Todd Ellenbecker - Academia.edu (original) (raw)
Papers by Todd Ellenbecker
Springer eBooks, 2021
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JSES international, 2022
Background The electromyography (EMG) activity of the teres minor (TMi) and infraspinatus (IS) mu... more Background The electromyography (EMG) activity of the teres minor (TMi) and infraspinatus (IS) muscle has been demonstrated to vary depending on the arm position, such as in the coronal or scapular position, during intervention exercises. This may be reflected by different EMG activities demonstrated between the TMi and IS muscle during the acceleration and deceleration phases of the pitching motion. Tenderness in the scapular attachment site of the TMi muscle is often seen in baseball pitchers after pitching but not the attachment site of the IS muscle. However, few studies have investigated an interaction between TMi and IS muscle activity across different resistance exercises with different arm positions. The purpose of this study was to identify the feature of TMi and IS muscle activity in the presence of manual resistance applied in the prone position. Methods Eighteen collegiate baseball players volunteered their participation. Raw EMG amplitudes of the TMi, IS, posterior deltoid, middle deltoid, and upper trapezius muscles on the dominant shoulder were measured during intervention exercises. All subjects performed manual isometric resistance exercises: horizontal abduction (HABD) and external rotation (ER) of the glenohumeral joint with 40% of the manual maximum strength test in prone. The subjects also performed each of the HABD and ER resistance exercises with the arm actively positioned at 0° and 45° of ER of the glenohumeral joint in the coronal and scapular planes. Results Both TMi and IS muscle activities significantly increased with the arm positioned at 45° of ER compared with 0° of ER regardless of the exercise (P < .05). TMi activity was significantly greater with HABD resistance than IS muscle activity regardless of the arm positions, whereas it was significantly less with ER resistance than IS muscle activity. Conclusion The findings of this study indicated that the TMi and IS muscles were most highly activated during the HABD resistance with the arm actively positioned at 45° of ER in the coronal plane. The results of this study have clinical implications regarding the careful selection of arm position in both exercise and clinical examination for the TMi and IS muscles.
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Springer eBooks, 2017
Scapular dyskinesis presenting in patients with shoulder pain may have multiple causes related to... more Scapular dyskinesis presenting in patients with shoulder pain may have multiple causes related to shoulder impairments or may simply be an incidental finding. The physical examination should assess the impairments related to scapular dyskinesis in order to develop an appropriate rehabilitation program. The key impairments to examine are soft tissue tightness or laxity, muscular deficits of weakness or control, scapular position or movement faults, and the kinetic chain. This chapter will describe treatment and exercise protocols for flexibility deficits and muscular deficits related to the scapula. Attention is also given to the rehabilitation of scapular dyskinesis in the overhead athlete. The selection of key impairments, rehabilitation guidelines for selection, and progression were based on evidence and clinical experience of the authors. The outcomes and effectiveness of scapula-focused rehabilitation programs are presented.
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JSES international, May 1, 2021
Background The teres minor (TMi) muscle exposed relatively high activity during the acceleration ... more Background The teres minor (TMi) muscle exposed relatively high activity during the acceleration and deceleration phases of the throwing motion, compared with the infraspinatus muscle. However, few studies have identified TMi muscle activity in intervention exercises. The purpose of this study was to investigate TMi muscle activities in different horizontal adduction positions in the quadruped horizontal abduction exercise. This study hypothesized that TMi muscle activity would differ in response to resistance application across different horizontal adduction positions. Materials and methods Nineteen collegiate baseball players volunteered their participation. Raw electromyography activity of the TMi muscle along with 7 different muscles attached to the scapula on the dominant-side were collected, and normalized by each of the corresponding maximum voluntary isometric contractions. All subjects performed manual isometric resistance horizontal abduction exercises at 90° and 135° of abduction with 3 horizontal adduction angles in the quadruped position: 1) coronal, 2) scapular, and 3) sagittal plane. Electromyography data were also collected from rhythmical concentric contraction of horizontal abduction at 90° of abduction in the quadruped position. Results TMi muscle activity was significantly greater with the arm positioned in the coronal plane than that of the scapular and sagittal planes (41, 26, and 17% maximum voluntary isometric contraction, respectively) (P < .05). Conclusion The present study demonstrated that TMi muscle activity varied depending on horizontal adduction positions.
