The shoulder is the most complex joint in the body. It is capable of moving in more than 16,000 positions. Many of its ailments, including the most common ones, involve biomechanical mechanisms that are unique to the shoulder. The most common shoulder problem for which professional help is sought out for is shoulder impingement (Haig 1996). Shoulder impingement is primarily an overuse injury that involves a mechanical compression of the supraspinatus tendon, subacromial bursa, and the long head of the biceps tendon, all of which are located under the coracoacromial arch (Prentice 2001). Impingement has been described as a continuum during which repetitive compression eventually leads to irritation and inflammation that progresses to fibrosis and eventually to rupture of the rotator cuff. Because impingement involves a spectrum of lesions of tissue in the shoulder, a working knowledge of its structural relationships will facilitate an understanding of the factors that result in abnormalities. This paper will provide knowledge of the anatomy, biomechanics, and correct rehabilitation involved with shoulder impingement.
Impingement syndrome was originally described by Dr. Charles Neer as mechanical impingement of the supraspinatus muscle and the long head of the biceps tendon underneath the acromial arch. Neer classified three stages of impingement. Stage I is characterized by edema and hemorrhage of the rotator cuff and suprahumeral tissue. Stage II is characterized by fibrosis of the glenohumeral capsule and subacromial bursa and tendonitis of the involved tendons. Patients usually demonstrate a loss of active and passive range of motion because of capsular fibrosis. Stage III is the most difficult to treat and is characterized by disruption of the rotator cuff tendons. This includes rotator cuff tears, biceps rupture, and bone changes. Since this is a continuous disease process, there is often overlap of signs and symptoms (Hawkins and Abrams 1987).
For descriptive purposes, factors related to shoulder impingement can be divided into intrinsic and extrinsic categories. Intrinsic factors directly involve the subacromial space and include changes in vascularity of the rotator cuff, degeneration, and anatomy or bony anomalies. Extrinsic factors include muscle imbalances and motor control problems of t...
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Many factors like patients age, symptoms, size of the tear, and nature of onset (traumatic or degenerative) are responsible for determining the prognosis of the physical therapy treatment 9. Since it’s a partial thickness tear of the rotator cuff, the non-operative treatment is reasonable unlike, a full thickness tear where surgery will be required to treat the patient 9. The patient shows symptoms of moderate irritability without significant functional deficit which makes him a good candidate for conservative treatment 10. The pain reported by the patient is 6/10 so the patient participates well in physical therapy exercise to increase shoulder strength, and flexibility. There was a study done from Finland which asserted that physical therapy alone can produce results which are equal to those produced by arthroscopic surgery and open surgical repair in cases of rotator cuff tears 11. In this case, with three weeks of physical therapy the patient has showed a decrease in pain and reported it as 4/10 on pain rating scale and showed improvements in abduction (140̊) and external rotation (65̊). The MMT for shoulder abduction was 4-/5 and external rotation is still same as
When comparing rotator cuff tears from the common people and athletes, they are much more common when a person is physically active in sports. An injury in the rotator ...
Snap, crackle, pop. That is the horrific sound a baseball pitcher hears after throwing a pitch. The UCL tear used to haunt pitchers forever until 1974, when a man named Tommy John had a surgery to repair his UCL tendon and it was successful causing this surgery to transform baseball. Before his arrival, Tommy John Surgery was known as a “dead arm” injury (Tommy John Surgery). When doctors diagnose players with this injury, it’s no longer a total shock as today you are easily able to come back from this surgery as when 30 years ago, you couldn’t. In my paper I will talk about the basics of the injury, history of the UCL, ways to diagnose a UCL tear, and how to recover from Tommy John surgery along with some unbelievable facts about this distressing injury. This injury and surgery has revolutionized baseball and prolonged the careers of many great players in the MLB.
For those who are unaware, the act of throwing overhand is an unnatural motion. For this reason, baseball players need to strengthen and build up the tiny muscles in their rotator cuffs (shoulder), and the deep muscles of the shoulder blades. The best way to carry out this is by performing exercises like shoulder stability movements.
