Orthopaedic Rehabilitation of the Athlete

Matthew T. Provencher CAPT (Ret.) MC USNR Professor of Surgery & Orthopaedics, USUHS Shoulder, Knee and Sports Surgery The Steadman Clinic Fellowship Director, Steadman Philippon Research Institute Vail, Colorado

Part 1. Shoulder
Shoulder Instability

1. Anterior Shoulder Instability
Introduction
Nonoperative Rehabilitation Following Anterior Capsulolabral Injury
Postoperative Rehabilitation After Arthroscopic Anterior Shoulder Stabilization
Postoperative Rehabilitation After Open Anterior Stabilization of the Shoulder With or Withour Bone Grafting (Iliac Crest Graft, Latarjet Procedure)

2. Posterior Shoulder Instability
Introduction
Postoperative Rehabilitation After Open or Arthroscopic Posterior Shoulder Stabilization
Beyond Basic Rehabilitation: Return to Football After Posterior Shoulder Stabilization

3. Multidirectional Shoulder Instability
Introduction
Nonoperative Rehabilitation of Multidirectional Shoulder Instability
Postoperative Rehabilitation After Treatment of Multidirectional Shoulder Instability
Beyond Basic Rehabilitation: Return to Swimming After Treatment for Multidirectional Shoulder Instability
Superior Labral Pathology (SLAP/Long Head Biceps)

4. Superior Labral Pathology (SLAP/Long Head Biceps)
Introduction
Nonoperative Rehabilitation of Slap Tears
Postoperative Rehabilitation After Treatment of Slap Tears
Beyond Basic Rehabilitation: Return to Pitching and Throwing After Slap Tear Repair
Beyond Basic Rehabilitation: Return to Volleyball After Labral Surgery (Slap Repair or Debridement and Decompression of Spinoglenoid Notch Cyst)

5. Biceps Tendon Disorders
Introduction
Nonoperative Rehabilitation of Long Head of Biceps Tendinitis/Tendinosis
Postoperative Rehabilitation After Biceps Tenotomy and Tenodesis
Beyond Basic Rehabilitation: Return to Weightlifting After Biceps Tenodesis
Rotator Cuff Injuries

6. Rotator Cuff Injuries
Introduction
Nonoperative Rehabilitation of Rotator Cuff Impingement Syndrome
Postoperative Rehabilitation After Subacromial Decompression
Beyond Basic Rehabilitation: Return to Pitching After Subacromial Decompression
Nonoperative Rehabilitation of Internal Impingement
Postoperative Rehabilitation Following Arthroscopic Rotator Cuff Repair
Beyond Basic Rehabilitation:Return to Tennis After Rotator Cuff Repair
Beyond Basic Rehabilitation: Return to Golf After Rotator Cuff Repair
Acromioclavicular and Sternoclavicular Joint Injuries

7. Acromioclavicular Joint Injuries and Sternoclavicular Joint Injuries
Introduction
Nonoperative Rehabilitation Of Acromioclavicular Joint Sprain/Separation
Postoperative Rehabilitation After Distal Clavicular Resection (Mumford)
Nonoperative Rehabilitation of Sternoclavicular Joint Sprains
Postoperative Rehabilitation After Joint Reconstruction of Acromioclavicular Separations
Beyond Basic Rehabilitation: Reclavicular Joint Injury or Surgery
Nonoperative Rehabilitation of Clavicle Fracture
Postoperative Rehabilitation After Repair of Clavicle Fracture
Beyond Basic Rehabilitation: Return to Motorcross After Clavicle Fracture
Shoulder Cartilage Injuries, Arthritis, and Capsulitis

8. Adhesive Capsulitis and Shoulder Arthroplasty
Introduction
Nonoperative Rehabilitation of Adhesive Capsulitis
Postoperative Rehabilitation After Capsular Release For Glenohumeral Adhesive Capsulitis
Postoperative Rehabilitation After Arthroplasty (Replacements), Hemiarthroplasty, Total Shoulder or Joint Reconstruction
Beyond Basic Reahbilitation: Return to Golf, Swimming, and Tennis After Shoulder Arthroplasy


