Overhead Sports Research Articles

Arthroscopic anterior shoulder stabilisation in overhead sport athletes: 5-year follow-up.

Shoulder instability following traumatic glenohumeral dislocation is a common injury sustained by athletes particularly in contact and collision sports. Overhead contact sports such as gaelic football and hurling pose a unique hazard to the glenohumeral joint, increasing the risk of dislocation. To assess return to sport, level of play, recurrence and functional outcomes in gaelic football and hurling athletes in comparison with players of other sports. A retrospective cohort study was carried out from 2007 to 2016. Follow-up was conducted via telephone interview using the Western Ontario Shoulder Instability Index (WOSI) score used to assess functional outcomes as well as return to sport, level of return and recurrence. Ninety patients were included with follow-up which was obtained on 61 patients (68%) with a mean follow-up of 5.04years. 91.8% played sport at the time of injury, 55.4% of those (31 patients) played a gaelic sport with 44.6% (25 patients) playing other sports. 76.8% returned to their sport, 80.4% of these able to return at their pre-injury level. Recurrence occurred in 10 patients (16.4%). WOSI scores were not significantly different between groups (p = 0.77). No significance in recurrence between groups was noted (p = 0.78). Favourable outcomes can be expected for overhead contact sport athletes undergoing anterior arthroscopic stabilisation for recurrent instability. Players from these groups returned to sport sooner than those from other sports and no difference in recurrence was noted. The level at which they can expect to return to is favourable with most athletes reaching their pre-injury level.

Physiological adaptations in the dominant and non-dominant shoulder in male competitive junior volleyball players

Summary Background In the overhead sport volleyball, the glenohumeral joint is subject to repeatedly high biomechanical loading. For injury prevention, especially in adolescent players, periodic orthopaedic and biomechanical monitoring of the stabilising structures is advisable, thereby contributing to a well-balanced state of shoulder mobility and stability. The aim of the study was to examine 20 healthy male competitive junior volleyball players (16 ± 1 years) to quantify sport-specific orthopaedic and biomechanical adaptations at that age. Material and methods Standard sport-orthopaedic testing was combined with overhead-specific isokinetic shoulder strength and mobility tests. The isokinetic tests were carried out in the volleyball-specific anatomic planes of external/internal rotation (ER/IR) and horizontal abduction/adduction (hAbd/hAdd) in a typical overhead posture. Results Sport-orthopaedic testing did not yield any pathological adaptations, yet revealed significant functional differences between sides (p Conclusions Mean lateral asymmetries in shoulder strength and mobility as derived in this study for healthy male adolescent volleyball players may serve as a reference of functional shoulder adaptations for future sport-orthopaedic and biomechanical shoulder diagnostics and thereby contribute to a well-balanced training control in competitive junior and junior elite sports.

The Overhead Athletes Shoulder.

The overhead athlete places tremendous forces across the shoulder which result in necessary adaptive, but also potentially pathologic structural change. In this chapter we aim to review the biomechanics of throwing, the mechanisms of injury with overhead sports, the detailed history, and physical examination in this population, and concluding with specific diagnoses and the various treatment options.

A systematic review on posterior circumflex humeral artery pathology: sports and professions at risk and associated risk factors.

Posterior circumflex humeral artery (PCHA) aneurysm formation and thrombosis as overuse injury in the dominant shoulder can result in ischemia of the forearm, hand and digits due to arterial embolisms. Increased awareness among physicians is necessary as PCHA pathology (PCHAP) might be underdiagnosed. Knowledge of sports and professions at risk and risk-factors for obtaining PCHAP is essential for the development of future preventive measures. This study aims to identify sports and professions at risk as well as risk factors for PCHAP. The databases of MEDLINE, EMBASE, BIOSIS, CINAHL and SPORTDiscus were systematically searched. Twenty-seven papers fulfilled the inclusion criteria and described 67 patients with PCHAP involved in seven sports and three professions. The sports (number of cases) were volleyball (41), baseball (13), swimming (1), tennis (3), American football (2), canoeing (1) and yoga (1) (2 unknown). The professions included a baseball coach, a circus trapeze artist and a mechanic. Apart from expert opinions, no studies have identified risk factors for PCHAP. An anatomic variation of the PCHA origin is suggested to be protective for PCHAP. PCHAP is reported in seven overhead sports and three professions. No risk factors for PCHAP were identified. An anatomic variant of the PCHA origin was found to be a potential protective factor for PCHAP. Physicians should be cautious for distal embolization as a result of PCHAP in athletes and workers, both adult and adolescent, involved in repetitive powerful overhead movements.

