Instabiliteit elleboog en...

15
INSTABILITEIT ELLEBOOG EN FYSIOTHERAPIE Best practice Pjotr Goossens MSc, Manueeltherapeut / Handtherapeut

Transcript of Instabiliteit elleboog en...

Page 1: Instabiliteit elleboog en fysiotherapieschoudernetwerkwestbrabant.nl/wp-content/uploads/2016/12/Instabil… · Matthew J. Solomito,*y MS, Erin J. Garibay,y MS, Jessica R. Woods,z

INSTABILITEIT ELLEBOOG EN FYSIOTHERAPIE

Best practice

Pjotr Goossens MSc

Manueeltherapeut Handtherapeut

KOLOMMEN ELLEBOOG

TYPEN INSTABILITEIT

bull PLRI

bull Valgus instabiliteit

bull Varus instabiliteit

VALGUS INSTABILITEIT

bullTrauma

bullOveruse (sports)

bullStructureel

MCL- UCL LETSEL

bull Pijnlijke mediale zijde elleboog (ldquopoprdquo)

bull Verlies flexie extensie elleboog

bull Tinteling ulnarisgebied (cubitale tunnel)

bull ldquoDead onderarmrdquo

bull Verlies accuraatheid en snelheid kracht

bull Klachten kinetische keten

bull Artrogeen artrokinematica

bull Passieve stabiliteit

bull Actieve componenten

ONDERZOEK INSTABILITEIT

bull Valgus stress test

bull Pivot shift test

bull Moving valgus stress test

bull Milking maneuver test

wwwphysio-pediacom

OVERUSE

bull Schade MCL

bull Extensie- supinatiebeperking

bull Impingement elleboog waar

bull GIRD schouder

bull Kinetische keten

ACUTE FASE TRAUMAbull Fase 1 Inflammatie en protectie (0-3 wkn)

Behoud stabiliteit

Protected joint motion gewrichtsstijfheid

Keten oefeningen

bull Fase 2 fibroblasten- en vroege remodulatiefase (3-6 wkn)

Protectie collageen littekenweefsel

Protectie stabiliteit behoud toename ROM

Krachttraining onderarmmusculatuur

Keten oefeningen

bull Fase 3 Maturatieperiode (6-12 Wkn)

Max ROM

Toename kracht en endurance

Verdere hervatting ADL

Keten oefeningen

BEHANDELING

bull wwwelleboogklinieknl

bull Mobilisaties extensie en supinatie (elleboog eacuten pols)

bull MLPP 70 gr flexie en 25 gr supinatie

bull Endorotatie schouder ndash sleepersstretch

bull Oefentherapie elleboog- schoudermusculatuur

bull Vrije ROM kinetische keten (heup LWK TLO CTO)

bull Corestability dynamisch

OEFENTHERAPIE

bull Throwers ten program

bull Neurodynamics

bull Dynamische corestability

bull Back to sports

LATERAL TRUNK LEAN IN PITCHERS AFFECTS BOTH BALL VELOCITY AND UPPER EXTREMITY JOINT MOMENTS

Matthew J Solomitoy MS Erin J Garibayy MS Jessica R Woodsz BSBE

Sylvia O ˜ unpuuz MSc and Carl W Nissen

bull Methods A total of 99 pitchers were recruited for this study and underwent a pitching analysis

using 3-dimensional motion analysis techniques A random intercept mixed-effects regression

model was used to determine if statistically significant associations existed between

contralateral trunk lean (away from the pitching arm side) and ball velocity as well as the

elbow varus moment and glenohumeral internal rotation moment

bull Results The results demonstrated that the greatest contralateral trunk lean occurs around the

time of the peak elbow varus moment Statistically significant associations were found

between contralateral trunk lean and increased ball velocity (P = 003) indicating that for

every 10 increase in contralateral lean ball velocity increased 05 ms Results also indicated

that for every 10 increase in contralateral lean elbow varus moments increased by 37 Nm

and glenohumeral internal rotation moments increased by 25 Nm( P 001 for both)

Conclusion Study findings indicate that the positioning of the trunk plays a substantial role in

pitching performance and pitcher injury potential

RETURN-TO-PLAY OUTCOMES IN PROFESSIONAL BASEBALL PLAYERS AFTERMEDIAL ULNAR COLLATERAL LIGAMENT INJURIES

COMPARISON OF OPERATIVE VERSUS NONOPERATIVE TREATMENT BASED ON MAGNETIC RESONANCE IMAGING FINDINGS

GREGORY M FORD

bull Conclusion Incomplete UCL injuries in professional baseball players can be successfully

treated nonoperatively in the majority of cases Pitchers are more likely to have complete tears

leading to surgery MRI grading of UCL injuries can help predict RTP and the need for surgery

bull Therapie

bull Lokaal ultrasone electro laser weke delen ROM

bull Rotator cuff training geiumlsoleerd

bull Interval werprevalidatie

REFERENTIESbull Am J Sports Med 2016 Mar44(3)723-8 doi 1011770363546515621756 Epub 2016 Jan 13

Return-to-Play Outcomes in Professional Baseball Players After Medial Ulnar Collateral Ligament Injuries Comparison of Operative

Versus Nonoperative Treatment Based on Magnetic Resonance Imaging Findings

Ford GM1 Genuario J2 Kinkartz J2 Githens T3 Noonan T2 LEVEL 4

bull Am J Sports Med 2014 Apr42(4)880-5 doi 1011770363546513519072 Epub 2014 Feb 4

Analysis of pitching velocity in major league baseball players before and after ulnar collateral ligament reconstruction

Jiang JJ1 Leland JM LEVEL 3

bull Am J Sports Med 2003 Jul-Aug31(4)621-35

Elbow injuries in throwing athletes a current concepts review

Cain EL Jr1 Dugas JRWolf RS Andrews JR

bull J Sports Sci 201533(7)713-23 doi 101080026404142014962572 Epub 2014 Dec 17

A kinematic comparison of the overhand throw and tennis serve in tennis players how similar are they really

Reid M1 Giblin GWhiteside D

Page 2: Instabiliteit elleboog en fysiotherapieschoudernetwerkwestbrabant.nl/wp-content/uploads/2016/12/Instabil… · Matthew J. Solomito,*y MS, Erin J. Garibay,y MS, Jessica R. Woods,z

KOLOMMEN ELLEBOOG

TYPEN INSTABILITEIT

bull PLRI

bull Valgus instabiliteit

bull Varus instabiliteit

VALGUS INSTABILITEIT

bullTrauma

bullOveruse (sports)

bullStructureel

MCL- UCL LETSEL

bull Pijnlijke mediale zijde elleboog (ldquopoprdquo)

bull Verlies flexie extensie elleboog

bull Tinteling ulnarisgebied (cubitale tunnel)

bull ldquoDead onderarmrdquo

bull Verlies accuraatheid en snelheid kracht

bull Klachten kinetische keten

bull Artrogeen artrokinematica

bull Passieve stabiliteit

bull Actieve componenten

ONDERZOEK INSTABILITEIT

bull Valgus stress test

bull Pivot shift test

bull Moving valgus stress test

bull Milking maneuver test

wwwphysio-pediacom

OVERUSE

bull Schade MCL

bull Extensie- supinatiebeperking

bull Impingement elleboog waar

bull GIRD schouder

bull Kinetische keten

ACUTE FASE TRAUMAbull Fase 1 Inflammatie en protectie (0-3 wkn)

Behoud stabiliteit

Protected joint motion gewrichtsstijfheid

Keten oefeningen

bull Fase 2 fibroblasten- en vroege remodulatiefase (3-6 wkn)

