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Biomedical subjects

W Ben Kibler

Publications and source records attributed to W Ben Kibler.

17 recordsLinked to original sources
PubMed2006

Evaluation of apparent and absolute supraspinatus strength in patients with shoulder injury using the scapular retraction test.

BACKGROUND: Physical examination of patients with shoulder injury not involving actual rotator cuff tears frequently demonstrates decreased rotator cuff strength on manual muscle testing. This decrease has been attributed to supraspinatus muscle weakness, but it may be owing to alterations in scapular position. HYPOTHESIS: The position of stabilized scapular retraction, by minimizing proximal kinetic chain factors and providing a stable base of muscle origin, positively influences demonstrated supraspinatus strength. STUDY DESIGN: Controlled laboratory study. METHODS: Supraspinatus strength was tested in 20 injured patients and 10 healthy controls in both the empty-can arm position and a position of scapular retraction using a handheld dynamometer. Pain in both maneuvers was measured by use of a visual analog scale. RESULTS: Paired t tests indicated the scapular retraction position resulted in statistically significantly (P = .001) higher supraspinatus strength values within both groups. There was no significant difference between the 2 positions in visual analog scale scores. CONCLUSION: This study shows that demonstrated apparent supraspinatus weakness on clinical examination in symptomatic patients may be dependent on scapular position. The weakness may be owing to other factors besides supraspinatus muscle weakness, such as a lack of a stable base in the kinetic chain or scapula. CLINICAL RELEVANCE: The clinical examination that addresses scapular posture and includes scapular retraction will allow more accurate determination of absolute supraspinatus muscle strength and allow efficacious rehabilitation protocols to address the source of the demonstrated weakness.

Adult↗
PubMed2006

The pediatric overhead athlete: what is the real problem?

OBJECTIVE: The purposes of this article are to examine shoulder and elbow injuries in pediatric athletes, to evaluate the pathophysiology and pathomechanics that may be associated with the pathoanatomy, and to present suggestions for the prevention of those injuries. DATA SOURCES: This article will review the published sports medicine literature on these topics in baseball and tennis injuries and present a kinetic chain-based perspective on the possible causative factors that are present in the young thrower. RESULTS: The published literature shows that there are multiple intrinsic and extrinsic factors that contribute to the risk of injury in young throwing athletes. These factors appear to develop over time; if not recognized or addressed early, they have undesirable outcomes. CONCLUSIONS: A multitude of factors, including anatomical, biomechanical, and environmental concerns, can contribute to the dysfunction of the shoulder and elbow in young overhead athletes. Understanding the force-generating and load-absorbing processes of the body will help clinicians, coaches, and others prevent or limit the deleterious effects of such occurrences.

Adolescent↗
PubMed2006

The role of core stability in athletic function.

The importance of function of the central core of the body for stabilisation and force generation in all sports activities is being increasingly recognised. 'Core stability' is seen as being pivotal for efficient biomechanical function to maximise force generation and minimise joint loads in all types of activities ranging from running to throwing. However, there is less clarity about what exactly constitutes 'the core', either anatomically or physiologically, and physical evaluation of core function is also variable. 'Core stability' is defined as the ability to control the position and motion of the trunk over the pelvis to allow optimum production, transfer and control of force and motion to the terminal segment in integrated athletic activities. Core muscle activity is best understood as the pre-programmed integration of local, single-joint muscles and multi-joint muscles to provide stability and produce motion. This results in proximal stability for distal mobility, a proximal to distal patterning of generation of force, and the creation of interactive moments that move and protect distal joints. Evaluation of the core should be dynamic, and include evaluation of the specific functions (trunk control over the planted leg) and directions of motions (three-planar activity). Rehabilitation should include the restoring of the core itself, but also include the core as the base for extremity function.

Humans↗
PubMed2006

Scapular involvement in impingement: signs and symptoms.

Normal scapular motion is closely integrated with arm motion to provide efficient scapulohumeral rhythm in shoulder function. This rhythm is often disrupted in patients with symptoms and signs of shoulder impingement. A large percentage of patients with shoulder impingement have scapular dyskinesis and alterations in the normal resting position of the scapula or in dynamic scapular motion. Scapular dyskinesis usually manifests as a loss of control in the motions of scapular external rotation and the translation of scapular retraction. This loss of control results in alteration in timing and magnitude of acromial upward rotation, excessive antetilting of the glenoid, and loss of maximal rotator cuff muscle activation capability. These pathophysiologic and pathomechanical alterations cause or increase the dysfunction associated with impingement. Scapular dyskinesis may have proximal or distal causative factors. Proximal factors are mainly associated with muscle factors, and can usually be treated with rehabilitation. Distal factors are mainly caused by internal derangements of joints and frequently require surgical treatment followed by appropriate rehabilitation. Physical examination techniques that specifically evaluate scapular dyskinesis can identify the causative factors and guide treatment and rehabilitation strategies.

