The American journal of sports medicine
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In this 3-year longitudinal study, we studied lumbar mobility and the occurrence of low back pain among 98 adolescents who were free of previous severe low back pain: 33 nonathletes (16 boys, 17 girls), 34 boy athletes (ice hockey and soccer players) and 31 girl athletes (figure skaters and gymnasts). During the followup, low back pain lasting longer than 1 week was reported by 29 athletes (15 boys and 14 girls) and by 6 nonathletes (3 boys and 3 girls). ⋯ The girls in the lowest tertile of maximal lumbar extension at baseline had a relative risk of 3.4 to have future low back pain compared with those in the highest tertile. We conclude that the low individual physiologic maximum of lower segment lumbar extension mobility may cause overloading of the low back among athletes involved in sports with frequent maximal lumbar extension and that it predicts future low back pain.
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The anatomic proximity of several neurovascular structures remains a major concern to the surgeon interested in performing arthroscopic capsular release. We evaluated the anatomic relationships between the released capsule and the axillary nerve, posterior circumflex humeral artery, and brachial artery in a frozen cadaveric model. With the aid of electrocautery, seven cadaveric shoulders underwent complete arthroscopic capsular release. ⋯ Anatomic dissection revealed an average distance from the capsular release to the axillary nerve of 7.04 mm (95% confidence interval, 5.62, 8.47), to the posterior circumflex humeral artery of 8.2 mm (95% confidence interval, 6.41, 9.99), and to the brachial artery of 15.97 mm (95% confidence interval, 9.85, 22.09). As the axillary nerve was followed medially from the released capsule, the inferior border of the subscapularis muscle became interposed between the capsule and the axillary nerve. This limited anatomic study shows that a relatively safe margin between the capsule and the neighboring neurovascular structures can be obtained by releasing the capsule within 1 cm of the glenoid rim.