Protectie collageen littekenweefsel

Protectie stabiliteit behoud toename ROM

Krachttraining onderarmmusculatuur

Keten oefeningen

bull Fase 3 Maturatieperiode (6-12 Wkn)

Max ROM

Toename kracht en endurance

Verdere hervatting ADL

Keten oefeningen

BEHANDELING

bull wwwelleboogklinieknl

bull Mobilisaties extensie en supinatie (elleboog eacuten pols)

bull MLPP 70 gr flexie en 25 gr supinatie

bull Endorotatie schouder ndash sleepersstretch

bull Oefentherapie elleboog- schoudermusculatuur

bull Vrije ROM kinetische keten (heup LWK TLO CTO)

bull Corestability dynamisch

OEFENTHERAPIE

bull Throwers ten program

bull Neurodynamics

bull Dynamische corestability

bull Back to sports

LATERAL TRUNK LEAN IN PITCHERS AFFECTS BOTH BALL VELOCITY AND UPPER EXTREMITY JOINT MOMENTS

Matthew J Solomitoy MS Erin J Garibayy MS Jessica R Woodsz BSBE

Sylvia O ˜ unpuuz MSc and Carl W Nissen

bull Methods A total of 99 pitchers were recruited for this study and underwent a pitching analysis

using 3-dimensional motion analysis techniques A random intercept mixed-effects regression

model was used to determine if statistically significant associations existed between

contralateral trunk lean (away from the pitching arm side) and ball velocity as well as the

elbow varus moment and glenohumeral internal rotation moment

bull Results The results demonstrated that the greatest contralateral trunk lean occurs around the

time of the peak elbow varus moment Statistically significant associations were found

between contralateral trunk lean and increased ball velocity (P = 003) indicating that for

every 10 increase in contralateral lean ball velocity increased 05 ms Results also indicated

that for every 10 increase in contralateral lean elbow varus moments increased by 37 Nm

and glenohumeral internal rotation moments increased by 25 Nm( P 001 for both)

Conclusion Study findings indicate that the positioning of the trunk plays a substantial role in

pitching performance and pitcher injury potential

RETURN-TO-PLAY OUTCOMES IN PROFESSIONAL BASEBALL PLAYERS AFTERMEDIAL ULNAR COLLATERAL LIGAMENT INJURIES

COMPARISON OF OPERATIVE VERSUS NONOPERATIVE TREATMENT BASED ON MAGNETIC RESONANCE IMAGING FINDINGS

GREGORY M FORD

bull Conclusion Incomplete UCL injuries in professional baseball players can be successfully

treated nonoperatively in the majority of cases Pitchers are more likely to have complete tears

leading to surgery MRI grading of UCL injuries can help predict RTP and the need for surgery

bull Therapie

bull Lokaal ultrasone electro laser weke delen ROM

bull Rotator cuff training geiumlsoleerd

bull Interval werprevalidatie

REFERENTIESbull Am J Sports Med 2016 Mar44(3)723-8 doi 1011770363546515621756 Epub 2016 Jan 13

Return-to-Play Outcomes in Professional Baseball Players After Medial Ulnar Collateral Ligament Injuries Comparison of Operative

Versus Nonoperative Treatment Based on Magnetic Resonance Imaging Findings

Ford GM1 Genuario J2 Kinkartz J2 Githens T3 Noonan T2 LEVEL 4

bull Am J Sports Med 2014 Apr42(4)880-5 doi 1011770363546513519072 Epub 2014 Feb 4

Analysis of pitching velocity in major league baseball players before and after ulnar collateral ligament reconstruction

Jiang JJ1 Leland JM LEVEL 3

bull Am J Sports Med 2003 Jul-Aug31(4)621-35

Elbow injuries in throwing athletes a current concepts review

Cain EL Jr1 Dugas JRWolf RS Andrews JR

bull J Sports Sci 201533(7)713-23 doi 101080026404142014962572 Epub 2014 Dec 17

A kinematic comparison of the overhand throw and tennis serve in tennis players how similar are they really

Reid M1 Giblin GWhiteside D

Page 3: Instabiliteit elleboog en fysiotherapieschoudernetwerkwestbrabant.nl/wp-content/uploads/2016/12/Instabil… · Matthew J. Solomito,*y MS, Erin J. Garibay,y MS, Jessica R. Woods,z

TYPEN INSTABILITEIT

bull PLRI

bull Valgus instabiliteit

bull Varus instabiliteit

VALGUS INSTABILITEIT

bullTrauma

bullOveruse (sports)

bullStructureel

MCL- UCL LETSEL

bull Pijnlijke mediale zijde elleboog (ldquopoprdquo)

bull Verlies flexie extensie elleboog

bull Tinteling ulnarisgebied (cubitale tunnel)

bull ldquoDead onderarmrdquo

bull Verlies accuraatheid en snelheid kracht

bull Klachten kinetische keten

bull Artrogeen artrokinematica

bull Passieve stabiliteit

bull Actieve componenten

ONDERZOEK INSTABILITEIT

bull Valgus stress test

bull Pivot shift test

bull Moving valgus stress test

bull Milking maneuver test

wwwphysio-pediacom

OVERUSE

bull Schade MCL

bull Extensie- supinatiebeperking

bull Impingement elleboog waar

bull GIRD schouder

bull Kinetische keten

ACUTE FASE TRAUMAbull Fase 1 Inflammatie en protectie (0-3 wkn)

Behoud stabiliteit

Protected joint motion gewrichtsstijfheid

Keten oefeningen

bull Fase 2 fibroblasten- en vroege remodulatiefase (3-6 wkn)

Protectie collageen littekenweefsel

Protectie stabiliteit behoud toename ROM

Krachttraining onderarmmusculatuur

Keten oefeningen

bull Fase 3 Maturatieperiode (6-12 Wkn)

Max ROM

Toename kracht en endurance

Verdere hervatting ADL

Keten oefeningen

BEHANDELING

bull wwwelleboogklinieknl

bull Mobilisaties extensie en supinatie (elleboog eacuten pols)

bull MLPP 70 gr flexie en 25 gr supinatie

bull Endorotatie schouder ndash sleepersstretch

bull Oefentherapie elleboog- schoudermusculatuur

bull Vrije ROM kinetische keten (heup LWK TLO CTO)

bull Corestability dynamisch

OEFENTHERAPIE

bull Throwers ten program

bull Neurodynamics

bull Dynamische corestability

bull Back to sports

LATERAL TRUNK LEAN IN PITCHERS AFFECTS BOTH BALL VELOCITY AND UPPER EXTREMITY JOINT MOMENTS

Matthew J Solomitoy MS Erin J Garibayy MS Jessica R Woodsz BSBE

Sylvia O ˜ unpuuz MSc and Carl W Nissen

bull Methods A total of 99 pitchers were recruited for this study and underwent a pitching analysis

using 3-dimensional motion analysis techniques A random intercept mixed-effects regression

model was used to determine if statistically significant associations existed between

contralateral trunk lean (away from the pitching arm side) and ball velocity as well as the

elbow varus moment and glenohumeral internal rotation moment

bull Results The results demonstrated that the greatest contralateral trunk lean occurs around the

time of the peak elbow varus moment Statistically significant associations were found

between contralateral trunk lean and increased ball velocity (P = 003) indicating that for

every 10 increase in contralateral lean ball velocity increased 05 ms Results also indicated

that for every 10 increase in contralateral lean elbow varus moments increased by 37 Nm

and glenohumeral internal rotation moments increased by 25 Nm( P 001 for both)