Humans↗
PubMed2005

Tennis injuries.

OBJECTIVE: The purpose of this chapter is to critically review the existing studies on the epidemiology of tennis injuries in pediatric athletes, present suggestions for the prevention of injury based on these studies, and present suggestions for future research. DATA SOURCES: Data sources included published articles on pediatric tennis injuries, a previously published review by the authors, and unpublished data from one of the authors (MS). MAIN RESULTS: Most studies of tennis injuries show that they are of microtrauma origin, develop over time, and result in short times of absence from play. They involve all joints of the body, but have a higher incidence in the shoulder, back, and knee. Intrinsic and extrinsic risk factors may be related to the incidence of injury. These factors may be evaluated by a comprehensive pre-participation exam, and preventive strategies may be implemented. CONCLUSIONS: Most injury studies in pediatric tennis players vary in the population studied, methods of injury evaluation, and risk factors studied. Consequently, few specific conclusions can be derived about the causative factors. Further longitudinal prospective studies need to be done to completely discover all the factors involved in producing tennis injuries.

Athletic Injuries↗
PubMed2004

Kinetic chain contributions to elbow function and dysfunction in sports.

The elbow functions in throwing and other athletic activities as a link in the kinetic chain of force development, regulation, and transfer. Efficient function, with maximal performance and minimal injury risk, requires optimum activation of all the link in the kinetic chain. Injury is often associated with alterations in force production or regulation capabilities in links that may be distant to the site of injury. Evaluation of injured athletes should include screening examinations for these areas, and treatment and conditioning should also include these areas.

Athletic Injuries↗
PubMed2003

Rehabilitation of rotator cuff tendinopathy.

Rehabilitation of the dysfunction that is associated with rotator cuff tendinopathy should be based on the evidence known about the pathoetiology of the tendinopathy, what is known about the extent of the local anatomic injury, the local and distant physiological and biomechanical alterations, and on the knowledge developed regarding progressive loading of the injured or altered structures. Prehabilitation, or prospective exercises to minimize future rotator cuff loading stresses, should be included at the end of rehabilitation as part of the return to function.

Humans↗
PubMed2003

The disabled throwing shoulder: spectrum of pathology Part I: pathoanatomy and biomechanics.

PROLOGUE: Several years ago, when we began to question microinstability as the universal cause of the disabled throwing shoulder, we knew that we were questioning a sacrosanct tenet of American sports medicine. However, we were comfortable in our skepticism because we were relying on arthroscopic insights, clinical observations, and biomechanical data, thereby challenging unverified opinion with science. In so doing, we assembled a unified concept of the disabled throwing shoulder that encompassed biomechanics, pathoanatomy, kinetic chain considerations, surgical treatment, and rehabilitation. In developing this unified concept, we rejected much of the conventional wisdom of microinstability-based treatment in favor of more successful techniques (as judged by comparative outcomes) that were based on sound biomechanical concepts that had been scientifically verified. Although we have reported various components of this unified concept previously, we have been urged by many of our colleagues to publish this information together in a single reference for easy access by orthopaedic surgeons who treat overhead athletes. We are grateful to the editors of Arthroscopy for allowing us to present our view of the disabled throwing shoulder. Part I: Pathoanatomy and Biomechanics is presented in this issue. Part II: Evaluation and Treatment of SLAP Lesions in Throwers will be presented in the May-June issue. Part III: The "SICK" Scapula, Scapular Dyskinesis, the Kinetic Chain, and Rehabilitation will be presented in the July-August issue. We hope you find it thought-provoking and compelling.

Adolescent↗
PubMedDate not supplied

The effect of limb support on muscle activation during shoulder exercises.

The purpose of this study was to determine the difference in demands on glenohumeral musculature during unsupported and supported active range-of-motion (AROM) shoulder exercises. Twenty healthy subjects volunteered for this study. Surface or fine-wire bipolar electrodes were applied to the infraspinatus, posterior deltoid, anterior deltoid, pectoralis major, and supraspinatus muscles. Subjects performed vertical wall slides and diagonal wall slides (45 degrees angle) with their hand in contact with the wall (supported) and not in contact with the wall (unsupported). Significantly greater supraspinatus activity was found in the unsupported exercises versus the supported exercises (F(4,76) = 4.38, P = .003). Exercises performed in the 45 degrees diagonal position were more demanding on shoulder musculature than vertical exercises (F(1,19) = 19.3, P < .001). Although our results were obtained in healthy subjects and the implications in a pathological population are not clear, we suggest that when designing a progression of exercises for increasing shoulder muscular activity, supported short lever arm AROM exercises should precede unsupported long lever arm AROM exercises.

