Abstract
This clinical case presents an elite level 23-year-old female tennis athlete with a high-grade partial thickness tear of the supraspinatus with associated pain, dysfunction, and deficits in strength and range of motion (ROM) of her trunk and lower extremities. The purpose was to determine the efficacy of using a regional interdependence approach in the treatment of a partial supraspinatus tear with associated kinetic chain deficits in an elite level athlete. Following 24 physical therapy sessions, pain, mobility (ROM), strength, and function improved in the dominant shoulder in addition to further symmetry of the trunk and lower extremity due to a regional interdependence rehabilitation approach and returned to elite level of play. As a result of this case, it is important for clinicians to consider a comprehensive, global approach to patient rehabilitation following injury.
Highlights
The purpose was to determine the efficacy of using a regional interdependence approach in the treatment of a partial supraspinatus tear with associated kinetic chain deficits in an elite level athlete
It is common for overhead athletes to suffer from various shoulder injuries, including chronic shoulder overuse, rotator cuff tendinopathy and superior labral tear from anterior to posterior often associated with repetitive physical force and microtrauma to the shoulder of involved overhead movements[1,2]
Range of motion in internal rotation increased from 40° to 55° in the right shoulder and no end range pain was noted in flexion and abduction
Summary
It is common for overhead athletes to suffer from various shoulder injuries, including chronic shoulder overuse, rotator cuff tendinopathy and superior labral tear from anterior to posterior often associated with repetitive physical force and microtrauma to the shoulder of involved overhead movements[1,2]. Partial rotator cuff tendinitis and tearing (tendinopathy) are increasingly prevalent in high level athletes participating in overhead sports, often requiring conservative treatment measures prior to surgical intervention. Current standard clinical practice for shoulder conditions, including rotator cuff tendinopathy, does not include the assessment of kinetic chain as a region that may share movement deficits with the glenohumeral joint[3,4]. A broader approach of examining the whole body, including the kinetic chain can facilitate a clearer understanding of its ability to generate symptoms and underlie local impairments. The purpose of this case study was to examine the efficacy of a conservative RIA in rehabilitation on an Journal of Orthopedics and Orthopedic Surgery elite tennis athlete with a high-grade partial thickness tear of the supraspinatus with associated deficits to the kinetic chain. We hypothesized successful treatment and full return to play following this RIA to treatment
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