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The International journal of sports physical therapy, May 1, 2020
Background and Purpose The return to play percentage of baseball pitchers who have undergone isol... more Background and Purpose The return to play percentage of baseball pitchers who have undergone isolated superior labrum anterior-posterior (SLAP) repair has been reported to be less than 60%. Scapular dyskinesis (SD), characterized by scapular prominence during dynamic scapulohumeral movements, may be used to assist in diagnosing a baseball pitcher with shoulder pathology including a SLAP lesion. The purpose of this case report was to describe the use of the SD test to assess the scapular muscles and report EMG findings in a college baseball pitcher diagnosed with a Type 2 posterior SLAP lesion. Case Description The subject was a NCAA-D1 senior collegiate baseball right hand 3/4 slot pitcher (21 years old) with a primary complaint of pain in the anterior portion of the shoulder during the entire fall practice season, which was attributed to labral surgery performed when he was a senior in high school. No positive clinical testing of the patient was found including: the sulcus sign, tests of gross instability, and the load & shift test. A Type II posterior SLAP lesion was identified via magnetic resonance imaging. The subject presented with glenohuemral internal rotation deficit (GIRD). The SD test identified moderate to severe prominence of scapular medial boarder in shoulder flexion/extension (FLX/EXT). Furthermore, surface EMG analyses indicated that the lower trapezius (LT) muscle was abruptly inhibited on the dominant side during the descending phase of FLX, compared with the non-dominant side. Additionally, a remarkably higher ratio of upper trapezius to LT muscle EMG activity on the dominant side compared to that of the non-dominant side was identified during the descending phase from flexion. Discussion After identification of SD, an off season conservative treatment program allowed him to compete in his last college baseball season, appearing 22 times out of the bullpen in which he was credited four wins with a 3.70 earned run average (ERA) in 41.1 innings in 57 games. The SD test may play a critical role in identifying rehabilitation potential and guide the focus of the rehabilitation program to improve scapulothoracic stability and mobility for unilateral repetitive overhead athletes. Particularly the descending phase during sagittal plane motion (FLX/EXT) may effectively accentuate the scapular prominence during movement, portentially due to LT muscle activity inhibition. Level of Evidence 5 Case Report.
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Human Kinetics eBooks, 2017
In Sport Therapy for the Shoulder: Evaluation, Rehabilitation, and Return to Sport, readers will ... more In Sport Therapy for the Shoulder: Evaluation, Rehabilitation, and Return to Sport, readers will learn about best practices and evidence-based guidelines for assessing and treating patients’ shoulder injuries for re-entry into sport. Written by renowned physical therapists Todd S. Ellenbecker and Kevin E. Wilk, this text is a key resource for physical therapists, athletic trainers, sport chiropractors, massage therapists, strength and conditioning professionals, personal trainers, and other clinicians in sports medicine who work with patients recovering from shoulder injuries.
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International Journal of Sports Physical Therapy
Background A pattern of scapular dyskinesis on the dominant side has been demonstrated to be asso... more Background A pattern of scapular dyskinesis on the dominant side has been demonstrated to be associated with a decrease in throwing arm conditions identified by a self-report outcome assessment in collegiate baseball pitchers during the course of a single season. However, it is unclear if symptomatic shoulders in baseball pitchers may be associated with the presence of scapular dyskinesis. Purpose To study the relationship between the presence of scapular dyskinesis and throwing-related injury in collegiate baseball pitchers during each respective course of up to four subsequent seasons. Methods A single Division 1 National Collegiate Athletic Association team participated in this study over a four-year-period. The scapular dyskinesis test was implemented during the preseason for baseball pitchers. Players were followed throughout each respective season to track the incidence of throwing-related upper extremity injuries. Results A total of 36 collegiate baseball pitchers (height: 18...
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Bookmarks Related papers MentionsView impact
British Journal of Sports Medicine, 2020
The IOC has proposed standard methods for recording and reporting of data for injury and illness ... more The IOC has proposed standard methods for recording and reporting of data for injury and illness in sport. The IOC consensus statement authors anticipated that sport-specific statements would provide further recommendations. This statement is the tennis-specific extension of the partner IOC statement. The International Tennis Federation Sport Science and Medicine Committee, in collaboration with selected external experts, met in June 2019 to consider athlete health monitoring issues specific to tennis. Once the IOC consensus statement was finalised, the tennis-specific consensus was drafted and agreed on by the members over three iterations. Compared with the IOC consensus statement, the tennis consensus contains tennis-specific information on injury mechanism, mode of onset, injury classification, injury duration, capturing and reporting exposure, reporting risk and study population. Our recommendations apply to able-bodied as well as wheelchair tennis players. Where applicable, sp...
