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Paper 223: Etiology of Shoulder Injuries in SA Tennis Players
ABSTRACTS imental group (n⫽20) for the rehabilitation model or a control group (n⫽20). Data were collected from patients recently injured and at 4, 6 and 12 months after the injury. The self-administrated instruments K-SES, Tegner activity score, Physical Activity Score (PAS), Knee Injury and Osteoarthritis Outcome Score (KOOS) Lysholm and Multidimensional Health Locus of Control (MHLC) were used as outcome measures. Twenty-four patients, 12 in each group, completed the 12 month follow-up. Results: There was a significant increase in both the experimental and control group for K-SESpresent (p⫽0.005 and p⫽0.003), KOOSsport (p⫽0.005 and p⫽0.044), and KOOSqol (p⫽0.014 and p⫽0.041) at the 12 month follow-up. Both groups revealed a significantly lower physical activity level (Tegner) (p⫽0.009 and p⫽0.036) at the 12 month follow up. The control group had also a significantly lower score for physical intensity and frequency (PAS) (p⫽0.020) and internal locus of control (MHLC) (p⫽0.026) at the 12 month follow-up. No significant differences were found between the experimental group and the control group at inclusion or at the 12 month follow-up for any of the outcome measures. Conclusion: Increased self-efficacy of knee function as well as subjective satisfaction with knee symptoms and function was achieved in both groups. The experimental group, however, did not decrease in physical intensity and frequency and internal locus of control, which may be an important aspect for future function and possible surgical intervention. Key Words: Self-efficacy, physical activity, symptoms, function, locus of control, self-administrated instruments
Paper 223: Etiology of Shoulder Injuries in SA Tennis Players DANIEL FRANCOIS MORKEL, MD, SOUTH AFRICA, PRESENTING AUTHOR RICHARD DE VILLIERS, SOUTH AFRICA JUSTHINUS BARNARD, PHD, SOUTH AFRICA PIETER POLDERMAN, MD, SOUTH AFRICA , CHARL VAN DEN BERG, MD, SOUTH AFRICA ABRAHAM JOHANNES LAMBRECHTS, MB.CH.B(PRET.)M.MED(ORTH.)(PRET.), SOUTH AFRICA NEIL RUBEN KRUGER, MD, SOUTH AFRICA ABSTRACT Background: Shoulder injuries are the most common upper limb injuries in first class tennis players and there is little information on the etiology. The pathology in the painful shoulder in tennis is often equated to be the same as other overhead sports like in baseball pitcher’s injuries. Studies have shown an increased external rotation
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and decreased internal rotation, due to posterior capsule tightness, in the dominant arm in tennis players. Objectives: A study was performed trying to find a relationship between difference in ranges of movement, grip position on racket on serve and average speed of service on shoulder symptoms and objective ultrasound findings in a cohort of first class tennis players in South Africa. Subjects: Our study consisted of 76 players that were recruited at the yearly senior interprovincial tennis tournament. Methods: A detailed history was taken, taking into consideration level of competitiveness, years of playing, position of grip on the racket, amount of serves in training, shoulder injuries, previous treatment and preventative measures taken. Objective ranges of movement of dominant and nondominant shoulders were done and high definition ultrasound was performed on all dominant shoulders. The player’s speed of service was also recorded with a radar device. Results: 20 players reported previous acute and chronic shoulder pain. Dominant shoulder on the male tennis players showed tendency for increased range of external rotation (p⫽.05) and a significant decrease in internal rotation in 90° abduction (p⬍ .05). Although there was an increased external rotation in female players (p⬍.01), in the dominant shoulder, there was not a resultant decreased internal rotation. There was no difference in ultrasound rotator cuff pathology and shoulder symptoms compared to average service speed, amount of serves in training, racket grip position and level of competition. No differences in range of movement in players with shoulder injuries Conclusions: 1) The dominant shoulder of tennis players showed to have an increased range of external rotation in males and females compared to non-dominant side 2) In male tennis players there was a decreased range of internal rotation on the dominant side compared to non-dominant shoulder. 3) No correlation between grip positions, speed of service, years and level of competition and shoulder injuries or ultrasound pathology could be found 4) No correlation between differences in range of movement in shoulders and shoulder injuries or ultrasound pathology could be found. Paper 224: Efficacy of the F-MARC 11 and the FMARC 11ⴙa Training Program on Collegiate Football Teams MASAKATSU SETOJIMA, MD, JAPAN, PRESENTING AUTHOR
Paper 223: Etiology of Shoulder Injuries in SA Tennis Players DANIEL FRANCOIS MORKEL, MD, SOUTH AFRICA, PRESENTING AUTHOR RICHARD DE VILLIERS, SOUTH AFRICA JUSTHINUS BARNARD, PHD, SOUTH AFRICA PIETER POLDERMAN, MD, SOUTH AFRICA , CHARL VAN DEN BERG, MD, SOUTH AFRICA ABRAHAM JOHANNES LAMBRECHTS, MB.CH.B(PRET.)M.MED(ORTH.)(PRET.), SOUTH AFRICA NEIL RUBEN KRUGER, MD, SOUTH AFRICA ABSTRACT Background: Shoulder injuries are the most common upper limb injuries in first class tennis players and there is little information on the etiology. The pathology in the painful shoulder in tennis is often equated to be the same as other overhead sports like in baseball pitcher’s injuries. Studies have shown an increased external rotation
e467
and decreased internal rotation, due to posterior capsule tightness, in the dominant arm in tennis players. Objectives: A study was performed trying to find a relationship between difference in ranges of movement, grip position on racket on serve and average speed of service on shoulder symptoms and objective ultrasound findings in a cohort of first class tennis players in South Africa. Subjects: Our study consisted of 76 players that were recruited at the yearly senior interprovincial tennis tournament. Methods: A detailed history was taken, taking into consideration level of competitiveness, years of playing, position of grip on the racket, amount of serves in training, shoulder injuries, previous treatment and preventative measures taken. Objective ranges of movement of dominant and nondominant shoulders were done and high definition ultrasound was performed on all dominant shoulders. The player’s speed of service was also recorded with a radar device. Results: 20 players reported previous acute and chronic shoulder pain. Dominant shoulder on the male tennis players showed tendency for increased range of external rotation (p⫽.05) and a significant decrease in internal rotation in 90° abduction (p⬍ .05). Although there was an increased external rotation in female players (p⬍.01), in the dominant shoulder, there was not a resultant decreased internal rotation. There was no difference in ultrasound rotator cuff pathology and shoulder symptoms compared to average service speed, amount of serves in training, racket grip position and level of competition. No differences in range of movement in players with shoulder injuries Conclusions: 1) The dominant shoulder of tennis players showed to have an increased range of external rotation in males and females compared to non-dominant side 2) In male tennis players there was a decreased range of internal rotation on the dominant side compared to non-dominant shoulder. 3) No correlation between grip positions, speed of service, years and level of competition and shoulder injuries or ultrasound pathology could be found 4) No correlation between differences in range of movement in shoulders and shoulder injuries or ultrasound pathology could be found. Paper 224: Efficacy of the F-MARC 11 and the FMARC 11ⴙa Training Program on Collegiate Football Teams MASAKATSU SETOJIMA, MD, JAPAN, PRESENTING AUTHOR