RESUMO
Rotator cuff (RTC) injuries are common in master athletes, especially overhead athletes. Risk factors include aging and degeneration as nonmodifiable and volume of activity, muscle weakness, and loss of motion as modifiable. The clinical presentation involves limited range of motion (ROM), pain at rest and at night. Injury classification into traumatic versus nontraumatic and tendinopathy, partial or full-thickness tears helps to establish a treatment plan. RTC injury rehabilitation protocols are criteria-based, multimodal, and divided into four phases. The acute phase addresses pain, inflammation, ROM, and RTC protection. The recovery phase addresses kinetic chain abnormalities, flexibility, and strength, and the functional phase involves exercises directed toward specific sport activities. Return to sports is based on clinical recovery, kinetic chain principles, and adequate sports technique. Nonsurgical management is recommended in most cases, and surgical management is considered if symptoms progress, especially for full-thickness tears.
Assuntos
Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/reabilitação , Lesões do Manguito Rotador/diagnóstico , Lesões do Manguito Rotador/reabilitação , Atletas , Humanos , Manejo da Dor , Volta ao EsporteRESUMO
Core strengthening concepts have gained increased popularity in low back rehabilitation. Traditional low back pain rehabilitation is based on a static spine stability model and is composed mostly of modalities, stretching and strengthening exercises. More recent theories, however, include newer concepts of dynamic spinal stability, coordination and neuromuscular control. Core strengthening exercises incorporate these new concepts. Although more research is necessary, the best available evidence suggests that a core strengthening program may be beneficial in reducing pain scores, functional disability and recurrences of acute low back pain episodes. This article reviews "core" anatomy, physiologic models of spinal stability, effects, of low back pain on spinal stability, evidence-based reasoning behind core strengthening and the basic concepts involved in designing a core strengthening program.
