically used either set time frames or achievement of certain criteria for determining when to advance patients from one level of rehabilitation to the next. Each system has its own unique set of advantages and disadvantages. Because of the disadvantages, we developed a new model that primarily uses patient activity levels and secondarily uses objective criteria as the system of advancement for our shoulder girdle rehabilitation protocol. Our purpose here is threefold: (1) to discuss the rationale behind this model of exercise progression, (2) to present the eight discrete shoulder activity levels that are combined into four functional activity levels, and (3) to present the components and rationale for a four-phase, 50-step shoulder rehabilitation program that can return a patient to high-level shoulder activity that includes rapid acceleration and deceleration and repetitive overhead shoulder activity with load.

ISSN:1062-8592    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Rehabilitation plays a vital role in the ultimate functional outcome after surgery in the overhead-throwing athlete. The ultimate goal of the postoperative rehabilitation program is to return the athlete to unrestricted sport specific activities as expeditiously and safely as possible while minimizing postsurgical complications. Rehabilitation after surgical procedures to stabilize the throwing shoulder must allow adequate healing time without allowing significant loss of motion to occur. Emphasis is placed on immediate but restricted and controlled motion, as well as the development of proprioception, neuromuscular control, and dynamic stabilization of the glenohumeral and scapulothoracic joint. The rehabilitation program will vary based on the unique characteristics and pathology of each patient, the specific surgical procedure performed, and the healing rate of the soft tissues involved. All of these factors must be considered when designing a postsurgical rehabilitation program for the overhead-throwing athlete. This article discusses the postoperative rehabilitation principles for the overhead athlete as well as specific programs used following thermal-assisted capsular shrinkage, arthroscopic Bankart repairs, open anterior capsular shift procedures, and glenoid labrum procedures.

ISSN:1062-8592    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Shoulder injuries are relatively common in the overhead athlete due to the repetitive nature of the activity that involves high stress and velocity. Fortunately, most injuries respond to nonoperative treatment. This involves a comprehensive rehabilitation program that is individualized to the athlete and to the sport. The program is broken down into three phases based on the temporal relationship to the injury and response to treatment. It is important to achieve full range of motion and strength in the injured shoulder before the athlete's return to play. In addition, the rehabilitation must address the entire kinematic chain to prevent further injury and to prevent deconditioning upon returning to the sport. Any biomechanical deficits and adaptation to form that have developed in response to the injury must also be corrected during the treatment.

ISSN:1062-8592    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The purpose of this section is to present the general guidelines for rehabilitating an injured tennis player. The focus is on treating the most common injury pattern of overhead athletes, i.e., rotator cuff pathology with secondary bursitis and finally microtraumatic instability. The pathologic cascade starts with an overload of the dynamic stabilizers, and if not recognized and not treated appropriately, the affected tissues will decompensate in this stage and result in chronic tendinitis. In case of a misinterpretation of the athlete's symptoms and a therapeutic mismanagement, the dynamic overload increases successively and ends up in a static overload of the capsuloligamenteous restraints. A static overload in terms of a capsular elongation has to be suspected if competent and specific physical therapy does not succeed in alleviating the athlete's symptoms. The rehabilitation program concerns a three-phase approach. It begins with the acute phase, followed by an intermediate phase, and finally the return to sports phase. Weight-bearing exercises are an integral part of the rehabilitation program. Specific criteria are discussed to determine when the athlete can return to unrestricted playing.

ISSN:1062-8592    

出版商:OVID    

年代:2001

数据来源: OVID