Peripheral nerve injuries in weight training: sites, pathophysiology, diagnosis, and treatment

Transient Exertional Compressive Radial Neuropathy in a Collegiate Baseball Pitcher: A Case Report

CASE

A 21-year-old collegiate baseball pitcher presented with transient lateral arm pain and wrist extension weakness after pitching more than 1 inning. Physical examination was unremarkable at rest. Ultrasound-guided injection of the radial nerve at the level of the lateral intramuscular septum improved his symptoms. After decompression of the radial nerve, the patient noted resolution of his symptoms while pitching.

CONCLUSION

Atraumatic radial neuropathy is a rare but documented phenomenon. As far as we know, this is the first reported case of a transient exertional radial neuropathy in an athlete at the level of the lateral intermuscular septum.

Recurrent Median Nerve Injury in a Weight Lifter

Recurrent median neuropathy is an uncommon injury that can be commonly mistaken for other pathological causes. It is important to be aware of the potential causes and symptoms of injury as delay in diagnosis can lead to permanent decrease in hand function and disability. This case is a description of a 33-year-old male patient who previously presented with radicular symptoms and had complete resolution of his pain after a C7 selective nerve root block. Several months after presentation, he developed significant thenar atrophy, localized pain, and weakness associated with weight lifting activities. He was originally diagnosed with a recurrence of his C7 symptoms and a wrist sprain and was treated with a prednisone taper and wrist splint. After no improvement, he was referred to a physiatrist at an outpatient orthopedic clinic where he was examined and found to have a recurrent median neuropathy on electrodiagnostic studies. A left hand MRI was ordered which demonstrated no anatomical evidence of a compressive nerve lesion, and it was concluded that his injury was secondary to direct compression from high intensity weight lifting.

Progressive resistance strength training and the related injuries in older adults: the susceptibility of the shoulder

The benefits of progressive resistance training (PRT) among the older adults are evident, especially in the prevention of sarcopenia and improving muscle strength, which reverse the age-related loss of functional ability. However, PRT carries some risk, particularly when participants are older adults with a certain degree of muscle weakness. The purpose of this article is to discuss the PRT-related injuries, and present an overview of documented shoulder injuries among the elderly, discerning possible mechanisms of injury and risk factors. A literature search was conducted in the PUBMED database to identify the relevant literature using combinations of keywords: strength-training injuries, resistance-training injuries, sports injuries in the elderly, shoulder complex, shoulder injury, and shoulder disorder. Acute and chronic injuries attributed to PRT have been cited in the epidemiological literature. The shoulder complex, has been alluded to as one of the most prevalent regions of injury, particularly in exercises that place the arm extended above the head and posterior to the trunk. However, the risk for injuries appears to be higher for testing than for training itself. One-repetition maximum strength testing may result in a greater injury risk. This technique, though acceptable, needs additional precautions in inexperience older adults to prevent injury. Thus, the best treatment for PRT age-related injuries is prevention. Appropriate and individualized training programs, the use of safe equipment, careful warming up and cooling down, correct range of motion, progressive intensity training, cardiovascular and musculoskeletal fitness are essential aspects of injury prevention among the elderly.

Technique and safety aspects of resistance exercises: a systematic review of the literature

A systematic review of the scientific literature was conducted to identify the optimal ranges of motion for preventing injury in the main joints of the body during resistance exercise performance. These ranges of motion are independent of the type in which the resistance exercises could be applied (ie, adults, elderly, athletes, recreational exercisers), and the regions examined include the shoulder, spine, and knee, which are injured most often. It can be concluded that during the performance of any resistance exercise, it is possible to put anatomical structures at risk with certain body positions; therefore, it is necessary to understand these movements so injury can be avoided.

Sports-related injuries of the elbow

Sports-related injuries about the elbow occur commonly and are often managed by a wide variety of health care providers. It is particularly important that a surgeon well versed in arthroscopy, reconstructive trauma, and peripheral nerve techniques evaluates potentially complex injuries. It is equally imperative that the preoperative care regimen and postoperative management be conducted by an experienced therapist who understands elbow biomechanics and function. Acute pathology, such as fracture or severe ligamentous and tendinous injury, usually warrants operative treatment. A thorough understanding of the anatomy and biomechanics of the elbow is crucial since the expected recovery in the nonathlete will not suffice for the competitive athlete. Demanding activities, such as the overhead-throwing motion cycle, require a much more complete recovery than simple return to activities of daily living. Chronic elbow problems in the athlete can often be managed with appropriate therapy and modification to the training protocol. Poor response to conservative means should lead to a more thorough evaluation by an experienced elbow surgeon as these injuries can often be career ending. The spectrum of commonly seen lesions in the athlete's elbow is described here, as are conservative care measures, operative treatments, and postoperative management.