Evaluation & Treatment of the Scapula in Athletes: How Important is the Scapula Kevin E Wilk, PT, DPT,FAPTA
|
|
|
- Morris Tyler
- 6 years ago
- Views:
Transcription
1 Evaluation & Treatment of the Scapula in Athletes: How Important is the Scapula Kevin E Wilk, PT, DPT,FAPTA Kevin E Wilk, PT, DPT,FAPTA 2016 Baseball Sports Medicine Conference Faculty Disclosure: Theralase Laser Medical Advisory Board LiteCure Laser Consultant AlterG Medical Advisory Board Intelliskin USA Medical Advisory Board Zetroz Medical Medical Advisory Brd Throw Like A Pro Co-Owner Dr PRP Rehab Advisor Educational Grants:» Performance Health» Joint Active System»ERMI» Bauerfeind Brace Book Royalties:» CV Mosby, Lippincott, Human Kinetics
2 Evaluation & Treatment Scapula Goals of the Presentation Present new concepts in the treatment of scapula disorders Discuss the role of the scapula Scapular dyskinesis: what is it? What it isn t? Describe exercises for strengthening scapular muscles Discuss scapular neuromuscular control exercises & drills
3 Scapulothoracic Joint Introduction Scapular Dyskinesis: altered scapular position or movement due to boney or soft tissue lesions as well as weakness or inflexibility Kibler & Sciascia: Br J Spts Med 10
4 Scapular Dyskinesis Test (SDT) McClure et al: JAT 09 2 handheld weights based on body size: < 68.1kg = 3 Ib. weights >68.1 kg = 5 Ib weights Perform 5 bilateral reps of shoulder flexion & then shoulder abduction Speed of movement 3 sec ascend/descend Videotaped for analysis Scapular Evaluation Scapular Dysfunction Shoulder elevation scapular plane Without resistance With resistance Shoulder abduction Without resistance With resistance Scapular Evaluation Scapular Dysfunction
5 Scapular Evaluation Evaluation Post-Fatigue Scapular Dysfunction Injury Risk in Baseball Players Pre-season screening of 246 high school players (mean age 16.6 yrs) playing 10yrs Assessed scapula using the SDT described by McClure et al: JAT 09 Examined examiners analyzed video (2) 122/246 identified with scapular dysfunction 2/122 in scap dysf grp their shoulder or elbow 10/124 in the normal scap group - injuries Total of 12 injuries SHOULDER COMPLEX BIOMECHANICS Scapular Position Ventral surface floats on convex thoracic wall Resting position: o anterior to coronal plane plane of the scapula Arm motions occur predominately in the scapula plane Clinically important position
6 Scapulothoracic Control for Normal GH Motion Allows the Humerus to above 90 0 Maintains normal GH relationship Maintains consistent length-tension relationship of muscles Follows the humeral head Acts as anchor allows increased motion Scapulothoracic Joint Scapulohumeral Rhythm setting phase : : 1 Overall ratio 1.7 : 1
7 Scapular Kinematics 3 Rotations» Upward/ Downward» Internal/External» Anterior/Posterior 3 Translations» Superior/Inferior» Anterior/Posterior» Medial/Lateral constrained by clavicle McClure JSES 01 Translation /Position: Superior Rotation: Upward Superior/Inferior Translation Internal / External Rotation Ant / Post Tilting Anterior / Posterior Translation Up / Down Rotation
8 Scapular Motion
9 Scapular Posterior Tilting (n=8) Posterior Mean = 30 o (13) Anterior McClure JSES 01 Humerothoracic SP Elevation [degrees] Scapular Upward Rotation (n = 8) Upward Rotation [deg] Upward Mean = 50 o (4.8) 10 Downward McClure JSES 01 Humerothoracic SP Elevation [degrees] Lukasiewicz et al: JOSPT 99 Analyze scapular position and orientation in subject w/ impingement & normals 3D electromechanical devices in 3 planes During arm elevation: posterior tilting, upward rotation, retraction Impingement subjects: greater scapula elevation & less posterior tilting
10 Rehabilitation of Shoulder Impingement Rehab Overview: Specific rehab concepts: pain reduction restoration ROM& flexibility normalizing posture muscular strength (balance) advanced phases return to activity phase sports work activities
11 Baseball Players - Posture Borich, Bright, Lorello, et al: JOSPT 36(12) , 2006 Scapular angular position assessment at end range internal rotation 3- dimensional scapular assessment 23 subjects were analyzed IR ROM deficit group exhibited significantly greater scapular anterior tilt (9 deg) compared to control group Solem - Bertoft: Clin Orthop 93 Used MRI to determine effect of scapular retraction & protraction on acromial space Subjects supine & passively positional Protraction position sign reduced acromial angle, or increased anterior tilting of scapula & decreased SA space
12 Slouched Thoracic Posture Shoulder abduction ROM» Erect: (+ 10.8)» Slouched: (+ 13.7) Abduction 90» Erect: 10.4kg (+ 4.5)» Slouched: 8.7kg (+ 3.5) Scapular Kinematics Upward rotation:» Erect: 43.1 (+7.5)» Slouched: 37.9 (+6.5) Posterior tilt» Erect: 44.7 (+6.8)» Slouched: 40.6 (+6.9) Kebaetse et al. Arch Phy Med Rehab 1999 Roll Tide
