Abstract
Successful rehabilitation following reconstruction of the ulnar collateral ligament (UCL) of the elbow requires a specific procedure to regain optimal range of motion, muscular strength and endurance, and ultimately enhanced upper extremity and kinetic chain function. This requires not only specific emphasis on the elbow and distal upper extremity but rather a complete upper extremity and kinetic chain focus that globally addressed the entire body beyond the elbow including the glenohumeral and scapulothroracic articulations as well as the core and lower extremity as well. Additionally, sport-specific resistive exercise applications are of paramount importance as well as interval sport return programs to prepare the athlete for the specific demands they will undergo during their return to full sport participation. The goal of this chapter is to review key concepts in sport-specific rehabilitation as they relate to the patient following UCL reconstruction and provide examples of kinetic chain rehabilitation and sport-specific progressions for clinical application.
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References
Vitale MA, Ahmad CS. The outcome of elbow ulnar collateral ligament reconstruction in overhead athletes. Am J Sports Med. 2008; 36(6):1193–1205.
Waris W. Elbow injuries in javelin throwers. Acta Chir Scand. 1946;93:563–75.
Reiman MP, Manske RC. The assessment of function: How is it measured? A clinical perspective. J Man Manip Ther. 2011;19(2):91–99.
Verstegen M, Falsone S, Orr R, Smith S. Suggestions from the field for the return to sports participation following anterior cruciate ligament reconstruction: American football. J Orthop Sports Phys Ther. 2012;42(4):337–344.
Ellenbecker TS, DeCarlo M, DeRosa C. Effective functional progressions in sport rehabilitation. Champaign: Human Kinetics; 2009
Ellenbecker TS, Mattalino AJ.Concentric isokinetic shoulder internal and external rotation strength in professional baseball pitchers. J Orthop Sports Phys Ther. 1997;25(5):323–28.
Wilk KE, Andrews JR, Arrigo CA, Keirns MA, Erber DJ. The strength characteristics of internal and external rotator muscles in professional baseball pitchers. Am J Sports Med. 1993;21:61–6.
Byram IR, Bushnell BD, Dugger K, Charron K, Harrell FE, Noonan TJ. Preseason shoulder strength measurements in professional baseball pitchers. Identifying players at risk for injury. Am J Sports Med. 2010;38(7):1375–1382.
Steindler A. Kinesiology of the human body. Springfield: Charles C Thomas; 1955.
Ellenbecker TS, Mattalino AJ. The Elbow in Sport. Champaign: Human Kinetics; 1997.
Ellenbecker TS, Nirschl RP, Renstrom P. Current concepts in examination and treatment of elbow tendon injury. Sports Health. 2013;5(2):186–94.
Donatelli RA, Ekstrom RA, Soderberg GL. Surface electromyographic analysis of exercises for the trapezius and serratus anterior muscles. J Orthop Sports Phys Ther. 2003;33(5):247–58.
Oyama S, Myers JB, Wassinger CA, Daniel Ricci R, Lephart SM. Asymmetric resting scapular posture in healthy overhead athletes. J Athl Train. 2008;43(6):565–70
Laudner KG, Myers JB, Pasquale MR, Bradley JP, Lephart SM. Scapular dysfunction in throwers with pathologic internal impingement. J Orthop Sports Phys Ther. 2006;36(7):485–94.
Kibler WB, Sciascia AD, Uhl TL, Tambay N, Cunningham T. Electromyographic analysis of specific exercises for scapular control in early phases of shoulder rehabilitation. Am J Sports Med. 2008;36:1789–1798.
Ellenbecker TS, Roetert EP. Age specific isokinetic glenohumeral internal and external rotation strength in elite junior tennis players. J Sci Med Sport. 2003;6(1):63–70.
Ellenbecker TS, Davies GJ. The application of isokinetics in testing and rehabilitation of the shoulder complex. J Athl Train. 2000;35(3):338–350.
