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At least 1,693 records · Page 94Linked to original sources
PubMed1995

A modified internal rotation stretching technique for overhand and throwing athletes.

Strength, stretching, and rehabilitation methods for the shoulder have been previously described and have been universally applied; nevertheless, many throwing athletes continue to develop overuse injuries. The pitching process tends to increase external rotation and limit internal rotation of the shoulder joint. Our technique involves a modified stretching method of the posterior shoulder musculature. The athlete lies prone with the elbow flexed 90 degrees. With the shoulder abducted 90 degrees, in neutral flexion/extension, and 90 degrees or more of internal rotation, the scapula protrudes posteriorly. By depressing the inferior angle of the scapula toward the thoracic wall, the infraspinatus muscle and posterior joint capsule are effectively isolated and stretched. Manual stabilization of the scapula onto the chest wall transfers the internal rotation movements to the glenohumeral joint, as opposed to sharing the movement with the scapulothoracic articulation. This method improves the efficacy of the internal rotation stretching exercise for the glenohumeral joint. Such an addition to traditional stretching methods may increase the efficiency of the least effective component. We conclude that this modification to traditional programs should be an integral part of the training and rehabilitation program of any athlete requiring near maximal performance of the shoulder.

Athletic Injuries↗
PubMed1995

Posture in patients with shoulder overuse injuries and healthy individuals.

Assessment of posture is an integral component of patient evaluation with shoulder overuse injuries. However, the professional literature contains relatively few studies that have assessed the relationship between posture, function, and injury. The purpose of this study was to determine the relationship and differences in postural variables within and between subjects with overuse injuries to the shoulder of healthy subjects. Thirty patient subjects and 30 healthy subjects matched for age and gender were recruited. Scapular protraction and rotation, forward head position, midthoracic curvature, and passive humeral elevation in the plane of the scapula were measured randomly in standing. All measurement techniques were standardized and validated. Intrarater and interrater reliability for all clinical measures were established before data collection. Forward head position was significantly greater (p < .001) in the patient group than the healthy group; humeral elevation was significantly greater (p < .001) in the healthy group than in the patient group and in the uninvolved shoulders (p < .01) than the involved shoulders within the patient group. Scapular protraction, rotation, midthoracic curvature, and scapular symmetry were not significantly different between groups. Scapula protraction and rotation were significantly related (p < .05) in the patient group. No other postural variables were related. Conclusions regarding the influence of posture to shoulder injury are inconclusive based on several confounding variables that may have affected the outcome.

Adolescent↗
PubMed1996

Sensory dysfunction associated with repetitive strain injuries of tendinitis and focal hand dystonia: a comparative study.

Repetitive strain injuries are reaching epidemic levels among workers who perform heavy schedules of rapid alternating movements (eg., computer programmers, data entry workers) or repetitive, sustained, coordinated movements (eg., editors, writers, salespeople). The purpose of this study was to determine if patients with repetitive strain injury demonstrated degraded sensory motor performance with their hands. Sixty age-matched adults were recruited, with 15 each assigned to a healthy adult control group, a healthy musician control group, a tendinitis group, or a focal dystonia group. Four sensory motor subtests from the Sensory Integration and Praxis Test were given to the subjects according to a standardized protocol. Using multiple one-factor analyses of variance in the parametric or nonparametric mode followed by post hoc pairwise testing, no significant differences were found between the healthy controls and the musician controls. On the test of kinesthesia, using the left hand, subjects with tendinitis performed significantly worse than controls and subjects with focal dystonia. Compared with controls, subjects with focal dystonia did significantly worse on graphesthesia and manual form perception (part 1 and part 2). Subjects with focal dystonia also did significantly worse than subjects with tendinitis when using the left hand on graphesthesia and manual form perception (part 2). When treating patients with repetitive strain injury, discriminative sensory motor skills must be carefully assessed and may need to be addressed as part of an effective treatment program.

Adult↗
PubMed1997

The effect of fatigue on multijoint kinematics, coordination, and postural stability during a repetitive lifting test.

