Hip injuries in the overhead athlete.

BACKGROUND: The overhead athlete is at risk for shoulder and elbow injuries. However, the mechanics associated with overhead sports also place athletes at risk for hip injuries. Advancements in hip arthroscopy have identified femoroacetabular impingement (FAI) and instability as potential contributors to labral and chondral pathology in this athletic population. QUESTIONS/PURPOSES: We therefore determined whether hip function improves after arthroscopic treatment of FAI in overhead athletes and the rate at which overhead athletes returned to preinjury level of play. METHODS: We retrospectively identified high-level baseball and lacrosse players (varsity high school, collegiate, and professional) who underwent arthroscopic treatment for FAI. Thirty-four athletes with an average age of 21.4 years met study criteria. There were 16 baseball players and 18 lacrosse players. All patients completed modified Harris hip scores and were assessed for ability to return to preinjury level of play. The minimum followup was 12 months (average, 25 months; range 12-41 months). RESULTS: Mean modified Harris hip scores improved from 70 to 92. Thirty-three of 34 patients were able to return to preinjury level of sports participation. CONCLUSIONS: Arthroscopic management of hip injuries in the high-level overhead throwing athlete can result in a high rate of return to play. Mechanical overload of the hip from impingement and secondary instability can have a substantial effect on hip function and may be the cause of deterioration in athletic performance in some cases. LEVEL OF EVIDENCE: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

The relationship between lower extremity closed kinetic chain strength & sagittal plane landing kinematics in female athletes.

BACKGROUND: Female athletes continue to injure their anterior cruciate ligaments at a greater rate than males in comparable sports. During landing activities, females exhibit several different kinematic and kinetic traits when compared to their male counterparts including decreased knee flexion angles as well as decreased lower extremity (LE) strength. While open kinetic chain strength measures have not been related to landing kinematics, given the closer replication of movement patterns that occur during closed kinetic chain (CKC) activity, it is possible that lower extremity strength if measured in this fashion will be related to landing kinematics. PURPOSE: To determine if unilateral isometric CKC lower extremity (LE) strength was related to sagittal plane tibiofemoral kinematics during a single leg landing task in competitive female athletes. We hypothesized females who demonstrated lesser CKC LE strength would exhibit decreased sagittal plane angles during landing. METHODS: 20 competitive female athletes (age = 16.0 ± 1.8 yrs; height = 166.5 ± 8.3 cm; weight = 59.7 ± 10.2 kg) completed CKC LE strength testing followed by 5 unilateral drop landings on the dominant LE during one test session at an outpatient physical therapy clinic. Closed kinetic chain LE strength was measured on a computerized leg press with an integrated load cell while sagittal plane tibiofemoral kinematics were quantified with an electrogoniometer. RESULTS: No significant relationships between absolute or normalized isometric CKC strength and sagittal plane landing kinematics were identified. CONCLUSIONS: Closed kinetic chain lower extremity isometric strength tested at 25 degrees of knee flexion is not related to sagittal plane landing kinematics in adolescent competitive female athletes. LEVELS OF EVIDENCE: Analytic, Observational.