Chronic Shoulder Injuries Research Articles

Evaluation and treatment of shoulder injuries in tennis players: a review

Tennis, one of the most popular sports in the United States, requires both strenuous aerobic and anaerobic effort, placing competitors at risk of significant fatigue and subsequently faulty mechanics. Repetitive stress on the upper extremity especially when serving contributes to the high incidence of chronic shoulder injuries as well as acute injuries. Shoulder injuries may include scapular dyskinesis, glenohumeral internal rotation deficit, internal impingement, and labral, biceps, or rotator cuff lesions. Physical therapy and rehabilitation are the mainstays of treatment. When surgical treatment is necessary, prolonged recovery and difficulty with a return to pre-injury levels of competition can occur. This review focuses on the most common shoulder injuries seen in tennis players, with an emphasis on evaluation and treatment.

The epidemiology of MRI detected shoulder injuries in athletes participating in the Rio de Janeiro 2016 Summer Olympics

BackgroundTo use Magnetic Resonance Imaging (MRI) to characterize the severity, location, prevalence, and demographics of shoulder injuries in athletes at the Rio de Janeiro 2016 Summer Olympic Games.MethodsThis was a retrospective analysis of all routine shoulder MRIs obtained from the Olympic Village Polyclinic during the Rio 2016 Summer Olympics. Imaging was performed on 1.5 T and 3 T MRI, and interpretation was centrally performed by a board-certified musculoskeletal radiologist. Images were assessed for tendon, muscle, bone, bursal, joint capsule, labral, and chondral abnormality.ResultsA total of 11,274 athletes participated in the Games, of which 55 (5%) were referred for a routine shoulder MRI. Fifty-three (96%) had at least two abnormal findings. Seven (13%) had evidence of an acute or chronic anterior shoulder dislocation. Forty-nine (89%) had a rotator cuff partial tear and / or tendinosis. Subacromial / subdeltoid bursitis was present in 29 (40%). Thirty (55%) had a tear of the superior labrum anterior posterior (SLAP).ConclusionOur study demonstrated a high prevalence of both acute and chronic shoulder injuries in the Olympic athletes receiving shoulder MRI. The high rates of bursal, rotator cuff, and labral pathology found in these patients implies that some degree of glenohumeral instability and impingement is occurring, likely due to fatigue and overuse of the dynamic stabilizers. Future studies are needed to better evaluate sport-specific trends of injury.

Generalized Ligamentous Laxity: An Important Predisposing Factor for Shoulder Injuries in Athletes.

BackgroundGeneralized ligamentous laxity is defined as an increased range of joint motion compared to that of the general population. It is a predisposing factor for sports injuries, especially in the lower extremities. Nevertheless, there is little evidence about the relationship between generalized ligamentous laxity and sports injuries in the upper extremities.ObjectivesTo evaluate the relationship of generalized ligamentous laxity with acute and chronic shoulder injuries in athletes.Patients and MethodsOur study comprised 118 volunteer athletes with a history of at least six months of sports activities and a shoulder injury in the three years prior to participation in our study. The athletes were divided into two groups: those with or without generalized ligamentous laxity. Acute and chronic shoulder injuries, shoulder pain, shoulder instability, and functional status assessed via the QuickDASH measure were determined and compared between the two groups. A P value of less than 0.05 was considered significant.ResultsGroup A (with ligamentous laxity) consisted of 43 participants (36.4%) and group B (without ligamentous laxity) consisted of 75 participants (63.6%). The athletes in group A had more shoulder pain (P = 0.016), chronic shoulder injuries (P = 0.032), and shoulder instability (P = 0.004), and less functionality (P = 0.030) than those in group B. If fracture were not considered an acute injury in both groups, the athletes with generalized ligamentous laxity would have had more acute shoulder injuries.ConclusionsGeneralized ligamentous laxity is an important predisposing factor for acute and chronic shoulder injuries in athletes. Prescreening programs for beginners and rehabilitation shoulder programs for sports athletes at high risk are strongly recommended.

Adaptations of the Shoulder to Overhead Throwing in Youth Athletes.