A review of shoulder injuries in young athletes

Participation in youth sports is widespread throughout the United States. Shoulder injuries can be burdensome for a young athlete, particularly in overhead sports. This article is a review of the current literature regarding shoulder injuries in athletes, with a focus on the youth.

Rotator Cuff Repair in Adolescent Athletes

Background: Rotator cuff tears are rare injuries in adolescents but cause significant morbidity if unrecognized. Previous literature on rotator cuff repairs in adolescents is limited to small case series, with few data to guide treatment. Hypothesis: Adolescent patients would have excellent functional outcome scores and return to the same level of sports participation after rotator cuff repair but would have some difficulty with returning to overhead sports. Study Design: Case series; Level of evidence 4. Methods: A retrospective search of the practice’s billing records identified all patients participating in at least 1 sport who underwent rotator cuff repair between 2006 and 2014 with an age <18 years at the time of surgery and a minimum follow-up of 2 years. Clinical records were evaluated for demographic information, and telephone follow-up was obtained regarding return to play, performance, other surgery and complications, a numeric pain rating scale (0-10) for current shoulder pain, American Shoulder and Elbow Surgeons (ASES) Shoulder Assessment Form, and the Western Ontario Rotator Cuff Index. Results: Thirty-two consecutive adolescent athletes (28 boys and 4 girls) with a mean age of 16.1 years (range, 13.2-17.9 years) met inclusion criteria. Twenty-nine patients (91%) had a traumatic event, and 27 of these patients (93%) had no symptoms before the trauma. The most common single tendon injury was to the supraspinatus (21 patients, 66%), of which 2 were complete tendon tears, 1 was a bony avulsion of the tendon, and 18 were high-grade partial tears. Fourteen patients (56%) underwent single-row repair of their rotator cuff tear, and 11 (44%) underwent double-row repair. All subscapularis injuries were repaired in open fashion, while all other tears were repaired arthroscopically. Twenty-seven patients (84%) completed the outcome questionnaires at a mean 6.2 years after surgery (range, 2-10 years). The mean ASES score was 93 (range, 65-100; SD = 9); mean Western Ontario Rotator Cuff Index, 89% (range, 60%-100%; SD = 13%); and mean numeric pain rating, 0.3 (range, 0-3; SD = 0.8). Overall, 25 patients (93%) returned to the same level of play or higher. Among overhead athletes, 13 (93%) were able to return to the same level of play, but 8 (57%) were forced to change positions. There were no surgical complications, but 2 patients did undergo a subsequent operation. Conclusion: Surgical repair of high-grade partial-thickness and complete rotator cuff tears yielded successful outcomes among adolescents, with excellent functional outcomes at midterm follow-up. However, overhead athletes may have difficulty playing the same position after surgery.

Scapular motion adaptations in junior overhead athletes: a three-dimensional kinematic analysis in tennis players and non-overhead athletes

Adult overhead athletes without a history of shoulder injury show scapular adaptations. There is a lack of detailed assessment of scapular kinematics in junior overhead athletes. This study aims to investigate three-dimensional scapular kinematics in junior overhead athletes. We recruited a total of 20 junior tennis players and 20 healthy children without participation in any overhead sports in this study. Bilateral scapular kinematic data were recorded using an electromagnetic tracking device for scapular plane glenohumeral elevation. The data were further analysed at 30°, 45°, 60°, 90° and 120° during glenohumeral elevation and lowering. Statistical comparisons of the data between groups (junior overhead athletes and non-overhead athletes) and sides (serve dominant and non-dominant shoulders of the overhead athletes) were analysed with the ANOVA. Comparisons showed that, in general, the scapula was more upwardly rotated and anteriorly tilted in overhead athletes when compared to non-overhead athletes, however there was no side-to-side differences when serve dominant and non-dominant shoulders compared in junior overhead athletes. The serve dominant arm of junior overhead athletes had alternations in scapular kinematics when compared with the non-overhead athletes. These findings provide clinical evaluation implications and the need for clinicians to assess for potential adaptations in junior overhead athletes.