Adult↗
PubMedDate not supplied

Qualitative clinical evaluation of scapular dysfunction: a reliability study.

The purpose of this study was to determine the intrarater and interrater reliability of a clinical evaluation system for scapular dysfunction. No commonly accepted terminology presently exists for describing the abnormal dynamic scapular movement patterns that are commonly associated with shoulder injury. A method of observation was devised for clinical evaluation of scapular dysfunction. Blinded evaluators (2 physicians and 2 physical therapists) were familiarized with the evaluation method of scapular movement patterns before viewing a videotape of 26 subjects with and without scapular dysfunction. Each evaluator was asked to categorize the predominant scapular movement pattern observed during bilateral humeral scaption and abduction motions. Reliability was assessed by a kappa coefficient. Intertester reliability (kappa = 0.4) was found to be slightly lower than intratester reliability (kappa = 0.5). These results indicate that, with refinement, this qualitative evaluation method may allow clinicians to standardize the categorization of dynamic scapular dysfunction patterns.

Adult↗
PubMedDate not supplied

Differences in kinematics and electromyographic activity between men and women during the single-legged squat.

BACKGROUND: Numerous factors have been identified as potentially increasing the risk of anterior cruciate ligament injury in the female athlete. However, differences between the sexes in lower extremity coordination, particularly hip control, are only minimally understood. HYPOTHESIS: There is no difference in kinematic or electromyographic data during the single-legged squat between men and women. STUDY DESIGN: Descriptive comparison study. METHODS: We kinematically and electromyographically analyzed the single-legged squat in 18 intercollegiate athletes (9 male, 9 female). Subjects performed five single-legged squats on their dominant leg, lowering themselves as far as possible and then returning to a standing position without losing balance. RESULTS: Women demonstrated significantly more ankle dorsiflexion, ankle pronation, hip adduction, hip flexion, hip external rotation, and less trunk lateral flexion than men. These factors were associated with a decreased ability of the women to maintain a varus knee position during the squat as compared with the men. Analysis of all eight tested muscles demonstrated that women had greater muscle activation compared with men. When each muscle was analyzed separately, the rectus femoris muscle activation was found to be statistically greater in women in both the area under the linear envelope and maximal activation data. CONCLUSIONS: Under a physiologic load in a position commonly assumed in sports, women tend to position their entire lower extremity and activate muscles in a manner that could increase strain on the anterior cruciate ligament.

Adult↗
PubMedDate not supplied

New vision for health promotion within sports medicine.

Providing medical care for the treatment and prevention of injuries and health problems for competitive or recreational athletes is the most widely recognized role of sports medicine. However, the field is much broader and includes clinical practice and research in many areas related to physical activity in the prevention and treatment of chronic disease. Sports medicine and exercise science involve not only physicians and other licensed health care practitioners but also physiologists, social scientists, epidemiologists, kinesiologists, and other public health and medical professionals. There is overwhelming scientific evidence that a physically active lifestyle is important for optimal health. A key role of sports medicine is to focus the attention of a wide variety of health professionals, educators, and policy makers on developing and implementing strategies to help more individuals enjoy the many health-promoting benefits of regular physical activity.

Athletic Injuries↗
PubMedDate not supplied

Scapular dyskinesis and its relation to shoulder pain.

Scapular dyskinesis is an alteration in the normal position or motion of the scapula during coupled scapulohumeral movements. It occurs in a large number of injuries involving the shoulder joint and often is caused by injuries that result in the inhibition or disorganization of activation patterns in scapular stabilizing muscles. It may increase the functional deficit associated with shoulder injury by altering the normal scapular role during coupled scapulohumeral motions. Scapular dyskinesis appears to be a nonspecific response to shoulder dysfunction because no specific pattern of dyskinesis is associated with a specific shoulder diagnosis. It should be suspected in patients with shoulder injury and can be identified and classified by specific physical examination. Treatment of scapular dyskinesis is directed at managing underlying causes and restoring normal scapular muscle activation patterns by kinetic chain-based rehabilitation protocols.

Athletic Injuries↗