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.

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.

Exercise training for tennis.

Tennis is a physically demanding sport. A complete conditioning program designed to address both the demands of the sport and the individual player's musculoskeletal base is important in tennis, particularly at the competitive junior and professional levels. Recreational players can certainly use conditioning to improve their level of performance, but the primary concern in this group is general fitness development and injury prevention.

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.

Sport-specific conditioning.

The goal of the athlete is to optimize performance. The goal of the sports medicine physician is to minimize injury risk. By preparing the athlete's body for the mechanical and metabolic demands inherent in a particular sport, sport-specific conditioning programs can help achieve both these goals.

Implementing structure and control over unofficial inventories in a multispecialty group practice.

Materiel managers have been in control of most aspects of the supply chain except for the inventories of the end users, which account for 70 percent of the inventory supply dollars. When the Materials Manager at Lexington Clinic in Lexington, Kentucky, was approached by the Clinic's Chief Executive Officer to implement cost containment measures, the Materials Manager seized the opportunity to implement a six-step program aimed at controlling those supply dollars. Through requisition training, enforcing approval levels, limiting the number of requisitioners, and establishing par levels on floor inventories, the clinic's "unofficial" inventory supply dollars were reduced by 7 percent in the first 12 departments where the par levels were established.

Physiology of aerobic fitness/endurance.

Aerobic fitness and aerobic endurance are two separate components of aerobic metabolism. Aerobic fitness, best measured by VO2max, is a measure of oxygen transport and utilization. Aerobic endurance is not measured in a VO2max test because it does not measure the ability of the muscle to perform prolonged work.

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.

Preventing diabetic foot disease.

Diabetic foot disease results from two common pathologies: peripheral vascular disease and diabetic neuropathy. If these pathologies are not identified, ulceration may occur in the foot. Ulcers can lead to infection and finally amputation.

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.

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.

Shoulder strength, power, and endurance in college tennis players.

Twenty-four college tennis players were tested for bilateral shoulder internal/external rotation strength on a Cybex 340 isokinetic dynamometer; they were positioned supine with the glenohumeral joint abducted to 90 degrees. Subjects produced significantly (P less than 0.01) more torque in internal rotation at 60 and 300 deg/sec in the dominant arm compared to the nondominant arm.

Functional biomechanical deficits in running athletes with plantar fasciitis.

Plantar fasciitis is a relatively common injury that occurs in running athletes. The disease entity is a good example of an overloaded process of the plantar fascia at its calcaneal insertion. This study was designed to examine the strength and flexibility findings in the muscles that are put on tensile load during running, and which are responsible for controlling the forces on the foot during stance and pushoff, thus modifying the overload.

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.

Flexibility comparisons of junior elite tennis players to other athletes.

Flexibility measurements were obtained in 86 junior elite tennis players and compared to the flexibility measurements of 139 athletes involved in other sports. The measurements obtained included sit and reach flexibility, quadricep flexibility, hamstring flexibility, gastrocnemius flexibility, shoulder internal rotation, and shoulder external rotation. All measurements except sit and reach flexibility were obtained goniometrically.

A musculoskeletal approach to the preparticipation physical examination. Preventing injury and improving performance.

Preparticipation physical examinations provide information concerning an athlete's ability to participate safely in sports. By collecting information specific to the musculoskeletal system in addition to that from a general medical examination, information can be gained that may improve performance and help prevent certain injuries. Two thousand one hundred seven athletes from a variety of sports from the junior high to the college level were examined using specific tests for flexibility, strength, and endurance.

A new treatment for invasive squamous cell bladder cancer: the Nigro regimen: preoperative chemotherapy and radiation therapy.

We report 5 cases of invasive squamous cell bladder cancer treated with preoperative mitomycin C and 5-fluorouracil in combination with preoperative external beam radiation therapy (the Nigro regimen), and the subsequent apparent cure of 3 of the 5 patients.

Renal capsular leiomyoma.

An exophytic renal mass was diagnosed preoperatively as renal cell carcinoma by ultrasound, computerized tomography and arteriography. Intraoperative recognition of the proper diagnosis of leiomyoma of the renal capsule permitted renal-sparing excision. Renal capsular leiomyoma should always be considered in the differential diagnosis of an apparent exophytic renal cell carcinoma.