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Biomedical subjects

F W Jobe

Publications and source records attributed to F W Jobe.

At least 37 records · Page 2Linked to original sources
PubMed1989

Shoulder pain in the overhand or throwing athlete. The relationship of anterior instability and rotator cuff impingement.

Shoulder pain in the overhand or throwing athlete can often be traced to the stabilizing mechanisms of the glenohumeral joint. During the physical examination, signs of impingement will often be obvious, whereas subluxation signs are subtle. Use of the Apprehension Test followed by the Relocation Test has proved to be the most sensitive means of detecting occult anterior glenohumeral subluxation. When subluxation is suspected, an examination under anesthesia and orthroscopy are the most helpful next step. Patients can be classified into one of four groups on the basis of the results of the examinations. If conservative rehabilitation fails, then surgery may be considered.

Adolescent↗
PubMed1988

Rotator cuff injuries in baseball. Prevention and rehabilitation.

Rotator cuff and ligamentous capsule injuries are common in the young baseball player. In order to understand these injuries, it is important to first appreciate the delicate balance between shoulder mobility and stability as well as the biomechanics of throwing. This background information makes it easy to see how shoulder injuries are really part of a progressive continuum beginning with instability leading to subluxation, and later impingement which can result in a rotator cuff tear. A detailed and precise history and physical is crucial in determining where a patient might be on the continuum. An accurate evaluation will also help appropriately place a patient in one of the following 4 groups: pure impingement, anterior instability due to trauma with secondary impingement, anterior stability due to a hyperelasticity with secondary impingement, and pure anterior instability. A kinesiological repair is the initial treatment of choice. It is the best preventative or early treatment available, and consists of a specific strengthening programme. If this fails (as in only 5 to 10% of the cases), an anatomical repair is instituted. There are 4 basic guidelines when doing this surgery: (a) maintain muscle attachments and proprioceptive fibres; (b) do not shorten the capsule significantly; (c) build up the anterior labrum; and (d) regain full range of motion quickly through abduction splinting and rehabilitation. A postoperative rehabilitation programme is then diligently adhered to, as it is at least as important as the surgery itself.

Adolescent↗
PubMed1987

Rehabilitation of shoulder joint instabilities.

The overall goal of the rehabilitation period is a return to full range of motion and a strengthening of the muscles that have a role in protecting the shoulder from injury. Rehabilitation is accomplished gradually and is performed initially in a limited range that excludes the terminal 30 degrees at either end. Two key muscle groups are to be strengthened. One group is for the glenohumeral joint: the deltoid, latissimus dorsi, pectoralis major, and the rotator cuff muscles--especially the subscapularis muscle for internal rotation and the infraspinatus and the teres minor muscles for external rotation. The second group, the trapezius, rhomboids, and serratus anterior muscles, is strengthened for scapular control. Finally, general conditioning and trunk flexibility exercises are critical for a return to former competitive levels.

Exercise Therapy↗
PubMed1986

Electromyography and motion analysis of the upper extremity in sports.

This article reviews the results of studies using electromyographic recordings to determine muscle function during athletic activities. Electromyographic recordings were synchronized with high-speed film to provide information on shoulder muscle firing patterns during baseball pitching, swimming, tennis, and golf. The information obtained about the contributions of specific muscles during these activities may be useful in developing effective injury prevention and rehabilitation strategies.

Baseball↗
PubMed1986

Surgical treatment of tears of the rotator cuff in athletes.

Forty-five athletes with either a partial or a complete tear of the rotator cuff were treated with anterior acromioplasty and repair of the tear. The minimum duration of follow-up was twenty-four months (average, forty-two months). Thirty patients had an incomplete tear and fifteen had a complete tear. Postoperatively, thirty-nine (87 per cent) of the patients stated that they were improved compared with their preoperative status, although only thirty-four patients (76 per cent) felt that they had a significant reduction of pain postoperatively. Objectively, twenty-five (56 per cent) of the patients were rated as having a good result, which allowed them to return to their former competitive level without significant pain. Twelve (41 per cent) of the twenty-nine athletes who had been involved in pitching and throwing returned to their former competitive status. Seven (32 per cent) of the twenty-two pitchers and throwers who had been active at a professional or collegiate level returned to the same competitive level. In our experience, a repair of the rotator cuff combined with an acromioplasty in a young athletic population provides satisfactory relief of pain but does not guarantee that the patient will be able to return to his or her former competitive status in all sports.