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Isokinetics and Exercise Science, 1996
ABSTRACT
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Journal of Shoulder and Elbow Surgery, 2016
Bookmarks Related papers MentionsView impact
Journal of athletic training, 2016
The appropriate resistance intensity to prescribe for shoulder rehabilitative exercise is not com... more The appropriate resistance intensity to prescribe for shoulder rehabilitative exercise is not completely known. Excessive activation of the deltoid and upper trapezius muscles could be counterproductive for scapulohumeral rhythm during humeral elevation. To identify the effects of different exercise intensities on the scapular muscles during a free-motion "robbery" exercise performed in different degrees of shoulder abduction in seated and standing positions. Descriptive laboratory study. Kinesiology Adapted Physical Education Laboratory. A total of 15 healthy male college students (age = 20.5 ± 2.2 years, height = 174.5 ± 5.3 cm, mass = 63.8 ± 6.0 kg). Participants performed 5 repetitions of a randomized exercise sequence of the robbery exercise in 2 body positions (seated, standing), 2 shoulder-abducted positions (W [20°], 90/90 [90°]) at 3 intensities (0%, 3%, and 7% body weight). Electromyographic (EMG) activity of the upper trapezius, lower trapezius, serratus anterio...
Bookmarks Related papers MentionsView impact
Bookmarks Related papers MentionsView impact
The Athlete's Shoulder, 2009
Bookmarks Related papers MentionsView impact
International journal of sports physical therapy, 2012
Injury rates for softball players are similar to baseball players yet information regarding risk ... more Injury rates for softball players are similar to baseball players yet information regarding risk factors, pitching, and physical characteristics for high school windmill softball pitchers is limited. This information is needed to guide prevention, training, and rehabilitation efforts. The purpose of this study was to report descriptive data regarding the physical characteristics and pitching volume experienced by high school softball pitchers during one academic season. A secondary aim was to track and describe upper extremity injuries suffered by high school softball pitchers throughout the course of the 2009 season. Twelve uninjured female softball pitchers (13-18y) from 5 Greenville, South Carolina high schools participated. Prior to the 2009 season, the pitchers' shoulder internal, external, total arc of rotation and horizontal adduction PROM was measured. During the 10-week season, aggregate pitch counts (pitch volume) and occurrence of upper extremity injury were tracked f...
Bookmarks Related papers MentionsView impact
North American journal of sports physical therapy : NAJSPT, 2009
The importance of the scapular stabilizing muscles has led to an increased interest in quantitati... more The importance of the scapular stabilizing muscles has led to an increased interest in quantitative measurements of their strength. Few studies have measured isometric or concentric isokinetic forces. Additionally, limited reports exist on the reliability of objective measures for testing scapular protraction and retraction muscle strength or scapular testing that does not involve the glenohumeral joint. To determine the reliability of four new methods of measuring the maximal isometric strength of key scapular stabilizing muscles for the actions of protraction and retraction, both with and without the involvement of the glenohumeral (GH) joint. The Isobex® stationary tension dynamometer was used to measure the maximal isometric force (kg) on thirty healthy females (ages 22-26 years). Three measures were taken for each method that was sequentially randomized for three separate testing sessions on three nonconsecutive days. Intraclass correlations (ICC2,3) for intrasession reliabilit...
