Critical Reviews™ in Physical and Rehabilitation Medicine

ISSN for PRINT: 0896-2960

For Online Access

Best Paper Award Selection - Editorial Board Site

2008, Volume20

Issue 1

87 pages

Issue price - $205.00

William Micheo
Department of Physical Medicine, Rehabilitation and Sports Medicine, University of Puerto Rico, School of Medicine, San Juan, PR 00935

Overhead sports commonly result in injury to the shoulder. Shoulder injury is associated with factors such as high volume of activity, muscle weakness, and imbalance, as well as abnormal sports-specific mechanics. Static stability of the shoulder is important in the extremes of shoulder motion and depends on the integrity of the capsule, ligaments, and glenoid labrum. Dynamic stability of the shoulder in functional ranges of motion is a result of muscle activity of the rotator cuff and extrinsic shoulder muscles, and scapular stabilizers. The throwing motion requires integration of the complete kinetic chain, with transfer of energy from the lower extremities through the trunk and back to the upper extremity. Shoulder injury in throwers is usually associated with overuse, which results in impingement of the rotator cuff, attritional changes of the capsule, and damage to the glenoid labrum. Evaluation of patients with shoulder pain requires a complete history, physical examination, and appropriate diagnostic testing to identify the specific clinical symptoms, site of anatomic injury, and the functional deficits. Rehabilitation of the injured thrower is divided into acute, recovery, and functional phases. The acute phase has the goals of reducing symptoms and protecting the injured structures. The recovery phase should work on improvement of shoulder flexibility, muscle strength, and balance, as well as integrating the complete kinetic chain. The functional phase of rehabilitation works on power, sports-specific technique, and the prevention of further injury.

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