Acromion↗
PubMed1986

Throwing injuries of the elbow.

With the burgeoning popularity of racquet and throwing sports in our society, an increasing awareness of the elbow injuries sustained with repetitive upper extremity activity is important. Particular attention should be paid to proper technique, equipment, and duration of activity, and preventive measures should be taken. In the adolescent or adult individual who sustains elbow injury, it is imperative that the treating physician recognize the pathologic stage early in order to minimize the consequences of these activities. Only with a thorough history and physical examination of this complex joint and a firm understanding of the forces generated during activity will the sports medicine physician entertain the proper diagnosis and initiate a treatment protocol that is likely to be successful.

Athletic Injuries↗
PubMed1986

Reconstruction of the ulnar collateral ligament in athletes.

Reconstruction of the ulnar collateral ligament using a free tendon graft was performed on sixteen athletes. All participated in sports that involved throwing (mostly professional baseball), and all had valgus instability of the elbow. After reconstruction and rehabilitation, ten of the sixteen patients returned to their previous level of participation in sports, one returned to a lower level of participation, and five retired from professional athletics. Despite precautions, there was a high incidence of complications related to the ulnar nerve. Two patients had postoperative ulnar neuropathy (one late and one early) that required a secondary operation, but they eventually recovered completely. Three others reported some transient postoperative hypoesthesia along the ulnar aspect of the forearm that resolved after a few weeks or months.

Adult↗
PubMed1985

The coracoid transfer for recurrent anterior instability of the shoulder in adolescents.

Thirty-six shoulders with recurrent anterior dislocation or subluxation in thirty-four adolescent patients were treated with a modified Bristow procedure. The average length of follow-up was five years and ten months. Postoperatively, two patients had recurrent anterior subluxation on one occasion and none had recurrent anterior dislocation. The average loss of external rotation was 10 degrees. Despite the fact that young patients have a high rate of recurrence after anterior dislocation or subluxation of the shoulder, the modified Bristow procedure is an effective method of treating recurrent anterior instability of the shoulder in adolescents.

Adolescent↗
PubMed1985

Shoulder impingement syndrome in athletes treated by an anterior acromioplasty.

Shoulder pain caused by a impingement syndrome commonly affects an athlete's performance. Thirty-five shoulders in 33 athletes had an impingement syndrome treated by an anterior acromioplasty after failure of conservative treatment. Thirty-one of 35 shoulders (89%) were subjectively judged improved by the patients from their preoperative status. The moderate and severe pain was reduced from 97% of the shoulders preoperation to 20% postoperation. The pain at rest and with activities of daily living was reduced from 71% of the shoulders preoperation to 9% postoperation. However, only 15 of 35 operated shoulders (43%) allowed return to the same preinjury level of competitive athletics, and only four of 18 athletes involved in pitching and throwing returned to their former preinjury status. This operation is satisfactory for pain relief but does not allow an athlete to return to his former competitive status. A prolonged rehabilitation program may improve the results.

Acromion↗
PubMed1983

Painful athletic injuries of the shoulder.

Pain in the athlete's shoulder is likely to have a mechanical origin, because the athlete performs repetitive high-stress activity. Proper treatment is based on understanding the biomechanics and physiology of the tissues, as well as the demands of the patient's specific athletic activity. Correct rehabilitation is the key to successful conservative and surgical management. A return to previous activity depends on restoring the normal biomechanics, either through conservative management or surgery. Some of these problems are unsolved and remain fruitful areas for future research.

Athletic Injuries↗
PubMed1983

Lower extremity electromyographic analysis of running gait.

