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At least 991 records · Page 55Linked to original sources
PubMed2003

Internal impingement in the etiology of rotator cuff tendinosis revisited.

PURPOSE: The theory of internal impingement holds that, in overhead athletes, repeated contact between the undersurface of the rotator cuff and the posterosuperior glenoid rim leads to articular-sided partial-thickness rotator cuff tears and superior labral lesions. However, we have noted this same constellation of lesions in our general patient population. These recreational athletic patients do not routinely assume the position of extreme abduction and external rotation, and thus are unlikely to experience significant internal impingement forces. The goal of this study was to document the prevalence of superior labral lesions in patients being treated for partial-thickness undersurface rotator cuff tears. TYPE OF STUDY: Retrospective case series. METHODS: We retrospectively reviewed the records of 75 shoulders arthroscopically treated for partial-thickness articular-sided rotator cuff tears. With the exception of one professional tennis player, no patients were playing sports at a professional or major college level. No professional or collegiate throwing athletes were included. The prevalence of these lesions and their association with recreational athletics was noted. RESULTS: We found that 55 of 75 (73.3%) shoulders with articular-sided partial-thickness rotator cuff tears also had superior labral lesions. A statistically significant increased prevalence of superior labral lesions in the dominant shoulder was seen (P =.03). In addition, our patients who engaged in overhand throwing had significantly fewer superior labral lesions in the dominant shoulders than did nonthrowers (P =.017). CONCLUSIONS: The "kissing lesions" of undersurface rotator cuff tears and posterosuperior labral damage may be explained by mechanisms other than "internal impingement."

Adolescent↗
PubMed1996

The lateral synovial recess of the knee: anatomy and role in chronic Iliotibial band friction syndrome.

The tissue deep to the iliotibial band (ITB) and its relationship to the lateral knee joint capsule was studied anatomically and the histopathology of this tissue in chronic iliotibial band friction syndrome (ITBFS) was examined. Findings show that the tissue under the ITB consists of a synovium that is a lateral extension and invagination of the actual knee joint capsule and is not a separate bursa as described in the literature. Additionally, in cases of chronic ITBFS seen in young elite athletes, synovial tissue taken from this lateral synovial recess reveals histological evidence of inflammation and hyperplasia that suggests its involvement in the pathological process.

Adolescent↗
PubMed1997

Superior detachment of a glenoid labrum variant resembling an incomplete discoid meniscus in a wheelchair ambulator.

Symptoms of instability and painful clunking in the shoulder were found associated with superior detachment of an incomplete discoid glenoid labrum and biceps origin in a 25-year-old woman. The patient was paraplegic below the T4 level secondary to resection of a spinal cord astrocytoma at age of 17. Symptoms began after 3 years of wheelchair use and repetitive transfer injuries. On arthroscopic examination, only the central surface of the articular glenoid cartilage was visible because of labral coverage. The entire labrum was meniscoid without distinguishable variation. The superior labrum was in continuity with the root of the biceps tendon; however, the superior biceps-labral complex was completely stripped away from the underlying glenoid. The anterior, posterior and inferior labrum was firmly attached peripherally about the glenoid. An arthroscopic staple was used to reattach the biceps root and superior labrum to bone. At 6 year follow-up, the functional result was satisfactory.

Adult↗
PubMed1998

Incidence of overuse syndromes of the upper limb in young pianists and its correlation with hand size, hypermobility and playing habits.

The incidence of overuse syndromes of the elbow, wrist and hand was evaluated in a series of 66 pianists: 28 presented such a pathology. No significant correlation with starting age, or duration and intensity of practice was revealed. Smaller hands lead to more frequent overuse syndromes, in both males and females. Conditioning, sports activity, playing a second or third instrument, warming-up before playing and stretching afterwards did not influence the incidence of overuse syndromes. Pianists were not more hypermobile than a sex- and age-matched control group, nor was there any significant difference in hypermobility between pianists with and without overuse problems. There was no significant difference in incidence between the left and right side.

Adolescent↗
PubMed1989

Patellar fractures in total knee arthroplasty.

The incidence of patellar fractures following total knee arthroplasty varies from 3% to 21%. This problem has been attributed to avascular necrosis of the patella secondary to the surgical approach, including medial arthrotomy and lateral release, patellar bone resection, thermal necrosis, and anatomic variation. Management of these patellar fractures may be conservative or surgical.

Bone Wires↗
PubMed1996

Overuse syndromes in adult athletes.