Prevalence of Glenohumeral Internal Rotation Deficit and its Association with Scapular Dyskinesia and Rotator Cuff Strength Ratio in Collegiate Athletes Playing Overhead Sports

Introduction: Glenohumeral Internal Rotation Deficit (GIRD) indicates a 15° or greater loss of internal rotation of the throwing shoulder compared with the non-dominant shoulder.Aim: To estimate the prevalence of GIRD in collegiate overhead sports player and determine whether GIRD is associated with scapular dyskinesia and rotator cuff strength ratio. Materials and Methods: The present study was a Cross-sectional study. A total of 127 collegiate athletes were assessed for passive range of motion, external to internal rotation strength ratio (ER/IR ratio) and scapular dyskinesia for the throwing and non-throwing shoulder. Internal and external rotation of shoulder was measured using an inclinometer with the subject in prone and arm abducted to 90°. Scapular dyskinesia was measured using Lateral Scapula Slide test (LSST) and external to internal rotator strength was measured using a held hand isometric dynamometer. Chi-square test was used to find the association between GIRD and scapular dyskinesia and rotator cuff strength ratio.Results: Prevalence of GIRD (n=37) was found to be 29.1%. GIRD was not found to be associated with Scapular dyskinesia (p=0.237) and ER/IR strength ratio (p=0.411).Conclusion: Prevalence of GIRD in collegiate athletes playing overhead sports was found to be 29.1% and there was no association of GIRD with scapular dyskinesia, rotator cuff strength ratio.

Scapular Dyskinesis in Young, Asymptomatic Elite Swimmers.

Background:Overhead athletes are at a greater risk of developing scapular dyskinesis (SD). Although swimming is considered an overhead sport, information regarding SD in these athletes is scarce.Purpose:To determine the prevalence of SD in young, asymptomatic elite swimmers.Study Design:Cross-sectional study; Level of evidence, 3.Methods:A total of 661 asymptomatic elite swimmers were enrolled in this study (344 male, 317 female; mean age, 15.83 ± 2.20 years). Anthropometric characteristics, training routine, and stroke specialty were recorded. SD was assessed using a dynamic test consisting of an examination of the shoulder blades throughout synchronous forward flexion motion in the sagittal plane and was deemed to be either present or absent. Each movement was repeated 5 times. These evaluations were performed with athletes at rest, before any training or competition. Statistical analysis was performed.Results:SD was detected in 56 (8.5%) participants. Type I SD was the most common (46.5%); male participants were 2 times as likely to have SD as female participants (39 male, 17 female; P < .01). No correlation was found between the dominant limb and side affected (P = .258); rather, a correlation was found between the breathing side and side affected, in that swimmers with a preferred breathing side were more prone to develop SD in the opposite shoulder (P < .05). Swimmers involved in long-distance races were found to have a greater risk of developing SD (P = .01).Conclusion:SD may be an asymptomatic condition in elite young swimmers and is present in 8.5% of these athletes. Early diagnosis may be useful for asymptomatic athletes with SD and to avoid its possible evolution to a symptomatic condition.