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Medicine & Science in Sports & Exercise, 2002
Bookmarks Related papers MentionsView impact
Medicine & Science in Sports & Exercise, 1998
Bookmarks Related papers MentionsView impact
Journal of Strength and Conditioning Research, 2000
Bookmarks Related papers MentionsView impact
Clinics in Sports Medicine, 2010
Bookmarks Related papers MentionsView impact
Springer eBooks, 2021
Bookmarks Related papers MentionsView impact
JSES international, 2022
Background The electromyography (EMG) activity of the teres minor (TMi) and infraspinatus (IS) mu... more Background The electromyography (EMG) activity of the teres minor (TMi) and infraspinatus (IS) muscle has been demonstrated to vary depending on the arm position, such as in the coronal or scapular position, during intervention exercises. This may be reflected by different EMG activities demonstrated between the TMi and IS muscle during the acceleration and deceleration phases of the pitching motion. Tenderness in the scapular attachment site of the TMi muscle is often seen in baseball pitchers after pitching but not the attachment site of the IS muscle. However, few studies have investigated an interaction between TMi and IS muscle activity across different resistance exercises with different arm positions. The purpose of this study was to identify the feature of TMi and IS muscle activity in the presence of manual resistance applied in the prone position. Methods Eighteen collegiate baseball players volunteered their participation. Raw EMG amplitudes of the TMi, IS, posterior deltoid, middle deltoid, and upper trapezius muscles on the dominant shoulder were measured during intervention exercises. All subjects performed manual isometric resistance exercises: horizontal abduction (HABD) and external rotation (ER) of the glenohumeral joint with 40% of the manual maximum strength test in prone. The subjects also performed each of the HABD and ER resistance exercises with the arm actively positioned at 0° and 45° of ER of the glenohumeral joint in the coronal and scapular planes. Results Both TMi and IS muscle activities significantly increased with the arm positioned at 45° of ER compared with 0° of ER regardless of the exercise (P < .05). TMi activity was significantly greater with HABD resistance than IS muscle activity regardless of the arm positions, whereas it was significantly less with ER resistance than IS muscle activity. Conclusion The findings of this study indicated that the TMi and IS muscles were most highly activated during the HABD resistance with the arm actively positioned at 45° of ER in the coronal plane. The results of this study have clinical implications regarding the careful selection of arm position in both exercise and clinical examination for the TMi and IS muscles.
Bookmarks Related papers MentionsView impact
Springer eBooks, 2017
Scapular dyskinesis presenting in patients with shoulder pain may have multiple causes related to... more Scapular dyskinesis presenting in patients with shoulder pain may have multiple causes related to shoulder impairments or may simply be an incidental finding. The physical examination should assess the impairments related to scapular dyskinesis in order to develop an appropriate rehabilitation program. The key impairments to examine are soft tissue tightness or laxity, muscular deficits of weakness or control, scapular position or movement faults, and the kinetic chain. This chapter will describe treatment and exercise protocols for flexibility deficits and muscular deficits related to the scapula. Attention is also given to the rehabilitation of scapular dyskinesis in the overhead athlete. The selection of key impairments, rehabilitation guidelines for selection, and progression were based on evidence and clinical experience of the authors. The outcomes and effectiveness of scapula-focused rehabilitation programs are presented.
Bookmarks Related papers MentionsView impact
JSES international, May 1, 2021
Background The teres minor (TMi) muscle exposed relatively high activity during the acceleration ... more Background The teres minor (TMi) muscle exposed relatively high activity during the acceleration and deceleration phases of the throwing motion, compared with the infraspinatus muscle. However, few studies have identified TMi muscle activity in intervention exercises. The purpose of this study was to investigate TMi muscle activities in different horizontal adduction positions in the quadruped horizontal abduction exercise. This study hypothesized that TMi muscle activity would differ in response to resistance application across different horizontal adduction positions. Materials and methods Nineteen collegiate baseball players volunteered their participation. Raw electromyography activity of the TMi muscle along with 7 different muscles attached to the scapula on the dominant-side were collected, and normalized by each of the corresponding maximum voluntary isometric contractions. All subjects performed manual isometric resistance horizontal abduction exercises at 90° and 135° of abduction with 3 horizontal adduction angles in the quadruped position: 1) coronal, 2) scapular, and 3) sagittal plane. Electromyography data were also collected from rhythmical concentric contraction of horizontal abduction at 90° of abduction in the quadruped position. Results TMi muscle activity was significantly greater with the arm positioned in the coronal plane than that of the scapular and sagittal planes (41, 26, and 17% maximum voluntary isometric contraction, respectively) (P < .05). Conclusion The present study demonstrated that TMi muscle activity varied depending on horizontal adduction positions.