Reinhold MM, Wilk KE, Fleisig GS et al. Electromyographic analysis of the rotator cuff and deltoid musculature during common shoulder external rotation exercises. J Orthop Sports Phys Ther. 2004;34(7):385–94.
Townsend H, Jobe FW, Pink M, Perry J. Electromyographic analysis of the glenohumeral muscles during a baseball rehabilitation program. Am J Sports Med. 1991;19:264–72.
Wilk KE, Obma P, Simpson CD, Cain LE, Dugas JR, Andrews JR. Shoulder injuries in the overhead athlete. J Orthop Sports Phys Ther. 2009;39(2):38–54.
Ellenbecker TS, Cools A. Rehabilitation of shoulder impingement syndrome and rotator cuff injuries: an evidence based review. Br J Sports Med. 2010;44:319–27.
Fleisig GS, Andrews JR, Dillman CJ et al. Kinetics of baseball pitching with implications about injury mechanisms. Am J Sports Med. 1995;23:233–9.
Kovacs M, Ellenbecker TS. An 8-stage model for evaluating the tennis serve. Implications for performance enhancement and injury prevention. Sports Health. 2011;3(6):504–13.
Ellenbecker TS, Wilk KE, Altchek DW, Andrews JR. Current concepts in rehabilitation following ulnar collateral ligament reconstruction. Sports Health. 2009;1:301–13.
Watkins, RG, Dennis S, Dillin WH, Schnebel B, Schneiderman G, Jobe F, Farfan H, Perry J, Pink M. Dynamic EMG analysis of torque transfer in professional baseball pitchers. Spine 1989;14:404–408.
Shaffer B, Jobe FW, Pink M, Perry J. Baseball batting. An electromygraphic study. Clin Orthop Relat Res. 1993;292:285–93
Chow JW, Shim JH, Lim YT. Lower trunk muscle activity during the tennis serve. J Sci Med Sport. 2003;6:512–518.
McGill S, Juker D, Kropf P. Appropriately placed surface EMG electrodes reflect deep muscle activity (psoas, quadratus lumborum, abdominal wall) in the lumbar spine. J Biomech. 1996;29:1503–7.
McGill SM. Distribution of tissue loads in the low back during a variety of daily and rehabilitation tasks. J Rehabil Res Dev. 1997;34:448–58.
Axler CT, McGill SM. Low back loads over a variety of abdominal exercises: searching for the safest abdominal challenge. Med Sci Sports Exerc. 1997;29:804–11.
McGill SM. Low back stability: from formal description to issues for performance and rehabilitation. Exerc Sport Sci Rev. 2001;29:26–31.
McGill SM, Grenier S, Kavcic N, Cholewicki J. Coordination of muscle activity to assure stability of the lumbar spine. J Electromyogr Kinesiol. 2003;13:353–9.
Myer GD, Chu DA, Brent JL, Hewett TE. Trunk and hip control neuromuscular training for the prevention of knee joint injury. Clin Sports Med. 2008;27:425–48.
Escamilla RF, Babb E, DeWitt R, Jew P, Kelleher P, Burnham T, Busch J, D’Anna K, Mowbray R, Imamura RT. An electromyographic analysis of traditional and non-traditional abdominal exercises: implications for rehabilitation and training. Phys Ther. 2006a;86(5):656–671.
Escamilla RF, McTaggart MSC, Fricklas EJ, DeWitt R, Kelleher P, Taylor MK, Hreljac A, Moorman CT. An electromyographic analysis of commercial and common abdominal exercises: implications for rehabilitation and training. J Orthop Sports Phys Ther. 2006b;36(2):45–57.
Escamilla RF, Lewis C, Bell D, Bramblet G, Daffron J, Lambert S, Pecson A, Imamura R, Paulos L, Andrews JR. Core muscle activation in swiss ball exercises compared to traditional abdominal exercises. J Orthop Sports Phys Ther. 2010;40(5):265–76.
