Shoulder motion and laxity in the professional baseball player.

We studied 148 professional baseball players with no history of shoulder problems to assess range of motion and laxity of their dominant and nondominant shoulders. There were 72 pitchers and 76 position players. Average external rotation with the arm in 90 degrees of abduction was statistically greater and average internal rotation was statistically less in the dominant shoulders than in the nondominant shoulders, both in pitchers and position players. There was no statistical difference in forward elevation of external rotation with the arm at the side of the body in either group. Both dominant and nondominant shoulders of pitchers had greater average range of motion in forward elevation and external rotation (both at the side and at 90 degrees of abduction) and less average internal rotation than those of position players. Regarding laxity testing, 61% of dominant shoulders in pitchers had a sulcus sign, as compared with 47% in position players. Also, this degree of inferior laxity was significantly greater in pitchers than in position players. Differences in range of motion and laxity exist in the throwing shoulder of athletes involved in overhead throwing motions and should be considered in rehabilitation protocols and surgical repair.

Special considerations in the athletic throwing shoulder.

Overhead athletes are susceptible to a number of shoulder problems due to the repetitive nature and force needed to perform at a competitive level. Frequently, the rotator cuff becomes injured due to primary or secondary impingement. In young athletes, subtle instability is often the cause of rotator cuff tendinitis, but will frequently respond to a coordinated rehabilitation program. Older athletes are more likely to have rotator cuff injuries due to anatomic changes in the coracoacromial arch. This article outlines the mechanism of injury to the rotator cuff and our approach in dealing with shoulder problems in the overhead athlete.

Spontaneous atraumatic rupture of the flexor hallucis longus tendon under the sustentaculum tali: case report, review of the literature, and treatment options.

A case of spontaneous rupture of the flexor hallucis longus tendon within the hind part of the foot is reported in a middle-aged woman who had no trauma or systemic disease. Repair was effected by tenodesis to the flexor digitorum longus tendon above and below the fibro-osseous tunnel. Hyperextension of the interphalangeal joint which most troubled the patient was corrected postoperatively. Active range of motion was equal in extension. Flexion at the IP joint was present, but significantly less than the unaffected side.

Isolated dorsomedial dislocation of the first ray at the medial cuneonavicular joint of the foot: a rare injury to the tarsus. A case report.

An isolated dorsomedial dislocation of the medial cuneiform and first ray at the medial cuneonavicular joint in a 37-year-old woman was reduced easily under general anesthesia. The reduction was stable. Early diagnosis, including comparative roentgenographic views and expeditious treatment are essential for recovery of normal function.