The high number of repetitions and high forces associated with overhead throwing lead to anatomical adaptations, such as humeral retrotorsion and posterior-capsule thickness, in elite and professional baseball athletes. However, little is known about the origin and progression of these changes that may account for the increasing trend of chronic shoulder injuries in youth baseball and precipitate subsequent pathologic conditions throughout a young athlete's lifetime. To investigate the relationship of age and upper extremity dominance on humeral retrotorsion, posterior-capsule thickness, and glenohumeral range of motion. Cross-sectional study. Research laboratory, local baseball fields, and training facilities. Thirty-six boys (mean age = 10.94 ± 1.34 years, height = 151.31 ± 12.17 cm, mass = 42.51 ± 10.32 kg) ranging in age from 8 to 12 years and involved in organized youth baseball. Diagnostic ultrasound was used to determine humeral retrotorsion and posterior-capsule thickness. Glenohumeral internal rotation and external rotation were measured using a handheld inclinometer. We used 2 × 2 mixed-model analyses of variance to compare the influence of limb dominance and age on the dependent variables of humeral retrotorsion, posterior-capsule thickness, internal rotation, and external rotation. The dominant shoulders of youth throwers exhibited less glenohumeral internal rotation but greater humeral retrotorsion, posterior-capsule thickness, and glenohumeral external rotation than the nondominant shoulders. Dominant internal rotation was greater in the 8- to 10-year-old group than in the 11- to 12-year-old group, and results trended toward a difference (F1,33 = 4.12, P = .05). Correlations existed between humeral retrotorsion and range of motion (P < .05). The structural adaptations in the dominant shoulders of younger baseball players were similar to adaptations observed in older baseball athletes, indicating that more examination is needed in younger athletes. We are the first to demonstrate greater posterior-capsule thickness in the dominant shoulders of youth baseball athletes.

Shoulder injuries in provincial male fast bowlers - predisposing factors

Objectives. To investigate the relationship between shoulder flexibility and isokinetic strength as possible factors that may predispose provincial fast bowlers to shoulder injuries. Design. Twenty-one players, 12 of whom had no history of shoulder injuries and 9 of whom had experienced a shoulder injury to the bowling arm, were assessed for shoulder strength using a Cybex Norm isokinetic dynamometer. Absolute and relative peak torque measures were obtained at isokinetic speeds of 90°/s and 180°/s, with both concentric and eccentric contractions performed. Shoulder flexibility was tested using a Leighton Flexometer in both internal and external shoulder rotation. The players were classified into a front-on (N = 7), semi front-on (N = 7) or side-on (N = 7) bowling action from video footage recorded after a bowling trial in the nets. Results. Shoulder injuries were more common in fast bowlers with a front-on action (N = 5) than the bowlers with a side-on (N = 2) or semi front-on (N = 2) action. Sixteen of the 21 fast bowlers showed low stability ratios compared with gravity corrected functional ratios, indicating an imbalance and the presence of possible dysfunction. The injured group of fast bowlers showed higher concentric weight-normalised torque values for internal rotation at the higher velocity (180°/s) (65.20 ± 10.03 vs. 45.91 ± 10.26 Nm.kg-1 p &lt; 0.009: injured vs. uninjured), which would suggest greater instability when compared with the uninjured players. This imbalance could indicate the presence of a predisposition to impingement syndrome in the injured subjects. There was an increase in the external rotation ranges of movement for both groups, indicating a degree of hypermobility in both groups. The results indicate that the presence of possible dysfunction in the shoulder rotators, combined with a front-on bowling action and external rotation hypermobility, are possible predisposing factors for chronic shoulder injuries in cricket fast bowlers. South African Journal of Sports Medicine Vol.16(1) 2004: 25-28

Shoulder injuries in provincial male fast bowlers - predisposing factors

Objectives. To investigate the relationship between shoulder flexibility and isokinetic strength as possible factors that may predispose provincial fast bowlers to shoulder injuries. Design. Twenty-one players, 12 of whom had no history of shoulder injuries and 9 of whom had experienced a shoulder injury to the bowling arm, were assessed for shoulder strength using a Cybex Norm isokinetic dynamometer. Absolute and relative peak torque measures were obtained at isokinetic speeds of 90°/s and 180°/s, with both concentric and eccentric contractions performed. Shoulder flexibility was tested using a Leighton Flexometer in both internal and external shoulder rotation. The players were classified into a front-on (N = 7), semi front-on (N = 7) or side-on (N = 7) bowling action from video footage recorded after a bowling trial in the nets. Results. Shoulder injuries were more common in fast bowlers with a front-on action (N = 5) than the bowlers with a side-on (N = 2) or semi front-on (N = 2) action. Sixteen of the 21 fast bowlers showed low stability ratios compared with gravity corrected functional ratios, indicating an imbalance and the presence of possible dysfunction. The injured group of fast bowlers showed higher concentric weight-normalised torque values for internal rotation at the higher velocity (180°/s) (65.20 ± 10.03 vs. 45.91 ± 10.26 Nm.kg-1 p &lt; 0.009: injured vs. uninjured), which would suggest greater instability when compared with the uninjured players. This imbalance could indicate the presence of a predisposition to impingement syndrome in the injured subjects. There was an increase in the external rotation ranges of movement for both groups, indicating a degree of hypermobility in both groups. The results indicate that the presence of possible dysfunction in the shoulder rotators, combined with a front-on bowling action and external rotation hypermobility, are possible predisposing factors for chronic shoulder injuries in cricket fast bowlers. South African Journal of Sports Medicine Vol.16(1) 2004: 25-28

The Diagnosis of Some Chronic Shoulder Injuries

The Diagnosis of Some Chronic Shoulder Injuries