Term of Award

Spring 1999

Document Type and Release Option

Thesis (restricted to Georgia Southern)

Committee Chair

James McMillan

Committee Member 1

A. Barry Joyner

Committee Member 2

W. Kent Guion

Abstract

The purpose of this study was to examine the various rehabilitative practices and protocols for a (hypothetical, overhead throwing high school) pitcher with impingement, posterior cuff contracture and a small rotator cuff tear by orthopedic surgeons, physical therapists and athletic trainers. A questionnaire was mailed to a systematic, random sampling of the members of the Physical Therapist's Association of Georgia, Incorporated, all members of the Georgia Athletic Trainers Association (1997-1998 mailing list) and members of the American Academy of Orthopedic Surgeons in Georgia (1997-1998 mailing list). The questionnaire solicited information regarding the rehabilitational time line and specific rehabilitative exercises that they use in returning their pitchers to participation and which type of surgery was utilized. A total of 882 surveys were mailed. The response rate for the mailing totaled 116/882 (13%). The physical therapists (PT) had a response rate of 64/316 (20%). The orthopedic surgeons had a response rate of 43/421 (10%). The athletic trainers had a response rate of 9/145 (6%)) (due to the low response rate, the data from this group was not included. Analysis of the data indicated that significant differences existed between the rehabilitation protocols followed by PT and surgeons (p<.001). Although there was no significant difference regarding the duration of sling use by the physical therapists and the orthopedists. There was a significant difference (p< 0.01) in the initiation of open kinetic chain and closed kinetic chain exercises. The timing of the initiation of a throwing program, return to competition and rehabilitational protocol for this situation with an additional labral tear (between physical therapists and orthopedic surgeons) were also

significantly different (p < .01). These differences suggest that there is not a standard mode of shoulder rehabilitation between the different professions. Current literature has shown many different techniques in rehabilitating someone in this situation and the analysis of the present data has shown that many different techniques are being utilized. (However, based on the healing process, the anatomy and a specific type of surgery involved, a standard rehabilitation protocol should exist.)

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