Conclusion Study findings indicate that the positioning of the trunk plays a substantial role in

pitching performance and pitcher injury potential

RETURN-TO-PLAY OUTCOMES IN PROFESSIONAL BASEBALL PLAYERS AFTERMEDIAL ULNAR COLLATERAL LIGAMENT INJURIES

COMPARISON OF OPERATIVE VERSUS NONOPERATIVE TREATMENT BASED ON MAGNETIC RESONANCE IMAGING FINDINGS

GREGORY M FORD

bull Conclusion Incomplete UCL injuries in professional baseball players can be successfully

treated nonoperatively in the majority of cases Pitchers are more likely to have complete tears

leading to surgery MRI grading of UCL injuries can help predict RTP and the need for surgery

bull Therapie

bull Lokaal ultrasone electro laser weke delen ROM

bull Rotator cuff training geiumlsoleerd

bull Interval werprevalidatie

REFERENTIESbull Am J Sports Med 2016 Mar44(3)723-8 doi 1011770363546515621756 Epub 2016 Jan 13

Return-to-Play Outcomes in Professional Baseball Players After Medial Ulnar Collateral Ligament Injuries Comparison of Operative

Versus Nonoperative Treatment Based on Magnetic Resonance Imaging Findings

Ford GM1 Genuario J2 Kinkartz J2 Githens T3 Noonan T2 LEVEL 4

bull Am J Sports Med 2014 Apr42(4)880-5 doi 1011770363546513519072 Epub 2014 Feb 4

Analysis of pitching velocity in major league baseball players before and after ulnar collateral ligament reconstruction

Jiang JJ1 Leland JM LEVEL 3

bull Am J Sports Med 2003 Jul-Aug31(4)621-35

Elbow injuries in throwing athletes a current concepts review

Cain EL Jr1 Dugas JRWolf RS Andrews JR

bull J Sports Sci 201533(7)713-23 doi 101080026404142014962572 Epub 2014 Dec 17

A kinematic comparison of the overhand throw and tennis serve in tennis players how similar are they really

Reid M1 Giblin GWhiteside D

Page 4: Instabiliteit elleboog en fysiotherapieschoudernetwerkwestbrabant.nl/wp-content/uploads/2016/12/Instabil… · Matthew J. Solomito,*y MS, Erin J. Garibay,y MS, Jessica R. Woods,z

VALGUS INSTABILITEIT

bullTrauma

bullOveruse (sports)

bullStructureel

MCL- UCL LETSEL

bull Pijnlijke mediale zijde elleboog (ldquopoprdquo)

bull Verlies flexie extensie elleboog

bull Tinteling ulnarisgebied (cubitale tunnel)

bull ldquoDead onderarmrdquo

bull Verlies accuraatheid en snelheid kracht

bull Klachten kinetische keten

bull Artrogeen artrokinematica

bull Passieve stabiliteit

bull Actieve componenten

ONDERZOEK INSTABILITEIT

bull Valgus stress test

bull Pivot shift test

bull Moving valgus stress test

bull Milking maneuver test

wwwphysio-pediacom

OVERUSE

bull Schade MCL

bull Extensie- supinatiebeperking

bull Impingement elleboog waar

bull GIRD schouder

bull Kinetische keten

ACUTE FASE TRAUMAbull Fase 1 Inflammatie en protectie (0-3 wkn)

Behoud stabiliteit

Protected joint motion gewrichtsstijfheid

Keten oefeningen

bull Fase 2 fibroblasten- en vroege remodulatiefase (3-6 wkn)

Protectie collageen littekenweefsel

Protectie stabiliteit behoud toename ROM

Krachttraining onderarmmusculatuur

Keten oefeningen

bull Fase 3 Maturatieperiode (6-12 Wkn)

Max ROM

Toename kracht en endurance

Verdere hervatting ADL

Keten oefeningen

BEHANDELING

bull wwwelleboogklinieknl

bull Mobilisaties extensie en supinatie (elleboog eacuten pols)

bull MLPP 70 gr flexie en 25 gr supinatie

bull Endorotatie schouder ndash sleepersstretch

bull Oefentherapie elleboog- schoudermusculatuur

bull Vrije ROM kinetische keten (heup LWK TLO CTO)

bull Corestability dynamisch

OEFENTHERAPIE

bull Throwers ten program

bull Neurodynamics

bull Dynamische corestability

bull Back to sports

LATERAL TRUNK LEAN IN PITCHERS AFFECTS BOTH BALL VELOCITY AND UPPER EXTREMITY JOINT MOMENTS

Matthew J Solomitoy MS Erin J Garibayy MS Jessica R Woodsz BSBE

Sylvia O ˜ unpuuz MSc and Carl W Nissen

bull Methods A total of 99 pitchers were recruited for this study and underwent a pitching analysis

using 3-dimensional motion analysis techniques A random intercept mixed-effects regression

model was used to determine if statistically significant associations existed between

contralateral trunk lean (away from the pitching arm side) and ball velocity as well as the

elbow varus moment and glenohumeral internal rotation moment

bull Results The results demonstrated that the greatest contralateral trunk lean occurs around the

time of the peak elbow varus moment Statistically significant associations were found

between contralateral trunk lean and increased ball velocity (P = 003) indicating that for

every 10 increase in contralateral lean ball velocity increased 05 ms Results also indicated

that for every 10 increase in contralateral lean elbow varus moments increased by 37 Nm

and glenohumeral internal rotation moments increased by 25 Nm( P 001 for both)

Conclusion Study findings indicate that the positioning of the trunk plays a substantial role in

pitching performance and pitcher injury potential

RETURN-TO-PLAY OUTCOMES IN PROFESSIONAL BASEBALL PLAYERS AFTERMEDIAL ULNAR COLLATERAL LIGAMENT INJURIES

COMPARISON OF OPERATIVE VERSUS NONOPERATIVE TREATMENT BASED ON MAGNETIC RESONANCE IMAGING FINDINGS

GREGORY M FORD

bull Conclusion Incomplete UCL injuries in professional baseball players can be successfully

treated nonoperatively in the majority of cases Pitchers are more likely to have complete tears

leading to surgery MRI grading of UCL injuries can help predict RTP and the need for surgery

bull Therapie

bull Lokaal ultrasone electro laser weke delen ROM

bull Rotator cuff training geiumlsoleerd

bull Interval werprevalidatie

REFERENTIESbull Am J Sports Med 2016 Mar44(3)723-8 doi 1011770363546515621756 Epub 2016 Jan 13

Return-to-Play Outcomes in Professional Baseball Players After Medial Ulnar Collateral Ligament Injuries Comparison of Operative

Versus Nonoperative Treatment Based on Magnetic Resonance Imaging Findings

Ford GM1 Genuario J2 Kinkartz J2 Githens T3 Noonan T2 LEVEL 4

bull Am J Sports Med 2014 Apr42(4)880-5 doi 1011770363546513519072 Epub 2014 Feb 4

Analysis of pitching velocity in major league baseball players before and after ulnar collateral ligament reconstruction

Jiang JJ1 Leland JM LEVEL 3

bull Am J Sports Med 2003 Jul-Aug31(4)621-35

Elbow injuries in throwing athletes a current concepts review

Cain EL Jr1 Dugas JRWolf RS Andrews JR

bull J Sports Sci 201533(7)713-23 doi 101080026404142014962572 Epub 2014 Dec 17

A kinematic comparison of the overhand throw and tennis serve in tennis players how similar are they really

Reid M1 Giblin GWhiteside D

Page 5: Instabiliteit elleboog en fysiotherapieschoudernetwerkwestbrabant.nl/wp-content/uploads/2016/12/Instabil… · Matthew J. Solomito,*y MS, Erin J. Garibay,y MS, Jessica R. Woods,z

