From April 1, 1985, through June 30, 1987, 25 skilled athletes with shoulder pain secondary to anterior glenohumeral instability that had failed to improve with conservative therapy had an anterior capsulolabral reconstruction. All but one athlete completed a formal rehabilitation program with an average followup of 39 months. The results at followup were rated excellent in 68%, good in 24%, fair in 4%, and poor in 4%. Seventeen patients returned to their prior competitive level for at least 1 year. This operation and rehabilitation program may allow many athletes who participate in overhand activities or throwing sports to return to their prior level of competition.

Context:Vitamin D is a potent secosteroid hormone that provides many skeletal and extraskeletal health benefits. Musculoskeletal injury prevention and recovery are potentially affected by sufficient circulating levels of the storage form of vitamin D: 25-hydroxyvitamin D3, or 25(OH)D. Vitamin D deficiency can exist among young, active, and healthy people, which may put them at increased risk for injury and prolonged recovery.Evidence Aquisition:PubMed was searched using vitamin D and skeletal muscle, vitamin D and athletic performance, and vitamin D review articles. Studies from the 1930s to 2012 were used for the review.Results:There is strong correlation between vitamin D sufficiency and optimal muscle function. Increasing levels of vitamin D reduce inflammation, pain, and myopathy while increasing muscle protein synthesis, ATP concentration, strength, jump height, jump velocity, jump power, exercise capacity, and physical performance. 25(OH)D levels above 40 ng/mL are required for fracture prevention, including stress fractures. Optimal musculoskeletal benefits occur at 25(OH)D levels above the current definition of sufficiency (> 30 ng/mL) with no reported sports health benefits above 50 ng/mL.Conclusions:Vitamin D deficiency is common in athletes. For athletes presenting with stress fractures, musculoskeletal pain, and frequent illness, one should have a heightened awareness of the additional likely diagnosis of vitamin D deficiency. Correction of this deficiency is completed by standardized and supervised oral supplementation protocols producing significant musculoskeletal sports health benefits.

Lateral epicondylitis occurs frequently in tennis players and appears to be caused by tears in the extensor aponeurosis. The purpose of this study was to compare the electromyographic activities of 5 muscles in players with lateral epicondylitis with those of injury-free players during the single-handed backhand tennis stroke. Finewire electrodes were placed into the extensor digitorum communis, extensor carpi radialis longus and brevis, pronator teres, and flexor carpi radialis muscles in competitive tennis players; 8 players had lateral epicondylitis and 14 had normal upper extremities. The backhand stroke then was recorded on high-speed film and synchronized with the electromyographic signal. The injured players had significantly greater activity for the wrist extensors and pronator teres muscles during ball impact and early follow-through. This activity increase may have been caused by the abnormal mechanics evident on film, including a "leading elbow," wrist extension and an open racquet face near the time of ball impact, and ball contact in the lower half of the strings. These mechanics not only result in a lower level of play but also leave the wrist extensors and the pronator teres muscles vulnerable to injury. This is the first study that documents increased activity in muscles that have been previously injured.

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