13 Lukasiewicz et al: JOSPT 99 Analyze scapular position and orientation in subject w/ impingement & normals 3D electromechanical devices in 3 planes During arm elevation: posterior tilting, upward rotation, protraction Impingement subjects: greater scapula elevation & less posterior tilting* Assessment of Scapular Position Kibler et al: Br J Sports Med 10 McClure et al: J Athl Train 09 Uhl et al: Arthroscopy 09 Borich et al: JOSPT 06 Thomas et al: CORR 10
14
15 Bastan, Wilk, Reinold: APTA CSM 06 Analyzed scapular position in 43 professional baseball pitchers Assessed 4 static positions»arm at side» Full can» 90 deg abd ER» 90 deg abd IR Compared bilateral differences (T vs NT) Results: most significant difference was with protraction in all positions, then anterior tilt Macrina, Wilk: CSM 07 Analyzed the effects of fatigue on scapular position in 39 professional baseball pitchers Assessed 4 static positions»arm at side» Full can» 90 deg abd ER» 90 deg abd IR Compared bilateral differences (T vs NT) Results: most significant difference was with protraction in all positions then anterior tilt
16 Scapular Strength Ratios Wilk, Reinold, Hooks Unpublished data 07 Pitchers Non-throwers D ND D ND Elev / Depress 400% 480% 520% 540% Retract / Protract 88% 71% 78% 71% Scapular Retraction Test Perform provocative test» Assess strength of deltoid and rotator cuff Have patient retract scapula and manually provide scapular stability then retest strength Improved symptoms (strength) indicates scapular muscular control is compromised Supraspinatus strength improved with retraction Kibler: AJSM 06 Scapular Assistance Test Assist the scapula retract and upwardly rotate as the arm is elevated (+) Pain diminished & range of motion increased Indicates improving scapular motion may diminish symptom Kibler & McMullen JAAOS 03
17 Best Stretch for Pectoralis Minor Pectoralis Minor Muscle Stretching Overview Pectoralis Minor Muscle J Shoulder Stretching Elb Surg 06 Overview
18
19 Best Exercises for the Scapular Muscles Enhancing Activation of Posterior Cuff
20 Schachter, McHugh,Tyler, et al: JSES 10 8 subjects SEMG and fine wire» Infraspinatus» Middle trapezius» Serratus anterior» Pectoralis major EMG activity during ER/IR isokinetics at 60 deg/sec and rowing During ER/IR - scapular muscle activity occurred During scapular retraction at 90 deg rotator cuff activity occurred Not isolated movements cuff & scapula relationship Kibler, Sciascia, Uhl: AJSM 08 EMG analysis of specific scapular exercises in early phase rehab Studied: SA, UT, LT, Ant & SA > UT, AD (23) Post Deltoid Performed: low row, inf glide, lawnmower, & robbery exercises Moderate EMG activity across all exercises SA highest during low row (30%) UT & LT were highest during lawnmower & robbery PD > UT, LT (42)
21 Kibler et al: AJSM 08 LT > UT, SA (30) UT > LT, SA (31) Escamilla, Reinold,Wilk: JOSPT 09
22 Kibler, Sciascia, Uhl: AJSM 08 EMG analysis of specific scapular exercises in early phase rehab Studied: SA, UT, LT, Ant & SA > UT, AD (23) Post Deltoid Performed: low row, inf glide, lawnmower, & robbery exercises Moderate EMG activity across all exercises SA highest during low row (30%) UT & LT were highest during lawnmower & robbery PD > UT, LT (42) Kibler et al: AJSM 08
23 Kibler et al: AJSM 08 Lower Trapezius Exercises!!!
24 Lower Trapezius Exercises Activation Exercises Strengthening Exercises
25 Cools,Witvrouw,et al : AJSM 03 Scapular muscle recruitment patterns (timing) Compared 39 overhead athletes with shoulder pain (impingement) to 30 painfree overhead athletes Performed semg to scapular & deltoid muscles performed drop arm test Significant slower muscle activation in MT,LT in painful grp. compared to control grp. (esp. LT) Painful grp. slower recruitment from deltoid to trapezius
26 Scapular Neuromuscular Exercise Scapular Muscle Training Alternating day schedule: Isotonic table exercises days- Goal: strengthen/hypertrophy traditional exercises progress with dumbbells neuromuscular drills Stability Ball days- Goal: NM control & dynamic stab Isotonic exercises on stability ball NM control drills Core, hips & legs
27 Advanced Thrower s Ten Program
28 Scapular Motor Control Re-education Visual feedback» Mirror Two mirrors positioned at side of patient to view posterior trunk»video Video posterior with the person watching the monitor Do not overly verbal correct Uhl & Kibler: 06 Scapular Motor Control Re-education Scapular & Back Across Wall Feedback & Posture
29 Scapular Motor Control Re-education mirror to mirror Scapular Muscle Training Train the Scapular Daily Isotonic table days» Heavier weights» Isolated movements» Hypertrophy» Neuromuscular drills Scapular Muscle Training Train the Scapular Daily Isotonic table days» Heavier weights» Isolated movements» Hypertrophy» Neuromuscular drills Stability Ball days» Lighter weights» Bilateral movts.» Combined movts» Trunk, core,
