Physical examination tests may aid diagnosis; 6 tests are recommended for confirming and 1 test is recommended for ruling out a SLAP lesion. Combinations of tests may be helpful to diagnose SLAP lesions. Clinical trials directly comparing outcomes between surgical and nonoperative management are absent; however, in cohort trials, the reports of function and return-to-sport outcomes are similar for each management approach. Nonoperative management that includes rehabilitation, nonsteroidal anti-inflammatory drugs, and corticosteroid injections is recommended as the first line of treatment. Rehabilitation should address deficits in shoulder internal rotation, total arc of motion, and horizontal-adduction motion, as well as periscapular and glenohumeral muscle strength, endurance, and neuromuscular control. Most researchers have examined the outcomes of surgical management and found high levels of satisfaction and return of shoulder function, but the ability to return to sport varied widely, with 20% to 94% of patients returning to their sport after surgical or nonoperative management. On average, 55% of athletes returned to full participation in prior sports, but overhead athletes had a lower average return of 45%. Additional work is needed to define the criteria for diagnosing and guiding clinical decision making to optimize outcomes and return to play.

A 21-year-old male baseball catcher sustained an injury to the right testicle from a foul ball that ricocheted from the ground to his groin. The athlete was removed from competition when testicular pain began to increase. Ice was applied to the affected area and nonsteroidal anti-inflammatory drugs (NSAIDs) were utilized through the evening. Further diagnosis and treatment were warranted the following morning. Diagnostic ultrasound revealed a fracture to the right testicle, necessitating surgical repair. The athlete followed a return-to-play progression and returned to play 20 days postinjury. This case describes evaluation and treatment of a rare acute condition and the need for early recognition and diagnosis.

Four student-athletes (aged 20 to 22 years old) participating in NCAA Division I ice hockey served as cases. Cases were free of injury, and participated in all team activities without restrictions. A dry needling (DN) lower extremity recovery protocol was completed on all cases during a single session. To administer the DN recovery treatment, static needles were placed in specific bilateral locations that consisted of 5 points on both the anterior and posterior aspect of lower extremity and lumbopelvic complex. The Acute Recovery Stress Scale (ARSS) was used to evaluate the effect of the DN recovery treatment on each cases perception of recovery at 24 hours post, and 48 hours post DN treatment. Overall, total and average scores of ARSS for all cases were closer to baseline at 48-post than the other time points. Recovery techniques historically have been used post-activity because even normal training loads, which are considered positive, produce athlete stress and fatigue and can lead to injury. Results from this case series suggest that ice hockey athletes who are experiencing post-exercise stress, such as soreness and fatigue, may benefit from a lower extremity DN recovery treatment protocol.

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Context: Plantar heel pain is a common problem affecting foot function, causing pain in the foot under the heel. Plantar fasciitis is commonly treated with conservative treatment, such as joint and soft tissue mobilization, self-stretching home programs, foot orthoses, and night splinting or booting. Dry needling (DN) has shown to be an effective method of treating plantar fasciitis (PF) in multiple randomized control trials. Dry needling is a technique that has been reported to be beneficial in managing pain and dysfunction after PF. Still, there is limited published literature on DN, a myofascial sequence as part of the treatment of PF. Case Presentation: The patient was a 38-year-old female runner referred by a podiatrist for evaluation and treatment to include DN and therapy for persistent PF in the right foot. She was treated 4 times over 3 weeks with a home exercise program. Management and Outcomes: The DN intervention was beyond the local plantar fascia and incorporated 11 locations from the foot up the posterior chain and 2 electric stim channels. The patient had reduced pain as measured by a visual analog scale, increased function as measured by the functional ankle disability index, and range of motion increases. Conclusions: This case illustrates the use of DN and a home exercise program to provide a favorable outcome in a patient with PF.