EMG Analysis of Dynamic Warm-up Exercises for Overhead Sports

EMG Analysis of Dynamic Warm-up Exercises for Overhead Sports

Ultrasound comparison of the effects of prehabilitation exercises and the scapular assistance test on the acromiohumeral distance

Background: Prolonged participation in overhead sports creates shoulder muscle imbalances which eventually alter the efficacy of the shoulder stabiliser muscles and heighten injury risk, such as subacromial impingement syndrome. Objectives: The aim of this study was to determine if ultrasound is effective to measure the acromiohumeral distance (AHD) to compare the effect of the scapular assistance test (SAT) on the AHD with a prehabilitative exercise intervention programme in asymptomatic cricket players. Methods: Baseline testing on cricket players from the North- West University cricket squad (N=34) included AHD measurements performed by a sonographer at 0°, 30° and 60° humeral abduction angles respectively, with and without the SAT application. Players were then randomly assigned to an intervention and control group. The control group continued with their normal in-season programme, whereas the intervention group also performed shoulder stability exercises for six weeks. Results: The exercise intervention had a similar effect as the SAT on the AHD at 0o and 30o humeral abduction angles in the intervention group. The AHD measurements in the exercise intervention group indicated widening at all abduction angles after the six-week intervention period, whereas the AHD measurements in the control group were equal or smaller than baseline measurements without the SAT at 30o and 60o respectively. Conclusion: Exercise intervention has a similar effect on the AHD of asymptomatic cricket players compared to the SAT – especially in 0°and 30o of humeral abduction. Ultrasound can therefore be utilised to assist in identifying the risk of developing subacromial impingement syndrome (SIS) in asymptomatic overhead athletes by measuring the AHD at different angles of humeral abduction, without and with the SAT application.

Ultrasound comparison of the effects of prehabilitation exercises and the scapular assistance test on the acromiohumeral distance

Background: Prolonged participation in overhead sports creates shoulder muscle imbalances which eventually alter the efficacy of the shoulder stabiliser muscles and heighten injury risk, such as subacromial impingement syndrome. Objectives: The aim of this study was to determine if ultrasound is effective to measure the acromiohumeral distance (AHD) to compare the effect of the scapular assistance test (SAT) on the AHD with a prehabilitative exercise intervention programme in asymptomatic cricket players. Methods: Baseline testing on cricket players from the North- West University cricket squad (N=34) included AHD measurements performed by a sonographer at 0°, 30° and 60° humeral abduction angles respectively, with and without the SAT application. Players were then randomly assigned to an intervention and control group. The control group continued with their normal in-season programme, whereas the intervention group also performed shoulder stability exercises for six weeks. Results: The exercise intervention had a similar effect as the SAT on the AHD at 0o and 30o humeral abduction angles in the intervention group. The AHD measurements in the exercise intervention group indicated widening at all abduction angles after the six-week intervention period, whereas the AHD measurements in the control group were equal or smaller than baseline measurements without the SAT at 30o and 60o respectively. Conclusion: Exercise intervention has a similar effect on the AHD of asymptomatic cricket players compared to the SAT – especially in 0°and 30o of humeral abduction. Ultrasound can therefore be utilised to assist in identifying the risk of developing subacromial impingement syndrome (SIS) in asymptomatic overhead athletes by measuring the AHD at different angles of humeral abduction, without and with the SAT application.

Trends in Sports-Related Elbow Ulnar Collateral Ligament Injuries.