Onset of firing for the quadriceps, hamstrings, and gastroc soleus groups during running, both on a treadmill and over ground, was determined in seven normal adult male subjects. Surface and wire electrode data were collected simultaneously from 959 individual gait cycles. The mean velocity over ground was 274 +/- 38 m/minute, with a mean cadence of 171 +/- 14 steps/minute. The treadmill was set at 107 m/minute (4 miles/hour), and the subjects' mean cadence was 147 +/- 11 steps/minute. Over ground, the mean swing/stance ratio was 70/30 +/- 3%, and that for the treadmill was 60/40 +/- 6%. Like muscle groups on the right and left showed a mean difference in onset of muscle activity of 1.3% (+/- 4.6%) when measured during a minimum of ten cycles per subject for each test condition. The average difference in time of onset between the surface and wire electrodes was 2% (SD +/- 4.9%) on the treadmill and 1.5% (SD +/- 3.7%) for over-ground running. These differences are not statistically significant. Surface and wire electrode data have been determined to be equivalent only for regional synergistic muscle groups and should not be extrapolated to compare functions of individual muscles within those groups.

Adult↗
PubMed1983

Serious rotator cuff injuries.

Usually, serious rotator cuff injuries can be operated upon and a high level of performance can be achieved afer surgery. This is not so for the substantial tears seen in baseball pitchers. However, a damaged rotator cuff can be rehabilitated and can recover from the threatened tear without surgery if detected early enough and given the proper treatment.

Adolescent↗
PubMed1979

Isolated lateral meniscectomy. A study of twenty-six patients with isolated tears.

To better define the role that the lateral meniscus plays in stabilizing the knee, a study was made of twenty-six patients who had an uncomplicated lateral meniscectomy between 1972 and 1977. Patients with any degree of ligament instability, cruciate or collateral, prior to lateral meniscectomy were eliminated from the study. Also eliminated were any patients with roentgenographic evidence of degenerative arthrits, osteochondritis dissecans, or loose bodies. Only patients whose operative reports stated that the articular cartilage of the lateral compartment was either grossly normal or showed Grade-1 chondromalacia (less than one centimeter in diameter and only softening of the cartilage) at the time of surgery were included in the review. The meniscal lesions included bucket-handle tears, horizontal cleavage tears, and multiple linear defects. No grossly cystic menisci were included in the study. Two menisci demonstrated cystic degenerative changes on histological section. In sixteen patients some degree of ligament instability developed. The longer the interval between injury to the meniscus and its excision, the less satisfactory the result. Only fifteen (54 per cent) of the patients reported satisfactory results, and twenty lost some motion of the knee. We concluded that stability of the knee joint is a multifactorial problem, in which the lateral meniscus certainly plays an important part.

Adolescent↗
PubMed1977

Human patellar-tendon rupture.

The first biomechanical analysis of a human patellar-tendon rupture during actual sports competition is reported. Cinematographic data for analysis were collected at a national weight-lifting championship. Dynamic equations to mathematically model the lifter were developed to compute time course and magnitudes of hip, knee and ankle-joint moments of force and of tensile loading of the patellar tendon before and during tendon trauma. Results provided evidence that the range of maximum tensile stress of the tendon may be considerably greater during rapid dynamic loading conditions, as in many sports situations, than maximum tensile stress obtained during static test conditions.

Adult↗
PubMed1977

Fracture of the hook of the hamate in athletes.

During an eight-year period, four tennis players, seven golfers, and nine baseball players were seen with a fracture of the hook of the hamate. Eighteen of these twenty patients were disabled by pain and after the fracture fragment was removed, all eighteen were relieved so that they returned to their athletic pursuits. Two patients were asymptomatic, their old fracture being discovered accidentally when they were treated for other injuries. Nineteen of the twenty patients had been examined before coming under our care, but the correct diagnosis had been made in only two. Conservative treatment, including rest, physical therapy, and injections of steroids into the wrist and hand, had not been beneficial. From the history and findings, we believe that these fractures were caused by a direct blow against the hook of the hamate caused by the handle of the tennis racket, golf club, or bat during a swing, and not by indirect force produced by the ligaments and muscles attached to the hook. The fracture was demonstrated in all twenty patients by a roentgenogram (profile view) of the carpal tunnel.

Adolescent↗
PubMed1976

The modified Bristow procedure for recurrent dislocation of the shoulder.

A review of fifty-one cases of the modified Bristow procedure for recurrent anterior shoulder instability is presented. The results were favorable. The redislocation rate was 2% with few complications. The average limitation of motion was 11 degrees of external rotation. Athletic individuals with involvement of the dominant shoulder were not capable of returning to high performance levels of overhead sports activity (particularly throwing) after the operation.

Adolescent↗