jesse totoro.  anatomical mechanisms  biomechanical mechanisms

Download Jesse Totoro.  Anatomical Mechanisms  Biomechanical Mechanisms

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  • Slide 1
  • Jesse Totoro
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  • Anatomical Mechanisms Biomechanical Mechanisms
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  • Short Term: -Rest -Reduce Pain -Reduce Inflammation -Begin ROM exercises -Begin resistance exercises Long Term -Full ROM -Full Strength -Pain free -Psychologically prepared for safe return
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  • A progressive rehabilitation protocol based on the healing phase should be implemented: -Inflammatory Phase (0-2 weeks) -Sub-Acute Phase (2-4 weeks) -Tissue Remodeling Phase (4-6 weeks)
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  • Goals: -Rest -Reduce pain -Reduce any inflammation -Begin ROM exercises (within pain tolerance) Modality for pain modulation (Ice and E-Stim) Flexibility Criteria for progression -Pain starts to decrease -Inflammation becomes reduced -Exercises become too easy for the athlete
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  • Important factor in the rehabilitation process Can help decrease the onset of re-injury Helps to increase performance Should not be performed with acute pain
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  • Sleeper Stretch -Can be performed at 70, 90, and 110 degrees of motion. Biceps -Make sure palm is facing up when performing this stretch.
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  • Goals: -Continue with stretching protocol -Introduce CV endurance (elliptical for upper extremity) -Continue to reduce pain/inflammation -Continue to increase strength and ROM Joint Mobilizations Resistance Training can begin Continue with modalities to modulate pain Criteria for Progression: -Athlete feels significant reduction in pain -Significant improvements in ROM -Very little to no swelling -Athlete is not challenged by resistance exercises
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  • Swelling reduced Provides a precise stretch Tensile forces applied over time 2-3 oscillations per second Allowing capsular tissue to remodel in an elongated position. Remember the convex/concave rule!!!
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  • Inferior Glide Posterior Glide Anterior Glide Long Axis Traction
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  • Progress from light to heavy resistance Easy to complex exercises Stable to unstable surfaces Do not perform resistance training with acute pain!!
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  • Theraband/Theratubing Exercises Scapular Stabilizer Strength
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  • D1 and D2 patterns
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  • Goals: -Begin more sport specific exercises -Throwing program -Overhead activities -Acquire full ROM -Pain free -Full strength Athlete should be preparing for functional testing and RTP
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  • Functional test should include sport specific maneuvers (throwing, blocking, tackling, etc.) Athlete should meet the following criteria before RTP: -Ability to have full ROM -Perform all overhead tasks the sport demands -NO PAIN!! -Full strength (specifically rotator cuff musculature) -Should be able to perform all tasks at full speed
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  • Dont do too much too soon!! Stretching, Stretching, and more Stretching!! Be creative with rehab!!
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  • Michener L, McClure P, Karduna A. Anatomical and biomechanical mechanisms of subacromial impingement syndrome. Clinical Biomechanics. 2003;18:369-379. Conroy D, Hayes K. The effect of Joint Mobilization as a component of comprehensive treatment for primary shoulder impingement syndrome. J Orthop Sports Phys Ther. 1998;28:3-14. Bang M, Deyle G. Comparison of supervised exercise with and without manual physical therapy for patients with shoulder impingement syndrome. J Orthop Sports Phys Ther. 2000;30:126-137.