Musculoskeletal Screening Tool for the Overhead Athlete
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Musculoskeletal Screening Tool for the Overhead Athlete Chris Ham, ATC, Kerry Wilbar, ATC, Justin Wenzel, ATC, Shannon Gordon, ATC, Tim Lee, ATC, Jon Demarie, ATC. Research Questions.

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Musculoskeletal Screening Tool for the Overhead Athlete

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Musculoskeletal Screening Tool for the Overhead Athlete

Chris Ham, ATC, Kerry Wilbar, ATC, Justin Wenzel, ATC, Shannon Gordon, ATC, Tim Lee, ATC, Jon Demarie, ATC


Research Questions

  • What screening tools should be used on overhead athletes that will help prevent the loss of play through reducing the incidence of injury?

  • What is the relationship between lower extremity/core deficiencies and the injuries sustained in the upper extremity?

  • Will athletes who have deficiency indicators found during a screening benefit from an appropriate core strengthening and deficiency specific treatment protocol?


Methodology

  • Subgroups were created to focus on and critically evaluate the literature for the different areas of our project.

    • Group 1: Examined the glenohumeral joint and upper extremity

    • Group 2: Looked at the scapula and its role in the screening process

    • Group 3: Evaluated the literature on the hips/core and their role in the kinetic chain.

  • All subgroups have compiled evidence-based literature in the respective areas to establish the criteria for our screening to and its utility for the overhead athlete.


Research Goals

  • A screening tool will aid in properly identifying risk factors to reduce incidence of injury

  • Identifying these factors in advance will decrease the amount of time lost to injury by the athletes requiring more extensive rehab

  • Properly identifying and treating conditions in a proactive manner can reduce inherent costs associated with treatment


Screening Tool – Assessing Posture

  • Areas of concern/focus

    • Head Forward

    • Rounded/Forward Shoulders

    • Lateral Spine Curvature

    • Level Hips

    • Scapular Winging (Standing Posture)

    • Scapular Rhythm

    • Prominence of Scapula (Yes/No)

      • Inferior Medial Border

      • Entire Medial Border

      • Superior Medial Border


Screening Tool – Range of Motion ROM

  • Wrist – Measured Bilaterally

    • Flexion

    • Extension

  • Shoulder – Measure Bilaterally

    • Flexion

    • Extension

    • Abduction (ABD)

    • Internal Rotation (IR) @ 90 Degrees

    • External Rotation (ER) @ 90 Degrees

    • Horizontal Abduction Internal Rotation (HAIR)

    • Total Arc (IR + ER)


Screening Tool – Range of Motion (ROM)

  • Hips – Measured Bilaterally

    • Flexion

    • Abduction

    • Internal Rotation (IR)

    • External Rotation (ER)

  • Hamstrings and Quadriceps – Measured Bilaterally

    • 90 Degree Extension lag

    • Straight Leg

    • Knee Flexion

    • Thomas Test (Lack Hip Ext and Knee Flex < 45)

      • Pass/Fail

    • Thomas – Rectus Femoris Lag (Knee Flex <45)

      • Pass/Fail


Screening Tool – Kinetic Chain

  • Assessing Kinetic Chain

    • Trendelenburg Test

    • Single Leg Squat


Pathological Red Flags

  • Glenohumeral Internal Rotation Deficit (GIRD)

    • If the total arc of motion has a difference greater than 20 degrees, compared bilaterally, it is considered significant

  • SICK Scapula

    • Asymmetrical malpositioning of the scapula

    • Results in scapular dyskinesis

  • Hip Mobility

    • Hips are critical in the transfer of energy

    • Any loss of hip mobility, will lead to loss of energy or misdirection of that energy


Core and Upper Extremity Injuries

  • Literature lacks true definition of “core”

    • What musculoskeletal structures should be included in this region?

    • Many Facets have been examined

      • The lack of a defined “core” and the muscles that may be involved have led to the ambiguity of the research being conducted


Assessment – Year One

  • A review of current literature focusing on the measurements associated with posture, glenohumeral ROM, scapular positioning, lower extremity ROM, and core strength were used to construct a musculoskeletal screening tool

  • Data encompassing a criterion of indicators and pathologies in the kinetic chain that affect overhead athletes were, and will be collected


Assessment- Year Two

  • Intervention

    • “Core” strengthening and deficiency specific treatment protocol

      • An intervention program will be designed based upon the specific indicators or pathologies noted during the screening tool


Project Timeline

  • Now through August 2009

    • Complete literature review on corrective exercises for pathological deficiencies identified with screening tool

  • September – December 2009

    • Develop treatment plan for individual areas that need to be addressed as a result of screening

  • January 2010

    • Begin rough draft

  • March 2010

    • Presentation of Data

  • May 2010

    • Poster Fair


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