Neurocognitive and Neuromuscular Rehabilitation Techniques after ACL Injury, Part 1: Optimizing Recovery in the Acute Post-Operative Phase- A Clinical Commentary.

Anterior cruciate ligament (ACL) injury rates are on the rise, despite improved surgical techniques and prevention programs. While traditional rehabilitation emphasizes the restoration of motion, strength, and physical performance, emerging research highlights the importance of addressing neurocognitive deficits that can persist after injury. These deficits, including altered proprioception, impaired motor control and muscle recruitment, as well as heightened reliance on visual feedback, can significantly increase the risk of re-injury and impede return to sport.

Management of High Ankle Sprains Utilizing the Tightrope Surgical Procedure - A Novel Approach for a Rapid Return to Play.

Unlabelled: The distal tibiofibular joint is described as a syndesmosis. The syndesmosis is important to the structural integrity of the ankle joint by maintaining the proximity of the tibia, fibula, and talus. Syndesmotic or high ankle sprains, involving the syndesmotic ligaments, pose a significant rehabilitative challenge due to their intricate anatomy, prolonged recovery periods following injury, and high susceptibility to persistent disability.

Isokinetic Testing: Why it is More Important Today than Ever.

Isokinetics is a proven method to train and objectively assess the capability of muscle groups, particularly at the knee. The current re-injury rates and less than optimal return to sport percentages seen following anterior cruciate ligament surgery highlights the need for greater focus on what tests and methods are used to make these critical decisions. Isokinetics remains the best single method to objectively determine dynamic muscle strength, power, rate of force development and endurance.

An Interval Throwing Program for Baseball Pitchers Based upon Workload Data.

Background: Interval throwing programs (ITP) have been used for decades to enable baseball pitchers to return to competition after injury or surgery by gradually applying load to the throwing arm. Past programs have been based on personal experience; however, advances in our understanding of the biomechanics and workloads of throwing allow for a more modern data-based program to be developed.

Hypothesis/purpose: To 1) develop a updated ITP for rehabilitation of modern baseball pitchers based upon biomechanical and throwing workload data, and 2) compare the updated program with a past program to determine differences in chronic workload and acute:chronic workload ratios (ACWR).

Neurocognitive and Reactive Return to Play Testing Protocol in Overhead Athletes Following Upper Extremity Injury.

The incidence of upper extremity (UE) injuries in sport, particularly with the shoulder and elbow in baseball/softball players, appears to be increasing yearly, especially in younger age athletes. Improving the objective criteria and testing methods used to determine return to play (RTP) readiness following non-operative or post-operative management of UE injuries is one aspect of the rehabilitation process that may significantly help in reducing reinjury rates. Currently, the majority of clinicians are still using post operative time frame and/or strength/range of motion as their main criteria for clearance to RTP following UE injury.

Biomechanical Basis of Interval Throwing Programs for Baseball Pitchers: A Systematic Review.

Background: Interval throwing programs are used in rehabilitation of throwing injuries, especially ulnar collateral ligament injuries. Athletes who are rehabilitating begin by throwing on flat ground progressing through increasing distances, number of throws, and intensity of throwing. If the athlete is a baseball pitcher, the flat-ground throwing phase is followed by pitching on a mound at progressively increased effort.

The Golfer's Fore, Fore +, and Advanced Fore + Exercise Program: An Exercise Series and Injury Prevention Program for the Golfer.

Unlabelled: Golf is increasing in popularity with 24.8 million golfers in the U.S.

Patellofemoral Joint Loading during the Performance of the Wall Squat and Ball Squat with Heel-to-Wall-Distance Variations.

Introduction: Although bodyweight wall and ball squats are commonly used during patellofemoral rehabilitation, patellofemoral loading while performing these exercises is unknown, which makes it difficult for clinicians to know how to use these exercises in progressing a patient with patellofemoral pathology. Therefore, the purpose was to quantify patellofemoral force and stress between two bodyweight squat variations (ball squat vs wall squat) and between two heel-to-wall-distance (HTWD) variations (long HTWD vs short HTWD).