Approximately 50% of all sports participants will be injured at some point, and at least half of these injuries will be attributed to overuse. This article provides an in-depth review of the presentation, diagnosis, and treatment of the most common overuse injuries encountered in the adult population: epicondylitis, shoulder impingement/rotator cuff tears, patello-femoral dysfunction, and Achilles tendinitis. Stress fractures, the "ultimate" overuse injuries, are also discussed.

Achilles Tendon↗
PubMedDate not supplied

Treatment effectiveness for patients with a history of repetitive hand use and focal hand dystonia: a planned, prospective follow-up study.

Recent studies show that rapid, nearly simultaneous, stereotypical repetitive fine motor movements can degrade the sensory representation of the hand and lead to a loss of normal motor control with a target task, referred to as occupational hand cramps or focal hand dystonia. The purpose of this prospective follow-up study was to determine whether symptomatic patients in jobs demanding high levels of repetition could be relieved of awkward, involuntary hand movements following sensory discriminative retraining complemented by a home program of sensory exercises, plus traditional posture, relaxation, mobilization, and fitness exercises. Twelve patients participated in the study. They all had occupational hand cramps, as diagnosed by a neurologist. Each patient was evaluated by a trained, independent research assistant before treatment and three to six months after treatment, by use of a battery of sensory, motor, physical, and functional performance tests. Care was provided by a physical therapist or a supervised physical therapist student in an outpatient clinic. Patients were asked to stop performing the target task and to come once a week for supervised treatment that included 1) heavy schedules of sensory training with and without biofeedback to restore the sensory representation of the hand, and 2) instructions in stress-free hand use, mirror imagery, mental rehearsal, and mental practice techniques designed to stop the abnormal movements and facilitate normal hand control. Patients were instructed in therapeutic exercises to be performed in the home to improve postural alignment, reduce neural tension, facilitate relaxation, and promote cardiopulmonary fitness. Following the defined treatment period, all patients were independent in activities of daily living, and all but one patient returned to work. Significant gains were documented in motor control, motor accuracy; sensory discrimination, and physical performance (range of motion, strength, posture, and balance). This descriptive study that includes patients with occupation-related focal hand dystonia provides evidence that aggressive sensory discriminative training complemented by traditional fitness exercises to facilitate musculoskeletal health can improve sensory processing and motor control of the hand.

Adult↗
PubMedDate not supplied

Manual muscle strength testing and dynamometry for bilateral ulnar neuropraxia in a surgeon.

This case study describes a patient who had bilateral neuropraxia of the ulnar nerve following a 5-day bicycle ride across the Swiss Alps. The patient, who was a surgeon, and the referring therapist were uncertain about the diagnosis at the time of referral. The purposes of this case study are to familiarize the hand therapist with "cyclist's palsy" and to illustrate how the recoveries of both nerves were followed using manual muscle strength testing and dynamometry. A form developed for the simultaneous assessment and comparison of the two measurements is presented. Muscle strength is tested and graded as suggested in another article of this issue.

Adult↗
PubMedDate not supplied

Body and soul.

Explore the source record for details and available documents.

Attitude of Health Personnel↗
PubMedDate not supplied

Repetitive use and static postures: a source of nerve compression and pain.

Nerve compression or musculoskeletal diagnoses require consideration of both the repetitive movements and static postures that may be contributing to the problem. Certain postures and positions assumed at home, at work, and during sleep will have three major influences: (1) directly increasing pressure on nerves at entrapment sites; (2) placing muscles in shortened positions so that adaptive muscle shortening may then secondarily compress nerves; and (3) placing some muscles in elongated and weakened positions, resulting in other muscles being over-used, thus creating the cycle of muscle imbalance. Successful management of the patient with upper extremity pain, paresthesia, and numbness should begin with initial identification of all sites that are contributing to the presenting symptoms. Treatment must then be directed toward the sources of nerve compression and musculoskeletal dysfunction. Upper quadrant symptomatology can be alleviated with an appropriate therapy program, even in the patient with chronic symptoms, but only with patient education, compliance with an exercise program, and behavioral modification at home, work, and during sleep.

Arm↗
PubMedDate not supplied

Presentation and response of patients with upper extremity repetitive use syndrome to a multidisciplinary rehabilitation program: a retrospective review of 24 cases.