Part 2. Elbow and Forearm, Wrist and Hand
Elbow and Forearm Injuries

9. Epicondylitis
Introduction
Nonoperative Rehabilitation of Lateral Epicondylitis (Tennis Elbow)
Postoperative Rehabilitation After Open or Arthroscopic Surgery For Epicondylitis
Beyond Basic Rehabilitation: Return to Tennis After Nonoperative or Surgical Treatment of Epicondylitis
Nonoperative Rehabilitation of Golfer's Elbow
Beyond Basic Rehabilitation: Return to Golf After Treatment For Medial Epicondylitis (Golfer's Elbow)

10. Epiphyseolysis and Osteochodritis
Introduction
Nonoperative Rehabilitation of Epiphyseolysis of the Medial Epicondyle (Little League Elbow)
Postoperative Rehabilitation After Treatment of Osteochondritis Dissecans of the Capitullum
Beyond Basic Rehabilitation: Return to Pitching After Osteochondritis Dissecans of the Capitullum

11. Ulnar Collateral Ligament Injuries
Introduction
Nonsurgical Rehabilitation of Ulnar Collateral Ligament Injuries
Postoperative Rehabilitation After Ulnar Collateral Ligament Reconstruction
Beyond Basic Rehabilitation: Return to Pitching After Ulnar Collateral Ligament Reconstruction

12. Elbow Stiffness
Introduction
Postoperative Rehabilitation After Elbow Capsular Release

13. Forearm Nerve Entrapments
Introduction
Nonoperative Rehabilitation for Forearm Nerve Entrapments

14. Forearm Tendinitis
Introduction
Nonoperative Rehabilitation of Forearm Tendinitis
Wrist and Hand Injuries

15. Triangular Fibrocartilage Complex Injuries
Introduction
Nonoperative Rehabilitation of Wrist Sprains and Triangular Fibrocartilage Complex Injuries
Postsurgical Rehabilitation After Triangular Fibrocartilage Complex Repair/Debridement and Wrist Ligament Repair/Wrist Athroscopy

16. Jersey Finger and Mallet Finger
Introduction
Nonoperative Rehabilitation For Mallet Finger
Postsurgical Rehabilitation For Mallet Finger and Jersey Finger

17. Thumb Ulnar Collateral Ligament Injuries
Introduction
Nonoperative Rehabilitation of Thumb Ulnar Collateral Ligament Injuries
Postoperative Rehabilitation After Treatment of Thumb Ulnar Collateral Ligament Injuries
Beyond Basic Rehabilitation: Return to Skiing After Nonoperative or Operative Treatment of Thumb Ulnar Collateral Ligament Injuries


Part 3. Lumbar, Thoracic and Cervical Spine
Lumbar Spine Injuries

18. Lumbar Spine Strains and Sprains
Introduction
Nonoperative Rehabilitation of Lumbar Spine Strains and Sprains

19. Herniated Lumbar Disc
Introduction
Nonoperative Rehabilitation of Herniated Lumbar Disc
Postoperative Rehabilitation After Lumbar Disc Herniation Surgery
Beyond Basic Rehabilitation: Return to Golf After Lumbar Disc Herniation

20. Spondylolysis
Introduction
Nonoperative Rehabilitation of Spondylolysis
Postoperative Rehabilitation After Repair of Spondylolysis
Beyond Basic Rehabilitation: Return to Gymnastics After Surgical Repair of Spondylolysis
Thosacic Spine Injuries

21. Musculoskeletal Thoracic and Chest Injuries
Introduction
Non-Surgical Rehabilitation of Thoracic Spine Injuries
Cervical Spine Injuries

22. Cervical Spine Strains, Sprains, and Burners
Introduction
Nonoperative Rehabilitation of Cervical Spine Strains/Sprains/Burners

23. Cervical Spine Disc Injuries
Introduction
Nonoperative Rehabilitation of Cervical Spine Disc Injuries
Beyond Basic Rehabilitation: Return to Play Contact Sports Cervical Spine Injury or Surgery


Part 4. Hip and Thigh
Hip/Thigh Muscle Strains

24. Muscle Strains about the Hip and Thigh
Introduction
Nonoperative Rehabilitation of Adductor and Hip Joints Strains
Beyond Basic Rehabilitation: Return to Hockey After Adductor Strain
Nonoperative Rehabilitation of Hamstring Strains and Contusions
Beyond Basic Rehabilitation: Return to Sprinting Activities After Hamstring Strain
Postoperative Rehabilitation After Repair of Proximal Hamstring Avulsion
Beyond Basic Rehabilitation: Return to Rugby After Repair of Hamstring Avulsion