30 Best Exercises for Scapular Muscles Lower Trapezius Prone horz abd at 105 abd Ekstrom 93 Blackburn JAT prone full can Robbery exercise Kibler et al: AJSM 08 Table push down w/ arm at side Wilk: NAJSPT 06 Modified Robbery Exercise Wilk: NAJSPT 06 Table press down Kibler AJSM 08
31 Lower Trape 5
32 Best Exercises for Scapular Muscles Serratus Anterior Push-up with a plus Moseley: AJSM 92 Punches Kendall: 79 Dynamic hug Decker: AJSM 99 Wall slide Hardwick: JOSPT 06 Bench press
33 Wall Slide (high EMG 90 >)
34 Best Exercises for Scapular Muscles Middle Trapezius - Rhombs Prone Horz Abd at 90 palm down Moseley: AJSM 92 Seated Rowing high hands Wilk & Escamilla: JOSPT 00 Prone horz abd at 90 thumb up Moseley: AJSM 92 Resisted Shoulder Abduction Perry J: Shoulder 78 Reverse Pect. Deck
35 Advanced Thrower s Ten Program
36
37
38
39 Scapulothoracic Joint Summary Key to shoulder joint function Intimately involved in shoulder pathology Scapular muscle function Synchronized action Muscles working in concert Scapular motion (normal & pathology) Understanding abnormal & normal movements patterns assists in assessment Think Proximal Stability Distal Mobility Best exercises for scapular muscles
40
Return to Play Criteria in the Overhead Thrower
in the Overhead Thrower Kevin E. Wilk, PT, DPT,FAPTA 2018 The Overhead Thrower Introduction Highly skilled athlete Requires flexibility, muscle strength, coordination, synchronicity & NM efficiency Proper
ER + IR = Total Motion
Treating the Thrower s Shoulder Michael M. Reinold, PT, DPT, ATC, CSCS Introduction Common site of injury» Repetitive forces / stresses Tremendous joint forces» Anterior shear forces 1-1.5 1.5 X BW» Distraction
Disclosures. Training for the Scapulothoracic Joint and Thoracic Spine. Scapular Muscles Stabilization & Rotation 9/7/2018
Disclosures Training for the Scapulothoracic Joint and Thoracic Spine mtrigger Litecure Russ Paine, PT Director -UT Physicians Sportsmedicine Rehabilitation Houston, Texas 21 academic institutions 14 hospitals
Shoulder Stabilization in Athletes
Shoulder Stabilization in Athletes When Can I Play Kevin E. Wilk, DPT, PT,FAPTA Kevin E Wilk, PT, DPT,FAPTA 2016 U of Colorado Sports Medicine Symposium Faculty Disclosure: Theralase Laser Medical Advisory
11/6/2013. Keely Behning, PT, SCS, ATC MNPTA Fall Conference November 16, 2013
Keely Behning, PT, SCS, ATC MNPTA Fall Conference November 16, 2013 Upon completion of this course, attendees should be able to: Understand pertinent anatomy and biomechanics as they relate to specific
Throwing Athlete Rehabilitation. Brett Schulz LAT/CMSS Sport and Spine Physical Therapy
Throwing Athlete Rehabilitation Brett Schulz LAT/CMSS Sport and Spine Physical Therapy Disclosure No conflicts to disclose Throwing Athlete Dilemma The shoulder must have enough range of motion to allow
SHOULDER REHABILITATION PART II
SHOULDER REHABILITATION PART II Ann Cools, PT, PhD Ghent University - Belgium Dept of Rehabilitation Sciences & Physiotherapy Ann.Cools@UGent.be Shoulder rehab course level I Shoulder pathology and clinical
Phase I : Immediate Postoperative Phase- Protected Motion. (0-2 Weeks)
Phase I : Immediate Postoperative Phase- Protected Motion (0-2 Weeks) Appointments Progression Criteria 2 weeks after surgery Rehabilitation appointments begin within 7-10 days of surgery, continue 1-2
S3 EFFECTIVE FOR SHOULDER PATHOLOGIES -Dr. Steven Smith
S3 EFFECTIVE FOR SHOULDER PATHOLOGIES -Dr. Steven Smith Introduction: Scapular function and its role in shoulder biomechanics has gained increased notoriety in the pathogenesis of shoulder dysfunction
Rehabilitation of Overhead Shoulder Injuries
Rehabilitation of Overhead Shoulder Injuries 16 th Annual Primary Care Orthopaedic & Sports Medicine Symposium January 29, 2016 Jeremy Sherman, PT, MPT Disclosures No financial disclosures to note. Jeremy
Addressing Core and Balance Deficits to Maximize Return to Sport in Overhead Athletes
Addressing Core and Balance Deficits to Maximize Return to Sport in Overhead Athletes Meg Jacobs P.T. Momentum Physical Therapy and Sports Rehab Hands on care for faster results www.wegetyouhealthy.com
Describe methods to evaluate for scapular. Perform a scapular dyskinesis examination. With humeral elevation, the scapula:
Describe methods to evaluate for scapular dyskinesis Perform a scapular dyskinesis examination Lori Michener, PhD, PT, ATC Virginia Commonwealth University Richmond, VA Ant / Post Tilting Internal / External
Harold Schock III, MD Rotator Cuff Repair Rehabilitation Protocol
Harold Schock III, MD Rotator Cuff Repair Rehabilitation Protocol The following document is an evidence-based protocol for arthroscopic rotator cuff repair rehabilitation. The protocol is both chronologically
Shoulder: Clinical Anatomy, Kinematics & Biomechanics
Shoulder: Clinical Anatomy, Kinematics & Biomechanics Dr. Alex K C Poon Department of Orthopaedics & Traumatology Pamela Youde Nethersole Eastern Hospital Clinical Anatomy the application of anatomy to
Theodore B. Shybut, M.D.
