Rehabilitation specialists commonly observe upper-extremity injuries in golfers, baseball players, and tennis players. Traditional nonoperative and postoperative rehabilitation programs for these athletes involve a gradual restoration of range of motion (ROM), strength, muscular endurance, dynamic stabilization, and neuromuscular control. Upon successful completion of the early phases of the rehabilitation program, a gradual and controlled return to sport activities has been advocated by several authors. The term ‘‘interval sport programs’’ has been used to refer to functional rehabilitation guidelines that simulate sport activities. These programs are designed to progressively apply forces to the healing structures and are intended to gradually return the athlete to full athletic competition as quickly and safely as possible. The purpose of this paper is to describe specific interval sport programs currently utilized at our center to return golfers, baseball players, and tennis players to competition following an injury or surgery. In using an interval sport program (ISP) in conjunction with a structured rehabilitation program, the athlete should be able to return to full competition status. The general guidelines and specific programs outlined are used to minimize the chance of reinjury and to facilitate the return of function and confidence in the athlete. The program and its progression should be modified to meet the specific needs of each individual athlete. A comprehensive program consisting of a proper maintenance rehabilitation program incorporating strengthening, flexibility, plyometric, dynamic stabilization, and neuromuscular controls drills, as well as appropriate warm-up procedures and biomechanics, is essential in returning athletes to competition as quickly and safely as possible. J Ortho Sports Ther. 2002; 32(6):293-298.

Study Design: Two-group mixed-model analysis of covariance and correlation analysis.

Objectives: To determine whether differences in humeral translations exist between patients with shoulder impingement symptoms and an asymptomatic comparison group, and if so, to determine if shoulder range-of-motion (ROM) measures are associated with abnormal translations.

Background: Abnormal translations of the humeral head are believed to reduce the available subacromial space and to contribute to the development or progression of shoulder impingement symptoms. These abnormal translations have also been theorized to be related to tightness of the posterior capsule and decreased shoulder ROM.

Methods and Measures: Three-dimensional humeral translations were tracked in symptomatic construction workers and an asymptomatic comparison group while elevating the arm in the scapular plane under no-load, 2.3-kg, and 4.6-kg hand-load conditions. Between-group comparisons were made across 3 phases of motion (30°–60°, 60°–90°, and 90°–120°) and the association between humeral translations and cross-body adduction and shoulder internal rotation ROM measures were determined by Pearson correlation analysis.

Results: Persons with shoulder symptoms demonstrated small but significant changes in anterior-posterior translations of the humerus. These changes for the 90°–120° phase of humeral elevation were moderately negatively associated with available cross-body adduction ROM.

Conclusions: The identified kinematic deviations are consistent with possible reductions of the subacromial space. Further study of relationships between posterior capsule tightness, rotator cuff function, and abnormal humeral translations is warranted to better delineate underlying kinematic mechanisms that may contribute to shoulder impingement symptoms and to refine rehabilitation techniques.

J Orthop Sports Phys Ther. 2002; 32(6):248–259.

Key Words: biomechanics, kinematics, shoulder motion abnormalities

Glenohumeral joint instability is a common pathology observed in the orthopedic and sports medicine settings. Overhead athletes often exhibit a certain degree of acquired laxity that can lead to various pathologies. Unfavorable results often observed with traditional open procedures to correct instability in the overhead athlete have led to the development of arthroscopic thermal-assisted capsular shrinkage (TACS). TACS is not commonly used as an isolated procedure in overhead athletes; various procedures are often performed concomitantly. The overall outcome greatly depends on a postoperative rehabilitation program that must be assessed and adjusted frequently based on several factors. Knowledge of the basic science of TACS as well as emphasis on dynamic stabilization, proprioception, and neuromuscular control are vital to the rehabilitation program for overhead athletes. The purpose of this paper is to discuss the basic science and clinical application of thermal-assisted capsular shrinkage of the glenohumeral joint as well as the postoperative rehabilitation for the overhead athlete and the patient with congenital laxity and related multidirectional instability. J Orthop Sports Phys Ther. 2002; 32(6):268–292. Key Words: dynamic stabilization, glenohumeral instability, neuromuscular control, overhead athlete, SLAP lesions