Return to High-Level Throwing After Combination Infraspinatus Repair, SLAP Repair, and Release of Glenohumeral Internal Rotation Deficit

2012 ◽  
Vol 40 (11) ◽  
pp. 2536-2541 ◽  
Author(s):  
Jonathan P. Van Kleunen ◽  
Scott A. Tucker ◽  
Larry D. Field ◽  
Felix H. Savoie
Keyword(s):  
Internal Rotation ◽  
Sport Participation ◽  
Suture Anchor ◽  
Return To Play ◽  
Glenohumeral Internal Rotation Deficit ◽  
Throwing Athlete ◽  
Slap Repair ◽  
Overhead Throwing ◽  
High Level ◽  
Slap Tear

Background: The overhead-throwing athlete is a unique patient, requiring an elite, precise functional ability. Superior labral tears are quite common, and the percentage of athletes who return to play after superior labrum anterior-posterior (SLAP) repair has been variable. A tear of the infraspinatus caused by either internal impingement or tension overload may compromise this return. Hypothesis: The rate of return to a level of play similar to or greater than the preinjury level after repair of combined SLAP and infraspinatus injuries will be lower than in previous reports of SLAP repair alone. Study Design: Case series; Level of evidence, 4. Methods: In the current study, we examined a series of overhead-throwing athletes with diagnoses of both a SLAP tear and a significant (>50%) tear of the infraspinatus tendon who underwent surgical repair of both injuries. We identified 17 high-level baseball players younger than 25 years who underwent simultaneous arthroscopic repairs of a SLAP tear with a standard suture anchor technique and of an infraspinatus tear with either a free polydioxanone (PDS) suture or suture anchor between 2005 and 2008. The postoperative records of all patients were reviewed to determine their ability to return to play and their postoperative level of performance. All patients were then contacted to determine their Kerlan-Jobe Orthopaedic Clinic Overhead Athlete Shoulder and Elbow score and their current sport participation level. Results: All 17 patients in the series attempted to return to their prior sport after completion of postoperative rehabilitation. Only 6 patients (35%) were able to return to the same or a superior preinjury level of performance. Five of the remaining 11 patients returned to play at a lower level, either playing the same position or else forced to switch to another position of play because of a decline in throwing velocity. Six patients were unable to return to play. No complications or reoperations occurred in any of the patients following surgery. Conclusion: A significant (>50%) tear of the infraspinatus in combination with glenohumeral internal rotation deficit (GIRD) and SLAP tears in the throwing athlete results in a guarded prognosis in return to play at the same level. While the rates of return to play in overhead-throwing athletes with an isolated SLAP tear have historically been encouraging, the prognosis for an athlete with both a SLAP and infraspinatus tear is more guarded. These patients are not likely to return to their preinjury level of play.

scholarly journals Return-to-Play Considerations Following a COVID-19 Infection in Elite Athletes

2021 ◽  
Author(s):  
Ryan Ross ◽  
Laura Irvin ◽  
Rich Severin ◽  
Brian Ellis
Keyword(s):  
Sports Medicine ◽  
Sport Participation ◽  
Elite Athletes ◽  
Return To Play ◽  
Strength And Conditioning ◽  
Unique Challenge ◽  
Orthopedic Injuries ◽  
High Level ◽  
Isolation Period ◽  
Prolonged Absence

Abstract The COVID-19 pandemic has created a unique challenge for sports medicine staffs as they are attempting to safely transition elite athletes into sport participation after a COVID-19 infection. Athletes must isolate for a period of time after testing positive for COVID-19 to prevent the spread of the virus within a community. After an isolation period, a battery of cardiac tests must be given to assess whether or not an athlete is ready to begin a reconditioning protocol. A return-to-play plan should be established to safely re-integrate high-level athletes into strength and conditioning, sport-specific drill work, and contact drill work. Elite athletes should also be gradually eased back into full training loads in order to avoid increases in orthopedic injuries after a prolonged absence from training.