Because of the inability of strength tests to accurately discriminate between low back pain patients and healthy subjects, a multifactorial evaluation of low back pain patients is warranted. It is postulated that measurements of endurance, kinematics, postural stability, and coordination, in addition to strength, are necessary to fully document the patients' functional capabilities. This research study was conducted in order to understand the effects of fatigue on the above factors. Twelve healthy male subjects performed a repetitive lifting test in which a submaximal load was lifted at a maximal rate. Knee, hip, and trunk motion was measured using videography and electrogoniometry, postural stability was measured using a forceplate, and coordination parameters were determined using phase-plane analysis. Fatigue was documented by a 31% reduction in lifting power. At the end of the endurance test, there was less knee and hip range of motion and greater spine peak flexion, while the coordination measures demonstrated that there was greater hip and lumbar spine extension earlier in the lifting phase. The postural stability declined as the test endured. Utilization of these measures may guide physical therapists in their rehabilitation of low back pain patients.

Adult↗
PubMed1998

Adverse neural tension: a factor in repetitive hamstring strain?

The etiology and nature of repetitive hamstring strain is complex and not fully understood. The purpose of this study was to investigate the presence of adverse neural tension in 14 male Rugby Union players with a history of grade 1 repetitive hamstring strain. Comparison was made to an injury-free matched control group. Adverse neural tension was assessed using the slump test. Hamstring flexibility was measured using the active knee extension in lying test. Results indicated that 57% of the test group had positive slump tests, suggesting the presence of adverse neural tension. None of the control group had a positive slump test. Analysis of variance revealed no differences in flexibility between groups or between those demonstrating a positive or negative slump test. Results suggest that adverse neural tension may result from or be a contributing factor in the etiology of repetitive hamstring strain. Residual decreased flexibility is not apparent in this subject group.

Adolescent↗
PubMed2001

Comparison of ball-and-racquet impact force between two tennis backhand stroke techniqes.

STUDY DESIGN: A mixed design for kinetic comparison of 2 types of one-handed backhand strokes and 2 skill levels in tennis. OBJECTIVES: To develop and evaluate a model to estimate the impact force on the racquet during tennis stroke, and to compare the peak impact force between one-handed backhand stroke with a long backswing and one-handed backhand stroke with a short backswing and between the beginning and advanced players. BACKGROUND: A one-handed backhand stroke is commonly used in tennis and may be associated with many upper extremity over-use injuries. An understanding of kinetics of the backhand stroke is essential for understanding injury mechanisms and prevention. METHODS AND MEASURES: Five male advanced tennis players and 4 male and 1 female beginning tennis players participated. Mean age was 32.2 +/- 7.0 years. Each subject was instructed to use the 2 types of one-handed backhand strokes to hit balls from a tennis ball machine. Three-dimensional coordinates of critical body and racquet landmarks were obtained. A mathematical model was developed to estimate the contact duration and the peak impact force during a stroke. RESULTS: The estimated peak impact forces were reproducible and comparable to those reported in the literature from direct measurements. A one-handed backhand stroke with a short backswing had a significantly shorter contact duration (0.008 +/- 0.003 seconds) and a greater peak resultant impact force (330.0 +/- 140.7) than that with a long backswing (0.016 +/- 0.004 seconds and 180.8 +/- 49.1 N). Skill level did not significantly affect the peak resultant impact force. CONCLUSION: A long backswing in a one-handed backhand stroke may reduce the load on the upper extremity and may assist in reducing the risks of tennis-related upper extremity over-use injuries.

Adult↗
PubMed2001

Postures and repetitive movements during use of a long cane by individuals with visual impairment.

STUDY DESIGN: Descriptive. OBJECTIVE: To describe upper body postures and movements that occur when an individual with visual impairment uses a cane to explore the environment while walking. BACKGROUND: Previous research revealed self-reported neuromusculoskeletal problems related to cane use in individuals with visual impairments. No research, however, is available correlating neuromusculoskeletal problems with specific strategies of cane use or describing what movements and postures actually occur during cane use. METHODS AND MEASURES: Twenty-eight individuals with visual impairment who had been walking independently with a long cane for >1 year were videotaped walking with their canes. Subjects included 16 men and 12 women with a mean age of 39.8 +/- 15.2. Postures and movements of the head and neck, trunk, and each upper extremity body segment were analyzed using videotape. RESULTS: Thirty-nine categories of postures or repetitive joint movements were observed. Half of the subjects lacked intersegmental movement of the head, trunk, and shoulder girdles during walking. The repetitive movements used to manipulate the cane occurred at the forearm or wrist. Intrasubject variability of postures and movements was low. CONCLUSIONS: A variety of sustained postures and repetitive movements occur among individuals using long canes. Each individual displays minimal variability in cane manipulation strategy when walking in an uncomplicated environment. Cane manipulation is accomplished by repetitive movements of wrist flexion/extension, wrist ulnar/radial deviation, or forearm pronation/supination. The remainder of the upper body maintains sustained postures, and more than half of long cane users lack the normal intersegmental movement that typically occurs in the neck, trunk, and shoulder girdle during walking. Further research is needed to determine whether particular cane manipulation strategies or sustained postures during cane use increase the risk of musculoskeletal pain syndromes.