Theodore B. Shybut, M.D. Orthopedics and Sports Medicine 7200 Cambridge St. #10A Houston, Texas 77030 Non-operative Shoulder Rehabilitation Protocol Basic shoulder program for: o Scapular Dyskinesis (proximally
Outline. Training Interventions for Youth Baseball Athletes. 3 Rehabilitation Focus Points. What Training to Perform?
Outline Training Interventions for Youth Baseball Athletes Tim L. Uhl PhD ATC PT FNATA Division of Athletic Training Department of Rehabilitation Sciences College of Health Sciences University of Kentucky
IMPINGEMENT-TESTSTESTS
«thinking about.» DIFFERENTIAL DIAGNOSIS: Looking for the causes of Which special tests do you use in your shoulder examination? Ann Cools, PT, PhD Ghent University - Belgium Dept of Rehabilitation Sciences
DIFFERENTIAL DIAGNOSIS: Looking for the causes of impingement
DIFFERENTIAL DIAGNOSIS: Looking for the causes of Ann Cools, PT, PhD Ghent University - Belgium Dept of Rehabilitation Sciences & Physiotherapy Ann.Cools@UGent.be «thinking about.» Which special tests
Cross Country Education Leading the Way in Continuing Education and Professional Development.
Manual Therapy Exercises for the Shoulder To comply with professional boards/associations standards: I declare that I or my family do not have any financial relationship in any amount, occurring in the
Today s Shoulder. Session 108: Glenohumeral Stabilization For True Upper Extremity Function
To comply with professional boards/associations standards: I declare that I (or my family) do not have a financial relationship in any amount, occurring in the last 12 months with a commercial interest
SHOULDER PAIN LESSONS FROM THE SPORTS FIELD MOVEMENT RESTRICTIONS. Steve McCaig
SHOULDER PAIN LESSONS FROM THE SPORTS FIELD MOVEMENT RESTRICTIONS 1 Steve McCaig Senior Physiotherapist England Development Programme, ECB, Loughborough, United Kingdom Throwing High forces upper limb
Affiliations. Scapular Stabilization in the Overhead Athlete. COI Disclosure Information. Greetings Commonwealth of Kentucky 6/10/2015
Scapular Stabilization in the Overhead Athlete Tim L. Uhl PhD ATC PT FNATA Division of Athletic Training Department of Rehabilitation Sciences College of Health Sciences University of Kentucky COI Disclosure
Superior Labrum Repair Protocol - SLAP
Superior Labrum Repair Protocol - SLAP Stage I (0-4 weeks): Key Goals: Protect the newly repaired shoulder. Allow for decreased inflammation and healing. Maintain elbow, wrist and hand function. Maintain
Overhead Athlete Rehabilitation Guidelines
Overhead Athlete Rehabilitation Guidelines This document is designed to be used as a guideline in the rehabilitation of the athlete playing overhead sports, mainly baseball and softball, but also including
Anterior Stabilization of the Shoulder: Distal Tibial Allograft
Anterior Stabilization of the Shoulder: Distal Tibial Allograft Name: Diagnosis: Date: Date of Surgery: Phase I Immediate Post Surgical Phase (approximately Weeks 1-3) Minimize shoulder pain and inflammatory
Secrets and Staples of Training the Athletic Shoulder
Secrets and Staples of Training the Athletic Shoulder Eric Beard Corrective Exercise Specialist Athletic Performance Enhancement Specialist EricBeard.com AthleticShoulder.com Presentation Overview Rationale
REMINDER. an exercise program. Senior Fitness Obtain medical clearance and physician s release prior to beginning
Functional Forever: Exercise for Independent Living REMINDER Obtain medical clearance and physician s release prior to beginning an exercise program for clients with medical or orthopedic concerns. What
REHABILITATION GUIDELINES FOR ANTERIOR SHOULDER RECONSTRUCTION WITH BANKART REPAIR
REHABILITATION GUIDELINES FOR ANTERIOR SHOULDER RECONSTRUCTION WITH BANKART REPAIR The rehabilitation guidelines are presented in a criterion based progression. General time frames are given for reference
Integrating Sensorimotor Control Into Rehabilitation
Integrating Sensorimotor Control Into Rehabilitation BRADY L. TRIPP, PhD, LAT, ATC Florida International University Key Points As evidence accumulates, so does our appreciation of the integral roles that
Nonoperative Treatment of Subacromial Impingement Rehabilitation Protocol
Therapist Nonoperative Treatment of Subacromial Impingement Rehabilitation Protocol Subacromial impingement is a chronic inflammatory process produced as one of the Rotator Cuff Muscle the and the Subdeltoid
Biceps Tenodesis Protocol