MCL- UCL LETSEL

bull Pijnlijke mediale zijde elleboog (ldquopoprdquo)

bull Verlies flexie extensie elleboog

bull Tinteling ulnarisgebied (cubitale tunnel)

bull ldquoDead onderarmrdquo

bull Verlies accuraatheid en snelheid kracht

bull Klachten kinetische keten

bull Artrogeen artrokinematica

bull Passieve stabiliteit

bull Actieve componenten

ONDERZOEK INSTABILITEIT

bull Valgus stress test

bull Pivot shift test

bull Moving valgus stress test

bull Milking maneuver test

wwwphysio-pediacom

OVERUSE

bull Schade MCL

bull Extensie- supinatiebeperking

bull Impingement elleboog waar

bull GIRD schouder

bull Kinetische keten

ACUTE FASE TRAUMAbull Fase 1 Inflammatie en protectie (0-3 wkn)

Behoud stabiliteit

Protected joint motion gewrichtsstijfheid

Keten oefeningen

bull Fase 2 fibroblasten- en vroege remodulatiefase (3-6 wkn)

Protectie collageen littekenweefsel

Protectie stabiliteit behoud toename ROM

Krachttraining onderarmmusculatuur

Keten oefeningen

bull Fase 3 Maturatieperiode (6-12 Wkn)

Max ROM

Toename kracht en endurance

Verdere hervatting ADL

Keten oefeningen

BEHANDELING

bull wwwelleboogklinieknl

bull Mobilisaties extensie en supinatie (elleboog eacuten pols)

bull MLPP 70 gr flexie en 25 gr supinatie

bull Endorotatie schouder ndash sleepersstretch

bull Oefentherapie elleboog- schoudermusculatuur

bull Vrije ROM kinetische keten (heup LWK TLO CTO)

bull Corestability dynamisch

OEFENTHERAPIE

bull Throwers ten program

bull Neurodynamics

bull Dynamische corestability

bull Back to sports

LATERAL TRUNK LEAN IN PITCHERS AFFECTS BOTH BALL VELOCITY AND UPPER EXTREMITY JOINT MOMENTS

Matthew J Solomitoy MS Erin J Garibayy MS Jessica R Woodsz BSBE

Sylvia O ˜ unpuuz MSc and Carl W Nissen

bull Methods A total of 99 pitchers were recruited for this study and underwent a pitching analysis

using 3-dimensional motion analysis techniques A random intercept mixed-effects regression

model was used to determine if statistically significant associations existed between

contralateral trunk lean (away from the pitching arm side) and ball velocity as well as the

elbow varus moment and glenohumeral internal rotation moment

bull Results The results demonstrated that the greatest contralateral trunk lean occurs around the

time of the peak elbow varus moment Statistically significant associations were found

between contralateral trunk lean and increased ball velocity (P = 003) indicating that for

every 10 increase in contralateral lean ball velocity increased 05 ms Results also indicated

that for every 10 increase in contralateral lean elbow varus moments increased by 37 Nm

and glenohumeral internal rotation moments increased by 25 Nm( P 001 for both)

Conclusion Study findings indicate that the positioning of the trunk plays a substantial role in

pitching performance and pitcher injury potential

RETURN-TO-PLAY OUTCOMES IN PROFESSIONAL BASEBALL PLAYERS AFTERMEDIAL ULNAR COLLATERAL LIGAMENT INJURIES

COMPARISON OF OPERATIVE VERSUS NONOPERATIVE TREATMENT BASED ON MAGNETIC RESONANCE IMAGING FINDINGS

GREGORY M FORD

bull Conclusion Incomplete UCL injuries in professional baseball players can be successfully

treated nonoperatively in the majority of cases Pitchers are more likely to have complete tears

leading to surgery MRI grading of UCL injuries can help predict RTP and the need for surgery

bull Therapie

bull Lokaal ultrasone electro laser weke delen ROM

bull Rotator cuff training geiumlsoleerd

bull Interval werprevalidatie

REFERENTIESbull Am J Sports Med 2016 Mar44(3)723-8 doi 1011770363546515621756 Epub 2016 Jan 13

Return-to-Play Outcomes in Professional Baseball Players After Medial Ulnar Collateral Ligament Injuries Comparison of Operative

Versus Nonoperative Treatment Based on Magnetic Resonance Imaging Findings

Ford GM1 Genuario J2 Kinkartz J2 Githens T3 Noonan T2 LEVEL 4

bull Am J Sports Med 2014 Apr42(4)880-5 doi 1011770363546513519072 Epub 2014 Feb 4

Analysis of pitching velocity in major league baseball players before and after ulnar collateral ligament reconstruction

Jiang JJ1 Leland JM LEVEL 3

bull Am J Sports Med 2003 Jul-Aug31(4)621-35

Elbow injuries in throwing athletes a current concepts review

Cain EL Jr1 Dugas JRWolf RS Andrews JR

bull J Sports Sci 201533(7)713-23 doi 101080026404142014962572 Epub 2014 Dec 17

A kinematic comparison of the overhand throw and tennis serve in tennis players how similar are they really

Reid M1 Giblin GWhiteside D

Page 6: Instabiliteit elleboog en fysiotherapieschoudernetwerkwestbrabant.nl/wp-content/uploads/2016/12/Instabil… · Matthew J. Solomito,*y MS, Erin J. Garibay,y MS, Jessica R. Woods,z

bull Artrogeen artrokinematica

bull Passieve stabiliteit

bull Actieve componenten

ONDERZOEK INSTABILITEIT

bull Valgus stress test

bull Pivot shift test

bull Moving valgus stress test

bull Milking maneuver test

wwwphysio-pediacom

OVERUSE

bull Schade MCL

bull Extensie- supinatiebeperking

bull Impingement elleboog waar

bull GIRD schouder

bull Kinetische keten

ACUTE FASE TRAUMAbull Fase 1 Inflammatie en protectie (0-3 wkn)

Behoud stabiliteit

Protected joint motion gewrichtsstijfheid

Keten oefeningen

bull Fase 2 fibroblasten- en vroege remodulatiefase (3-6 wkn)

Protectie collageen littekenweefsel

Protectie stabiliteit behoud toename ROM

Krachttraining onderarmmusculatuur

Keten oefeningen

bull Fase 3 Maturatieperiode (6-12 Wkn)

Max ROM

Toename kracht en endurance

Verdere hervatting ADL

Keten oefeningen

BEHANDELING

bull wwwelleboogklinieknl

bull Mobilisaties extensie en supinatie (elleboog eacuten pols)

bull MLPP 70 gr flexie en 25 gr supinatie

bull Endorotatie schouder ndash sleepersstretch

bull Oefentherapie elleboog- schoudermusculatuur

bull Vrije ROM kinetische keten (heup LWK TLO CTO)

bull Corestability dynamisch

OEFENTHERAPIE

bull Throwers ten program

bull Neurodynamics

bull Dynamische corestability

bull Back to sports

LATERAL TRUNK LEAN IN PITCHERS AFFECTS BOTH BALL VELOCITY AND UPPER EXTREMITY JOINT MOMENTS

Matthew J Solomitoy MS Erin J Garibayy MS Jessica R Woodsz BSBE

Sylvia O ˜ unpuuz MSc and Carl W Nissen

bull Methods A total of 99 pitchers were recruited for this study and underwent a pitching analysis

using 3-dimensional motion analysis techniques A random intercept mixed-effects regression

model was used to determine if statistically significant associations existed between

contralateral trunk lean (away from the pitching arm side) and ball velocity as well as the

elbow varus moment and glenohumeral internal rotation moment

bull Results The results demonstrated that the greatest contralateral trunk lean occurs around the

time of the peak elbow varus moment Statistically significant associations were found

between contralateral trunk lean and increased ball velocity (P = 003) indicating that for

every 10 increase in contralateral lean ball velocity increased 05 ms Results also indicated

that for every 10 increase in contralateral lean elbow varus moments increased by 37 Nm

and glenohumeral internal rotation moments increased by 25 Nm( P 001 for both)

