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Here is what one athletic trainer experienced with a realworld athlete's rehabilitation from injury:

At a Saturday morning boys' basketball scrimmage, two athletes collided under the basket as one intended to shoot a layup. I was informed of the injury on the following Monday. I spoke with the injured athlete's mother on the telephone the day of the injury. She stated that her son felt like his left shoulder had "gone out." The mother also mentioned that her son had a history of a left elbow dislocation. The dislocation had occurred three times in the past 3 years. When asked whether her son had ever been informed that he was double-jointed or had "loose joints," the mother replied with a chuckled "yes." He had limited range of motion (ROM) and a clicking or catching sensation in his shoulder. Generally, I would not refer an athlete to an orthopedist without having evaluated the injury myself; however, I had a unique opportunity to get this athlete to the orthopedist through a walk-in clinic that evening. Given the situation, I had concerns about the possibility of several injuries, including a tear of the labrum, a rotator cuff tear, and a fracture of the humerus or surrounding bones. The suspected dislocation and self-reduction could have easily caused any or all of these injuries. I opted to refer the athlete immediately with the hopes of starting the evaluation process. The team's first game of the season was only 4 days away. The athlete and his mother were hoping that he might be able to play. He was seen by a physician's assistant who ordered both radiographs and magnetic resonance imaging (MRI) the following day. Just 3 days after the initial evaluation (5 days post-injury), the MRI results revealed no structural damage and the radiograph was clear of any possible fracture. The orthopedic surgeon released the athlete as tolerated with the request that we work on his ROM for the next 4 days. The athlete regained full ROM and strength (compared bilaterally) and was returned to play the following week, missing only the first game of the season.

Kristen Higgins, MS, AT, ATC

Wilson Memorial Hospital

Botkins and Jackson-Center High Schools

Sidney, Ohio


learning outcomes

After working through this chapter, you will be able to:

  1. Describe seven different goals of rehabilitation and the importance of each in the overall rehabilitation protocol.

  2. Verbalize indications for performing shoulder rehabilitative techniques.

  3. Discuss modifications and progressions that are used during a rehabilitation program for the shoulder.

  4. Discuss outcome measures used to identify activity levels and return-to-play guidelines for shoulder injuries.

  5. Explain what modality choice is proper for rehabilitation by using indications, contraindications, and the principles and theory related to the physiological response of the intervention.



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