Epidemiology of injuries in tennis players.

Purpose Of Review: To review the recent literature regarding the epidemiology of tennis injuries at all levels of play, and to discuss recent findings in injury surveillance by the Association of Tennis Professionals (ATP).

Recent Findings: Following the release of a consensus statement in 2009 calling for standardized documentation and analysis of tennis-related injuries, multiple studies have been published describing longitudinal injury incidences at Grand Slam tournaments and the Davis Cup. Recent efforts by the ATP have further elucidated injury patterns on tour.

Adaptation of muscle activity in scapular dyskinesis test for collegiate baseball players.

Background: The characteristics of scapular muscle activities in elevation and descent exercises have yet to be elucidated to assess scapular dyskinesis. The purpose of this study was to identify the adaptation of electromyograph (EMG) activities of the upper trapezius (UT), lower trapezius (LT), serratus anterior (SA), and anterior deltoid (AD) muscles with different weight loads in flexion (FLX) and abduction (ABD) in collegiate baseball players.

Materials And Methods: Twenty eight individuals, including 13 pitchers, were tested.

Electromyographic Activity of Scapular Muscle Control in Free-Motion Exercise.

Context: The appropriate resistance intensity to prescribe for shoulder rehabilitative exercise is not completely known. Excessive activation of the deltoid and upper trapezius muscles could be counterproductive for scapulohumeral rhythm during humeral elevation.

Objective: To identify the effects of different exercise intensities on the scapular muscles during a free-motion "robbery" exercise performed in different degrees of shoulder abduction in seated and standing positions.

Muscular activation during plyometric exercises in 90° of glenohumeral joint abduction.

Background: Plyometric exercises are frequently used to increase posterior rotator cuff and periscapular muscle strength and simulate demands and positional stresses in overhead athletes. The purpose of this study was to provide descriptive data on posterior rotator cuff and scapular muscle activation during upper extremity plyometric exercises in 90° of glenohumeral joint abduction.

Hypothesis: Levels of muscular activity in the posterior rotator cuff and scapular stabilizers will be high during plyometric shoulder exercises similar to previously reported electromyographic (EMG) levels of shoulder rehabilitation exercises.

Current concepts in examination and treatment of elbow tendon injury.

Context: Injuries to the tendons of the elbow occur frequently in the overhead athlete, creating a significant loss of function and dilemma to sports medicine professionals. A detailed review of the anatomy, etiology, and pathophysiology of tendon injury coupled with comprehensive evaluation and treatment information is needed for clinicians to optimally design treatment programs for rehabilitation and prevention.

Evidence Acquisitions: The PubMed database was searched in January 2012 for English-language articles pertaining to elbow tendon injury.

Reliability of scapular classification in examination of professional baseball players.

Background: Clinically evaluating the scapulothoracic joint is challenging. To identify scapular dyskinesis, clinicians typically observe scapular motion and congruence during self-directed upper extremity movements. However, it is unclear whether this method is reliable.

Clinical concepts for treatment of the elbow in the adolescent overhead athlete.

Injuries to the adolescent elbow are common because of the repetitive overuse inherent in many overhead sport activities. The management of these patients is greatly facilitated through a greater understanding of the demands placed on the upper extremity kinetic chain during these overhead activities as well as a detailed examination and rehabilitation for the entire upper extremity kinetic chain. Particular emphasis on improving rotator cuff strength and muscular endurance, along with scapular stabilization, is a critical part of elbow rehabilitation in these patients.

Rehabilitation of shoulder impingement syndrome and rotator cuff injuries: an evidence-based review.

Rehabilitation of the patient with glenohumeral impingement requires a complete understanding of the structures involved and the underlying mechanism creating the impingement response. A detailed clinical examination and comprehensive treatment programme including specific interventions to address pain, scapular dysfunction and rotator cuff weakness are recommended. The inclusion of objective testing to quantify range of motion and both muscular strength and balance in addition to the manual orthopaedic clinical tests allows clinicians to design evidence-based rehabilitation programmes as well as measure progression and patient improvement.

Rehabilitation of the elbow following sports injury.

Evaluation of the athlete with an elbow injury involves a complete upper extremity approach and a corresponding treatment approach that addresses the identified deficiencies to restore normal function. A significant focus should be placed on the proximal aspect of the upper extremity in addition to the obvious distal injury. A detailed review of the available treatment modalities fails to identify any clear definitive choice to address pain levels; however, a combination of modalities and appropriate exercise can be used in the early rehabilitation phases.

Current concepts in rehabilitation following ulnar collateral ligament reconstruction.

Injuries to the ulnar collateral ligament (UCL) in throwing athletes frequently occurs from the repetitive valgus loading of the elbow during the throwing motion, which often results in surgical reconstruction of the UCL requiring a structured postoperative rehabilitation program. Several methods are currently used and recommended for UCL reconstruction using autogenous grafts in an attempt to reproduce the stabilizing function of the native UCL. Rehabilitation following surgical reconstruction of the UCL begins with range of motion and initial protection of the surgical reconstruction, along with resistive exercise for the entire upper extremity kinetic chain.

Humeral resurfacing hemiarthroplasty with meniscal allograft in a young patient with glenohumeral osteoarthritis.

Study Design: Case report.

Background: Management of glenohumeral joint osteoarthritis in young, active patients is challenging due to the significant functional limitations and progression of the disease, coupled with the limited lifespan of prosthetic implants presently in use. The purpose of this report is to present the detailed rehabilitation program and outcome of a patient who suffered an initial glenohumeral dislocation and, following multiple surgical interventions, required shoulder hemiarthroplasty and biologic glenoid resurfacing to return to function.

A descriptive profile of age-specific knee extension flexion strength in elite junior tennis players.

