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Shoulder labrum rehabilitation

Ryuzo Arai, Taisuke Ito, Shuzo Okudaira, Shuichi Matsuda
Minor instability of the shoulder has recently drawn attention as a cause of shoulder pain in athletes. However, it is difficult to correctly diagnose the direction in which the humeral head translates and subluxates, and to clarify the pathology of the instability. We present a case of a 20-year-old male with an unstable shoulder who could not raise his left arm due to pain. Since 6 years prior to the onset of pain, the patient could asymptomatically perform voluntary subluxation, but it was slight and the direction of the subluxation could not be confirmed...
August 2017: Skeletal Radiology
Tahsin Beyzadeoglu, Esra Circi
BACKGROUND: Superior labrum anterior posterior (SLAP) lesions often cause shoulder pain, dysfunction, and instability. Professional athletes require a high level of shoulder function for competition and overhead activities. PURPOSE: To evaluate elite athletes who had arthroscopic surgery for common shoulder pathologies and SLAP lesions with a follow-up of more than 3 years. The associated intra-articular pathologies and return to play were documented. STUDY DESIGN: Case series; Level of evidence, 4...
April 2015: Orthopaedic Journal of Sports Medicine
Walter A Laughlin, Glenn S Fleisig, Anthony J Scillia, Kyle T Aune, E Lyle Cain, Jeffrey R Dugas
BACKGROUND: Baseball pitchers who undergo superior labrum anterior-posterior (SLAP) repair often have trouble returning to their previous level of performance. While the reason is often assumed to be diminished shoulder range of motion or other mechanical changes, differences in pitching biomechanics between baseball pitchers with a history of SLAP repair and pitchers with no injury history have not been studied previously. HYPOTHESIS: The primary hypothesis was that compared with the control group, the SLAP group would exhibit compromised shoulder range of motion (external rotation and horizontal abduction) and internal rotation torque during pitching...
December 2014: American Journal of Sports Medicine
Jessica W Witherspoon, Irina V Smirnova, Terence E McIff
The distribution, location, and spatial arrangement of mechanoreceptors are important for neural signal conciseness and accuracy in proprioceptive information required to maintain functional joint stability. The glenohumeral joint capsule and labrum are mechanoreceptor-containing tissues for which the distribution of mechanoreceptors has not been determined despite the importance of these tissues in stabilizing the shoulder. More recently, it has been shown that damage to articular mechanoreceptors can result in proprioceptive deficits that may lead to recurrent instability...
September 2014: Journal of Anatomy
J D Agneskirchner, M Haag, L Lafosse
OBJECTIVE: Arthroscopic visualisation and release of nerves around the shoulder, decompression of ganglion cysts. INDICATIONS: Arthroscopic treatment of nerve entrapment syndromes around the shoulder (suprascapular nerve, axillary nerve). Arthroscopic visualisation and release of osseous or ligamentous structures causing nerve entrapment. Arthroscopic decompression and resection of periglenoid ganglion cysts. Arthroscopic release of concomitant lesions (labrum, rotator cuff, biceps)...
June 2014: Operative Orthopädie und Traumatologie
Felix H Savoie, Michael J O'Brien
The disabled throwing shoulder is a multifactorial problem. Laxity of the glenohumeral joint is necessary to achieve a satisfactory velocity. Normal wear and tear with throwing may convert this normal amount of excessive translation into instability. Instability in the throwing athlete manifests itself in 2 forms: traumatic anterior instability that happens to occur in a throwing athlete and excessive anterior subluxation because of overuse that occurs in conjunction with the disabled throwing shoulder. In most cases, it is difficult to determine by physical examination or imaging how much laxity is too much; therefore, the managing physician should always err on the side of caution...
June 2014: Sports Medicine and Arthroscopy Review
Christina D Davlin, Dave Fluker
An unfused acromial epiphysis, called os acromiale, can become unstable and mobile when the deltoid contracts. This may cause pain and lead to impingement syndrome and rotator cuff tearing. After sustaining a direct blow to the right shoulder, a male division I basketball player was diagnosed with impingement syndrome and an os acromiale. Following failed conservative treatment, the athlete underwent arthroscopic subacromial decompression & debridement of the loose os acromiale in the right shoulder. One year later, following a fall on the left shoulder, the athlete was diagnosed with os acromiale, impingement syndrome and a superior labrum anterior-posterior (SLAP) lesion...
December 2003: Journal of Sports Science & Medicine
Wasyl W Fedoriw, Prem Ramkumar, Patrick C McCulloch, David M Lintner
BACKGROUND: The published return-to-play (RTP) rates for athletes who have undergone surgical repair of superior labrum anterior-posterior (SLAP) tears vary widely and are generally accepted to be lower in the subset of competitive throwers. The efficacy of nonsurgical treatment for this group is unknown. HYPOTHESIS: Nonsurgical treatment of SLAP tears in professional baseball players leads to RTP before consideration of surgical treatment. Incorporating performance statistics and level of competition will result in lower calculated RTP rates than have been previously reported...
May 2014: American Journal of Sports Medicine
Ann M Cools, Dorien Borms, Simon Cottens, Marcia Himpe, Stijn Meersdom, Barbara Cagnie
BACKGROUND: Although rehabilitation exercises are recommended in the nonoperative and postoperative treatment of biceps-related disorders and superior labrum anterior-posterior (SLAP) lesions in overhead athletes, a progressive exercise protocol with controlled low to moderate loads on the biceps has not yet been described. PURPOSE: To describe a continuum of exercises with progressive low to moderate loads on the biceps based on electromyographic (EMG) analysis...