Imaging of the Elbow in the Overhead Throwing Athlete

2003 ◽  
Vol 31 (3) ◽  
pp. 466-473 ◽  
Author(s):  
Andrew L. Chen ◽  
Thomas Youm ◽  
Bernard C. Ong ◽  
Mahvash Rafii ◽  
Andrew S. Rokito
Keyword(s):  
Functional Recovery ◽  
Return To Play ◽  
Radiographic Evaluation ◽  
Throwing Athlete ◽  
Elbow Injuries ◽  
Overhead Throwing ◽  
Patterns Of Injury

Elbow injuries in athletes who perform overhead throwing motions often present diagnostic challenges because of the undue stresses and often chronic, repetitive patterns of injury. Accurate and efficient assessment of the injured elbow is essential to maximize functional recovery and expedite return to play. Radiographic evaluation should be tailored to the specific injury suspected and requires a thorough understanding of normal anatomic relationships as well as familiarity with common injuries affecting these athletes.

Immediate effect of combining glenohumeral and scapulothoracic mobilization with stretching on improving shoulder internal rotation in overhead throwing athletes with glenohumeral internal rotation deficit: A randomized clinical trial study

2021 ◽  
pp. 1-8
Author(s):  
Fahimeh Kamali ◽  
Narjes Ghasempour ◽  
Nasrin Salehi Dehno
Keyword(s):  
Internal Rotation ◽  
External Rotation ◽  
Controlled Trial ◽  
Overhead Athletes ◽  
Joint Mobilization ◽  
Glenohumeral Internal Rotation Deficit ◽  
Posterior Shoulder ◽  
Before And After ◽  
Overhead Throwing ◽  
Posterior Shoulder Tightness

BACKGROUND: Posterior shoulder tightness as demonstrated by glenohumeral internal rotation deficit (GIRD) is a common contributor to many shoulder pathologies in overhead throwing athletes. PURPOSE: This study aimed to assess immediate effect of combining glenohumeral and scapulothoracic mobilization with stretching on improving internal rotation range of motion (ROM) in overhead athletes with GIRD METHODS: This study was a single-blind randomized controlled trial with parallel groups. The participants were 30 asymptomatic male volleyball players who had a loss of shoulder internal rotation ROM of 15 degrees or more on their dominant compared to their nondominant side. They were randomly assigned to 1 of 2 groups: stretching only (n = 15) or stretching plus joint mobilization (n = 15). Participants in the stretching group performed cross-body stretches, and those in stretching plus mobilization group were treated with both cross-body stretching and mobilization techniques for the glenohumeral and scapulothoracic joints. Both groups received the intervention every other day for 1 week. Shoulder internal and external ROM were measured before and after the intervention. RESULTS: Before the intervention, dominant-side deficits in internal rotation ROM compared to the nondominant side were 20.11±5.27 degrees in the stretching group and 21.87±8.06 degrees in the stretching plus mobilization group. After the intervention, internal rotation ROM deficit between the dominant and nondominant side decreased to 11.28±5.82 in the stretching group (P <  0.001) and 10.85±9.19 in the stretching plus mobilization group (P <  0.001). However, the between-group difference was not statistically significant (P = 0.389). External rotation ROM remained unchanged in both groups (P >  0.05). CONCLUSION: Both interventions (stretching and stretching plus mobilization) can have the same beneficial effect in decreasing GIRD in asymptomatic overhead athletes.

Rehabilitation of the Overhead Throwing Athlete: There Is More to It Than Just External Rotation/Internal Rotation Strengthening

PM&R ◽  
2016 ◽  
Vol 8 (3S) ◽  
pp. S78-S90 ◽  
Author(s):  
Kevin E. Wilk ◽  
Christopher A. Arrigo ◽  
Todd R. Hooks ◽  
James R. Andrews
Keyword(s):  
Internal Rotation ◽  
External Rotation ◽  
Throwing Athlete ◽  
Overhead Throwing

scholarly journals Soft Tissue Mobilization and Stretching for Shoulder in CrossFitters: A Randomized Pilot Study

2021 ◽  
Vol 18 (2) ◽  
pp. 575
Author(s):  
Marcos Jusdado-García ◽  
Rubén Cuesta-Barriuso
Keyword(s):  
Soft Tissue ◽  
Internal Rotation ◽  
Repeated Measures ◽  
Control Group ◽  
Average Weight ◽  
Average Height ◽  
Shoulder Injury ◽  
Glenohumeral Internal Rotation Deficit ◽  
Posterior Shoulder ◽  
Soft Tissue Mobilization

