Humeral hypertrophy in response to exercise.

We compared roentgenograms of the jumeri of a group of professional tennis players and showed that there was pronounced hypertrophy of bone on the playing side. The cortical thickness on that side was greater by 34.9 per cent in men and 28.4 per cent in women compared with the control side. This represents a highly significant hypertrophy of bone in response to exercise.

Tennis shoulder.

A depression of the exercised shoulder was found in skilled tennis players, and in other athletes employing the overhand motion. The deformity is attributed to stretching of the shoulder elevating muscles and hypertrophy of the extremity. Most symptoms were over the anterior rotator cuff, and occurred on abduction of the arm. Shoulder depression results in a relative abduction and abduction causes impingement of the cuff. Shoulder droop may induce thoracic outlet syndrome and may simulate scoliosis in the athlete.

Elbow injury in women's gymnastics.

This investigation reports on 30 female gymnasts with 32 elbow injuries acquired in gymnastics. Thirty of the injuries were acute fractures and dislocations, and two developed Panner's disease of the humeral capitellum. Primary treatment included 14 closed reductions and 11 open surgical procedures. Those who returned to competition lost an average of 4.1 months. Spotters were not present during nearly 60% of these injuries. The mechanism which led to a variety of elbow injuries was possibility singular: a fall on an outstretched arm. More than twice as many injuries occurred on this mats or the bare floor than on thicker mats. The authors concluded, after the study, that elbow immobilization for as short a time as possible was beneficial to regaining range of motion. We recommend reducing injuries by employing spotters, using thicker mats, and educating young gymnasts in techniques of falling.

Shoulder injuries in ice hockey.

Financial support for this study was provided by: the Hubbard Foundation, St. Paul, MN; Institute for Athletic Medicine, Fairview Community Hospitals, Minneapolis, MN; Institute for Athletic Medicine of John C. Lincoln Hospital. Phoenix, AZ; The Mendon Schutt Foundation, Minneapolis; Minnesota State High School League, Anoka, MN; University of Minnesota Computer Center; multiple private donations. A study of shoulder injuries incurred by high school ice hockey players was conducted for the 1982-1983 and 1983-1984 competitive seasons. Data from 480 players (73%), who competed on 12 teams within a 30 mile radius, were included in the analysis. Among these players, shoulder injuries accounted for a rate of 9.4 injuries per 100 players; separation of the acromioclavicular joint was the most common injury. Although 39% of the reported injuries were of mild severity, 44% were moderate in severity, and 18% were major in severity; moreover, 59% of the injured players reported residual persistent symptoms. Of the total injuries, 88% occurred in games or under game-type conditions. The greatest proportion of injuries occurred to players engaged in play in the forward position while in the offensive zone. Over 54% of the injuries were caused by contact with the boards surrounding the ice surface and, reportedly, 43% of the injuries were associated with illegal activities. Based on the study findings, strategies for injury prevention include the following: consideration of techniques of coaching and of play; enforcement of the current rules to decrease the number of injuries related to illegal activities; research relevant to board design and materials to determine if a more yielding barrier can be placed around the playing surface; and utilization of the latest equipment, incorporating unique design and materials, that facilitates dissipation of forces. In addition, there is a need for further comprehensive research efforts relevant to ice hockey injuries that can enable the identification of other risk factors so that prevention and control of injuries can be managed more readily.J Orthop Sports Phys Ther 1988;10(2):54-58.

The shoulder of the tennis player.

A depression of the exercised shoulder was found among highly trained tennis players, and in other athletes employing the overhand motion. This deformity is attributed to stretching of the shoulder elevating muscles, and to hypertrophy of the racket-holding extremity. Most symptoms in the shoulders studied were in the region of the rotator cuff, and occurred upon strokes requiring abduction. Shoulder dependency causes a relative abduction of the extremity, which may result in impingement of the rotator cuff. Shoulder droop may lead to thoracic outlet syndrome, and, in the athlete, may simulate scoliosis.

Elbow injuries in gymnastics.