Biceps Tenodesis Protocol A biceps tenodesis procedure involves cutting of the long head of the biceps just prior to its insertion on the superior labrum and then anchoring the tendon along its anatomical
Returning the Shoulder Back to Optimal Function. Scapula. Clavicle. Humerus. Bones of the Shoulder (Osteology) Joints of the Shoulder (Arthrology)
Returning the Shoulder Back to Optimal Function Sternum Clavicle Ribs Scapula Humerus Bones of the Shoulder (Osteology) By Rick Kaselj Clavicle Scapula Medial Left Anterior Clavicle Inferior View 20 degree
[12]. 100 subjects. The sampling method used was purposive sampling. Fifty gymers and fifty matched non gymers were
![[12]. 100 subjects. The sampling method used was purposive sampling. Fifty gymers and fifty matched non gymers were](/thumbs/90/103918912.jpg "[12]. 100 subjects. The sampling method used was purposive sampling. Fifty gymers and fifty matched non gymers were")
To Study the Prevalence of Scapular Dyskinesia in Gymers and Non Gymers Divya Khare 1, Supriya Vinay Deshmukh 2 Associate Professor, Physiotherapy Department, Ayushman College, Bhopal [Madhya Pradesh],
SLAP Lesions Assessment & Treatment
SLAP Lesions Assessment & Treatment Kevin E. Wilk,, PT, DPT Glenoid Labral Lesions Introduction Common injury - difficult to diagnose May occur in isolation or in combination SLAP lesions: Snyder: Arthroscopy
[ CLINICAL COMMENTARY ]
![[ CLINICAL COMMENTARY ]](/thumbs/75/72029404.jpg "[ CLINICAL COMMENTARY ]")
PAULA M. LUDEWIG, PT, PhD¹ PT, PhD² The Association of Scapular Kinematics and Glenohumeral Joint Pathologies houlder pain and associated glenohumeral joint movement dysfunctions are common and debilitating
Bradley C. Carofino, M.D. Shoulder Specialist 230 Clearfield Avenue, Suite 124 Virginia Beach, Virginia Phone
Subpectoral Bicep Tenodesis Protocol (Spreadsheet) Weeks 1-2 Modalities Treatment Restrictions Goals No active elbow flexion (6weeks) Full PROM shoulder and elbow PROM: Shoulder, elbow, forearm No active
REMINDER. Obtain medical clearance and physician s release prior to beginning an exercise program for clients with medical or orthopedic concerns
Understanding Shoulder Dysfunction REMINDER Obtain medical clearance and physician s release prior to beginning an exercise program for clients with medical or orthopedic concerns What is a healthy shoulder?
Nonoperative Treatment For Rotator Cuff Tendinitis/ Partial Thickness Tear Dr. Trueblood
Nonoperative Treatment For Rotator Cuff Tendinitis/ Partial Thickness Tear Dr. Trueblood Relieving Pain Patients who present with SIS will have shoulder pain that is exacerbated with overhead activities.
REHABILITATION GUIDELINES FOR ARTHROSCOPIC CAPSULAR SHIFT
REHABILITATION GUIDELINES FOR ARTHROSCOPIC CAPSULAR SHIFT The rehabilitation guidelines are presented in a criterion based progression. General time frames are given for reference to the average, but individual
Core deconditioning Smoking Outpatient Phase 1 ROM Other
whereby the ball does not stay properly centered in the shoulder socket during shoulder movement. This condition may be associated with impingement of the rotator cuff on the acromion bone and coracoacromial
SLAP Lesion Type II Repair Rehabilitation Program
SLAP Lesion Type II Repair Rehabilitation Program The GLSM SLAP Type II Repair Rehabilitation Program is an evidence-based and soft tissue healing dependent program allowing patients to progress to vocational
Biceps Tenodesis Protocol
Robert K. Fullick, MD 6400 Fannin Street, Suite 1700 Houston, Texas 77030 Ph.: 713-486-7543 / Fx.: 713-486-5549 Biceps Tenodesis Protocol The intent of this protocol is to provide the clinician with a
Rehabilitation for MDI in the Female Athlete. John Dale PT, DPT, SCS, ATC, CSCS Andrew Naylor PT, DPT, SCS
Rehabilitation for MDI in the Female Athlete John Dale PT, DPT, SCS, ATC, CSCS Andrew Naylor PT, DPT, SCS Disclosure No relevant financial relationship exists Session Learning Objectives Discuss etiology
Anterior Stabilization of the Shoulder: Latarjet Protocol
Robert K. Fullick, MD 6400 Fannin Street, Suite 1700 Houston, Texas 77030 Ph.: 713-486-7543 / Fx.: 713-486-5549 Anterior Stabilization of the Shoulder: Latarjet Protocol The intent of this protocol is
Anterior Labrum Repair Protocol
Anterior Labrum Repair Protocol Stage I (0-4 weeks): Key Goals: Protect the newly repaired shoulder. Allow for decreased inflammation and healing. Maintain elbow, wrist and hand function. Maintain scapular
