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Yoshimi M, Maeda N, Komiya M, Fukui K, Tashiro T, Kaneda K, Arima S, Tsutsumi S, Abekura T, Urabe Y. Effect of thoracic expansion restriction on scapulothoracic and glenohumeral joint motion during shoulder external rotation. J Back Musculoskelet Rehabil 2022; 35:1399-1406. [PMID: 35723089 PMCID: PMC9697060 DOI: 10.3233/bmr-220006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Shoulder external rotation in the throwing motion involves movement of the scapulothoracic and glenohumeral joints, thoracic spine, and the thorax. Restriction of thoracic expansion may decrease scapulothoracic joint motion and compensate by excessive glenohumeral joint motion. However, it is unclear how restricting the expansion of the thorax alters shoulder motion. OBJECTIVE To elucidate changes in scapulothoracic and glenohumeral joint movements caused by restricted thoracic expansion. METHODS Kinematic data were obtained using an electromagnetic tracking device (Liberty; Polhemus), from 18 male participants, during shoulder external rotation in the sitting position with and without restriction of thoracic expansion. The displacements from the start position to the maximum external rotation position were compared, and Pearson's correlation coefficient was calculated. RESULTS A significant difference was observed in the scapulothoracic posterior tilt angle (P< 0.01) and glenohumeral external rotation angle (P< 0.01). A significant positive correlation existed between scapulothoracic posterior tilt and glenohumeral external rotation (P< 0.05) with and without restriction. CONCLUSIONS Restriction of thoracic expansion decreased scapulothoracic motion and increased glenohumeral motion. Thus, a decrease in thoracic expansion may change scapulothoracic and glenohumeral movements, which may be a risk factor for throwing injuries.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Yukio Urabe
- Corresponding author: Yukio Urabe, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan. Tel.: +81 82 257 5405; Fax: +81 82 257 5405; E-mail:
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Tanaka Y, Ishida T, Ino T, Suzumori Y, Samukawa M, Kasahara S, Tohyama H. The effects of relative trunk rotation velocity on ball speed and elbow and shoulder joint torques during baseball pitching. Sports Biomech 2022:1-13. [PMID: 36223307 DOI: 10.1080/14763141.2022.2129431] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 09/22/2022] [Indexed: 10/17/2022]
Abstract
In baseball pitching, suppressing trunk rotation while rotating the pelvis in the early phase of arm cocking is important for throwing a fast ball. However, quantitative evaluation of trunk rotation during pitching has not been established, and its associations with elbow and shoulder torques are unclear. The purpose of this study was to examine the correlation of a new measure of trunk rotation suppression with ball speed and elbow and shoulder torques during pitching. Eighteen adult male baseball pitchers (21.7 ± 1.2 years old) participated. Three qualified pitches were analysed using a three-dimensional motion capture system. Trunk rotation velocity, normalised to the peak velocity, was derived at the time of peak pelvic velocity. Pearson's correlation coefficient was used to determine correlations. The normalised trunk rotation velocity at the peak pelvic velocity was significantly correlated with elbow valgus torque (R = -0.508, P = 0.032), shoulder external rotation torque (R = -0.507, P = 0.032) and ball speed (R = -0.504, P = 0.033). A smaller normalised trunk rotation angular velocity at the time of peak pelvic rotation velocity could increase ball speed but may also increase elbow and shoulder torques among pitchers who demonstrate trunk rotation after foot contact.
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Affiliation(s)
- Yousuke Tanaka
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Tomoya Ishida
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Takumi Ino
- Faculty of Health Sciences, Hokkaido University of Science, Sapporo, Japan
| | - Yuki Suzumori
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Mina Samukawa
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
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Yu IY, Kim SY, Kang MH. Strategies for controlling axial shoulder rotation change shoulder muscle activity during external rotation exercises. J Shoulder Elbow Surg 2021; 30:1230-1237. [PMID: 32920111 DOI: 10.1016/j.jse.2020.08.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/11/2020] [Accepted: 08/17/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND The infraspinatus muscle has a crucial role in shoulder stability. Although axial shoulder rotation is useful for selective activation of the infraspinatus, no study has examined the influence of exercise position on axial shoulder rotation during shoulder external rotation (ER) exercises. Thus, this study investigated the muscle activity in the infraspinatus, posterior deltoid, and middle trapezius during shoulder ER exercises performed with and without controlled axial shoulder rotation in 2 different positions. METHODS Twenty healthy subjects performed prone external rotation (PER) exercises with and without pressure biofeedback and seated external rotation (SITER) exercises with and without posterior humeral head gliding. Muscle activity during each ER exercise was measured using surface electromyography. RESULTS Exercise strategy (P < .001) and position (P < .001) had a significant main effect on muscle activity in the infraspinatus and posterior deltoid. However, no significant interaction between strategy and position was observed. For muscle activity in the middle trapezius, strategy and position had a significant interaction effect (P = .014). Muscle activity in the infraspinatus increased significantly with the use of strategies to control axial shoulder rotation, whereas muscle activity in the posterior deltoid and middle trapezius decreased significantly. For all 3 muscles, greater activity was observed in the prone position than the seated position. CONCLUSION We suggest that PER with pressure biofeedback can be useful to improve selective activation of the infraspinatus muscle while further eliciting infraspinatus muscle activity.
