Naiquan Zheng, Glenn S. Fleisig and James R. Andrews
Kevin E. Wilk, Naiquan Zheng, Glenn S. Fleisig, James R. Andrews and William G. Clancy
Closed kinetic chain exercise has become popular in rehabilitation of the ACL patient. While many clinicians agree on the benefits of closed kinetic chain exercise, there is great discrepancy as to which exercises fit this category. This discrepancy stems from the fact that the kinetic chain concept was originally developed using mechanical engineering concepts and not human kinesiology. In this paper, the kinetic chain concept is redefined in a continuum of lower extremity exercises from closed kinetic chain to open kinetic chain. The placement of an exercise in this continuum is based upon joint kinematics, quadriceps and hamstring muscle activity, cruciate ligament stress, and joint weight-bearing load. An understanding of these factors can help the clinician design a comprehensive and effective rehabilitation program for the ACL patient.
Tomoyuki Matsuo, Glenn S. Fleisig, Naiquan Zheng and James R. Andrews
Elbow varus torque is a primary factor in the risk of elbow injury during pitching. To examine the effects of shoulder abduction and lateral trunk tilt angles on elbow varus torque, we conducted simulation and regression analyses on 33 college baseball pitchers. Motion data were used for computer simulations in which two angles— shoulder abduction and lateral trunk tilt—were systematically altered. Forty-two simulated motions were generated for each pitcher, and the peak elbow varus torque for each simulated motion was calculated. A two-way analysis of variance was performed to analyze the effects of shoulder abduction and trunk tilt on elbow varus torque. Regression analyses of a simple regression model, second-order regression model, and multiple regression model were also performed. Although regression analyses did not show any significant relationship, computer simulation indicated that the peak elbow varus torque was affected by both angles, and the interaction of those angles was also significant. As trunk tilt to the contralateral side increased, the shoulder abduction angle producing the minimum peak elbow varus torque decreased. It is suggested that shoulder abduction and lateral trunk tilt may be only two of several determinants of peak elbow varus torque.
Rafael F. Escamilla, Glenn S. Fleisig, Steven W. Barrentine, Naiquan Zheng and James R. Andrews
The purpose of this study was to establish and compare kinematic data among four groups of collegiate pitchers who threw the fastball (FA), change-up (CH), curveball (CU), and slider (SL). Twenty-six kinematic parameters at lead foot contact, during the arm-cocking and arm acceleration phases, and at ball release were measured for 16 collegiate baseball pitchers. Approximately 60% of these parameters showed significant differences among the four pitch variations. The greatest number of differences (14 of 26) occurred between the FA and CH groups, while the fewest differences (2 of 26) occurred between the FA and SL groups. The CH group had the smallest knee and elbow flexion at lead foot contact and the greatest knee and elbow flexion at ball release. During the arm-cocking and arm acceleration phases, peak shoulder, elbow, and trunk angular velocities were generally greatest in the FA and SL groups and smallest in the CH group. At ball release the CH group had the most upright trunk and the greatest horizontal shoulder adduction, while the CU group had the most lateral trunk tilt. Understanding kinematic differences can help a pitcher select and learn different pitches and can help a batter learn how to identify different pitches.