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Biomedical subjects

W B Kibler

Publications and source records attributed to W B Kibler.

At least 19 recordsLinked to original sources
PubMed1998

Shoulder rehabilitation: principles and practice.

The goal of shoulder rehabilitation is to restore the function of the shoulder. Function can be described in many different ways, but the framework for restoration of function should include restoration of the anatomy plus normalization of physiology and biomechanics. Without the normalization of physiology and biomechanics, the shoulder will not function in a normal fashion. Most of the methods and practice of shoulder rehabilitation are involved in strategies to normalize physiology and biomechanics of the shoulder motion. This study will review the physiology and biomechanics of normal shoulder function and then describe basic principles and clinical practices to restore those functions.

Biomechanical Phenomena↗
PubMed1997

Diagnosis, treatment and rehabilitation principles in complete tendon ruptures in sports.

Complete tendon ruptures may occur in any tendon subjected to athletic stress. This article discusses diagnostic, treatment and rehabilitation principles that are common to all tendon ruptures. The most common tendon ruptures are then discussed more specifically, presenting pertinent diagnostic tests, treatment considerations and principles of rehabilitation.

Athletic Injuries↗
PubMed1997

Shoulder rehabilitation: clinical application, evaluation, and rehabilitation protocols.

This chapter has discussed and illustrated a shoulder rehabilitation protocol based on restoration of the anatomy, biomechanics, physiology, and motor firing organization that is responsible for normal shoulder function. Many protocols exist in the literature, most of which appear to achieve good results. There are no outcomes data to suggest the most efficacious protocols. Adherence to the basic principles outlined in these chapters appears to allow the best framework for constructing a good program.

Athletic Injuries↗
PubMed1996

Arthroscopic findings in ankle ligament reconstruction.

The author believes that there are several reasons that justify the use of a preliminary diagnostic and therapeutic arthroscopic examination in conjunction with an ankle ligament reconstruction. First, a high percentage of symptomatic unstable ankles demonstrate associated intra-articular pathologic conditions. Second, not all of these conditions are appreciated on preoperative clinical examination. Third, these pathologic conditions are addressed easily with standard arthroscopic techniques. Fourth, this technique addresses all of the periarticular problems that cause dysfunction. Last, ankle arthroscopy adds minimal time to the procedure and does not appear to confer significant morbidity.

Adolescent↗
PubMed1995

Specificity and sensitivity of the anterior slide test in throwing athletes with superior glenoid labral tears.

This study documents the sensitivity and specificity of a clinical test to aid in the diagnosis of superior glenoid labral lesions. The anterior slide test, a method of applying an anteriorly and superiorly directed force to the glenohumeral joint, was performed on several groups of athletes. These included symptomatic athletes with isolated superior labral tears, rotator cuff tears, and instabilities, and asymptomatic athletes with rotational deficits. In addition, non-throwing athletes were tested. The sensitivity of the test was 78.4%, and the specificity was 91.5%. This study shows that the anterior slide test can be used in the clinical examination, in that it has high specificity for superior labral lesions, but not enough sensitivity to be the sole diagnostic criterion for these lesions.

Adolescent↗
PubMed1995

Pathophysiology of overload injuries around the elbow.

The most common elbow injuries appear to have a pathophysiology that is microtrauma based but with multifactorial origin. This pathophysiology is a process of gradual degeneration on a cellular and tissue level, with resulting alterations that predispose to more overt injury as the athlete responds to the inherent demands of the sport. This process is similar to injury patterns described at the foot, knee, and shoulder. Evaluation frameworks can be used to describe the clinical changes that are detectable, and to evaluate all of the various components that may play a role in the causes of these injuries.

Athletic Injuries↗
PubMed1995

Biomechanical analysis of the shoulder during tennis activities.

Biomechanical analysis of the shoulder in tennis is still in early stages; however, the available data do allow some conclusions and some recommendations for conditioning, evaluation, and rehabilitation. Normal shoulder biomechanical function requires an intact kinetic chain to create the energy, produce the forces and stabilize the joint in tennis activities. Only through this mechanism can optimum performance with minimal injury risk be maintained. Conditioning of the shoulder for tennis should take this into account. Exercises should involve force generation by the large leg and trunk muscles, scapular stabilization, and closed chain co-contraction activity for the shoulder stabilizers. Similarly, clinical evaluation for shoulder problems must include assessment of areas distant to the shoulder. Kinetic chain failure can cause extra stress on the shoulder, causing or exacerbating clinical symptoms at the shoulder. Clinical evaluation of shoulder joint structures also is enhanced by knowledge of the integration of the constraint systems, and the fact that more than one system may be involved in shoulder pathology. Finally, rehabilitation efforts for shoulder problems need to focus on allowing functional return of the shoulder joint in the context of the entire kinetic chain of tennis specific activity. Rehabilitation of all areas of kinetic chain failure, such as trunk inflexibility or scapulothoracic dyskinesis, should be undertaken in conjunction with rehabilitation techniques for the shoulder. The sports medicine clinician will have a more functional framework for assessing shoulder activity and injury in tennis through the understanding of these biomechanical principles.

Biomechanical Phenomena↗
PubMed1994

Clinical biomechanics of the elbow in tennis: implications for evaluation and diagnosis.

Elbow injuries constitute a sizeable percentage of tennis injuries. Biomechanical analysis of the forces, loads, and motions on the elbow in tennis, and the constraint systems operating the control the forces, can lead to an understanding of the pathophysiology of these injuries. A biomechanically based evaluation framework can be used to document all of the clinical symptoms, anatomic alterations, and biomechanical alterations that are associated with the pathological problem.