OBJECTIVE: To analyze retrospectively a group of patients presenting to an outpatient hand rehabilitation clinic with complaints related to repetitive tasks of the upper extremity. DESIGN: Retrospective case study reviewing 24 consecutive cases for presenting symptoms and response of patients to a multidisciplinary rehabilitation approach. SETTING: An outpatient hand rehabilitation clinic in a tertiary referral center offering simultaneous medical, psychological, and occupational evaluations. PATIENTS: Twenty-four patients with upper extremity symptoms related to repetitive use, who had all failed various prior therapeutic interventions. Fifty percent of the patients were receiving medical disability compensation because of their symptoms. Sixty-two percent had filed a worker's compensation claim. INTERVENTIONS: Treatment consisted of medical management with pharmacologic interventions, occupational therapy with workplace simulation and job-site evaluations, and psychological treatment with pain management and biofeedback training. Treatments were individualized to meet each patient's needs. OUTCOME MEASURES: Reduction in symptom intensity or frequency, increase in work and performance of activities of daily living, and termination of medical disability with return to work. RESULTS: Most cases (83%) were found to be related to occupational computer keyboard use. Bilateral hand and forearm pain were the major symptoms. A unique physical finding was diffuse tendon tenderness and tightness of the long flexor and extensor muscles of the forearm. Carpal tunnel syndrome was found in only one patient. Twenty-five percent of patients achieved resolution of most symptoms, although on a modified and often reduced activity level; 54% had moderate improvement; and 13% had only minimal or no improvement. Of the patients receiving medical disability compensation, 58% returned to their previous jobs. CONCLUSIONS: Patients with upper extremity symptoms related to repetitive use often have unique physical findings, distinct from those of carpal tunnel syndrome. Resulting work disability is high. Patients who have not responded to conventional interventions within a reasonable time may benefit from a multidisciplinary treatment approach. Most patients improve with this treatment but do not fully recover.

Adult↗
PubMed1997

Musculoskeletal pain in cardiac ultrasonographers: results of a random survey.

Myalgias and arthralgias are common among workers whose jobs require repetitive isometric maneuvers or malalignment of body position. However, few systematic studies have been performed to evaluate the frequency of these complaints among cardiac ultrasonographers. Therefore the purpose of this study was to determine the prevalence of musculoskeletal pain (MSP) among ultrasonographers and to identify risk factors related to their occurrence. Two hundred twenty ultrasonographers randomly chosen from a list of more than 1600 active members of the American Society of Echocardiography were mailed surveys consisting of 22 questions. Included were questions regarding height, age, years of experience, frequency and type of physical exercise, and job-related parameters such as a number of scans per day, scanning from right or left side of bed, number of hours, bed type, type of equipment, and manual or self-propelled machines. Respondents were asked whether they had had back, neck, or shoulder pain related to their profession and to describe treatment rendered and its effectiveness. One hundred thirteen (51%) of 220 ultrasonographers responded to the survey. Ninety (80%) of 113 respondents reported new pain that was not present before they began scanning, with 42 of this group (46%) requiring either physiotherapy (n = 17) or medication (n = 23). Treatment was believed to be helpful in 63% of cases. Factors found to have a positive relationship to MSP included ultrasonographer height less than 63 inches, performing 100 or more scans per month, average scan time of 25 minutes or more per patient, and use of manually propelled machines (each p < 0.05). Factors found to have no relationship to MSP included age, type of equipment, right or left scan position, physical conditioning, bed type, and time between patients. Musculoskeletal pain is prevalent among cardiac ultrasonographers, and may have specific work-related factors for its occurrence.

Adult↗
PubMed1997

Occupational health hazards to the ultrasonographer and their possible prevention.

Occupational health hazards in ultrasonography are becoming more prevalent as the field continues to grow. Eye strain, musculoskeletal pain or injury, carpal tunnel syndrome, repetitive strain injuries, stress, burnout, and other hazards have been addressed as concerns in other studies and surveys. These topics are discussed, as well as the possible preventive measures that may be used to maximize and maintain the ultrasonographer's well-being throughout his or her career.

Asthenopia↗
PubMed2003

Upper extremity arterial injuries in athletes.

Upper extremity arterial injury resulting in hand and digit ischemia can occur in athletes who perform repetitive, high-stress, overhead arm motions. The initial presentation of these injuries often mimics the more common musculoskeletal injuries found in these athletes, and therefore, a high index of suspicion is essential to establish the diagnosis in a timely fashion. There are several described mechanisms of injury, most of which involve extrinsic compression and injury to the axillary artery or its branches from the humeral head. The clinical diagnosis is confirmed with noninvasive vascular laboratory testing, and the anatomy is generally confirmed using contrast arteriography. Surgical repair is almost always successful in these patients, allowing full recovery with return to competition.

Arteries↗