Shoulder Injury Research Paper

A September 7 elbow fracture during the Double-A playoffs will cause minor league second baseman Ozzie Albies to miss the remainder of the playoff season with his team, the Mississippi Braves. The 19-year-old, who was expected to be one of the stars of the playoffs, had split his time this year between the Mississippi Braves and the franchise's Triple-A team, the Gwinnett Braves. Although Albies' injury will require surgery, he should be able to return to playing baseball by January.

Four muscles that are attached to the shoulder blade make up the rotator cuff. These muscles work together to ensure the shoulder moves and rotates properly. If the muscles become inflamed or torn, you will struggle

This paper is going to be over rotator cuff injuries and what to do if this occurs to an athlete. The rotator cuff consists of four muscles which are the Subscapularis, infraspinatus, teres minor, and the supraspinatus and their associated tendons that insert into the Humerus. These groups of muscles are responsible for rotating the arm internally and externally as well as abducting the shoulder. The acronym for the four muscles of the rotator cuff is known as SITS. The best treatment for symptomatic, nontraumatic rotator cuff tears is unknown. The purpose of this trial was to compare the effectiveness of physiotherapy, acromioplasty, and rotator cuff repair for this injury. The way this trial worked was that 180 shoulders with the symptomatic,

There are many more terms and concepts in throwing a baseball then the wind-up, cocking, acceleration, and the follow through. There is also the stride, your pelvis, rotation, deceleration, force, gravity, resistance and speed. (Maranowski). Within the shoulder, there are three major bones used. They are the clavicle, humerus, and the scapula. Another major component of the shoulder while throwing is the rotator cuff. The rotator cuff is made up of four small muscles which are the subscapularis, supraspinatus, infraspinatus, and the teres minor. The main responsibility of the rotator cuff is for the stability of the shoulder joint. It holds the humeral head in the glenoid socket during early abduction while throwing. (" biomechanics of," ).

Millions of people across the United States suffer from either Bursitis or a rotator cuff injury every year. Although sometimes the two can be misconceived, they are very different in all actuality. Bursitis is the inflammation or irritation of the bursa. A bursa is a fluid-filled sac used as a bumper near the joints to reduce friction. There are many bursae located in your body, some of which being in the hip, shoulder, wrist, and elbow. However, a rotator cuff injury only affects the shoulder area of the body. The “rotator cuff” is composed of the supraspinatus, infraspinatus, subscapularis, and teres minor muscles. There is only one main way to be diagnosed with Bursitis and it happens when you overuse a joint in sports or on the job. You can put the bursa under pressure for a long time, thus causing the bursa to become inflamed.

As a shoulder expert, Dr. Armin Tehrany was asked by the NY Daily News to weigh in with his professional opinion about Wright’s shoulder impingement.

The patient was an active participant in both contact as well as non-contact athletic activities. The patient reported occurrence of different symptoms that included; pain, weakness, instability, paresthesia, crepitus, as well as instability of the shoulder during sleep. Sulculus sign was conducted to assess the rotator interval and load and shift test for determination of the patient’s posterior stability. The doctor diagnosed positive for multidirectional instability. The patient’s multidirectional instability was not caused by a traumatic event. The patient had not exercised the joint over a long period of time, hence he had a weak shoulder joint, particularly the rotator cuff. The doctor recommended that the patient should be treated for the pain and inflammation of the shoulder caused by the multidirectional instability and then placed on physical therapy aimed for one year aimed at helping in the strengthening of the muscles of the patient that support the scapula (shoulder blade) and the rotator cuff (shoulder joint) so as to help the patient in returning to normal physical activity and also prevent an injury at the same place

Throughout an athlete's career they will have their bumps and bruises on a daily basis. That same athlete could also face a major obstacle in the road that will question whether they continue their journey or quit. Usually this comes in the form of an injury depending on the circumstance and severity, this athlete may be referred to a physical therapist. According to Jennifer Robinson, ¨Physical therapy is one of the best choices you can make when you have long-term chronic pain¨ (¨Physical Therapy for Chronic Pain¨). The role of a physical therapist is to,¨examine, evaluate, and treat athletes who have conditions...that affects their ability to move freely and without pain¨, according to the article ¨Benefits of a Physical Therapist.” They

According to Kacprowicz (2017), “in order to properly diagnose and treat any injury to the UCL, a comprehensive understanding of the functional anatomy and biomechanics of the UCL in overhead throwing sports is imperative.” The anterior bundle of the UCL is particularly susceptible to injury. The study by Awh (2010) reports that, “These injuries are often associated with those of the flexor pronator muscle-tendon unit, a stabilizer at the medial elbow. Strains and/or fatigue of the dynamic stabilizers may cause increased tears of the UCL.” The posterior bundle of the UCL is not as vulnerable for injury since it does not play a large role in the overhead throwing motion.

