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Internal impingement is a commonly described cause of shoulder pain in the overhead athlete, particularly in tennis players. Three shoulder dysfunctions, often correlated with internal impingement symptoms, require attention in the rehabilitation strategy of internal impingement in the tennis player: (1) acquired glenohumeral anterior instability, (2) loss of internal rotation range of motion, and (3) lack of retraction strength. Based on recent literature, the following guidelines are proposed in the rehabilitation of the tennis player with internal impingement symptoms: (11 shoulder rehabilitation should be integrated into kinetic chain training, not only in the advanced phases of the athlete's rehabilitation, but from the initial phases; (2) both angular and translational mobilisations can be used in the treatment of acquired loss - of glenohumeral internal rotation range of motion to stretch the posterior structures of the glenohumeral joint; and 3) in the rehabilitation of scapular dyskinesis, the therapist should focus on restoration of intramuscular trapezius muscle balance in the scapular exercises, with special attention to strength training of the retractors. [ABSTRACT FROM AUTHOR]

We compared normalized trapezius muscle activity and intramuscular balance ratios between overhead athletes with impingement symptoms and non-injured athletes during isokinetic abduction and external rotation movements. Thirty-nine overhead athletes with chronic impingement symptoms and 30 non-injured athletes participated in the study. Electromyographic activity of upper, middle, and lower trapezius was measured during isokinetic abduction and external rotation, using surface electrodes. The results show a significant increase of upper trapezius activity during both movements in the patient group, with decreased activity in the lower trapezius during abduction, and in the middle trapezius during external rotation. Analysis of the intramuscular activity ratios revealed muscle imbalance on the injured side of the patient group for upper/middle trapezius and upper/lower trapezius during abduction, and for all three muscle activity ratios during external rotation. These results confirm the presence of scapular muscle imbalances in patients with impingement symptoms and emphasize the relevance of restoration of scapular muscle balance in shoulder rehabilitation. [ABSTRACT FROM AUTHOR]

The objective of this prospective study was to evaluate isokinetic muscle strength and functional outcome following surgical rotator cuff repair in patients with full-thickness tears compared to preoperative results and compared to normal values. Twenty-four patients and 29 healthy subjects participated in the study. We measured isokinetic lateral and medial rotation strength in the patient group prior to surgery, and 18 months postoperatively on both sides and performed the same evaluation procedure in the control group in a single assessment. Constant-Murley scores were taken for assessment of the patient's functional abilities. Pre-operative strength averaged 55.4%, 68.6%, 66% and 79.7% for lateral and medial rotation at 60 degrees/sec, and lateral and medial rotation at 180 degrees/sec respectively, compared to the control group. Eighteen months postoperative strength increased significantly compared to the non-injured side (p<0.05) for the measurements at 60 degrees/sec and nearly reached normal strength values since no group differences were apparent in the postoperative session. Measurements at 180 degrees/sec did not show significant improvement. Constant-Murley scores increased significantly from 40.4 preoperatively, to 68 postoperatively. However, these scores did not attain the normal values from the control group. It was concluded that although significant strength gains are present 18 months after rotator cuff repair, shoulder function is not completely normalised. Clinicians should pay attention to full functional restoration in the rehabilitation program. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To determine if the muscle force and electromyographic activity in the scapular rotators of overhead athletes with impingement symptoms showed differences between the injured and non-injured sides. METHODS: Isokinetic peak force was evaluated during protraction and retraction of the shoulder girdle, with simultaneous recording of electromyographic activity of the three trapezius muscles and the serratus anterior muscle, in 19 overhead athletes with impingement symptoms. RESULTS: Paired t tests showed significantly lower peak force during isokinetic protraction at high velocity (p<0.05), a significantly lower protraction/retraction ratio (p<0.01), and significantly lower electromyographic activity in the lower trapezius muscle during isokinetic retraction on the injured side than on the non-injured side (p<0.05). CONCLUSION: These results confirm that patients with impingement symptoms show abnormal muscle performance at the scapulothoracic joint. [ABSTRACT FROM AUTHOR]

Examines the efficacy of the oral antidepressant trazodone in patients with erectile dysfunction but without major organic findings. Derogatis sexual functioning inventory; Quality of partner relation; Depressive symptomatology.

A 37-year-old sports teacher suffering from idiopathic haemochromatosis with arthropathy of the MP joints has been treated and followed-up by us for 4 years. Three out of four affected MP joints were treated with arthroscopic operations; one of these had been treated elsewhere previously by arthrotomy. This article presents a brief review of the condition and its treatment by arthroscopic surgery with detailed technique. We believe that MP joint arthroscopy in certain cases is an alternative to open surgery and gives excellent results. No specific instruments are needed apart from a standard small joint arthroscopy set. [ABSTRACT FROM PUBLISHER]