Adolescent↗
PubMed2001

Factors contributing to the development of medial tibial stress syndrome in high school runners.

STUDY DESIGN: Predictive correlational study. OBJECTIVES: To identify the incidence of medial tibial stress syndrome (MTSS) in a group of high school cross-country runners and to determine if a relationship exists between lower extremity structural measures and the incidence of MTSS. BACKGROUND: Medial tibial stress syndrome is an overuse injury that occurs in long-distance runners. Literature exists that implicates structural deformity as a contributor to MTSS, but no studies have developed a predictive model. METHODS AND MEASURES: We measured 125 high school cross-country runners for tibiofibular varum, resting calcaneal position during stance, and gastrocnemius length. Runners developing MTSS over an 8-week period were placed in the injured group (2 men, 13 women; age 15.3 years 1.0), and 21 randomly selected uninjured runners were placed in the uninjured group (13 men, 8 women; age 15.7 years +/-1.5). Navicular drop was measured for runners in both groups. Reliability of measures was determined using an intraclass correlation coefficient (ICC 3,1). Paired t tests were used to compare the injury and noninjury groups. A logistic regression analysis was used to establish if the descriptive data could accurately predict the development of MTSS. RESULTS: Paired t tests showed a significant difference in navicular drop test measures between the injured (6.8 mm 3.7) and noninjured (3.6 mm 3.3) groups. Logistic regression analysis revealed navicular drop test measurements and sex correctly identified athletes who developed MTSS with 76% accuracy. CONCLUSION: Our study supported the hypothesis that a pronatory foot type is related to MTSS. The combination of sex and navicular drop test measures provides an accurate prediction for the development of MTSS. Clinical measures that identify biomechanical risk factors for MTSS may allow prevention or early intervention.

Adolescent↗
PubMed2003

Factors associated with triathlon-related overuse injuries.

STUDY DESIGN: Descriptive correlational investigation. OBJECTIVES: To assess the incidence of, and potential risk factors associated with, overuse injury in triathlon. BACKGROUND: The sport of triathlon is rapidly increasing in popularity with a concomitant rise in the prevalence of injuries sustained by triathletes. METHODS AND MEASURES: The training and injury patterns of 131 triathletes were surveyed over a 10-week prospective period during the triathlon competition season. A complementary retrospective 6-month analysis of training history and prior overuse injuries was conducted. RESULTS: Fifty percent of triathletes sustained an injury in the 6-month preseason at an injury exposure rate of 2.5 per 1000 training hours. Thirty-seven percent were injured during the 10-week competition season at an injury exposure rate of 4.6 per 1000 training hours. Overuse accounted for 68% of preseason and 78% of competition season injuries reported. Increased years of triathlon experience, high running mileage, history of previous injury, and inadequate warming-up and cooling-down regimes appeared to have individual associations with injury incidence. When interactions were included in a multiple logistic regression model, increasing years of triathlon experience was the most significant predictor of preseason injury risk and a previous history of injury and high preseason running mileage increased the risk of injury during the competition season. CONCLUSIONS: The results indicate that in assessing triathletes, a full training and competition history is required by the sports clinician for a comprehensive assessment of the factors that may contribute to overuse injury.

Adult↗
PubMed2004

Computer use associated with poor long-term prognosis of conservatively managed lateral epicondylalgia.

STUDY DESIGN: Multicenter prospective design with a cohort of patients with lateral epicondylalgia commencing physical therapy. OBJECTIVE: To identify key factors associated with long-term prognosis of conservatively managed lateral epicondylalgia. BACKGROUND: The response to conservative management of lateral epicondylalgia is inconsistent and the rate of recovery varies widely among individuals. The reasons for these discrepancies are not understood. The identification of factors associated with prognosis will aid in the prediction of patient outcomes. METHODS AND MEASURES: Sixty patients with lateral epicondylalgia, recruited from 9 sports medicine clinics and 2 hospital outpatient physical therapy departments in Ontario, Canada, were followed for 6 months. A baseline clinical assessment was conducted on each participant using standard physical therapy techniques. The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and a 100-mm pain visual analog scale (VAS) were completed at baseline and 6 months later. RESULTS: The key factor associated with both 6-month DASH and pain VAS scores was repetitive-work tasks (DASH, 9.8 [P < .011; pain VAS, 13.1 mm [P = .0105]). A subanalysis indicated that women were more likely than men to have cervical joint signs and, among women, positive cervical articular signs were also associated with higher final DASH and pain VAS scores. CONCLUSIONS: Although many of the participants identified sports activities as the cause of their injury, these findings emphasize the importance that a patient's work tasks can have on recovery of lateral epicondylalgia. This would suggest that management should perhaps focus on work stations, postures, and behaviors.