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Affiliation(s)
- Il-Young Yu
- Department of Rehabilitation Center, Dang Dang Korean Medicine Hospital, Changwon, Republic of Korea
| | - Soo-Yong Kim
- Department of Physical Therapy, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Min-Hyeok Kang
- Department of Physical Therapy, College of Health Sciences, Catholic University of Pusan, Busan, Republic of Korea.
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Miyakoshi K, Umehara J, Komamura T, Ueda Y, Tamezawa T, Kitamura G, Ichihashi N. Effect of different trunk postures on scapular muscle activities and kinematics during shoulder external rotation. J Shoulder Elbow Surg 2019; 28:2438-2446. [PMID: 31409561 DOI: 10.1016/j.jse.2019.04.059] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 04/17/2019] [Accepted: 04/24/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND Shoulder external rotation at abduction (ER) is a notable motion in overhead sports because it could cause strong stress to the elbow and shoulder joint. However, no study has comprehensively investigated the effect of different trunk postures during ER. This study aimed to investigate the effect of different trunk postures on scapular kinematics and muscle activities during ER. METHODS Fourteen healthy men performed active shoulder external rotation at 90° of abduction with the dominant arm in 15 trunk postures. At maximum shoulder external rotation in 15 trunk postures, including 4 flexion-extension, 6 trunk rotation, and 4 trunk side-bending postures, as well as upright posture as a control, scapular muscle activities and kinematics were recorded using surface electromyography and an electromagnetic tracking device, respectively. The data obtained in the flexion-extension, trunk rotation, and trunk side-bending postures were compared with those obtained in the upright posture. RESULTS In the flexion-extension condition, scapular posterior tilt and external rotation significantly decreased, but the muscle activities of the lower trapezius and infraspinatus significantly increased in maximum trunk flexion. Moreover, scapular upward rotation and the activity of the serratus anterior significantly increased in maximum trunk extension. In the rotation condition, scapular posterior tilt and external rotation significantly decreased, but the activity of the serratus anterior significantly increased in the maximum contralateral trunk rotation posture. In the trunk side-bending condition, scapular posterior tilt and the external rotation angle significantly decreased. CONCLUSION Trunk postures affected scapular kinematics and muscle activities during ER. Our results suggest that different trunk postures activate the lower trapezius and serratus anterior, which induce scapular posterior tilt.
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Affiliation(s)
- Kosuke Miyakoshi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Jun Umehara
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Research Fellow of the Japan Society for the Promotion of Science, Tokyo, Japan
| | - Tomohito Komamura
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yasuyuki Ueda
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Rehabilitation, Nobuhara Hospital, Hyogo, Japan
| | - Toru Tamezawa
- Department of Rehabilitation, Kanazawa University Hospital, Ishikawa, Japan
| | - Gakuto Kitamura
- Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan
| | - Noriaki Ichihashi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Flury M, Kwisda S, Kolling C, Audigé L. Latissimus dorsi muscle transfer reduces external rotation deficit at the cost of internal rotation in reverse shoulder arthroplasty patients: a cohort study. J Shoulder Elbow Surg 2019; 28:56-64. [PMID: 30224206 DOI: 10.1016/j.jse.2018.06.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 06/18/2018] [Accepted: 06/23/2018] [Indexed: 02/01/2023]
Abstract
HYPOTHESIS We hypothesized that treatment of rotator cuff arthropathy (RCA) with reverse shoulder arthroplasty (RSA) and an additional latissimus dorsi transfer (LDT) in patients with an active external rotation deficit (ERD) would restore external rotation (ER) with concomitant deterioration in internal rotation. METHODS In our cohort study, 26 RCA patients with an active ERD (ie, positive lag sign and maximum active ER of 0°) underwent RSA between September 2007 and February 2015; LDT was completed in 13 of these patients. In addition, 88 control patients without ERD who underwent only RSA were identified. Clinical outcomes of strength, range of motion, Constant-Murley score, and Shoulder Pain and Disability Index score, as well as complications, were documented 6, 12, 24, and 60 months postoperatively. We made comparative analyses using statistical mixed models. RESULTS The LDT procedure extended the surgical time by 26 minutes (P = .003). LDT patients had up to 22° better postoperative active ER than control patients (P < .001), although this was accompanied by an internal rotation deficit (77% vs 46% of control patients could not reach the lumbosacral region, P = .010). We calculated a 23% risk of local procedure-related complications for RSA patients with an active ERD and LDT. CONCLUSION Patients with RCA and an active ERD seem to benefit from an LDT, although this is accompanied by the potential loss of internal rotation. This additional procedure is associated with an extended surgical time as well as a possible increase in the risk of a complication occurring.