Background. The shoulder in CrossFit should have a balance between mobility and stability. Glenohumeral internal rotation deficit and posterior shoulder stiffness are risk factors for overhead shoulder injury. Objective. To determine the effectiveness of instrument-assisted soft tissue mobilization and horizontal adduction stretch in CrossFit practitioners’ shoulders. Methods: Twenty-one regular CrossFitters were allocated to experimental (stretching with isometric contraction and instrument-assisted soft tissue mobilization) or control groups (instrument-assisted soft tissue mobilization). Each session lasted 5 min, 2 days a week, over a period of 4 weeks. Shoulder internal rotation and horizontal adduction (digital inclinometer), as well as posterior shoulder stretch perception (Park scale), were evaluated. Shapiro–Wilk test was used to analyze the distribution of the sample. Parametric Student’s t-test was used to obtain the intragroup differences. The inter- and intra-rater differences were calculated using a repeated measures analysis of variance (ANOVA). Results. Average age was 30.81 years (SD: 5.35), with an average height of 178 (SD: 7.93) cm and average weight of 82.69 (SD: 10.82) kg. Changes were found in the experimental group following intervention (p < 0.05), and when comparing baseline and follow-up assessments (p < 0.05) in all variables. Significant differences were found in the control group following intervention (p < 0.05), in right horizontal adduction and left internal rotation. When comparing the perception of internal rotation and horizontal adduction in both groups, significant differences were found. Conclusions. Instrument-assisted soft tissue mobilization can improve shoulder horizontal adduction and internal rotation. An instrument-assisted soft tissue mobilization technique yields the same results alone as those achieved in combination with post-isometric stretch with shoulder adduction.

scholarly journals Avaliação do déficit de rotação medial e do encurtamento posterior do ombro em jogadores profissionais de basquetebol

2012 ◽  
Vol 18 (3) ◽  
pp. 171-175 ◽  
Author(s):  
Valquíria Nunes ◽  
Ricardo Vinícius dos Santos ◽  
Fabricio Wodewotzky ◽  
Hugo Maxwell Pereira ◽  
Lígia Leme ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Glenohumeral Internal Rotation Deficit

O arremesso destaca-se como um dos principais gestos que envolvem a articulação do ombro. Atletas que praticam arremessos acima da cabeça possuem maior propensão a desenvolver lesões no ombro e podem apresentar significativo aumento da rotação lateral (RL) e diminuição da rotação medial (RM). O déficit de RM é chamado GIRD (glenohumeral internal rotation deficit). O objetivo do estudo foi verificar a existência de alterações na mobilidade da articulação glenoumeral em atletas profissionais de basquetebol, bem como verificar se existe correlação entre a ADM de RM e o encurtamento posterior do ombro. MÉTODO: Foram avaliados 19 jogadores profissionais de basquetebol. A mensuração da RM e RL do ombro foi realizada através dos métodos de goniometria e biofotogrametria, e também foi realizado o teste para encurtamento posterior do ombro. RESULTADOS: Não foram observadas diferenças significantes entre os gêneros e também entre as rotações (RL e RM) quando comparados o ombro dominante e o não dominante, assim como, no teste de encurtamento posterior, não foram observadas diferenças estatisticamente significantes. Não houve correlações entre a diminuição de RM e o teste para encurtamento posterior do ombro. CONCLUSÃO: Alterações na mobilidade da articulação glenoumeral em atletas profissionais de basquetebol não foram encontradas nessa amostra, assim como não houve correlação entre a ADM de RM e o encurtamento posterior do ombro.

scholarly journals Imaging of the Overhead Throwing Athlete

2007 ◽  
Vol 11 (1) ◽  
pp. 091-091
Author(s):  
Hugue Ouellette ◽  
Ara Kassarjian ◽  
Patrice Tétreault ◽  
William Palmer
Keyword(s):  
Throwing Athlete ◽  
Overhead Throwing
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