Background:Elbow ulnar collateral ligament (UCL) injuries are common, particularly in adolescent athletes playing overhead sports. While the incidence and outcomes of surgical UCL injuries are well documented, the nonsurgical UCL injury patterns and injury management in this population are not yet known.Purpose/Hypothesis:The purpose of this study was to retrospectively assess the injury severity and subsequent management of UCL injuries among competitive athletes aged 11 to 22 years. We hypothesized that nonsurgical UCL injuries would occur more frequently in younger athletes compared with older athletes.Study Design:Descriptive epidemiological study.Methods:Electronic medical records (using International Classification of Diseases, 9th Revision and 10th Revision and Current Procedural Terminology codes) and keyword searches were used to identify all patients with sports-related UCL injuries between January 2000 and April 2016. A total of 136 records were included. Patients were stratified into 3 age brackets (age 11-13 years, n = 17; age 14-16 years, n = 49; age 17-22 years, n = 70). There were no prior elbow surgical interventions. The main outcome measures included the frequency and severity of UCL injuries and injury management (surgical, nonsurgical). Independent variables included age, UCL injuries per year, and sport classification.Results:There were 53 surgical and 83 nonsurgical UCL injuries. The number of nonsurgical cases increased 9-fold from 2000-2008 to 2009-2016. The UCL injuries were distributed as follows: 60 sprains, 39 partial tears, 36 ruptures, and 1 rerupture. Moreover, 7% of sprains, 51% of partial tears, and 78% of ruptures underwent UCL reconstruction. Nonsurgical management was most common in the youngest athletes (age 11-13 years, 100.0% of total injuries; age 14-16 years, 71.4% of total injuries; and age 17-22 years, 44.3% of total injuries) (P = .007). UCL injury volume was most commonly associated with javelin (odds ratio, 6.69; 95% CI, 0.72-61.62; P = .07) and baseball (odds ratio, 1.55; 95% CI, 0.69-3.51; P = .32).Conclusion:Younger athletes sustained less severe UCL injuries more often than older athletes. Participation in javelin and baseball was associated with a greater likelihood of UCL injuries based on our dataset. This is the first study to provide data on the volume of nonsurgical UCL injuries among athletes in various sports.

Risk Factors for the Postoperative Recurrence of Instability After Arthroscopic Bankart Repair in Athletes.

Background:Several risk factors for the postoperative recurrence of instability after arthroscopic Bankart repair have been reported, but there have been few detailed investigations of the specific risk factors in relation to the type of sport.Purpose:This study investigated the postoperative recurrence of instability after arthroscopic Bankart repair without additional reinforcement procedures in competitive athletes, including athletes with a large glenoid defect. The purpose of this study was to investigate risk factors related to the postoperative recurrence of instability in athletes.Study Design:Case-control study; Level of evidence, 3.Methods:A total of 115 athletes (123 shoulders) were classified into 5 groups according to type of sport: rugby (41 shoulders), American football (32 shoulders), other collision sports (18 shoulders), contact sports (15 shoulders), and overhead sports (17 shoulders). First, the recurrence rate in each sporting category was investigated, with 113 shoulders followed up for a minimum of 2 years. Then, factors related to postoperative recurrence were investigated in relation to the type of sport.Results:Postoperative recurrence of instability was noted in 23 of 113 shoulders (20.4%). The recurrence rate was 33.3% in rugby, 17.2% in American football, 11.1% in other collision sports, 14.3% in contact sports, and 12.5% in overhead sports. The most frequent cause of recurrence was tackling, and recurrence occurred with tackling in 12 of 16 athletes playing rugby or American football. Reoperation was completed in 11 shoulders. By univariate analysis, significant risk factors for postoperative recurrence of instability included playing rugby, age between 10 and 19 years at surgery, preoperative glenoid defect, small bone fragment of bony Bankart lesion, and capsular tear. However, by multivariate analysis, the most significant factor was not the type of sport but younger age at operation and a preoperative glenoid defect with small or no bone fragment. Compared with the other sports, there was a significantly greater recurrence rate among rugby players without the aforementioned significant risk factors (small glenoid defect, ≤10%; medium or large bone fragment, >5%; and no capsular tear).Conclusion:Younger age at operation and preoperative glenoid defect with small or no bone fragment significantly influenced recurrent instability among competitive athletes.

Posterior Shoulder Instability.

Posterior shoulder instability is a relatively uncommon condition, occurring in ∼10% of those with shoulder instability. Because of the rarity of the condition and the lack of knowledge in treatment, it is often misdiagnosed or patients experience a delay in diagnosis. Posterior instability typically affects athletes participating in contact or overhead sports and is usually the result of repetitive microtrauma or blunt force with the shoulder in the provocative position of flexion, adduction, and internal rotation, leading to recurrent subluxation events. Acute traumatic posterior dislocations are rare injuries with an incidence rate of 1.1 per 100,000 person years. This rate is ∼20 times lower than that of anterior shoulder dislocations. Risk factors for recurrent instability are: (1) age below 40 at time of first instability; (2) dislocation during a seizure; (3) a large reverse Hill-Sachs lesion; and (4) glenoid retroversion. A firm understanding of the pathoanatomy, along with pertinent clinical and diagnostic modalities is required to accurately diagnosis and manage this condition.

