Most physicians, trainers, and therapists are accustomed to thinking of open and closed kinetic chain terminology in terms of exercise and its application in rehabilitation protocols. This terminology can also be used to describe the mechanism by which injuries occur. Categorizing upper extremity injuries in this way not only provides vital insight into the mechanism of the injuries and helps identify possible injured structures but also allows the clinician to better develop treatment protocols. In this article, this categorization is applied to common shoulder and elbow injuries to provide insight into the nature of these injuries.
James R. Andrews and James M. Dennison are with the American Sports Medicine Institute, Birmingham, AL 35205. Kevin E. Wilk is with HEALTHSOUTH Sports Medicine & Rehabilitation Center, Birmingham, AL 35205.