Nine athletes (seven football offensive linemen, one defensive lineman, and one lacrosse player) were found at arthroscopy to have posterior labral detachment from the glenoid. In our series, this lesion is specific to contact athletes who engage their opponents with arms in front of the body. All patients had pain with bench pressing and while participating in their sport, diminishing their ability to play effectively. Conservative measures were ineffective in relieving their symptoms. Examination under anesthesia revealed symmetric glenohumeral translation bilaterally, without evidence of posterior instability. Treatment consisted of glenoid rim abradement and posterior labral repair with a bioabsorbable tack. All patients returned to complete at least one full season of contact sports and weightlifting without pain (minimum follow-up, > or = 2 years). Although many injuries leading to subluxation of the glenohumeral joint occur when an unanticipated force is applied, contact athletes ready their shoulder muscles in anticipation of impact with opponents. This leads to a compressive force at the glenohumeral joint. We hypothesize that, in combination with a posteriorly directed force at impact, the resultant vector is a shearing force to the posterior labrum and articular surface. Repeated exposure leads to posterior labral detachment without capsular injury. Posterior labral reattachment provides consistently good results, allowing the athlete to return to competition.

A 4-year prospective review of lost-time injuries and facial lacerations was performed for a National Collegiate Athletic Association Division I, intercollegiate ice hockey team. The total injury exposure time consisted of 798.5 practice hours and 163 games. There were 16 facial lacerations, with an incidence of 14.9 per 1000 player-game hours and 0.1 per 1000 player-practice hours; both incidences were found to be less than in previous comparable studies where the use of face masks was not mandatory. In addition, there were eight lost-time head and neck injuries that accounted for 6.3% of all lost-time injuries. We found that the mandatory use of face masks in intercollegiate ice hockey results in a reduction in facial lacerations and no increase in overall head and neck injuries.

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Context Upper extremity (UE) musculoskeletal injuries are common in baseball athletes due to the increased demand placed on the UE. The link between risk factors for UE musculoskeletal injuries and baseball athletes' perceived UE function and pain, as measured by the Kerlan-Jobe Orthopaedic Clinic (KJOC) questionnaire, is unclear. Objective To (1) describe the musculoskeletal characteristics of the UE (posture, range of motion, flexibility, and isometric strength) in a population of baseball athletes and (2) determine the predictive capability of UE musculoskeletal characteristics for the KJOC score in these athletes. Design Cohort study. Setting Athletic training room. Patients or Other Participants A total of 37 male National Collegiate Athletic Association Division I baseball athletes (age = 20.10 ± 1.27 years, height = 186.96 ± 7.64 cm, mass = 90.60 ± 10.69 kg). Intervention(s) Athletes self-reported all shoulder musculoskeletal injuries and completed the KJOC questionnaire. Postural assessment consisted of forward head and shoulder posture. Flexibility tests characterized glenohumeral internal and external rotation, posterior shoulder tightness, and pectoralis minor length. Strength tests involved the lower and middle trapezius, rhomboid, glenohumeral internal and external rotation, pectoralis major, serratus anterior, supraspinatus, and upper trapezius. Main Outcome Measure(s) All 10 KJOC questions were summed for an overall score out of 100. Questions 1 through 5 were summed for a pain score; questions 6 through 10 were summed for a function score. All data were assessed for normality. A stepwise multiple regression model was fit to determine if the predictor variables assessed could predict the KJOC score. We set the α level a priori at .05. Results For the KJOC total score, a 1-year history of shoulder injury accounted for 7.80% of the variance in the KJOC total score (P = .07). For KJOC questions 1 through 5, a history of UE injury in the year before testing and posterior shoulder tightness accounted for 14.40% of the variance in the KJOC total score (P = .047). Conclusions The link between a history of UE musculoskeletal injuries and the KJOC score highlights the need for continued focus on self-perceived pain and function after UE musculoskeletal injury.

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