Bookmarks Related papers MentionsView impact
The International journal of sports physical therapy, May 1, 2020
Background and Purpose The return to play percentage of baseball pitchers who have undergone isol... more Background and Purpose The return to play percentage of baseball pitchers who have undergone isolated superior labrum anterior-posterior (SLAP) repair has been reported to be less than 60%. Scapular dyskinesis (SD), characterized by scapular prominence during dynamic scapulohumeral movements, may be used to assist in diagnosing a baseball pitcher with shoulder pathology including a SLAP lesion. The purpose of this case report was to describe the use of the SD test to assess the scapular muscles and report EMG findings in a college baseball pitcher diagnosed with a Type 2 posterior SLAP lesion. Case Description The subject was a NCAA-D1 senior collegiate baseball right hand 3/4 slot pitcher (21 years old) with a primary complaint of pain in the anterior portion of the shoulder during the entire fall practice season, which was attributed to labral surgery performed when he was a senior in high school. No positive clinical testing of the patient was found including: the sulcus sign, tests of gross instability, and the load & shift test. A Type II posterior SLAP lesion was identified via magnetic resonance imaging. The subject presented with glenohuemral internal rotation deficit (GIRD). The SD test identified moderate to severe prominence of scapular medial boarder in shoulder flexion/extension (FLX/EXT). Furthermore, surface EMG analyses indicated that the lower trapezius (LT) muscle was abruptly inhibited on the dominant side during the descending phase of FLX, compared with the non-dominant side. Additionally, a remarkably higher ratio of upper trapezius to LT muscle EMG activity on the dominant side compared to that of the non-dominant side was identified during the descending phase from flexion. Discussion After identification of SD, an off season conservative treatment program allowed him to compete in his last college baseball season, appearing 22 times out of the bullpen in which he was credited four wins with a 3.70 earned run average (ERA) in 41.1 innings in 57 games. The SD test may play a critical role in identifying rehabilitation potential and guide the focus of the rehabilitation program to improve scapulothoracic stability and mobility for unilateral repetitive overhead athletes. Particularly the descending phase during sagittal plane motion (FLX/EXT) may effectively accentuate the scapular prominence during movement, portentially due to LT muscle activity inhibition. Level of Evidence 5 Case Report.
Bookmarks Related papers MentionsView impact
Human Kinetics eBooks, 2017
In Sport Therapy for the Shoulder: Evaluation, Rehabilitation, and Return to Sport, readers will ... more In Sport Therapy for the Shoulder: Evaluation, Rehabilitation, and Return to Sport, readers will learn about best practices and evidence-based guidelines for assessing and treating patients’ shoulder injuries for re-entry into sport. Written by renowned physical therapists Todd S. Ellenbecker and Kevin E. Wilk, this text is a key resource for physical therapists, athletic trainers, sport chiropractors, massage therapists, strength and conditioning professionals, personal trainers, and other clinicians in sports medicine who work with patients recovering from shoulder injuries.
Bookmarks Related papers MentionsView impact
International Journal of Sports Physical Therapy
Background A pattern of scapular dyskinesis on the dominant side has been demonstrated to be asso... more Background A pattern of scapular dyskinesis on the dominant side has been demonstrated to be associated with a decrease in throwing arm conditions identified by a self-report outcome assessment in collegiate baseball pitchers during the course of a single season. However, it is unclear if symptomatic shoulders in baseball pitchers may be associated with the presence of scapular dyskinesis. Purpose To study the relationship between the presence of scapular dyskinesis and throwing-related injury in collegiate baseball pitchers during each respective course of up to four subsequent seasons. Methods A single Division 1 National Collegiate Athletic Association team participated in this study over a four-year-period. The scapular dyskinesis test was implemented during the preseason for baseball pitchers. Players were followed throughout each respective season to track the incidence of throwing-related upper extremity injuries. Results A total of 36 collegiate baseball pitchers (height: 18...