Athletic Injuries↗
PubMed1993

A biomechanical approach to the prevention, treatment and rehabilitation of plantar fasciitis.

Plantar fasciitis is a repetitive microtrauma overload injury of the attachment of the plantar fascia at the inferior aspect of the calcaneus. The diagnosis of plantar fasciitis is common among athletes in many sports, primarily those sports that involve running. Common treatments for plantar fasciitis, including ice, stretching, ultrasound, and shoe inserts are helpful in reducing the symptoms. However, recurrence of the problem is common. By understanding the potential biomechanical causes of this disorder it may be possible to correct the anatomical and biomechanical variables that cause plantar fasciitis and reduce the rate of recurrence as well as speed the rehabilitation process. It may also be possible to identify predisposing maladaptations that can be corrected, therefore, preventing the initial occurrence of plantar fasciitis.

Athletic Injuries↗
PubMed1993

Injuries in adolescent and preadolescent soccer players.

This prospective study examined injury incidence, injury type, causative factors, and effect on playing status for injuries occurring among soccer players in a invitational tournament. Injury incidence was 23.8/10,000 player hours, and 62.5% were mild, with contusions, sprains, and strains predominating. Player to player contact, and player to ground contact accounted for 67% of the injuries. Females had a higher incidence of injuries. These results support other studies that show soccer is a relatively safe sporting activity for youth. Implications for continued safety may include adjustments in playing conditions for females, proper preparation of playing surfaces, education of coaches about safe coaching practices, and consistent refereeing.

Adolescent↗
PubMed1992

Musculoskeletal adaptations and injuries due to overtraining.

Overtraining places a demand on the musculoskeletal system that may lead to damage to the musculoskeletal system, as well as to clinical, functional, and biomechanical adaptations that may be detrimental to sport performance. The types of injuries identified range from overt, which are obvious injuries that will usually prevent athletic performance for some period of time, to the subclinical, which decrease performance, but may be seldom recognized. These injuries apparently may be avoided or lessened in severity by a combination of several methods. A thorough preparticipation evaluation is important to detect subtle adaptations in strength and flexibility that can result from overtraining and may increase the athlete's chances of injury. A good sport-specific conditioning program is necessary to give the athlete a strong musculoskeletal base on which to build athletic skills and to decrease the risk of overtraining adaptation. In many sports, prehabilitation exercises can be performed for those musculoskeletal areas that are under high stress in a particular sport. Also, a maintenance conditioning program that extends through the season may be important to maintain fitness throughout the season. Following proper principles of conditioning, including specificity, recovery, and progression, are important. A complete and accurate diagnosis of the injuries that do occur is necessary so that proper treatment may follow. This can be facilitated by understanding the types of clinical presentations of injuries, and the different anatomical and functional alterations that may be acting to cause or to continue the clinical presentation. By following these general guidelines, safe participation in sporting activities as well as performance will be enhanced. The exact point where "training" becomes "overtraining" is difficult to define, especially prospectively. An exciting area of sports medicine research will be to define the anatomic parameters and exercise doses that will cause overtraining, and to devise fitness examinations and training programs that will allow maximal performance with minimal overload risk. At the present time, retrospective studies do indicate that adaptations occur in muscles, tendons, and bones in response to high training loads, and these particular adaptations are not beneficial to performance and may be associated with increased injury risk. Since the optimal exercise dose is not known, provision for evaluation of these adaptations and prehabilitation of all noninjured areas or proper rehabilitation of all injured areas will best prepare the musculoskeletal system for training.

Adaptation, Physiological↗
PubMed1992

Principles of rehabilitation after chronic tendon injuries.

This article describes a framework for the evaluation, diagnosis, and management of tendon injuries that result from repetitive microtrauma overload. These injuries are commonly called tendinitis injuries, but are more often degenerative lesions. The initial management of acute tendon injuries with rupture is usually quite different than that of chronic injuries, but the functional rehabilitation of the acute injuries can follow the same framework.

Chronic Disease↗
PubMed1990

Clinical aspects of muscle injury.

Muscle injuries are a common part of the clinical practice of sports medicine. Due to variations in muscle injury, the clinical presentation may vary from the subclinical to the catastrophic. Muscle injuries may present in four broad categories: acute, chronic, acute exacerbation of a chronic problem, or subclinical alteration. Each muscle injury can be further broken down into five areas: tissue injury, clinical symptoms, functional biomechanical deficit, functional adaptations, and tissue overload. Case studies are presented to illustrate the presentation of each type and analysis of the component parts of the injury. It is only through such analysis that an accurate and complete diagnosis, followed by a functional rehabilitation plan, may be constructed.

Adult↗
PubMed1988

Fitness evaluations and fitness findings in competitive junior tennis players.

Elite tennis players, as well as a large number of active recreational players, are involved in a sport that applies high repetitive loads that can create tension overload situations in certain key anatomic areas of the body and add to possible overload situations in other areas of the body. This results in patterns of inflexibility and weakness that can be demonstrated on a tennis-specific musculoskeletal exam, and that can be correlated with areas of increased injury occurrence. These players report conditioning programs that are, for the most part, inadequate to confer total conditioning of all the muscular parameters important in playing tennis. All of these factors, in addition to the frequency and type of playing, contribute to the occurrence of the overload injuries noted. These aspects need to be addressed in a preventative program for injury reduction. We do not believe that major changes in the way that tennis is played should be implemented until the effects of a proper preventative conditioning program are evaluated. The "ideal" conditioning program has not yet been found. While the exact composition of the program is in doubt, our studies allow us to recommend flexibility, strength, and endurance training for all athletes playing tennis at frequent intervals. This program should be guided by the findings on the preparticipation exam.

Adolescent↗