^8,5 ASI occurs when the arm is in adduction with the shoulder internally rotated. The biceps complex pulley, also known as a capsuloligamentous complex, adjoins the anterior glenoid causing injury when in extreme motions. With the PSI, the pulley is put into risk with abduction and external rotation on the posterosuperior glenoid. ^8 PSI is also associated with partial-thickness tears on the deep side of the articular surface of the rotator cuff. ^5 This can be a common cause for a peel-back mechanism associated with a SLAP lesion. ^8 Peel-back mechanisms can be produced many different ways, but are mostly seen with a SLAP lesion or internal impingement. These can occur when the shoulder is placed into abduction and extreme external rotation with a torsional force added to the labro-bicipital complex that is at the base of the biceps on the posterior superior labrum. ^1,5 This causes fatigue and failure of the humeral head that rotates medially over the upper rim of the glenoid fossa creating a shearing force. ^1,5 Increased superior labral strain in overhead athletes occurs during the late-cocking phase of throwing when arm is externally rotated. ^1

In 1990 the acronym “SLAP lesion” (Superior Labral Anterior and Posterior) was coined by Synder et al, a shoulder pathology previously made known after arthroscopically identified by Andrews et al in 1985. 2,3 The prevalence of SLAP lesions in recreational athletic and athletic populations ranges from 3.9 %- 11.8%. 4 Kim, et al noted out of 544 shoulders arthroscopically evaluated, 25% were diagnosed with a SLAP lesion, and 88%, about 120 subjects, presented with another pathology.6

Glenohumeral joint kinematics change in an adaptive manner to chronic overhead activity, seen in multiple sports especially in baseball, volleyball, handball, and basketball(16-18). This involves all tissues of the shoulder – bone, capsule, and muscle(19). During normal human development the humeral head rotates from a retroverted position at birth to an anteverted position as an adult. However, when individuals begin overhead throwing at an early age, extrinsic forces on the humerus cause the humeral head to remain in relative retroversion compared to that of the non-dominant arm. This, combined with tightness of the posteroinferior capsule from chronic reactive scarring, and with scapular

608) puts forth in their report that the glenohumeral joint is the most movable joint in the body that is at the risk of decreased stability, therefore, complex interaction between static (osseous, soft tissue stabilizers) and dynamic stabilizers (tendon-muscle complex) commands elaborate balance and synchronicity. Any disruption in this intricate mechanism can lead to shoulder instability. In the research study of Rerko, Pan, Donaldson, Jones, & Bishop (2013), the examiners systematically interrupted the glenoid bone to show if it has any effect on the stability of the shoulder and if there is any impact, what imaging modality would be the best to demonstrate it to guide the surgeon in repairing the shoulder instability. The researchers used fresh cadavers shoulders and strategically created defects to the glenoid bone. Imaging modalities such as X-rays, CT scan, and MRI were taken. Measurement of the specificity and sensitivity of the various diagnostic imaging were made, and 3D CT scan has demonstrated a very high specificity and sensitivity compared to the other imaging tools. Furthermore, Bishop, Jones, Rerko, & Donaldson (2013, p. 1255) asserted the significance of preoperative 3-D CT scan to determine the anterior shoulder instability with a concern for a osseous loss of the glenoid bone. The authors believe that 3D CT scan is the most consistent imaging modality in providing an estimation of the bone deterioration compared

Arthroscopic Bankart repair of first-time anterior shoulder dislocations significantly reduces the recurrence rate of shoulder dislocations in young athletes when compared to traditional non-operative rehabilitation.

similar design and serves a similar purpose to the knee meniscus. Superior labral an- teroposterior (SLAP) results from extreme external rotation of humerus while the shoulder is at 90° abduction, so one of the common injury mechanisms is throwing activity. While the arm is in the described shoulder 90° abduction position, a compelling traction force works together with the biceps power to generate a significant shearing force on the labrum which could cause the tear (Modarresi, 2011). Other contributing factors include overuse and direct trauma. Clinically, SLAP does not present on its own, and other shoulder