Methods: Sixteen participants performed a dynamic ball squat and wall squat with long HTWD and short HTWD.

Patellofemoral Joint Loading in Forward Lunge With Step Length and Height Variations.

The objective was to assess how patellofemoral loads (joint force and stress) change while lunging with step length and step height variations. Sixteen participants performed a forward lunge using short and long steps at ground level and up to a 10-cm platform. Electromyography, ground reaction force, and 3D motion were captured, and patellofemoral loads were calculated as a function of knee angle.

The Clinician's Guide to Baseball Pitching Biomechanics.

Context: Improper baseball pitching biomechanics are associated with increased stresses on the throwing elbow and shoulder as well as an increased risk of injury.

Evidence Acquisition: Previous studies quantifying pitching kinematics and kinetics were reviewed.

Study Design: Clinical review.

Patellofemoral Joint Loading During the Performance of the Forward and Side Lunge with Step Height Variations.

Background: Forward and side lunge exercises strengthen hip and thigh musculature, enhance patellofemoral joint stability, and are commonly used during patellofemoral rehabilitation and training for sport.

Hypothesis/purpose: The purpose was to quantify, via calculated estimates, patellofemoral force and stress between two lunge type variations (forward lunge versus side lunge) and between two step height variations (ground level versus 10 cm platform). The hypotheses were that patellofemoral force and stress would be greater at all knee angles performing the bodyweight side lunge compared to the bodyweight forward lunge, and greater when performing the forward and side lunge at ground level compared to up a 10cm platform.

The Youth Throwers Ten Exercise Program: A variation of an exercise series for enhanced dynamic shoulder control in the youth overhead throwing athlete.

The overhead throwing motion is an extremely stressful athletic movement. The high velocity and repetitive nature of this activity places immense pressure on the entire body, which can frequently result in injury to the throwing arm. Extensive literature exists with regards to the management of these injuries in the collegiate and professional level athlete; and it is well understood that a multiphasic approach is required to return an individual to prior level of play.

Blood Flow Restriction Training.

Muscle weakness and atrophy are common impairments after musculoskeletal injury. Blood flow restriction (BFR) training offers the ability to mitigate weakness and atrophy without overloading healing tissues. It appears to be a safe and effective approach to therapeutic exercise in sports medicine environments.

Effect of Forearm Position on Glenohumeral External Rotation Measurements in Baseball Players.

Background: Alterations in glenohumeral internal rotation (GIR), glenohumeral external rotation (GER), and the total arc of motion (TAM) have been linked with increased injury risk in the shoulder and elbow. These motions have been routinely measured with the forearm in neutral rotation (GIRN, GERN, TAMN). GER capacity appears to be especially important.

Clinical Outcomes and Return to Play in Youth Overhead Athletes After Medial Epicondyle Fractures Treated With Open Reduction and Internal Fixation.

Background: There is limited literature regarding outcomes after operative treatment of displaced medial epicondyle avulsion fractures in adolescent athletes. Most studies have had a relatively small sample size and have not assessed return to play of the overhead athlete.

Purpose: To examine return to play and outcomes of youth overhead athletes who underwent open reduction and internal fixation (ORIF) with screw fixation.

Teamwork is Essential to Success: Sports Physical Therapy is No Exception.

Kevin Wilk, Christopher Arrigo, and Dr. James Andrews deliver the first editorial of the "new" IJSPT. They reflect on the importance of teamwork in successful outcomes in sports medicine.

RETURN TO SPORT PARTICIPATION CRITERIA FOLLOWING SHOULDER INJURY: A CLINICAL COMMENTARY.

Context: The shoulder complex is frequently injured during sports. The tremendous mobility of the shoulder makes returning to sport participation following shoulder injury a challenging task for both the clinician and athlete. The purpose of this clinical commentary is to review the current literature on return to sport criteria and provide evidence-informed and clinically useful guidelines and recommendations to aid in clinical decision making for return to sports after shoulder micro- and macro-traumatic injuries.