The medical literature contains little about elbow injuries in gymnastics. However, 30 females with 32 elbow injuries from gymnastics were found and studied. Two had Panner's disease (osteochondritis of the humeral capitellum), and all the others had fractures or dislocations. The majority required open or closed procedures. Recommendations to help reduce elbow injuries would include the use of experienced spotters, thicker pads whenever possible, and education of gymnasts in techniques of falling. After injury has occurred immobilization of the elbow for as short a period as necessary and follow-up therapy in a sports-oriented setting are recommended.

The Elbow and Tennis, Part 1: An Analysis of Players With and Without Pain.

After studylng 2,633 average tennis players, the authors offer some surprlslng new ideas about the factors that may contribute to elbow pain.

Spinal Trauma and Symptoms in High School Football Players.

In brief: Responses from 101 coaches (98%) and 3,063 players (81%) In a retrospective epidemiological study of 103 Minnesota secondary school varsity football teams showed an overall injury rate of 78 injuries per 100 players, which included a high incidence of spinal trauma and spinal trauma symptoms. Recognition of the incidence, severity, and chronicity of spinal trauma requires ongoing assessment of participants in contact activities. Continued use of the illegal techniques of butt-blocking and face-tackling by as many as 40% of the players was found to increase the risk of these symptoms significantly.

Treatment for lateral epicondylitis: variables related to recovery.

The purpose of this study was to determine the effectiveness of a treatment regime utilised for lateral epicondylitis that is designed to expedite return to activity and to identify variables related to treatment outcomes. Patients treated in a sports medicine clinic between 1978 and 1980 received, by mail, a brief questionnaire investigating the variables of the injuries and level of success of the treatment. Specific techniques ensured confidentiality and validation of information. Through the analyses conducted, an inverse relationship in the total group between the level of success and the duration of pain was documented; for example, the mean durations of pain, 17.3 months, 10.3 months, and 6.3 months correlated, respectively, with the levels of success, 0 (no recovery), 2 (moderate recovery), and 4 (complete recovery). In addition, the application of multiple risk factor analysis, incorporating a maximum of eight variables, identified the degree of pain prior to treatment as the most important predictor of complete recovery; the greater the pain the more likely the complete success of the treatments. The implications of these findings include a need for early case-finding to elicit the most favourable outcomes of the treatment regime studied.

An epidemiological study of high school ice hockey injuries.

Between 1976 and 1983, 42 spinal cord injuries among ice hockey participants were documented in Canada; within a recent 3-week period, three cases involving fractured necks were reported in a metropolitan area of Minnesota. The purpose of this comprehensive epidemiological study was to document rates, types, and severities of injuries incurred among high school varsity hockey players in Minnesota, as a result of participation in the 1982-1983 season, and to determine the variables associated with these injuries. Within a 30-mile radius of the state's major metropolitan area, 12 high school varsity hockey teams were selected for participation. Specific techniques were used to ensure confidentiality, high response rates, and validation of information. Among the players an injury rate of 75 injuries per 100 players was documented. Head and neck injuries accounted for 22% of the total injuries. Increased risks of injury were associated with multiple health-care provision variables and equipment utilized. Potential strategies are identified as a result of these findings.

Concussion incidences and severity in secondary school varsity football players.

The head coaches and players of 103 secondary school football teams in Minnesota were asked to respond to mail questionnaires. Information about injury incidence and concomitant health care provision was elicited. Responses from 3,063 players (81 per cent) yielded a total injury rate of 78 injuries/100 players; 19/100 players reported a concussion experience characterized by loss of consciousness and/or loss of awareness. Of the players who experienced a loss of consciousness, 69 per cent were returned to play the same day. Persistent concussion symptoms were reported as long as six to nine months following the end of the season; six cases involved permanent disabilities. Continued use of illegal techniques of butt-blocking and face-tackling by as many as 40 per cent of the players was associated with apparent increased risks of concussions and concussion symptoms. Players with a prior history of loss of consciousness had a risk of loss of consciousness four times that of the player without a prior history.