25. Groin Injury
Introduction
Nonoperative Rehabilitation of Longstanding Groin Injury
Postoperative Rehabilitation After Adductor Release
Beyond Basic Rehabilitation: Return to Football (Soccer) After Treatment of Acute Groin Injury
Femoroacetabular Impingement

26. Femoroacetabular Impingement and Labral Injuries
Introduction
Nonoperative Rehabilitation of Hip Stiffness and Hip Impingement (Cam/Pincer Lesions)
Postoperative Rehabilitation After Femoroacetabular Impingement Treatment, Labral Repair, Labral Debridement
Beyond Basic Rehabilitation: Return to Baseball After Surgical Treatment of Femoroacetabular Impingement
Beyond Basic Rehabilitation: Return to Golf After Surgical Treatment of Femoroacetabular Impingement

27. Stress Fractures of the Femoral Neck/Shaft
Introduction
Non-Surgical Rehabilitation For Stress Fracture of the Femoral Neck/Shaft
Beyond Basic Rehabilitation: Return to Running After Surgical Treatment of a Stress Fracture of the Femoral Neck


Part 5. Knee
Extensor Mechanism Injuries

28. Patellar Instability
Introduction
Non-Surgical Rehabilitation of Patellar Instability
Postoperative Rehabilitation After Proximal Realignment Procedures and Medial Patellofemoral Ligament (MPFL) Reconstruction
Postoperative Rehabilitation After Anteromedialization of the Tibial Tubercle

29. Patellar and Quadriceps Tendinopathy
Introduction
Nonoperative Rehabilitation of Patellar Tendinopathy
Postoperative Rehabilitation After Patellar Tendinopathy Debridement
Beyond Basic Rehabilitation: Return to Basketball After Surgical Treatment For Patellar Tendinopathy
Postoperative Rehabilitation After Repair of Patellar and Quadriceps Tendon
Meniscus Injuries

30. Meniscus Injuries
Introduction
Non-Surgical Rehabilitation of Meniscus Injuries
Postoperative Rehabilitation After Meniscus Repair
Postoperative Rehabilitation After Meniscus Repair and Primary Anterior Cruciate Ligament Reconstruction
Beyond Basic Rehabilitation: Return to Catching After Meniscal Repair
Articular Cartilage Injuries

31. Articular Cartilage Injury (Including Osteochondritis Dissecans) in the Young Athletic Knee
Introduction
Nonoperative Rehabilitation of Articular Cartilage Injuries
Postoperative Rehabilitation After Femoral Condyle or Trochlear Groove Microfracture
Postoperative Rehabilitation After Autologous Chondrocyte Implantation For Cartilage Restoration
Postoperative Rehabilitation After Osteochondral Allograft/Autograft Transfer For Cartilage Restoration
Beyond Basic Rehabilitation: Return to Basketball After Osteochondral Allograft Transplantation
Ligament Injuries

32. Anterior Cruciate Ligament Injuries
Introduction
Nonoperative and Preoperative Rehabilitation of Anterior Cruciate Ligament Injuries
Nonsurgical Rehabilitation of the Failed ACL Procedure 31B and 31C Will be Combined
Postoperative Rehabilitation After Bone-Patellar Tendon-Bone Anterior Cruciate Ligament Reconstruction (Autograft and Allograft)
Beyond Basic Rehabilitation: Return to Skiing After Anterior Cruciate Ligament Reconstruction
Postoperative Rehabilitation After Soft Tissue Anterior Cruciate Ligament Reconstruction (Autograft and Allograft)
Beyond Basic Rehabilitation: Return to Soccer After Anterior Cruciate Ligament Reconstruction
Postoperative Rehabilitation After Double Bundle Anatomic Anterior Cruciate Ligament Reconstruction

