International SportMed Journal - Volume 6, Issue 2, 2005
Volume 6, Issue 2, 2005
Author Rafael BahamondeSource: International SportMed Journal 6, pp 42 –63 (2005)More Less
<I>Objective:</i> The objective of this review is to summarise the published research available on the biomechanics of the elbow joint during the performance of different tennis strokes and the implications in sports medicine. <br><I>Data sources:</I> Academic Search Elite, PubMed, INFOTRAC and SportDiscus were use to search for related sources using a combination of terms such as: elbow, biomechanics, tennis, torques, kinetics, kinematics, forces, serve, backhand, forehand, tennis elbow, valgus overload, and tennis injuries from 1966-2004. Reference sections of key sources were also searched. <br><I>Study selection:</I> Ninety-six resources were selected based on how relevant and important they were in relation to the stated objective. <br><I>Data extraction:</I> The results presented in this review are the interpretation and summary of the author. No meta-analysis procedures were used in the presentation of the results. <br><I>Data synthesis:</I> The elbow joint complex undergoes a forceful extension and pronation during the tennis serve but these torques are small compared to the varus torque exerted as the results of the external rotation motion of the upper arm and the internal rotation torque transmitted through the humerus onto the elbow. A similar mechanism occurs during the forehand stroke making the medial aspect of the elbow joint susceptible to injuries. During the backhand stroke, the elbow joint extends and it seems to supinate, but little is known about the kinetics (force and torques) of the one and two-handed backhand. Racquet impact data (hand forces, accelerations, and goniometric) seem to support the hypothesis that tennis elbow is caused by the initial shock wave that creates an eccentric overload of the forearm muscles. <br><I>Conclusions:</I> The kinematics of the elbow during the tennis serve are well established but there exists a need for more kinetic and kinematics studies on all tennis strokes, especially on the backhand and forehand strokes. Future research needs to investigate how the effects of the different techniques, such as grip type, stance type, forehand and backhand type and poor techniques (leading elbow, off-centre hits, and hitting off the back foot) affect the elbow mechanics. Once kinetic models are developed, research should focus on the creation of computer simulations to provide information on technique modification in an effort to reduce the large mechanical loads placed at the elbow.
Author Basil C. VrettosSource: International SportMed Journal 6, pp 64 –83 (2005)More Less
<I>Objectives:</I> This review details the clinical approach to chronic injuries of the elbow and describes not only the common conditions occurring but those which are less common and about which the physician should be aware. <br><I>Data sources:</I> A thorough search of the MEDLINE database was conducted, using the individual conditions as search items. <br><I>Study section:</I> The information in this review is taken from the author's own experience, a review of articles and classical textbooks on the different conditions. <br><I>Conclusions:</I> Most elbow injuries occur as chronic repetitive overuse injuries and are related to the duration and intensity of the exercise. They can be diagnosed with a detailed history and thorough examination in most cases, special investigations are often not required. The physician must be aware of the less common conditions, particularly instability, where the history is the more useful and the examination finding often subtle. Decreased range of motion and in particular loss of extension usually signifies intra-articular pathology. Most conditions are treated with non-operative methods. Arthroscopy has become a useful tool in diagnosis and treatment.
Source: International SportMed Journal 6, pp 84 –98 (2005)More Less
<I>Objective:</I> A thorough review of the literature regarding fracture management of injuries to the elbow was reviewed, with emphasis placed on the care of the athlete. <br><I>Data sources:</I> The MEDLINE electronic database was searched from its inception to August 2004 with the following terms: elbow joint, athletic injuries, radius fractures, ulna fractures, Monteggia fractures, dislocations, and humerus fractures. <br><I>Study section:</I> Review articles, book chapters, original research, and case reports were used to construct this review. <br><I>Data extraction:</I> Results from the literature search were reviewed by the authors and selected to pertain to the treatment of the athlete. Studies with treatment and prognostic information were preferentially outlined and reviewed. <br><I>Data synthesis:</I> Proximal radius, coronoid, olecranon, Monteggia, and distal humerus fractures, as well as elbow dislocations, were thoroughly reviewed with regard to diagnosis, treatment, and prognosis. <br><I>Conclusions:</I> Most fractures about the elbow have a good prognosis for return to sport. Many can be treated conservatively with protected but early range of motion. More complex elbow fractures and dislocations require precise diagnosis and surgical treatment for optimal outcome, and the prognosis for return to sport is more guarded in these circumstances.
Author David RingSource: International SportMed Journal 6, pp 99 –123 (2005)More Less
Distal humerus fractures are relatively uncommon in athletes, but are becoming more common in sports such as snowboarding. Recognition of injury pattern is particularly important as complex articular comminution may be present even when the fracture looks like a simple capitellum fracture. Techniques of internal fixation continue to evolve, particularly for these more complex fractures.
The effects of forearm brace tension on neuromuscular performance in subjects with lateral humeral epicondylosis : a review : review articleAuthor Gabriel NgSource: International SportMed Journal 6, pp 124 –129 (2005)More Less
Lateral humeral epicondylosis (tennis elbow) is a common clinical condition affecting the middle-aged group in particular. Its usual clinical managements include therapeutic exercises, electro-physical treatments and forearm counterforce bracing. This paper reviews the effects of forearm bracing in terms of the neuromuscular performances. There is evidence that forearm counterforce bracing can increase the stretching pain threshold of the forearm extensor muscles in both the uninjured and people with lateral epicondylosis, but it does not seem to have significant effects on the strength, proprioception and stretch reflex latency of the forearm muscles. The effect on the pain threshold may depend on the tension in the brace - up to 50N of brace tension was found to be better than lower tension levels in uninjured subjects and those with symptoms of lateral epicondylosis.