Conclusion Study findings indicate that the positioning of the trunk plays a substantial role in

pitching performance and pitcher injury potential

RETURN-TO-PLAY OUTCOMES IN PROFESSIONAL BASEBALL PLAYERS AFTERMEDIAL ULNAR COLLATERAL LIGAMENT INJURIES

COMPARISON OF OPERATIVE VERSUS NONOPERATIVE TREATMENT BASED ON MAGNETIC RESONANCE IMAGING FINDINGS

GREGORY M FORD

bull Conclusion Incomplete UCL injuries in professional baseball players can be successfully

treated nonoperatively in the majority of cases Pitchers are more likely to have complete tears

leading to surgery MRI grading of UCL injuries can help predict RTP and the need for surgery

bull Therapie

bull Lokaal ultrasone electro laser weke delen ROM

bull Rotator cuff training geiumlsoleerd

bull Interval werprevalidatie

REFERENTIESbull Am J Sports Med 2016 Mar44(3)723-8 doi 1011770363546515621756 Epub 2016 Jan 13

Return-to-Play Outcomes in Professional Baseball Players After Medial Ulnar Collateral Ligament Injuries Comparison of Operative

Versus Nonoperative Treatment Based on Magnetic Resonance Imaging Findings

Ford GM1 Genuario J2 Kinkartz J2 Githens T3 Noonan T2 LEVEL 4

bull Am J Sports Med 2014 Apr42(4)880-5 doi 1011770363546513519072 Epub 2014 Feb 4

Analysis of pitching velocity in major league baseball players before and after ulnar collateral ligament reconstruction

Jiang JJ1 Leland JM LEVEL 3

bull Am J Sports Med 2003 Jul-Aug31(4)621-35

Elbow injuries in throwing athletes a current concepts review

Cain EL Jr1 Dugas JRWolf RS Andrews JR

bull J Sports Sci 201533(7)713-23 doi 101080026404142014962572 Epub 2014 Dec 17

A kinematic comparison of the overhand throw and tennis serve in tennis players how similar are they really

Reid M1 Giblin GWhiteside D

Page 7: Instabiliteit elleboog en fysiotherapieschoudernetwerkwestbrabant.nl/wp-content/uploads/2016/12/Instabil… · Matthew J. Solomito,*y MS, Erin J. Garibay,y MS, Jessica R. Woods,z

ONDERZOEK INSTABILITEIT

bull Valgus stress test

bull Pivot shift test

bull Moving valgus stress test

bull Milking maneuver test

wwwphysio-pediacom

OVERUSE

bull Schade MCL

bull Extensie- supinatiebeperking

bull Impingement elleboog waar

bull GIRD schouder

bull Kinetische keten

ACUTE FASE TRAUMAbull Fase 1 Inflammatie en protectie (0-3 wkn)

Behoud stabiliteit

Protected joint motion gewrichtsstijfheid

Keten oefeningen

bull Fase 2 fibroblasten- en vroege remodulatiefase (3-6 wkn)

Protectie collageen littekenweefsel

Protectie stabiliteit behoud toename ROM

Krachttraining onderarmmusculatuur

Keten oefeningen

bull Fase 3 Maturatieperiode (6-12 Wkn)

Max ROM

Toename kracht en endurance

Verdere hervatting ADL

Keten oefeningen

BEHANDELING

bull wwwelleboogklinieknl

bull Mobilisaties extensie en supinatie (elleboog eacuten pols)

bull MLPP 70 gr flexie en 25 gr supinatie

bull Endorotatie schouder ndash sleepersstretch

bull Oefentherapie elleboog- schoudermusculatuur

bull Vrije ROM kinetische keten (heup LWK TLO CTO)

bull Corestability dynamisch

OEFENTHERAPIE

bull Throwers ten program

bull Neurodynamics

bull Dynamische corestability

bull Back to sports

LATERAL TRUNK LEAN IN PITCHERS AFFECTS BOTH BALL VELOCITY AND UPPER EXTREMITY JOINT MOMENTS

Matthew J Solomitoy MS Erin J Garibayy MS Jessica R Woodsz BSBE

Sylvia O ˜ unpuuz MSc and Carl W Nissen

bull Methods A total of 99 pitchers were recruited for this study and underwent a pitching analysis

using 3-dimensional motion analysis techniques A random intercept mixed-effects regression

model was used to determine if statistically significant associations existed between

contralateral trunk lean (away from the pitching arm side) and ball velocity as well as the

elbow varus moment and glenohumeral internal rotation moment

bull Results The results demonstrated that the greatest contralateral trunk lean occurs around the

time of the peak elbow varus moment Statistically significant associations were found

between contralateral trunk lean and increased ball velocity (P = 003) indicating that for

every 10 increase in contralateral lean ball velocity increased 05 ms Results also indicated

that for every 10 increase in contralateral lean elbow varus moments increased by 37 Nm

and glenohumeral internal rotation moments increased by 25 Nm( P 001 for both)

Conclusion Study findings indicate that the positioning of the trunk plays a substantial role in

pitching performance and pitcher injury potential

RETURN-TO-PLAY OUTCOMES IN PROFESSIONAL BASEBALL PLAYERS AFTERMEDIAL ULNAR COLLATERAL LIGAMENT INJURIES

COMPARISON OF OPERATIVE VERSUS NONOPERATIVE TREATMENT BASED ON MAGNETIC RESONANCE IMAGING FINDINGS

GREGORY M FORD

bull Conclusion Incomplete UCL injuries in professional baseball players can be successfully

treated nonoperatively in the majority of cases Pitchers are more likely to have complete tears

leading to surgery MRI grading of UCL injuries can help predict RTP and the need for surgery

bull Therapie

bull Lokaal ultrasone electro laser weke delen ROM

bull Rotator cuff training geiumlsoleerd

bull Interval werprevalidatie

REFERENTIESbull Am J Sports Med 2016 Mar44(3)723-8 doi 1011770363546515621756 Epub 2016 Jan 13

Return-to-Play Outcomes in Professional Baseball Players After Medial Ulnar Collateral Ligament Injuries Comparison of Operative

Versus Nonoperative Treatment Based on Magnetic Resonance Imaging Findings

Ford GM1 Genuario J2 Kinkartz J2 Githens T3 Noonan T2 LEVEL 4

bull Am J Sports Med 2014 Apr42(4)880-5 doi 1011770363546513519072 Epub 2014 Feb 4

Analysis of pitching velocity in major league baseball players before and after ulnar collateral ligament reconstruction

Jiang JJ1 Leland JM LEVEL 3

bull Am J Sports Med 2003 Jul-Aug31(4)621-35

Elbow injuries in throwing athletes a current concepts review

Cain EL Jr1 Dugas JRWolf RS Andrews JR

bull J Sports Sci 201533(7)713-23 doi 101080026404142014962572 Epub 2014 Dec 17

A kinematic comparison of the overhand throw and tennis serve in tennis players how similar are they really

Reid M1 Giblin GWhiteside D

Page 8: Instabiliteit elleboog en fysiotherapieschoudernetwerkwestbrabant.nl/wp-content/uploads/2016/12/Instabil… · Matthew J. Solomito,*y MS, Erin J. Garibay,y MS, Jessica R. Woods,z

OVERUSE

bull Schade MCL

bull Extensie- supinatiebeperking

bull Impingement elleboog waar

bull GIRD schouder

bull Kinetische keten

ACUTE FASE TRAUMAbull Fase 1 Inflammatie en protectie (0-3 wkn)

Behoud stabiliteit

Protected joint motion gewrichtsstijfheid

Keten oefeningen

bull Fase 2 fibroblasten- en vroege remodulatiefase (3-6 wkn)