June 2014: American Journal of Sports Medicine
K E Dreinhöfer, S Schüler, M Schäfer, T Ohly
BACKGROUND: Rehabilitation of athletes following surgical interventions for shoulder injuries is of utmost importance for recovery and return to sport. OBJECTIVES: The aim was to determine adequate concepts for rehabilitation following shoulder surgery in athletes. METHODS: A selective literature search was carried out in PubMed and a review of the available concepts is given taking personal experiences as well as national and international recommendations into consideration...
March 2014: Der Orthopäde
Haifeng Ren, Ryan T Bicknell
In conclusion, instability as a cause of shoulder pain in the young athlete is a difficult and often missed diagnosis. These young patients often seek treatment of shoulder pain but do not recall any episodes of shoulder instability. As a result, these uncommon, poorly described forms of instability are often misdiagnosed. A heightened clinical suspicion and an accurate, prompt diagnosis of instability is of paramount importance in this athletic group. It dictates appropriate treatment of the condition, avoids treatment delays and failure, provides better outcomes, and ensures timely return to play...
October 2013: Clinics in Sports Medicine
W Ben Kibler
Knowledge is evolving regarding the importance of the superior labrum in shoulder function and dysfunction. Biomechanical and clinical studies are defining the role of the labrum in shoulder joint function and instability, and guidelines for the diagnosis and the treatment of disorders are emerging. There is a positive association between clinically important, symptomatic labral tears requiring treatment and alterations in labral anatomy. The diagnosis is based on the patient's history and clinical examination findings that indicate a loss of labral function...
2013: Instructional Course Lectures
Jonathan P Van Kleunen, Scott A Tucker, Larry D Field, Felix H Savoie
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...
November 2012: American Journal of Sports Medicine
H Resch, K Golser, H Thoeni, G Sperner
Complete detachment of the glenoid labrum from the superior pole of the glenoid, which is associated with a destabilization of the origin of the long biceps tendon, leads to altered function in the shoulder joint. This is especially noticeable when the shoulder is used in overhead activities. Two operative techniques are described for reattachment of the glenoid labrum to the glenoid. In the first six patients the glenoid labrum was reattached with small cannulated titanium screws. In five patients these screws were inserted under arthroscopic control from a cranial direction...
May 1993: Journal of Shoulder and Elbow Surgery
Deepak N Bhatia
Arthroscopic posterior labral repair and capsular shift procedures are technically difficult in the beach-chair position as compared with the lateral decubitus position. Optimal visualization in the beach-chair position, and anchor placement in the posterior glenoid rim, necessitate various lateral trans-cuff portals, and these may result in damage to the rotator cuff tendons. The author has devised a new technique for posterior labral repair in the beach-chair position; the technique involves visualization of the posterior capsulolabral complex through a 70-degree arthroscope placed in the posterior axillary pouch portal, and labral repair is performed through percutaneous medial portals...
September 2012: Techniques in Hand & Upper Extremity Surgery
James Crichton, Doug R Jones, Lennard Funk
BACKGROUND: Shoulder injuries in rugby players are common, but the mechanisms of injury are less well understood. This study aims to elucidate common mechanisms of injury and identify the patterns of injury they produce. MATERIALS AND METHODS: Twenty-four elite rugby players, referred to the senior author for diagnosis and management of shoulder injuries, were selected. Videos of the injuries were independently reviewed by rugby-medical experts to describe the mechanisms of injury...
June 2012: British Journal of Sports Medicine
Jason J Jancosko, Jack E Kazanjian
Shoulder injuries in the throwing athlete are becoming more frequent. Sports specialization at a younger age, playing multiple seasons, increased awareness of injury and injury prevention, advances in diagnosis, and surgical treatment all play a part in the increase in diagnosis of these injuries. Understanding the biomechanics of throwing and pathologies that are encountered in the throwing athlete can aid the clinician in successful diagnosis and nonoperative/operative treatment of the throwing athlete. This article discusses the relevant anatomy, biomechanics, and pathoanatomy of the throwing shoulder...
February 2012: Physician and Sportsmedicine
Brian G Leggin, Scott Sheridan, Brian J Eckenrode
The overhead throwing motion is a complex and coordinated movement pattern involving the lower extremities, the trunk, and the upper extremity. Because of these tremendous demands on the shoulder, various shoulder injuries may occur. Two of the more common injuries to throwers are shoulder instability and superior labrum anterior-posterior lesions. Although nonoperative treatment is frequently successful in treating these conditions, surgical management may be necessary for the athlete to return to their sport...
March 2012: Sports Medicine and Arthroscopy Review
W Ben Kibler, David Dome
Internal impingement is a general term usually applied to the pathologic combination of a superior labral anterior-posterior injury and a partial thickness rotator cuff injury that is commonly seen in the disabled throwing shoulder. Clinical presentation varies but involves a combination of internal derangement (popping, clicking, catching, sliding) and rotator cuff weakness. Evaluation should be precise to delineate all components of the injury. Treatment must be directed toward both of the components and any other coexisting pathology...
March 2012: Sports Medicine and Arthroscopy Review
Brad Muir, Jaclyn A Kissel, Dominique Forand Yedon
OBJECTIVE: To present the diagnostic and clinical features of an intraosseous ganglion cyst of the humeral head of a female flat water canoe athlete. CLINICAL FEATURES: An 18-year old female flat water canoeist complaining of right shoulder pain following a strenuous paddling training camp. INTERVENTION AND OUTCOME: A trial of passive care was conducted, including soft tissue therapy, spinal manipulative therapy, acupuncture, and rehabilitation...
December 2011: Journal of the Canadian Chiropractic Association
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