Wilk KE, Reinold MM, Macrina LC, Porterfield R, Devine KM, Suarez K, Andrews JR. Glenohumeral internal rotation measurements differ depending on stabilization techniques. Sports Health. 2009;1(2):131–6.
Ellenbecker TS, Roetert EP, Bailie DS, Davies GJ, Brown SW. Glenohumeral joint total rotation range of motion in elite tennis players and baseball pitchers. Med Sci Sports Exerc. 2002;34(12):2052–6.
Wilk KE, Macrina LC, Fleisig GS, Porterfield R, Simpson CD, Harker P, Paparesta N, Andrews JR. Correlation of glenohumeral internal rotation deficit and total rotational motion to shoulder injuries in professional baseball pitchers. Am J Sports Med. 2011;39:329–335.
Dines JS, Frank JB, Akerman M, et al. Glenohumeral internal rotation deficits in baseball players with ulnar collateral ligament deficiency. Am J Sports Med. 2009;37(3):566–70
McClure P, Balaicuis J, Heiland D. A randomized controlled comparison of stretching procedures for posterior shoulder tightness. J Orthop Sports Phys Ther. 2007;37:108–14.
Laudner KG, Sipes RC, Wilson JT. The acute effects of sleeper stretches on shoulder range of motion. J Athl Train. 2008;43(4):359–63.
Manske RC, Meschke M, Porter A, Smith B, Reiman M. A randomized controlled single-blinded comaparison of stretching versus stretching and joint mobilization for posterior shoulder tightness measured by internal rotation loss. Sports Health. 2010;2(2):94–100.
Moore SD, Laudner KG, McLoda TA, Shaffer MA. The immediate effects of muscle energy technique on posterior shoulder tightness: a randomized controlled trial. J Orthop Sports Phys Ther. 2011;41(6):400–407.
Carter AB, Kaminsky TW, Douex AT Jr, Knight CA, Richards JG. Effects of high volume upper extremity plyometric training on throwing velocity and functional strength ratios of the shoulder rotators in collegiate baseball players. J Strength Cond Res. 2007;21(1):208–15.
Reinold MM, Wilk KE, Reed J, et al. Interval sport programs: guidelines for baseball, tennis, and golf. J Orthop Sports Phys Ther 2002;32:293–8.
Zheng N, Barrentine SW, Fleisig GS, Andrews JR. Kinematic analysis of swing in pro and amateur golfers. Int J Sports Med. 2008;29(6):487–93.
Ellenbecker TS, Wilk KE, Reinold MM, Murphy TF, Paine RM. Use of interval return programs for shoulder rehabilitation. In, Ellenbecker TS. Shoulder Rehabilitation: non Operative Treatment. New York: Theime; 2006.
Elliott B, Marsh T, Blanksby B. A three dimensional cinematographic analysis of the tennis serve. Int J Sports Biomech. 1986;2:260–71.
Morris M, Jobe FW, Perry J, Pink M, Healy BS. Electromyographic analysis of elbow function in the tennis players. Am J Sports Med. 1989;17:241–7.
Ellenbecker TS. Rehabilitation of Shoulder and Elbow Injuries in Tennis Players. Clin Sports Med. 1995;14(1):87–110.
Fleisig G, Nicholls R, Elliott B, Escamilla R. Kinematics used by world class tennis players to produce high-velocity serves. Sports Biomech. 2003;2(1):51–71.
Marshall RN, Noffal GJ, Legnani G. Simulation of the tennis serve: Factors affecting elbow torques related to medial epicondylitis. Paris: ISB.
Davis JT, Limpisvasti O, Fluhme D, et al. The effect of pitching biomechanics on the upper extremity in youth and adolescent baseball pitchers. Am J Sports Med. 2009;37:1484–1491.
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Ellenbecker, T., Wilk, K. (2015). Sport-Specific Rehabilitation After Ulnar Collateral Ligament Surgery. In: Dines, J., Altchek, D. (eds) Elbow Ulnar Collateral Ligament Injury. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7540-9_28
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