Protectie collageen littekenweefsel

Protectie stabiliteit behoud toename ROM

Krachttraining onderarmmusculatuur

Keten oefeningen

bull Fase 3 Maturatieperiode (6-12 Wkn)

Max ROM

Toename kracht en endurance

Verdere hervatting ADL

Keten oefeningen

BEHANDELING

bull wwwelleboogklinieknl

bull Mobilisaties extensie en supinatie (elleboog eacuten pols)

bull MLPP 70 gr flexie en 25 gr supinatie

bull Endorotatie schouder ndash sleepersstretch

bull Oefentherapie elleboog- schoudermusculatuur

bull Vrije ROM kinetische keten (heup LWK TLO CTO)

bull Corestability dynamisch

OEFENTHERAPIE

bull Throwers ten program

bull Neurodynamics

bull Dynamische corestability

bull Back to sports

LATERAL TRUNK LEAN IN PITCHERS AFFECTS BOTH BALL VELOCITY AND UPPER EXTREMITY JOINT MOMENTS

Matthew J Solomitoy MS Erin J Garibayy MS Jessica R Woodsz BSBE

Sylvia O ˜ unpuuz MSc and Carl W Nissen

bull Methods A total of 99 pitchers were recruited for this study and underwent a pitching analysis

using 3-dimensional motion analysis techniques A random intercept mixed-effects regression

model was used to determine if statistically significant associations existed between

contralateral trunk lean (away from the pitching arm side) and ball velocity as well as the

elbow varus moment and glenohumeral internal rotation moment

bull Results The results demonstrated that the greatest contralateral trunk lean occurs around the

time of the peak elbow varus moment Statistically significant associations were found

between contralateral trunk lean and increased ball velocity (P = 003) indicating that for

every 10 increase in contralateral lean ball velocity increased 05 ms Results also indicated

that for every 10 increase in contralateral lean elbow varus moments increased by 37 Nm

and glenohumeral internal rotation moments increased by 25 Nm( P 001 for both)

Conclusion Study findings indicate that the positioning of the trunk plays a substantial role in

pitching performance and pitcher injury potential

RETURN-TO-PLAY OUTCOMES IN PROFESSIONAL BASEBALL PLAYERS AFTERMEDIAL ULNAR COLLATERAL LIGAMENT INJURIES

COMPARISON OF OPERATIVE VERSUS NONOPERATIVE TREATMENT BASED ON MAGNETIC RESONANCE IMAGING FINDINGS

GREGORY M FORD

bull Conclusion Incomplete UCL injuries in professional baseball players can be successfully

treated nonoperatively in the majority of cases Pitchers are more likely to have complete tears

leading to surgery MRI grading of UCL injuries can help predict RTP and the need for surgery

bull Therapie

bull Lokaal ultrasone electro laser weke delen ROM

bull Rotator cuff training geiumlsoleerd

bull Interval werprevalidatie

REFERENTIESbull Am J Sports Med 2016 Mar44(3)723-8 doi 1011770363546515621756 Epub 2016 Jan 13

Return-to-Play Outcomes in Professional Baseball Players After Medial Ulnar Collateral Ligament Injuries Comparison of Operative

Versus Nonoperative Treatment Based on Magnetic Resonance Imaging Findings

Ford GM1 Genuario J2 Kinkartz J2 Githens T3 Noonan T2 LEVEL 4

bull Am J Sports Med 2014 Apr42(4)880-5 doi 1011770363546513519072 Epub 2014 Feb 4

Analysis of pitching velocity in major league baseball players before and after ulnar collateral ligament reconstruction

Jiang JJ1 Leland JM LEVEL 3

bull Am J Sports Med 2003 Jul-Aug31(4)621-35

Elbow injuries in throwing athletes a current concepts review

Cain EL Jr1 Dugas JRWolf RS Andrews JR

bull J Sports Sci 201533(7)713-23 doi 101080026404142014962572 Epub 2014 Dec 17

A kinematic comparison of the overhand throw and tennis serve in tennis players how similar are they really

Reid M1 Giblin GWhiteside D

Page 9: Instabiliteit elleboog en fysiotherapieschoudernetwerkwestbrabant.nl/wp-content/uploads/2016/12/Instabil… · Matthew J. Solomito,*y MS, Erin J. Garibay,y MS, Jessica R. Woods,z

ACUTE FASE TRAUMAbull Fase 1 Inflammatie en protectie (0-3 wkn)

Behoud stabiliteit

Protected joint motion gewrichtsstijfheid

Keten oefeningen

bull Fase 2 fibroblasten- en vroege remodulatiefase (3-6 wkn)

Protectie collageen littekenweefsel

Protectie stabiliteit behoud toename ROM

Krachttraining onderarmmusculatuur

Keten oefeningen

bull Fase 3 Maturatieperiode (6-12 Wkn)

Max ROM

Toename kracht en endurance

Verdere hervatting ADL

Keten oefeningen

BEHANDELING

bull wwwelleboogklinieknl

bull Mobilisaties extensie en supinatie (elleboog eacuten pols)

bull MLPP 70 gr flexie en 25 gr supinatie

bull Endorotatie schouder ndash sleepersstretch

bull Oefentherapie elleboog- schoudermusculatuur

bull Vrije ROM kinetische keten (heup LWK TLO CTO)

bull Corestability dynamisch

OEFENTHERAPIE

bull Throwers ten program

bull Neurodynamics

bull Dynamische corestability

bull Back to sports

LATERAL TRUNK LEAN IN PITCHERS AFFECTS BOTH BALL VELOCITY AND UPPER EXTREMITY JOINT MOMENTS

Matthew J Solomitoy MS Erin J Garibayy MS Jessica R Woodsz BSBE

Sylvia O ˜ unpuuz MSc and Carl W Nissen

bull Methods A total of 99 pitchers were recruited for this study and underwent a pitching analysis

using 3-dimensional motion analysis techniques A random intercept mixed-effects regression

model was used to determine if statistically significant associations existed between

contralateral trunk lean (away from the pitching arm side) and ball velocity as well as the

elbow varus moment and glenohumeral internal rotation moment

bull Results The results demonstrated that the greatest contralateral trunk lean occurs around the

time of the peak elbow varus moment Statistically significant associations were found

between contralateral trunk lean and increased ball velocity (P = 003) indicating that for

every 10 increase in contralateral lean ball velocity increased 05 ms Results also indicated

that for every 10 increase in contralateral lean elbow varus moments increased by 37 Nm

and glenohumeral internal rotation moments increased by 25 Nm( P 001 for both)

Conclusion Study findings indicate that the positioning of the trunk plays a substantial role in

pitching performance and pitcher injury potential

RETURN-TO-PLAY OUTCOMES IN PROFESSIONAL BASEBALL PLAYERS AFTERMEDIAL ULNAR COLLATERAL LIGAMENT INJURIES

COMPARISON OF OPERATIVE VERSUS NONOPERATIVE TREATMENT BASED ON MAGNETIC RESONANCE IMAGING FINDINGS

GREGORY M FORD

bull Conclusion Incomplete UCL injuries in professional baseball players can be successfully

treated nonoperatively in the majority of cases Pitchers are more likely to have complete tears

leading to surgery MRI grading of UCL injuries can help predict RTP and the need for surgery

bull Therapie

bull Lokaal ultrasone electro laser weke delen ROM

bull Rotator cuff training geiumlsoleerd

bull Interval werprevalidatie

REFERENTIESbull Am J Sports Med 2016 Mar44(3)723-8 doi 1011770363546515621756 Epub 2016 Jan 13

Return-to-Play Outcomes in Professional Baseball Players After Medial Ulnar Collateral Ligament Injuries Comparison of Operative