The Relationship of Periscapular Strength on Scapular Upward Rotation in Professional Baseball Pitchers
Journal of Sport Rehabilitation, 2008, 17, 95-105 2008 Human Kinetics, Inc. Original Research Reports The Relationship of Periscapular Strength on Scapular Upward Rotation in Professional Baseball Pitchers
Rehabilitation Guidelines for Labral/Bankert Repair
Rehabilitation Guidelines for Labral/Bankert Repair The true shoulder joint is called the glenohumeral joint and consists humeral head and the glenoid. It is a ball and socket joint. Anatomy of the Shoulder
Ms. Ruth A. Delaney, MB BCh BAO, MMedSc, MRCS
Ms. Ruth A. Delaney, MB BCh BAO, MMedSc, MRCS Consultant Orthopaedic Surgeon, Shoulder Specialist. +353 1 5262335 ruthdelaney@sportssurgeryclinic.com Modified from the protocol developed at Boston Shoulder
ARTHROSCOPIC SLAP LESION REPAIR (TYPE II) WITH THERMAL CAPSULAR SHRINKAGE
ARTHROSCOPIC SLAP LESION REPAIR (TYPE II) WITH THERMAL CAPSULAR SHRINKAGE I. Phase I Immediate Postoperative Phase Restrictive Motion (Day 1 to Week 6) Goals: Protect the anatomic repair Prevent negative
Arthroscopic Anterior Stabilization Rehab
Arthroscopic Anterior Stabilization Rehab Phase I (0-3weeks) Sling immobilization-md directed Codmans/Pendulum exercises Wrist/Elbow ROM Gripping exercises FF-AAROM (supine)-limit to 90 o ER to 0 o Sub
Throwing Injuries and Prevention: The Physical Therapy Perspective
Throwing Injuries and Prevention: The Physical Therapy Perspective Andrew M Jordan, PT, DPT, OCS Staff Physical Therapist, Cayuga Medical Center Physical Therapy and Sports Medicine ajordan@cayugamed.org
Get Rhythm or what s the link between scapular dyskinesis and Algorithm?
Get Rhythm or what s the link between scapular dyskinesis and Algorithm? Rehabilitation of scapular dyskinesis: from the office worker to the elite overhead athlete Adapted Critical appraised Paper and
Strength and muscle activity of shoulder external rotation of subjects with and
Strength and muscle activity of shoulder external rotation of subjects with and without scapular dyskinesis DAISUKE UGA, RPT, MS 1,2), RIE NAKAZAWA, RPT, PhD 2), MASAAKI SAKAMOTO, RPT, PhD 2) 1) Jobu Hospital
Sterile gauze used at incision site. Check brace for rubbing or irritation. Compression garment at elbow to be used with physician s authorization
ULNAR COLLATERAL LIGAMENT RECONSTRUCTION GUIDELINE Functional Outcome Measure KJOC (Appendix 1) should be completed at initial evaluation and at all identified times through guideline, Phase 1 Immediate
Rehabilitation Following Arthroscopic Anterior Shoulder Plication in the Overhead Athlete
Rehabilitation Following Arthroscopic Anterior Shoulder Plication in the Overhead Athlete PHASE I IMMEDIATE GUARDED MOTION PHASE (Weeks 0-6) Reduce postoperative pain and inflammation Promote capsular
Pathomechanics of Common Shoulder Injuries
Pathomechanics of Common Shoulder Injuries Kevin E. Wilk,, DPT Birmingham, Alabama, USA www.kevinwilk kevinwilk.. com Shoulder Injuries in Sports Introduction Shoulder injuries are common in sports» Collision
Scapular protraction. Ipsilateral shoulder flexion Push up plus
Exercise Progression: base on EMG evidence Rotator Cuff Musculature Supraspinatus Infraspinatus Subscapularis Exercise Mn Sd Exercise Mn Sd Exercise Mn Sd Supine PROM 11 1 6 Forward bow 11 2 2 Scaption
Biceps Tenotomy Protocol
Biceps Tenotomy Protocol A biceps tenotomy procedure involves cutting of the long head of the biceps just prior to its insertion on the superior labrum. A biceps tenotomy is typically done when there is
CSM 2018 Outline. Educational Session Title: Shoulder Pathomechanics in the Throwing Athlete - Causes, Surgery, Outcomes, & Rehab
CSM 2018 Outline Educational Session Title: Shoulder Pathomechanics in the Throwing Athlete - Causes, Surgery, Outcomes, & Rehab Speakers: Dr. Rafael F Escamilla, Department of Physical Therapy, California
Rehabilitation Guidelines for Anterior Shoulder Reconstruction with Arthroscopic Bankart Repair
UW HEALTH SPORTS REHABILITATION Rehabilitation Guidelines for Anterior Shoulder Reconstruction with Arthroscopic Bankart Repair The anatomic configuration of the shoulder joint (glenohumeral joint) is
APPENDIX: The Houston Astros Stretching Program
Vol. 35, No. 4, 2007 Glenohumeral Internal Rotation Deficits 1 APPENDIX: The Houston Astros Stretching Program Our Flexibility program consists of 5 positions. Four of the 5 have 2 variations of each position.
