Stahl Ryan A, Eckenrode Brian J
Ivy Rehab Physical Therapy, Cherry Hill, NJ, USA.
Arcadia University, Department of Physical Therapy, Glenside, PA, USA.
Int J Sports Phys Ther. 2020 Dec;15(6):1211-1221. doi: 10.26603/ijspt20201211.
Injuries frequently occur in competitive wrestling, with the elbow joint representing about 25% of all injuries. Specific to the elbow, the ulnar collateral ligament (UCL) can be injured traumatically from takedowns in wrestling. In athletes with complete UCL tears, surgical management is often recommended with nonoperative management resulting in less favorable outcomes. The purpose of this case report is to present a nonoperative criterion-based rehabilitation program for a high school wrestler with a complete UCL tear of the elbow.
A 17-year-old male wrestler presented to outpatient physical therapy with a complete UCL tear sustained from falling on an outstretched hand during a wrestling match. He presented with limited elbow range of motion (ROM), medial elbow instability, and weakness of the involved shoulder and forearm musculature. A three staged criterion-based rehabilitation protocol was developed for this subject based on specific criteria, including pain, elbow ROM, arm strength, and functional outcomes.
The subject was treated for nine visits over six weeks, and demonstrated improvements in all strength tests of the involved upper extremity, with elbow flexion strength improving the most by 58%. Return to sport (RTS) tests were used to assess the subject's ability to return to practice. At approximately eight weeks after initial injury, the subject was able to return to full participation in competitive wrestling with no reports of elbow pain or instability.
Through the utilization of a criterion-based rehabilitation protocol for the nonoperative management of an UCL injury, this high school wrestler was able to safely progress back to wrestling without pain or instability in an accelerated time frame. Previously, no detailed rehabilitation guidelines for nonoperative management of UCL injuries in contact sports have been described. Additionally, few studies exist which report on the inclusion of RTS testing following an injury to the UCL of the elbow, as RTS testing is optimal for determining readiness for sport.
4, Case Report.
竞技摔跤中经常出现损伤，其中肘关节损伤约占所有损伤的25%。具体到肘部，尺侧副韧带（UCL）可能因摔跤中的摔倒动作而受到创伤性损伤。对于完全性UCL撕裂的运动员，通常建议手术治疗，非手术治疗的效果往往较差。本病例报告的目的是为一名肘部完全性UCL撕裂的高中摔跤运动员介绍一个基于标准的非手术康复计划。
一名17岁的男性摔跤运动员因在摔跤比赛中伸手撑地摔倒导致完全性UCL撕裂，前来门诊接受物理治疗。他表现出肘关节活动范围（ROM）受限、内侧肘关节不稳定以及受累肩部和前臂肌肉无力。基于包括疼痛、肘关节ROM、手臂力量和功能结果等特定标准，为该受试者制定了一个三阶段的基于标准的康复方案。
该受试者在六周内接受了九次治疗，受累上肢的所有力量测试均有改善，其中肘关节屈曲力量改善最为明显，提高了58%。采用重返运动（RTS）测试来评估受试者恢复训练的能力。在初次受伤约八周后，该受试者能够完全恢复参加竞技摔跤，且无肘关节疼痛或不稳定的报告。
通过对UCL损伤采用基于标准的康复方案进行非手术治疗，这名高中摔跤运动员能够在加速的时间框架内安全地恢复摔跤，且无疼痛或不稳定情况。此前，尚无关于接触性运动中UCL损伤非手术治疗的详细康复指南。此外，很少有研究报告在肘部UCL损伤后纳入RTS测试，因为RTS测试对于确定运动准备情况最为理想。
4，病例报告。