Elbow flexion and forearm supination strength in a healthy population

Despite the lack of representative data of a healthy population, many clinical trials concerning the measurement of postoperative elbow flexion or forearm supination strength use the contralateral side as a control. We hypothesized that there are no differences in elbow flexion and supination strength between the dominant and nondominant sides in healthy volunteers. The study was performed on a cross-sectional cohort of healthy subjects without any prior injuries or surgical interventions of the upper extremities. Isometric elbow flexion strength and supination strength were measured on both the dominant and nondominant sides. The results were analyzed for the entire group and subanalyzed for female vs. male, for different age groups, and according to handedness and regular practice of overhead sports. A total of 150 subjects (75 female and 75 male subjects; mean age, 44 ± 15 years [range, 18-72 years]) were included in this study. Within the entire collective, no significant differences concerning the elbow flexion strength between the dominant and nondominant sides could be detected, whereas the supination strength was 7% higher on the dominant side (P = .010). Women, right-hand-dominant subjects, and subjects who do not regularly practice overhead sports have a significant 8% higher supination strength on the dominant side compared with the nondominant side (P < .05). Left-hand-dominant subjects have an 8% higher elbow flexion strength on the nondominant right side (P < .05). Elbow flexion strength and forearm supination strength differ between the dominant and nondominant sides. The contralateral upper extremity cannot be used as a matched control without some adjustments.

The Use of Osteopathic Manual Therapy and Rehabilitation for Subacromial Impingement Syndrome: A Case Report

Rotator cuff dysfunction is common in athletes involved with overhead sports. Secondary subacromial impingement is a common cause of pain for patients with rotator cuff dysfunction. Exercise rehabilitation and manual therapy can be used in the treatment of subacromial impingement to decrease pain, increase functionality and support a return to activity. The current case report describes a 24-year-old patient with supraspinatus tendinosis and secondary subacromial impingement who was experiencing pain when playing tennis, and during daily activities involving overhead movements. Osteopathic manual therapy and rehabilitation was undertaken leading to significant improvements in pain and function over a six-week period. The current case report describes an evidence-informed approach to the management of subacromial impingement syndrome whilst incorporating a manual therapy technique, balanced ligamentous tension, that has received little attention in the literature.