33. Posterior Cruciate Ligament Injuries
Introduction
Nonoperative Rehabilitation of Posterior Cruciate Ligament Injuries
Postoperative Rehabilitation After Posterior Cruciate Ligament Reconstruction
Beyond Basic Rehabilitation: Return to Football After Posterior Cruciate Ligament Injury
Beyond Basic Rehabilitation: Return to Jogging After Multiligament Knee Reconstruction

34. Medial Collateral Ligament Injuries
Introduction
Nonoperative Rehabilitation of Medial Collateral Ligament Injuries
Postoperative Rehabilitation After Repair or Reconstruction of the Medial Collateral Ligament
Beyond Basic Rehabilitation: Return to Football After Medial Collateral Ligament Surgery

35. Lateral Collateral Ligament and Posterolateral Ligament Injuries
Isolated Lateral Collateral Ligament Injuries: Introduction
Combined Lateral Collateral Ligament and Posterolateral Ligamentous Injuries: Introduction
Nonoperative Rehabilitation of Lateral Collateral Ligament Sprains
Postoperative Rehabilitation After Posterolateral Corner Repair or Reconstruction
Beyond Basic Rehabilitation: Return to Rugby League After Posterolateral Corner Knee Reconstruction with Autograft


Part 6. Leg, Ankle and Foot
Lower Leg Conditions

36. Leg Pain in the Athlete: Stress Fractures, Medial Tibial Stress Syndrome, and External Compartment Syndromes
Introduction
Nonoperative Rehabilitation of Medial Tibial Stress Syndrome
Nonoperative Rehabilitation of Tibial Stress Fracture
Postoperative Rehabilitation After Treatment of Exertional Compartment Syndromes
Beyond Basic Rehabilitation: Return to Running After Stress Fracture of the Tibia

37. Tbial Shaft Fractures
Introduction
Nonoperative Rehabilitation of Tibial Shaft Fractures
Postoperative Rehabilitation After Tibial Shaft Fracture
Beyond Basic Rehabilitation: Return to Skiing After Treatment of Tibial Shaft Fracture
Achilles Tendon Injuries

38. Achilles Tendinopathy and Rupture
Introduction
Nonoperative Rehabilitation of Achilles Tendinopathy
Postoperative Rehabilitation of Achilles Tendinopathy
Nonoperative Rehabilitation For Achilles Tendon Rupture
Postoperative Rehabilitation of Achilles Tendon Rupture
Beyond Basic Rehabilitation: Return to Basketball Treatment of Achilles Tendon Rupture
Ankle Injuries

39. Ankle Sprains, Fractures, and Chondral Injuries
Introduction
Nonoperative Rehabilitation of Lateral and Syndemosis Sprains
Postoperative Rehabilitation After Lateral Ankle Ligament Repair/Reconstruction
Postoperative Rehabilitation After Treatment of Lateral and Medial Ankle Fractures
Postoperative Rehabilitation After Treatment of Microfracture or Chondral Injuries of the Ankle

40. Ankle Impingement
Introduction
Beyond Basic Rehabilitation: Return to Soccer After Surgical Treatment of Posterior Ankle Impingement

41. Flexor Hallucis Longus Tendinopathy
Introduction
Beyond Basic Rehabilitation: Return to Ballet After Treatment For Flexor Hallucis Longus Tendinopathy and Posterior Impingement
Foot Injuries

42. Plantar Fasciitis
Introduction
Nonoperative Rehabilitation of Plantar Fasciitis
Postoperative Rehabilitation After Plantar Fasciitis Surgery

43. Midfoot Sprains and Strains and Lisfranc Injuries
Introduction
Nonoperative Rehabilitation of Midfoot Sprains (Stage I Ligamentous Lisfranc Injuries)
Postsurgical Rehabilitation of Midfoot Sprains (Stage II-III Ligamentous Lisfranc Injuries)

44. Fifth Metatarsal Fractures
Introduction
Nonoperative Rehabilitation of Fifth Metatarsal Fractures (Including Jones Fracture)
Postoperative Rehabilitation After Internal Fixation of the Fifth Metatarsal Fractures
Beyond Basic Rehabilitation: Return to Football After Open Reduction and Internal Fixation of Jones Fracture

45. First Metatarsophalangeal Joint Sprain (Turf Toe)
Introduction
Monoperative Rehabilitation of First Metatarsophalangeal Sprain (Turf Toe)