Versus Nonoperative Treatment Based on Magnetic Resonance Imaging Findings

Ford GM1 Genuario J2 Kinkartz J2 Githens T3 Noonan T2 LEVEL 4

bull Am J Sports Med 2014 Apr42(4)880-5 doi 1011770363546513519072 Epub 2014 Feb 4

Analysis of pitching velocity in major league baseball players before and after ulnar collateral ligament reconstruction

Jiang JJ1 Leland JM LEVEL 3

bull Am J Sports Med 2003 Jul-Aug31(4)621-35

Elbow injuries in throwing athletes a current concepts review

Cain EL Jr1 Dugas JRWolf RS Andrews JR

bull J Sports Sci 201533(7)713-23 doi 101080026404142014962572 Epub 2014 Dec 17

A kinematic comparison of the overhand throw and tennis serve in tennis players how similar are they really

Reid M1 Giblin GWhiteside D

Page 10: Instabiliteit elleboog en fysiotherapieschoudernetwerkwestbrabant.nl/wp-content/uploads/2016/12/Instabil… · Matthew J. Solomito,*y MS, Erin J. Garibay,y MS, Jessica R. Woods,z

BEHANDELING

bull wwwelleboogklinieknl

bull Mobilisaties extensie en supinatie (elleboog eacuten pols)

bull MLPP 70 gr flexie en 25 gr supinatie

bull Endorotatie schouder ndash sleepersstretch

bull Oefentherapie elleboog- schoudermusculatuur

bull Vrije ROM kinetische keten (heup LWK TLO CTO)

bull Corestability dynamisch

OEFENTHERAPIE

bull Throwers ten program

bull Neurodynamics

bull Dynamische corestability

bull Back to sports

LATERAL TRUNK LEAN IN PITCHERS AFFECTS BOTH BALL VELOCITY AND UPPER EXTREMITY JOINT MOMENTS

Matthew J Solomitoy MS Erin J Garibayy MS Jessica R Woodsz BSBE

Sylvia O ˜ unpuuz MSc and Carl W Nissen

bull Methods A total of 99 pitchers were recruited for this study and underwent a pitching analysis

using 3-dimensional motion analysis techniques A random intercept mixed-effects regression

model was used to determine if statistically significant associations existed between

contralateral trunk lean (away from the pitching arm side) and ball velocity as well as the

elbow varus moment and glenohumeral internal rotation moment

bull Results The results demonstrated that the greatest contralateral trunk lean occurs around the

time of the peak elbow varus moment Statistically significant associations were found

between contralateral trunk lean and increased ball velocity (P = 003) indicating that for

every 10 increase in contralateral lean ball velocity increased 05 ms Results also indicated

that for every 10 increase in contralateral lean elbow varus moments increased by 37 Nm

and glenohumeral internal rotation moments increased by 25 Nm( P 001 for both)

Conclusion Study findings indicate that the positioning of the trunk plays a substantial role in

pitching performance and pitcher injury potential

RETURN-TO-PLAY OUTCOMES IN PROFESSIONAL BASEBALL PLAYERS AFTERMEDIAL ULNAR COLLATERAL LIGAMENT INJURIES

COMPARISON OF OPERATIVE VERSUS NONOPERATIVE TREATMENT BASED ON MAGNETIC RESONANCE IMAGING FINDINGS

GREGORY M FORD

bull Conclusion Incomplete UCL injuries in professional baseball players can be successfully

treated nonoperatively in the majority of cases Pitchers are more likely to have complete tears

leading to surgery MRI grading of UCL injuries can help predict RTP and the need for surgery

bull Therapie

bull Lokaal ultrasone electro laser weke delen ROM

bull Rotator cuff training geiumlsoleerd

bull Interval werprevalidatie

REFERENTIESbull Am J Sports Med 2016 Mar44(3)723-8 doi 1011770363546515621756 Epub 2016 Jan 13

Return-to-Play Outcomes in Professional Baseball Players After Medial Ulnar Collateral Ligament Injuries Comparison of Operative

Versus Nonoperative Treatment Based on Magnetic Resonance Imaging Findings

Ford GM1 Genuario J2 Kinkartz J2 Githens T3 Noonan T2 LEVEL 4

bull Am J Sports Med 2014 Apr42(4)880-5 doi 1011770363546513519072 Epub 2014 Feb 4

Analysis of pitching velocity in major league baseball players before and after ulnar collateral ligament reconstruction

Jiang JJ1 Leland JM LEVEL 3

bull Am J Sports Med 2003 Jul-Aug31(4)621-35

Elbow injuries in throwing athletes a current concepts review

Cain EL Jr1 Dugas JRWolf RS Andrews JR

bull J Sports Sci 201533(7)713-23 doi 101080026404142014962572 Epub 2014 Dec 17

A kinematic comparison of the overhand throw and tennis serve in tennis players how similar are they really

Reid M1 Giblin GWhiteside D

Page 11: Instabiliteit elleboog en fysiotherapieschoudernetwerkwestbrabant.nl/wp-content/uploads/2016/12/Instabil… · Matthew J. Solomito,*y MS, Erin J. Garibay,y MS, Jessica R. Woods,z

OEFENTHERAPIE

bull Throwers ten program

bull Neurodynamics

bull Dynamische corestability

bull Back to sports

LATERAL TRUNK LEAN IN PITCHERS AFFECTS BOTH BALL VELOCITY AND UPPER EXTREMITY JOINT MOMENTS

Matthew J Solomitoy MS Erin J Garibayy MS Jessica R Woodsz BSBE

Sylvia O ˜ unpuuz MSc and Carl W Nissen

bull Methods A total of 99 pitchers were recruited for this study and underwent a pitching analysis

using 3-dimensional motion analysis techniques A random intercept mixed-effects regression

model was used to determine if statistically significant associations existed between

contralateral trunk lean (away from the pitching arm side) and ball velocity as well as the

elbow varus moment and glenohumeral internal rotation moment

bull Results The results demonstrated that the greatest contralateral trunk lean occurs around the

time of the peak elbow varus moment Statistically significant associations were found

between contralateral trunk lean and increased ball velocity (P = 003) indicating that for

every 10 increase in contralateral lean ball velocity increased 05 ms Results also indicated

that for every 10 increase in contralateral lean elbow varus moments increased by 37 Nm

and glenohumeral internal rotation moments increased by 25 Nm( P 001 for both)

Conclusion Study findings indicate that the positioning of the trunk plays a substantial role in

pitching performance and pitcher injury potential

RETURN-TO-PLAY OUTCOMES IN PROFESSIONAL BASEBALL PLAYERS AFTERMEDIAL ULNAR COLLATERAL LIGAMENT INJURIES

COMPARISON OF OPERATIVE VERSUS NONOPERATIVE TREATMENT BASED ON MAGNETIC RESONANCE IMAGING FINDINGS

GREGORY M FORD

bull Conclusion Incomplete UCL injuries in professional baseball players can be successfully

treated nonoperatively in the majority of cases Pitchers are more likely to have complete tears

leading to surgery MRI grading of UCL injuries can help predict RTP and the need for surgery

bull Therapie

bull Lokaal ultrasone electro laser weke delen ROM

bull Rotator cuff training geiumlsoleerd

bull Interval werprevalidatie

REFERENTIESbull Am J Sports Med 2016 Mar44(3)723-8 doi 1011770363546515621756 Epub 2016 Jan 13

Return-to-Play Outcomes in Professional Baseball Players After Medial Ulnar Collateral Ligament Injuries Comparison of Operative

Versus Nonoperative Treatment Based on Magnetic Resonance Imaging Findings

Ford GM1 Genuario J2 Kinkartz J2 Githens T3 Noonan T2 LEVEL 4

bull Am J Sports Med 2014 Apr42(4)880-5 doi 1011770363546513519072 Epub 2014 Feb 4