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Affiliation(s)
- Matthias Flury
- Upper Extremities Department, Schulthess Clinic, Zürich, Switzerland
| | - Sebastian Kwisda
- Upper Extremities Department, Schulthess Clinic, Zürich, Switzerland
| | - Christoph Kolling
- Upper Extremities Department, Schulthess Clinic, Zürich, Switzerland; Research and Development Department, Schulthess Clinic, Zürich, Switzerland
| | - Laurent Audigé
- Upper Extremities Department, Schulthess Clinic, Zürich, Switzerland; Research and Development Department, Schulthess Clinic, Zürich, Switzerland.
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Simone JP, Streubel PN, Sanchez-Sotelo J, Steinmann SP, Adams JE. Change in the Distance From the Axillary Nerve to the Glenohumeral Joint With Shoulder External Rotation or Abduction Position. Hand (N Y) 2017. [PMID: 28644944 PMCID: PMC5484444 DOI: 10.1177/1558944716668849] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND This study investigated whether axillary nerve (AN) distance to the inferior border of the humeral head and inferior glenoid would change while placing the glenohumeral joint in different degrees of external rotation and abduction. METHODS A standard deltopectoral approach was performed on 10 fresh-frozen cadaveric specimens. The distance between AN and the inferior border of the humeral head and inferior glenoid while placing the shoulder in 0°, 45°, and 90° of external rotation or abduction was measured. Continuous variables for changes in AN position were compared with paired 2-tailed Student t test. RESULTS The mean distance between the AN and the humeral head with the shoulder in 0°, 45°, and 90° of external rotation and 0° of abduction was 13.77 mm (SD 4.31), 13.99 mm (SD 4.12), and 16.28 mm (SD 5.40), respectively. The mean distance between the AN and glenoid with the shoulder in 0°, 45°, and 90° of external rotation was 16.33 mm (SD 3.60), 15.60 mm (SD 4.19), and 16.43 (SD 5.35), respectively. The mean distance between the AN and the humeral head with the shoulder in 0°, 45°, and 90° of abduction and 0° of external rotation was 13.76 mm (SD 4.31), 10.68 mm (SD 4.19), and 3.81 mm (SD 3.08), respectively. The mean distance between the AN and glenoid with the shoulder in 0°, 45°, and 90° of abduction was 16.33 mm (SD 3.60), 17.66 mm (SD 5.80), and 12.44 mm (SD 5.57), respectively. CONCLUSIONS The AN position relative to the inferior aspect of the glenohumeral joint does not significantly change despite position of external rotation. Increasing shoulder abduction over 45° decreases the distance from the glenohumeral joint to the AN and should be avoided.
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Affiliation(s)
- Juan Pablo Simone
- Shoulder and Elbow Surgery, Hospital Alemán, Buenos Aires, Argentina
| | - Philipp N. Streubel
- Shoulder, Elbow and Hand Surgery, Department of Orthopedic Surgery, University of Nebraska Medical Center, Omaha, USA
| | | | | | - Julie E. Adams
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA,Department of Orthopedic Surgery, Mayo Clinic Health System, Austin, MN, USA,Julie E. Adams, Department of Orthopaedic Surgery, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.
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Ribeiro A, Pascoal A. Assessment of shoulder external rotation range-of-motion on throwing athletes: the effects of testing end-range determination (active versus passive). Physiother Theory Pract 2015; 31:362-6. [PMID: 25594241 DOI: 10.3109/09593985.2014.1003344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The purpose of this study was to compare the effects of active or passive end-range determination (supine position) for external rotation range of motion (ROM) in overhead throwing athletes and verify if athletes' ROM is similar to non-athletes. Kinematic data from the dominant shoulder of 24 healthy male subjects, divided into two groups (12 athletes and 12 non-athletes) were recorded at end-range external rotation, thoracohumeral and glenohumeral external rotation angles were compared and a 2-way repeated-measures ANOVA was used to calculate the effects of end-range determination (passive versus active) across groups (athlete and non-athlete). A significant main effect (p < 0.001) on both thoracohumeral and glenohumeral external end-range angles was observed while the highest end-range determination values were associated with passive motion. No differences were observed between the athletic or non-athletic groups for either thoracohumeral (p = 0.784) or glenohumeral (p = 0.364) motion.
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Affiliation(s)
- A Ribeiro
- Department of Sport & Health, CIPER, LBMF, Faculty of Human Kinetics, University of Lisbon , Lisbon , Portugal and
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