Rotator cuff repair tension as a determinant of functional outcome.

This study evaluated the effect of rotator cuff repair tension on surgical outcome. A total of 67 consecutive rotator cuff repairs for full-thickness tendon tears were prospectively evaluated. Rotator cuff repair tension was quantified by means of an intraoperative calibrated tensiometer after cyclic loading. The point of maximum repair tension was measured. Patients were evaluated for pain and improvement before and after surgery through use of Constant scores, American Shoulder and Elbow Surgeons' functional criteria, isokinetic strength-testing, and visual analog scale scores. Increased repair tension correlated with lesser gains in postoperative Constant score, a decrease in perceived improvement, decreased isokinetic strength measurements, and increased pain. Tension on repaired rotator cuff tendons should be minimized. High-tension repairs--those greater than 8 lb--are associated with poor subjective and objective outcomes and are not recommended.

Isokinetic back testing in the athlete.

With increasing numbers of professional, collegiate, and high school athletes developing low back pain, isokinetic back testing could prove to be a way of preventing the development of severe problems and extended stays on injured lists. Isokinetic testing provides an advantage over other testing procedures by more closely simulating the way muscles perform functional activities. This type of testing allows comparison between patients, normals, preoperative and postoperative status, and pre-rehabilitation and post-rehabilitation protocols.

Physical modalities in the treatment of tendon injuries.

Physical modalities such as heat, cold, and electricity have been used for many years in the treatment of tendon injuries. This article examines the basic modalities that the athletic trainer and physical therapist use in these treatment programs and how well they have performed. The indications and contraindications for both are included.