While not many acute injuries, or injuries that are associated with a traumatic event can be prevented, nearly all overuse injuries can be! Nevertheless, sports medicine physicians receive training to treat any kind of injury; acute, chronic, overuses or even psychogenic pain. Sports medicine dates back to Susruta of India who was the first “recorded” physician to prescribe moderate daily exercise around 600 B.C. (Tipton). Since then, professionals have redesigned and renovated the techniques and equipment used in this field. Sports medicine physicians go through years of education and training in order to effectively treat and interact with patients, as well as thrive in any workplace they are needed.
People have created a hectic and busy world, that includes careers and daily activities that require physical activity. While attempting to attain the required physical conditioning, people often take chances with their personal health as they try to stretch their physical limits. Sometimes, people can surpass their current limits and form new boundaries; however, other times people are not so fortunate. These unfortunate times often lead to injury, including workplace accidents, sporting incidents, disease afflictions, as well as others; any or all of which could bring about the need of rehabilitation services. Many of these require physical therapy, which includes assisting injured or otherwise impaired patients as they recover to their pre-injury status or to recover as much as is physically possible. The field of physical therapy is a choice career for those who enjoy helping people recover from injury, and the following text will provide reason for choosing this profession.
In the 1970's, thousands of people took to the road with a new trend of exercise----running. It was fairly easy; just put one foot in front of the other as fast as you can and go as far as you can. Feel the burn in your chest? The sweat trickling down your face? The throb in your knees as your foot pounds into the ground with every step? Well then, you're exercising! You’re running! Since then, running has become a dominant factor in sports and fitness; a factor so prevalent that the number of musculoskeletal injuries due to running has also increased over the last quarter century. These chronic injuries are usually due to overuse, improper training techniques, or a combination of the two. By using the results of other biomechanists’ studies, one can extrapolate an idea of what running should look like and what muscles are utilized during the activity. Consequently, changes in technique, strength training, and flexibility training can be made in order to decrease the potential for injury.
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It’s fair to say that a good baseball game can lie in the hands of the pitcher. According to an article by the American Journal of Sports Medicine, 50 percent of professional baseball pitchers experience elbow or shoulder pain due to the way they throw the ball. Because not much research has been done on professional baseball athletes, the purpose of this publication was to find at what point in the pitcher’s technique does most of the damage occur. The study began by taking 40 pro-baseball pitchers, all ranging from the age of 23-33 years old with relatively the same height and weight. Also, thirty-two of the 40 selected are right-hand dominant. Then they placed 3 cameras in different parts of the field. These cameras would take still frames of the pitchers and their technique when throwing the ball. They found that at the point where there is maximum rotation (aka the cocking phase) the distraction force was low.
Creative new training methods, developed by coaches, athletes and sport scientists, are aimed to help improve the quality and quantity of athletic training ( Kellmann, 2010, p.1). However, these methods have encountered a consistent set of barriers including overtraining ( Kellmann, 2010, p.1). Due to these barriers, the need for physical and mental recovery in athletics brought an increasing attention in practice and in research ( Kellmann, 2010, p.1).
Rotator cuff tear – The muscles adjoining the shoulder joint are required for rotating the shoulder, amid other movements. The tendons of these muscles furthermore influence the structural strength of the shoulder joint. Harsh, rapid actions, for example in tennis and baseball, can result in tearing of one of these tendons. This then causes pain as well as a decline in range of motion. Surgery possibly will be necessary to repair a torn
Playing a sport whether its basketball, soccer, football or any other of your interest can be thrilling, and exciting. Not only can it be fun, yet physical exercise is good for the mind, body, and spirit. Therefore, as an athlete, one must keep in mind that playing any sport, injury is part of life and inevitable. Research has proven from time to time that severe injuries in sports can trigger psychological mental health issues, affecting their athletic performance. Recovering from an injury can indeed be a difficult process and athletes must wait for however long before being able to play the sport again.
The shoulder is one of the most complicated groupings of joints, tendons and muscles in the body. No one knows that better than shoulder doctor McLaughlin, who has operated on both shoulders on more than 200 patients. Using cutting-edge
Sports psychology draws on knowledge from the fields of Kinesiology and Psychology. It involves the study of how psychological factors affect performance and how participation in sport and exercise affect psychological and physical factors. In addition to instruction and training of psychological skills for performance improvement, sport psychology may include work with athletes and coaches regarding injury, rehabilitation, communication, and team building (Weinberg, R.S. & Gould, D.,2010)....