The importance of shoulder and cervical dysfunction in the etiology and treatment of athletic elbow injuries.

Our clinical experience has demonstrated that the development of elbow injuries is often secondary to dysfunction of the shoulder and/or cervical regions. In response to this observation, we have developed a rehabilitation protocol for the entire upper quarter as the focus of our management of elbow injuries. Our approach addresses range of motion deficits in shoulder rotation, weakness of shoulder external rotation and abduction, cervical facet impingement, and other associated deficits, with the goal being restoration of the flexibility, strength, endurance, proprioception, and coordination needed for activity. Presented are specific elements of this approach, possible mechanisms of injury involved, and a case history. J Orthop Sports Phys Ther 1990;11(9):402-409.