Background: Tennis requires repetitive multidirectional movement patterns that can lead to lower extremity injury. Knowledge of population and age-specific strength parameters can be used during performance enhancement training and rehabilitation of tennis players.

Objectives: The purpose of this study was to generate population and age-specific descriptive profiles of concentric isokinetic knee extension and flexion strength in elite junior tennis players, and determine whether bilateral differences exist between extremities and across age ranges.

Descriptive profile of hip rotation range of motion in elite tennis players and professional baseball pitchers.

Background: Repetitive loading to the hip joint in athletes has been reported as a factor in the development of degenerative joint disease and intra-articular injury. Little information is available on the bilateral symmetry of hip rotational measures in unilaterally dominant upper extremity athletes.

Hypothesis: Side-to-side differences in hip joint range of motion may be present because of asymmetrical loading in the lower extremities of elite tennis players and professional baseball pitchers.

Descriptive report of shoulder range of motion and rotational strength 6 and 12 weeks following rotator cuff repair using a mini-open deltoid splitting technique.

Study Design: Retrospective chart review.

Objectives: To measure short-term postsurgery glenohumeral internal rotation and external rotation strength, shoulder range of motion (ROM), and subjective self-report ratings following mini-open rotator cuff repair of full-thickness rotator cuff tears.

Background: Physical therapists provide rehabilitation for patients following mini-open rotator cuff repair.

Isokinetic profile of wrist and forearm strength in elite female junior tennis players.

Background: In tennis, injuries to the elbow and wrist occur secondary to the repetitive nature of play and are seen at increasingly young ages. Isokinetic testing can be used to determine muscular strength levels, but dominant/non-dominant and agonist/antagonist relations are needed for meaningful interpretation of the results.

Objectives: To determine whether there are laterality differences in wrist extension/flexion (E/F) and forearm supination/pronation (S/P) strength in elite female tennis players.

The application of isokinetics in testing and rehabilitation of the shoulder complex.

Objective: We review the application of isokinetic testing and training for the shoulder complex, the interpretation of isokinetic testing data, and the application of normative data in the rehabilitation and performance enhancement of the athlete.

Data Sources: We searched MEDLINE for the years 1989- 1999 using the key words "isokinetics," "shoulder," and "upper extremity."

Data Synthesis: Isokinetic testing and training is an integral part of the comprehensive evaluation and treatment of the shoulder complex.

An isokinetic profile of trunk rotation strength in elite tennis players.

Purpose: The changes in stroke production in the modern game of tennis have increased the demands on trunk rotation in elite tennis players. Unlike the shoulder, where unilateral strength adaptations have been identified, no study to date has objectively quantified side to side rotational trunk strength in elite tennis players.

Methods: One hundred nine elite tennis players were tested using a Cybex isokinetic torso rotation unit at 60 and 120 degrees x s(-1) to measure left and right rotation while stabilized in a seated position.

Velocity of a tennis serve and measurement of isokinetic muscular performance: brief review and comment.

Isokinetic strength testing provides objective and reliable muscular performance data on elite tennis players; however, such data are not highly correlated with performance on a multiple-joint kinetic chain activity such as the tennis serve. In this brief review, an overview of the muscular performance characteristics generated through isokinetic testing for elite tennis players is presented. Application of population specific isokinetic strength profiles in specific populations for rehabilitation and performance enhancement is recommended.

Age specific isokinetic glenohumeral internal and external rotation strength in elite junior tennis players.

The high incidence of overuse shoulder injuries in elite junior tennis players is often attributed to both the high repetitive stresses inherent in the game, as well as muscular imbalances in the humeral rotators. The purpose of this study was to isokinetically measure concentric glenohumeral joint internal and external rotation strength, to develop a bilateral descriptive profile in elite junior tennis players across two age ranges. One hundred forty seven elite junior players between the ages of 12 and 21 were bilaterally tested on a Cybex isokinetic dynamometer with 90 degrees of abduction.

Isokinetic profile of elbow flexion and extension strength in elite junior tennis players.

Study Design: Descriptive study.

Objectives: To determine whether bilateral differences exist in concentric elbow flexion and extension strength in elite junior tennis players.

Background: The repetitive nature of tennis frequently produces upper extremity overuse injuries.

Glenohumeral joint total rotation range of motion in elite tennis players and baseball pitchers.

Unlabelled: The amount of glenohumeral joint internal and external rotation used during overhead sport activities has been measured experimentally by sports scientists. Clinical measurement of glenohumeral joint internal and external rotation using goniometry is an integral part of a shoulder evaluation after injury or surgery or during preseason or preventative musculoskeletal screenings.

Purpose: This study measured glenohumeral joint internal and external rotation in two groups of unilaterally dominant upper extremity athletes to compare the total arc of rotational range of motion between the dominant and nondominant extremities.

Intrarater and interrater reliability of a manual technique to assess anterior humeral head translation of the glenohumeral joint.

The purpose of this study was to determine the intrarater and interrater reliability of a manual anterior humeral head translation test. Fifteen subjects were positioned lying in a supine position with their identity shielded from examiners. A standard manual anterior humeral head translation test was performed and repeated with the glenohumeral joint in 90 degrees of elevation in the scapular plane, with use of the grading method proposed by Altchek and Dines in 1993.

Effects of a 4-month season on glenohumeral joint rotational strength and range of motion in female collegiate tennis players.

The purpose of this study was to examine the effects of a 4-month season of collegiate tennis on glenohumeral joint internal and external rotation strength and range of motion in female collegiate tennis players. Eleven female collegiate tennis players were isokinetically tested to assess glenohumeral joint internal and external rotation strength with 90 degrees of abduction on a Cybex 6000 isokinetic dynamometer. Subjects were also measured for internal and external rotation range of motion using a universal goniometer with 90 degrees of abduction.