Assessment Tools and Orthoses for the Athlete’s Return to Competitions

Abstract

The musculoskeletal system of the elbow is particularly prone to damaging trauma and/or degeneration due to the significant effort and training that must be endured during sport practice, especially in those who perform competitive activities that involve repetitive movements. At the end and during the rehabilitation program, we use, essentially, two evaluation tools to monitor the performance of the entire upper limb muscle strength: the dynamometer Jamar and Total Shoulder tool. Among the functional dynamometers, the most reliable tool in terms of validity and repeatability for the measurement of the strength of handheld outlet is the Jamar dynamometer, by which we evaluate the strength of the flexor muscles in the five outlet positions, which are permitted by the instrument, to better quantify the power of intrinsic and extrinsic muscles. This tool allows us to compare the healthy limb to the contralateral side and allows us to compare the values of the reference tables which take into account the characteristics of the job position and/or age. The second evaluative tool that we use is the Total Shoulder whose dedicated software detects the strength and power values expressed by the patient in isometric mode. The integration of the two devices allows us a proper training program around the upper limb and above allows us to determine the outcome, thus allowing return to sports. Depending on the lesion also, or the psychological state of the sportsman or simply the type of global exercise that we propose, our team makes use of some functional supports in order to provide a greater mechanical stability and a minor psychological apprehension: the tape neuromuscular (TNM) and the neoprene brace. The TNM is a functional bandage; a colored tape that is applied does not release drugs. All available assessments are static and above all do not measure the movement alterations during high training to which the elbow of a professional athlete is subjected. In biomechanical studies involving overhead athletes already in the literature, “focus mainly on the movement of” the humerus relative to the scapula and shoulder blade than the chest. With respect to the elbow are data exclusively to the flexion-extension (sagittal plane) and supination to pronation (transverse plane). Yet we know that the pathologies that involve more sports at a high level inherent to the elbow concern more with the instability of the medial/lateral compartment movement varus/valgus (frontal plane). It is therefore important to be able to understand if these new technologies are able to provide relevant information on this area, especially in dynamic movements. From this theoretical assumption, we have started a preliminary study analyzing some patients to see if this type of system is able to provide a reliable figure for the dynamic measurement of this particular corner.