Bookmarks Related papers MentionsView impact
Bookmarks Related papers MentionsView impact
British Journal of Sports Medicine, 2020
The IOC has proposed standard methods for recording and reporting of data for injury and illness ... more The IOC has proposed standard methods for recording and reporting of data for injury and illness in sport. The IOC consensus statement authors anticipated that sport-specific statements would provide further recommendations. This statement is the tennis-specific extension of the partner IOC statement. The International Tennis Federation Sport Science and Medicine Committee, in collaboration with selected external experts, met in June 2019 to consider athlete health monitoring issues specific to tennis. Once the IOC consensus statement was finalised, the tennis-specific consensus was drafted and agreed on by the members over three iterations. Compared with the IOC consensus statement, the tennis consensus contains tennis-specific information on injury mechanism, mode of onset, injury classification, injury duration, capturing and reporting exposure, reporting risk and study population. Our recommendations apply to able-bodied as well as wheelchair tennis players. Where applicable, sp...
Bookmarks Related papers MentionsView impact
Isokinetics and Exercise Science, 1996
ABSTRACT
Bookmarks Related papers MentionsView impact
Journal of Shoulder and Elbow Surgery, 2016
Bookmarks Related papers MentionsView impact
Journal of athletic training, 2016
The appropriate resistance intensity to prescribe for shoulder rehabilitative exercise is not com... more The appropriate resistance intensity to prescribe for shoulder rehabilitative exercise is not completely known. Excessive activation of the deltoid and upper trapezius muscles could be counterproductive for scapulohumeral rhythm during humeral elevation. To identify the effects of different exercise intensities on the scapular muscles during a free-motion "robbery" exercise performed in different degrees of shoulder abduction in seated and standing positions. Descriptive laboratory study. Kinesiology Adapted Physical Education Laboratory. A total of 15 healthy male college students (age = 20.5 ± 2.2 years, height = 174.5 ± 5.3 cm, mass = 63.8 ± 6.0 kg). Participants performed 5 repetitions of a randomized exercise sequence of the robbery exercise in 2 body positions (seated, standing), 2 shoulder-abducted positions (W [20°], 90/90 [90°]) at 3 intensities (0%, 3%, and 7% body weight). Electromyographic (EMG) activity of the upper trapezius, lower trapezius, serratus anterio...
Bookmarks Related papers MentionsView impact
Bookmarks Related papers MentionsView impact
The Athlete's Shoulder, 2009
Bookmarks Related papers MentionsView impact
International journal of sports physical therapy, 2012
Injury rates for softball players are similar to baseball players yet information regarding risk ... more Injury rates for softball players are similar to baseball players yet information regarding risk factors, pitching, and physical characteristics for high school windmill softball pitchers is limited. This information is needed to guide prevention, training, and rehabilitation efforts. The purpose of this study was to report descriptive data regarding the physical characteristics and pitching volume experienced by high school softball pitchers during one academic season. A secondary aim was to track and describe upper extremity injuries suffered by high school softball pitchers throughout the course of the 2009 season. Twelve uninjured female softball pitchers (13-18y) from 5 Greenville, South Carolina high schools participated. Prior to the 2009 season, the pitchers' shoulder internal, external, total arc of rotation and horizontal adduction PROM was measured. During the 10-week season, aggregate pitch counts (pitch volume) and occurrence of upper extremity injury were tracked f...
Bookmarks Related papers MentionsView impact
North American journal of sports physical therapy : NAJSPT, 2009
The importance of the scapular stabilizing muscles has led to an increased interest in quantitati... more The importance of the scapular stabilizing muscles has led to an increased interest in quantitative measurements of their strength. Few studies have measured isometric or concentric isokinetic forces. Additionally, limited reports exist on the reliability of objective measures for testing scapular protraction and retraction muscle strength or scapular testing that does not involve the glenohumeral joint. To determine the reliability of four new methods of measuring the maximal isometric strength of key scapular stabilizing muscles for the actions of protraction and retraction, both with and without the involvement of the glenohumeral (GH) joint. The Isobex® stationary tension dynamometer was used to measure the maximal isometric force (kg) on thirty healthy females (ages 22-26 years). Three measures were taken for each method that was sequentially randomized for three separate testing sessions on three nonconsecutive days. Intraclass correlations (ICC2,3) for intrasession reliabilit...
Bookmarks Related papers MentionsView impact
Medicine & Science in Sports & Exercise, 2002
Bookmarks Related papers MentionsView impact
Medicine & Science in Sports & Exercise, 1998
Bookmarks Related papers MentionsView impact
Journal of Strength and Conditioning Research, 2000
Bookmarks Related papers MentionsView impact
Clinics in Sports Medicine, 2010
Bookmarks Related papers MentionsView impact