Adult↗
PubMed1995

Rheumatoid factor and HLA antigens in wrist tenosynovitis and humeral epicondylitis.

A matched case-referent study was undertaken to assess whether rheumatoid factor (RF) is associated with repeating tenosynovitis or peritendinitis and whether HLA-B27 predisposes to epicondylitis. The study subjects consisted of 25 workers in manually strenuous jobs with a history of at least two episodes of tenosynovitis or peritendinitis in the wrist or forearm, or humeral epicondylitis, and their matched referents. The latex agglutination test was positive in seven of the 23 cases with tenosynovitis and in one of the referents (p = 0.03). The corresponding figures for IgM-RF by enzyme immunoassay were ten and two, respectively (p = 0.008). HLA-B27 antigen was found in five of the 13 workers with epicondylitis and in one worker with no such history (p = 0.13). It is possible that RF-positive repeating tenosynovitis represents an incomplete form of rheumatoid disease.

Case-Control Studies↗
PubMed1999

Save that arm: a study of problems in the remaining arm of unilateral upper limb amputees.

A study has been made by questionnaire, personal examination and telephone interview of unilateral upper limb amputees seen at the Prince Henry Hospital, Australia between 1994 and 1997. There were 60 questionnaires posted. Replies were received from 46. Problems were noted in the remaining arm of 23 (50%). The respondents' problems not only consisted of overuse symptoms, but also of an exacerbation of pre-existing arthritis and injury due to trauma to the remaining arm during the accident. Case histories are given in 3 typical cases. Treating professionals are warned about the hazards that one arm amputations present to the remaining arm.

Activities of Daily Living↗
PubMed1995

The Australian RSI debate: stereotyping and medicine.

The vehement scientific debate which took place in Australia in the 1980s over the epidemic of the chronic cervicobrachial pain syndrome known as repetition strain injury (RSI) was remarkable for the accompanying social commentary offered by many of the medical participants. This commentary was to have a profound effect on relationships between individual doctors and their patients with RSI. It reflected and reinforced the prevailing stereotypes within Australian society, not only of working women, but also of recipients of workers' compensation payments. On the other hand, some of the medical responses to the epidemic were severely criticized by social scientists who analysed the epidemic. In the process of such criticism, a number of stereotypes of doctors were also reinforced.

Adult↗
PubMed1990

Chronic trapezius myalgia. Morphology and blood flow studied in 17 patients.

Bilateral open biopsies from the painful upper part of the trapezius muscle were studied in 17 patients with localized chronic myalgia related to static load during repetitive assembly work. Isolated pathologic ragged red fibers were related to the presence of myalgia. The phenomenon indicating disturbed mitochondrial function was confined to the Type 1 fibers. Using a laser-Doppler flowmeter, the muscle blood flow was recorded in the exposed muscle before a biopsy was taken. Pain was assessed and graded as the difference between the two sides, as was the presence of ragged red fibers. The myalgia correlated with reduced local blood flow: the greater the pain difference, the greater the reduction in blood flow. There was a correlation between the presence of mitochondrial changes and reduced muscle blood flow.

Adult↗
PubMed1997

Repetitive strain injury. 1. An overview of the problem and the patients. The Goff Group.

Assembly-line workers, house painters, and many others whose activities entail repetitive motions can end up with swelling, pain, and limited movement in the affected muscles. Often, use of the six steps described in this article brings fairly rapid functional improvement and prevents recurrences, with a minimum of medical intervention. In some cases, though, recovery is prolonged or the outcome is unusual. The authors present additional factors to consider in such cases, such as psychosocial concerns, worker fraud, and ergonomic problems. Part 2 of this article, beginning on page 72, details six common repetitive strain injuries.

Cumulative Trauma Disorders↗