Analysis of pitching velocity in major league baseball players before and after ulnar collateral ligament reconstruction

Jiang JJ1 Leland JM LEVEL 3

bull Am J Sports Med 2003 Jul-Aug31(4)621-35

Elbow injuries in throwing athletes a current concepts review

Cain EL Jr1 Dugas JRWolf RS Andrews JR

bull J Sports Sci 201533(7)713-23 doi 101080026404142014962572 Epub 2014 Dec 17

A kinematic comparison of the overhand throw and tennis serve in tennis players how similar are they really

Reid M1 Giblin GWhiteside D

Page 12: Instabiliteit elleboog en fysiotherapieschoudernetwerkwestbrabant.nl/wp-content/uploads/2016/12/Instabil… · Matthew J. Solomito,*y MS, Erin J. Garibay,y MS, Jessica R. Woods,z

LATERAL TRUNK LEAN IN PITCHERS AFFECTS BOTH BALL VELOCITY AND UPPER EXTREMITY JOINT MOMENTS

Matthew J Solomitoy MS Erin J Garibayy MS Jessica R Woodsz BSBE

Sylvia O ˜ unpuuz MSc and Carl W Nissen

bull Methods A total of 99 pitchers were recruited for this study and underwent a pitching analysis

using 3-dimensional motion analysis techniques A random intercept mixed-effects regression

model was used to determine if statistically significant associations existed between

contralateral trunk lean (away from the pitching arm side) and ball velocity as well as the

elbow varus moment and glenohumeral internal rotation moment

bull Results The results demonstrated that the greatest contralateral trunk lean occurs around the

time of the peak elbow varus moment Statistically significant associations were found

between contralateral trunk lean and increased ball velocity (P = 003) indicating that for

every 10 increase in contralateral lean ball velocity increased 05 ms Results also indicated

that for every 10 increase in contralateral lean elbow varus moments increased by 37 Nm

and glenohumeral internal rotation moments increased by 25 Nm( P 001 for both)

Conclusion Study findings indicate that the positioning of the trunk plays a substantial role in

pitching performance and pitcher injury potential

RETURN-TO-PLAY OUTCOMES IN PROFESSIONAL BASEBALL PLAYERS AFTERMEDIAL ULNAR COLLATERAL LIGAMENT INJURIES

COMPARISON OF OPERATIVE VERSUS NONOPERATIVE TREATMENT BASED ON MAGNETIC RESONANCE IMAGING FINDINGS

GREGORY M FORD

bull Conclusion Incomplete UCL injuries in professional baseball players can be successfully

treated nonoperatively in the majority of cases Pitchers are more likely to have complete tears

leading to surgery MRI grading of UCL injuries can help predict RTP and the need for surgery

bull Therapie

bull Lokaal ultrasone electro laser weke delen ROM

bull Rotator cuff training geiumlsoleerd

bull Interval werprevalidatie

REFERENTIESbull Am J Sports Med 2016 Mar44(3)723-8 doi 1011770363546515621756 Epub 2016 Jan 13

Return-to-Play Outcomes in Professional Baseball Players After Medial Ulnar Collateral Ligament Injuries Comparison of Operative

Versus Nonoperative Treatment Based on Magnetic Resonance Imaging Findings

Ford GM1 Genuario J2 Kinkartz J2 Githens T3 Noonan T2 LEVEL 4

bull Am J Sports Med 2014 Apr42(4)880-5 doi 1011770363546513519072 Epub 2014 Feb 4

Analysis of pitching velocity in major league baseball players before and after ulnar collateral ligament reconstruction

Jiang JJ1 Leland JM LEVEL 3

bull Am J Sports Med 2003 Jul-Aug31(4)621-35

Elbow injuries in throwing athletes a current concepts review

Cain EL Jr1 Dugas JRWolf RS Andrews JR

bull J Sports Sci 201533(7)713-23 doi 101080026404142014962572 Epub 2014 Dec 17

A kinematic comparison of the overhand throw and tennis serve in tennis players how similar are they really

Reid M1 Giblin GWhiteside D

Page 13: Instabiliteit elleboog en fysiotherapieschoudernetwerkwestbrabant.nl/wp-content/uploads/2016/12/Instabil… · Matthew J. Solomito,*y MS, Erin J. Garibay,y MS, Jessica R. Woods,z

RETURN-TO-PLAY OUTCOMES IN PROFESSIONAL BASEBALL PLAYERS AFTERMEDIAL ULNAR COLLATERAL LIGAMENT INJURIES

COMPARISON OF OPERATIVE VERSUS NONOPERATIVE TREATMENT BASED ON MAGNETIC RESONANCE IMAGING FINDINGS

GREGORY M FORD

bull Conclusion Incomplete UCL injuries in professional baseball players can be successfully

treated nonoperatively in the majority of cases Pitchers are more likely to have complete tears

leading to surgery MRI grading of UCL injuries can help predict RTP and the need for surgery

bull Therapie

bull Lokaal ultrasone electro laser weke delen ROM

bull Rotator cuff training geiumlsoleerd

bull Interval werprevalidatie

REFERENTIESbull Am J Sports Med 2016 Mar44(3)723-8 doi 1011770363546515621756 Epub 2016 Jan 13

Return-to-Play Outcomes in Professional Baseball Players After Medial Ulnar Collateral Ligament Injuries Comparison of Operative

Versus Nonoperative Treatment Based on Magnetic Resonance Imaging Findings

Ford GM1 Genuario J2 Kinkartz J2 Githens T3 Noonan T2 LEVEL 4

bull Am J Sports Med 2014 Apr42(4)880-5 doi 1011770363546513519072 Epub 2014 Feb 4

Analysis of pitching velocity in major league baseball players before and after ulnar collateral ligament reconstruction

Jiang JJ1 Leland JM LEVEL 3

bull Am J Sports Med 2003 Jul-Aug31(4)621-35

Elbow injuries in throwing athletes a current concepts review

Cain EL Jr1 Dugas JRWolf RS Andrews JR

bull J Sports Sci 201533(7)713-23 doi 101080026404142014962572 Epub 2014 Dec 17

A kinematic comparison of the overhand throw and tennis serve in tennis players how similar are they really

Reid M1 Giblin GWhiteside D

Page 14: Instabiliteit elleboog en fysiotherapieschoudernetwerkwestbrabant.nl/wp-content/uploads/2016/12/Instabil… · Matthew J. Solomito,*y MS, Erin J. Garibay,y MS, Jessica R. Woods,z

REFERENTIESbull Am J Sports Med 2016 Mar44(3)723-8 doi 1011770363546515621756 Epub 2016 Jan 13

Return-to-Play Outcomes in Professional Baseball Players After Medial Ulnar Collateral Ligament Injuries Comparison of Operative

Versus Nonoperative Treatment Based on Magnetic Resonance Imaging Findings

Ford GM1 Genuario J2 Kinkartz J2 Githens T3 Noonan T2 LEVEL 4

bull Am J Sports Med 2014 Apr42(4)880-5 doi 1011770363546513519072 Epub 2014 Feb 4

Analysis of pitching velocity in major league baseball players before and after ulnar collateral ligament reconstruction

Jiang JJ1 Leland JM LEVEL 3

bull Am J Sports Med 2003 Jul-Aug31(4)621-35

Elbow injuries in throwing athletes a current concepts review

Cain EL Jr1 Dugas JRWolf RS Andrews JR

bull J Sports Sci 201533(7)713-23 doi 101080026404142014962572 Epub 2014 Dec 17

A kinematic comparison of the overhand throw and tennis serve in tennis players how similar are they really

Reid M1 Giblin GWhiteside D