SMALL-MEDIUM ROTATOR CUFF REPAIR GUIDELINE
SMALL-MEDIUM ROTATOR CUFF REPAIR GUIDELINE The rotator cuff is responsible for stabilization and active movement of the glenohumeral joint. An acute or overuse injury may cause the rotator cuff to be injured
Theodore B. Shybut, M.D. Orthopedics and Sports Medicine 7200 Cambridge St. #10A Houston, Texas Phone: Fax:
Theodore B. Shybut, M.D. Orthopedics and Sports Medicine 7200 Cambridge St. #10A Houston, Texas 77030 Phone: 713-986-5590 Fax: 713-986-5521 ROTATOR CUFF REPAIR PROTOCOL This rehabilitation protocol has
Large/Massive Rotator Cuff Repair
Large/Massive Rotator Cuff Repair 1. Defined a. Suturing of tears within the rotator cuff (most commonly supraspinatus muscle). Massive RCR usually involve more than the supraspinatus. b. May be done arthroscopically
Diagnosis: ( LEFT / RIGHT ) Shoulder Instability / SLAP Tear
UCLA OUTPATIENT REHABILITATION SERVICES! SANTA MONICA! WESTWOOD 1000 Veteran Ave., A level Phone: (310) 794-1323 Fax: (310) 794-1457 1260 15 th St, Ste. 900 Phone: (310) 319-4646 Fax: (310) 319-2269 FOR
Rotator Cuff Repair Protocol for tear involving Subscapularis Tendon with or without Pectoralis Major Tendon Transfer
Rotator Cuff Repair Protocol for tear involving Subscapularis Tendon with or without Pectoralis Major Tendon Transfer D. WATTS, MD Precautions: BASIS Tendon healing back to bone is a slow process that
Evaluation and Management of Scapular Dysfunction
Evaluation and Management of Scapular Dysfunction Phil McClure PT, PhD mcclure@arcadia.edu Goals of this presentation Relevance of scapular dysfunction to common shoulder pathologies rmal scapular motion
CENTER FOR ORTHOPAEDICS AND SPINE CARE PHYSICAL THERAPY PROTOCOL ARTHROSCOPIC SLAP LESION REPAIR (TYPE II) BENJAMIN J. DAVIS, MD
I. Phase I Immediate Postoperative Phase Restrictive Motion (Day 1 to Week 6) Goals: Protect the anatomic repair Prevent negative effects of immobilization Promote dynamic stability Diminish pain and inflammation
I (and/or my co-authors) have something to disclose.
Shoulder Anatomy And Biomechanics Nikhil N Verma, MD Director of Sports Medicine Professor, Department of Orthopedics Rush University Team Physician, Chicago White Sox and Bulls I (and/or my co-authors)
SHOULDER ARTHROSCOPY WITH ANTERIOR STABILIZATION / CAPSULORRHAPHY REHABILITATION PROTOCOL
General Notes As tolerated should be understood to include with safety for the surgical procedure; a sudden increase in pain, swelling, or other undesirable factors are indicators that you are doing too
Mark Adickes, M.D. Orthopedics and Sports Medicine 7200 Cambridge St. #10A Houston, Texas Phone: Fax:
Mark Adickes, M.D. Orthopedics and Sports Medicine 7200 Cambridge St. #10A Houston, Texas 77030 Phone: 713-986-6016 Fax: 713-986-5411 Pectoralis Major Tendon Repair The pectoralis major is a thick, fan-shaped
Shoulder Impingement Rehabilitation Recommendations
Shoulder Impingement Rehabilitation Recommendations The following protocol can be utilized for conservative care of shoulder impingement as well as post- operative subacromial decompression (SAD) surgery.
Continuing Education: Shoulder Stability
Continuing Education: Shoulder Stability Anatomy & Kinesiology: The GHJ consists of the articulation of three bones: the scapula, clavicle and humerus. The scapula has three protrusions: the coracoid,
Shoulder Arthroscopy with Rotator Cuff Repair Rehabilitation Protocol
General Notes: As tolerated should be understood to include with safety for the surgical procedure; a sudden increase in pain, swelling, or other undesirable factors are indicators that you are doing too
Structure and Function of the Bones and Joints of the Shoulder Girdle
Structure and Function of the Bones and Joints of the Shoulder Girdle LEARNING OBJECTIVES: At the end of this laboratory exercise the student will be able to: Palpate the important skeletal landmarks of
Background. Background. Movement Examination. Movement Examination. MSI Scapular Diagnoses Lecture October 2016
MSI Scapular Diagnoses Lecture October 2016 Diagnosis and Treatment of Movement System Impairment Syndromes of the Shoulder: Scapular Diagnoses Shirley Sahrmann, PhD, PT, FAPTA and Associates Developed
Diagnosis: s/p ( LEFT / RIGHT ) AC Joint Reconstruction -- Surgery Date:
UCLA OUTPATIENT REHABILITATION SERVICES! SANTA MONICA! WESTWOOD 1000 Veteran Ave., A level Phone: (310) 794-1323 Fax: (310) 794-1457 1260 15 th St, Ste. 900 Phone: (310) 319-4646 Fax: (310) 319-2269 FOR
Arthroscopic SLAP Lesion Repair Rehabilitation Guideline
Arthroscopic SLAP Lesion Repair Rehabilitation Guideline This rehabilitation program is designed to return the individual to their activities as quickly and safely as possible. It is designed for rehabilitation
Eric Magrum PT, DPT, OCS, FAAOMPT Orthopaedic Manual Physical Therapy Series Charlottesville
SHOULDER CASE 1 Eric Magrum PT, DPT, OCS, FAAOMPT Orthopaedic Manual Physical Therapy Series Charlottesville 2017-2018 Reproduction Without Consent 1 Prevalence Shoulder pain 2 nd to LBP prevalence MSK
Rehab protocol. Phase I: Immediate Post-Surgical Phase: Typically 0-4 weeks; 2 PT visits. Goals:
Reverse Total shoulder arthroplasty Rehab protocol Phase I: Immediate Post-Surgical Phase: Typically 0-4 weeks; 2 PT visits Allow healing of soft tissue Maintain integrity of replaced joint Gradually increase
Arthroscopic Anterior Capsulolabral Repair Protocol
PHASE I: POST-OP WEEKS 0-6 Goals: Arthroscopic Anterior Capsulolabral Repair Protocol Bart Eastwood D.O. 250 South Main St. Suite 224A Blacksburg, VA 24060 540-552-7133 Maximally protect the surgical repair
Return to play after shoulder injury and high performance training in the overhead athlete
Return to play after shoulder injury and high performance training in the overhead athlete Dr Ann Cools, PT, PhD Dept Rehab. Sciences & Physiotherapy Ghent University, Belgium Shoulder and scapular measurements
Rehabilitation Guidelines for Anterior Shoulder Reconstruction with Open Bankart Repair
UW HEALTH SPORTS REHABILITATION Rehabilitation Guidelines for Anterior Shoulder Reconstruction with Open Bankart Repair The anatomic configuration of the shoulder joint (glenohumeral joint) is often compared
Today s session. Common Problems in Rehab. UPPER BODY REHAB ESSENTIALS TIM KEELEY FILEX 2012
Tim Keeley B.Phty, Cred.MDT, APA Principal Physiotherapist physiofitness.com.au facebook.com/physiofitness Today s session Essential list for the upper body Rehab starting point Focussing on activation,
Rehabilitation after Arthroscopic Posterior Bankart Repair
Rehabilitation after Arthroscopic Posterior Bankart Repair Phase 1: 0 to 2 weeks after surgery POSTOPERATIVE INSTRUCTIONS You will wake up in the operating room. A sling and an ice pack will be in place.
Latarjet Repair Rehabilitation Protocol
General Notes: As tolerated should be understood to include with safety for the reconstruction/repair; a sudden increase in pain, swelling, or other undesirable factors are indicators that you are doing
FINANCIAL DISCLOSURE. The University of Texas Health Science Center at San Antonio School of Medicine. January 17 19, 2013
The University of Texas Health Science Center at San Antonio School of Medicine January 17 19, 2013 Presented By: Manuel C. Sanchez, PT, MPT, ATC, LAT FINANCIAL DISCLOSURE Mr. Manuel C. Sanchez, PT, MPT,
Stephanie D. Moore-Reed, PhD, ATC California State University, Fresno California State University, Fresno S E S A P IX Lead/Stride leg
OBJECTIVES Corrective Exercise to Address Common Biomechanical Alterations throughout Each Phase of the Throwing Motion Stephanie D. Moore-Reed, PhD, ATC California State University, Fresno Six phases
After Arthroscopic Subacromial Decompression Intact Rotator Cuff (Distal Clavicle Resection)
After Arthroscopic Subacromial Decompression Intact Rotator Cuff (Distal Clavicle Resection) Rehabilitation Protocol Phase 1: Weeks 0-4 Restrictions ROM 140 degrees of forward flexion 40 degrees of external
Biceps Tenotomy Protocol
Department of Rehabilitation Services Physical Therapy The intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergone
Management of Shoulder Multi Directional Instability. MDI with Labral Tear. Ligaments
Stability Principles What makes shoulder stable? Management of Shoulder Multi Directional Instability Russ Paine, PT Director of Rehabilitation Memorial Hermann Ironman Sportsmedicine Institute Houston,
To comply with professional boards/associations standards:
To comply with professional boards/associations standards: I declare that I (or my family) do not have a financial relationship in any amount, occurring in the last 12 months with a commercial interest
Rotation Before Elevation. Rotation Before Elevation. The Complex Mechanics of Shoulder Movement. Shoulder Movement of the Glenohumeral = Force Couple
Rotation Before Elevation Anatomy and mechanics of movement Component movements of elevation Muscle function and dysfunction Evaluation of rotation Treatment using rotation Complex Movements Elevation
Shoulder Arthroscopy with Posterior Labral Repair Rehabilitation Protocol
General Notes: As tolerated should be understood to include with safety for the surgical procedure; a sudden increase in pain, swelling, or other undesirable factors are indicators that you are doing too
AC reconstruction Protocol: Dr. Rolf
AC reconstruction Protocol: Dr. Rolf The intent of this protocol is to provide the clinician with a guideline of the post-operative rehabilitation course of a patient that has undergone a AC reconstruction
Clinical Assessment of Scapular Motion
Clinical Assessment of Scapular Motion BRADY L. TRIPP, MEd, ATC, and TIM L. UHL, PhD, ATC, PT University of Kentucky Key Points Many athletic therapists appreciate the role that scapular function plays
Rotator Cuff Repair Protocol
Protocol This rehabilitation protocol has been developed for the patient following a rotator cuff surgical procedure. This protocol will vary in length and aggressiveness depending on factors such as:
Scapular function and dysfunction
Scapular function and dysfunction - Impingement - Muscle detachment W. Ben Kibler, MD Medical director FUNCTION IMPINGEMENT REVISITED Is impingement always a diagnosis- isolated description of pathology