Rotator Cuff Repair in Adolescent Athletes

Objectives:Rotator cuff tears are rare injuries in adolescents, but can be a cause of significant morbidity if unrecognized. Previous literature on rotator cuff repairs in adolescents is limited to small case series, with little data to guide treatment. The purpose of this study was to investigate the clinical information, demographics, and results of surgical treatment of a consecutive series of adolescent athletes who underwent rotator cuff repair with a minimum 2-year follow-up. We hypothesized that adolescent patients would have excellent functional outcome scores and return to the same level of sports participation after rotator cuff repair, but would have some difficulty returning to the same position in overhead sports.Methods:A retrospective search of the practice’s billing records identified all patients with high-grade (>50%) partial-thickness or rotator cuff tears that underwent rotator cuff repair between 2006 and 2014 with an age of less than 18 years at the time of surgery and a minimum of two years of follow-up. Clinical records were evaluated for demographic information, and telephone follow-up was obtained for return to play, performance, other surgeries and complications, a numeric pain rating scale (0-10) for current shoulder pain, American Shoulder and Elbow Surgeons (ASES) Shoulder Assessment Form, and the Western Ontario Rotator Cuff Index (WORC). Statistical analysis was performed with JMP 10 (SAS Institute, Cary, NC) with p < 0.05 for significance. Descriptive statistics were prepared for all variables, and outcomes were compared according to affected tendon and concomitant procedures using two-sided Fisher’s exact tests and Student’s t-tests.Results:Thirty-two consecutive adolescent athletes (28 boys and 4 girls) with a mean age of 16.1 years (range 13.2-17.9 years, SD=1.3) met inclusion criteria. Twenty-nine patients (91%) had a traumatic event associated with the onset of their shoulder pain, and 27 of these patients (93%) had no symptoms prior to the trauma. The most common tendon affected was the supraspinatus (21 patients, 66%). All seven subscapularis injuries were repaired in open fashion, while all other tears were repaired arthroscopically with either a single-row or double-row configuration depending on tear size and anatomy. Of the 18 partial-thickness tears, eight (44%) were measured intraoperatively to be 50-75% of the footprint, and the remaining ten tears (56%) encompassed greater than 75% of the footprint from medial to lateral. Twenty-seven patients (84%) d the outcome questionnaires at a mean of 6.2 years after surgery (range 2-10 years, SD=2.6 years). The mean ASES score was 93 (range 65-100, SD=9), mean WORC was 89% (range 60%-100%, SD=13%), and mean numeric pain rating was 0.3 (range 0-3, SD=0.8). Table 1 Overall, 25 patients (93%) were able to return to the same level of play or higher. In overhead athletes, 13 patients (93%) were able to return to the same level of play, but 8 patients (57%) were forced to switch positions due to difficulty with throwing. There were no surgical complications, but two patients did undergo a second operation during the study period.Conclusion:Surgical repair of high-grade partial-thickness and rotator cuff tears yielded successful outcomes in adolescents, with excellent functional outcomes at mid-term follow-up. However, overhead athletes may have difficulty playing the same position after surgery due to difficulty throwing.Table 1:Patient outcomes and functional scores obtained from telephone follow-up.Patient Outcomes (n = 27 patients)Time from surgery to follow-up6.2 years (range 2-10 yrs., SD=2.6 yrs.)Return to sport at same level25 (93%)Play collegiate athletics8 (30%)Overhead athletes14 (52%)Return to play at same level13 (93%)Forced to switch positions8 (57%)ASES scoremean 93 (range 65-100, SD=9)WORC scoremean 89% (range 60%-100%, SD=13%)Numeric Pain Rating Scale (0-10)mean 0.3 (range 0-3, SD=0.8)

The efficacy of functional supports in mediating the effects of exercise on shoulder joint position sense

BACKGROUND: Prolonged exercise and joint position sense are considered aetiological risk factors for shoulder injury in overhead sports. OBJECTIVE: To investigate the efficacy of a neoprene sleeve and kinesiology tape (KT) in mediating the effect of exercise on shoulder joint position sense. METHODS: 25 overhead sports participants (women – 10, men – 15) completed 30 maximal isokinetic repetitions at 120◦/s of three shoulder exercise protocols: 9090 (seated 90◦ shoulder abduction, 90◦ elbow flexion, modified neutral (seated 45◦ shoulder abduction, 90◦ elbow flexion in the scapular plane and diagonal (seated GHJ flexion, abduction, external rotation and extension, adduction and internal rotation. Absolute error in active reproduction of passive positioning was assessed pre- and post-exercise at 10◦/s. This was conducted for end range internal and external rotation, and mid-range. RESULTS: A repeated measures general linear model revealed no significant main effect for gender or exercise in any test position. A main effect for support condition was observed pre-exercise in the KT condition, with JPS significantly (p < 0.01) impaired (5.30 ± 2.16◦) relative to baseline control scores (4.11 ± 2.81◦) in end range external rotation at the 9090 position. CONCLUSION: Results indicated that neither neoprene nor kinesio-tape were more effective in limiting the effects of exercise on joint position sense (JPS). Healthy, un-injured overhead athletes may not need to consider taping or supportive device, indeed KT application was observed to impair JPS in specific movements.

THE EFFECTS OF FATIGUE ON SCAPULA KINEMATICS DURING THROWING IN ELITE TEAM HANDBALL PLAYERS; DOES PAIN INFLUENCE? A PRELIMINARY STUDY

BackgroundNon-traumatic shoulder injuries are common in overhead sports, however many athletes still participate in their sport despite pain. Non-optimal scapula kinematics at the instant of maximal humeral external rotation (HumExtRot)...