Přednáška na kongresu

Lecture: Important considerations for the throwing athlete

The first known species to throw objects was homo erectus over 2 million years ago.  Since then, we have evolved to use throwing for hunting, war, recreation, and many variations of sport.  Unfortunately, the throwing athlete has become susceptible to many musculoskeletal injuries.  For example, in professional baseball, 25 percent of current pitchers have ruptured their ulnar collateral ligament in their elbow requiring a “tommy john surgery.”  Perhaps it is a multifactorial problem, but I strongly believe that faulty throwing biomechanics are the biggest culprit.  Since this has become an epidemic problem, finding causative factors is crucial for baseball moving forward.  Coaches, physicians, physical therapists, should be able to recognize harmful throwing mechanics and be able to use this information to prevent injury or even enhance performance. 

Another reason for injury in the throwing athlete can be poor quality of stabilization.  Often, rehabilitation programs are focused solely on the shoulder or elbow.  The throwing athlete must stabilize not just the upper extremity but the whole body.  Throwing is a kinetic chain of events that relies on the correct timing of stabilization throughout all the joints in the body.  An often missing link in rehabilitation is the proper instruction of Intra-Abdominal Pressure (IAP).  IAP is a prerequisite for all purposeful movement and stabilization.   Throwing requires maximum usage of muscular anatomic slings that must be controlled by the right amount of IAP.

© Copyright Viktor Kobes,Rehabilitation Prague School 1995 - 2014

© Copyright Viktor Kobes,Rehabilitation Prague School 1995 - 2017

Dvoudenní kurz:

Functional assessment and treatment of the throwing athlete

When stabilization is not ideal, we will always have a change in the soft tissues.   Attendees will be taught how to accurately palpate trigger points around the shoulder girdle and how to use these points as an audit to learn if you are improving the patient functionally.  Trigger points, originally described by Travell and Simons, offers clues about dysfunctional muscles.  We often don’t directly treat the trigger point, but we assess them after our treatment intervention to confirm progress.  We also assess muscle length to determine if muscles have become shortened due to protective patterns around a joint.  Finally, we will discuss when to use myofascial release procedures around the shoulder joint.

Functional testing has emerged as the new buzz words in manual medicine.  Sometimes, clinicians struggle with selecting the proper functional tests then find themselves frustrated when their tests look exactly the same weeks later.  In my experience, if the right exercise is used there will be a noticeable change in functional tests during re-evaluation.  Functional tests are paramount for determining the portal of entry for the clinician.  For example, I never treat a patient with scapular instability that does not also have a tight posterior capsule around the glenohumeral joint, as they are correlated functionally.  Meaning, that the tight posterior capsule is perhaps a good thing in a poor functioning system.  Many practitioners would immediately treat the tight posterior capsule, which could destabilize the patient.  The throwing athlete has specific functional tests that should be investigated. 


-  review the statistics on injured throwers

-  discuss orthopedic interventions for the throwing athlete

-  understand what proper throwing mechanics entail

-  what makes the best throwers in the world

-  know what biomechanical faults to look for with certain orthopedic injuries

-  know which functional tests to use for the throwing athlete

-  understand what exercises could be used to remedy faulty functional tests

-  know when to use soft-tissue techniques

-  learn ideas on how to enhance performance for the throwing athlete

DNS kongres 7. 9. 2018, kurz 8 - 9. 9. 2018

Přihláška na kongreshttps://events.hrgczechrepublic.cz/dns-2018/shapeimage_2_link_0
Přihláška na kurzhttp://www.rehabps.cz/rehab/course.php?c_id=1087shapeimage_4_link_0
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