The Influence of Glenohumeral Joint Posterior Capsule Tightness and Impingement Symptoms on Shoulder Impairments and Kinematics

2019 ◽  
Vol 99 (7) ◽  
pp. 870-881 ◽  
Author(s):  
Dayana P Rosa ◽  
John D Borstad ◽  
Julia K Ferreira ◽  
Paula R Camargo
Keyword(s):  
Internal Rotation ◽  
Shoulder Pain ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Posterior Capsule ◽  
Control Group ◽  
Pain Thresholds ◽  
Lower Pain ◽  
And Function ◽  
Rotation Strength

AbstractBackgroundPosterior capsule tightness (PCT) and shoulder impingement syndrome (SIS) symptoms are both associated with altered shoulder biomechanics and impairments. However, their combined effect on kinematics, pain, range of motion (ROM), strength, and function remain unknown.ObjectiveThe purpose of this study was to determine if the combination of PCT and SIS affects scapular and humeral kinematics, glenohumeral joint ROM, glenohumeral joint external rotation strength, pain, and function differently than does either factor (PCT or SIS) alone.DesignThe design was a cross-sectional group comparison.MethodsParticipants were placed into 1 of 4 groups based on the presence or absence of SIS and PCT: control group (n = 28), PCT group (n = 27), SIS group (n = 25), and SIS + PCT group (n = 25). Scapular kinematics and humeral translations were quantified with an electromagnetic motion capture system. Shoulder internal rotation and external rotation ROM, external rotation strength, and pain and Shoulder Pain and Disabilities Index scores were compared between groups with ANOVA.ResultsThe SIS group had greater scapular internal rotation (mean difference = 5.13°; 95% confidence interval [CI] = 1.53°–8.9°) and less humeral anterior translation (1.71 mm; 95% CI = 0.53–2.9 mm) than the other groups. Groups without PCT had greater internal rotation ROM (16.05°; 95% CI = 5.09°–28.28°). The SIS + PCT group had lower pain thresholds at the levator scapulae muscle (108.02 kPa; 95% CI = 30.15–185.88 kPa) and the highest Shoulder Pain and Disabilities Index score (∼ 44.52; 95% CI = 33.41–55.63).LimitationsThese results may be limited to individuals with impingement symptoms and cannot be generalized to other shoulder conditions.ConclusionsDecreased ROM and lower pain thresholds were found in individuals with both impingement symptoms and PCT. However, the combination of factors did not influence scapular and humeral kinematics.

scholarly journals Spiking Kinematics in Volleyball Players With Shoulder Pain

2019 ◽  
Vol 54 (1) ◽  
pp. 90-98 ◽  
Author(s):  
Yi-Fen Shih ◽  
Yuan-Ching Wang
Keyword(s):  
Internal Rotation ◽  
Shoulder Pain ◽  
Glenohumeral Joint ◽  
Tracking System ◽  
Cross Sectional Study ◽  
Control Group ◽  
Cross Sectional ◽  
Volleyball Players ◽  
Ball Contact ◽  
Posterior Tilt

Context Spiking is one of the most frequently used scoring techniques in volleyball games, and around 80% of shoulder pain in volleyball players is linked with the spiking movement. Objective To investigate the differences in glenohumeral joint, scapular, and trunk movements during the spiking motion between volleyball players with and those without shoulder pain. Design Cross-sectional study. Setting University laboratory. Patients or Other Participants Twenty amateur volleyball players with shoulder pain (age = 21.8 ± 1.79 years, with an average of 4.0 ± 0.92 years of volleyball experience and 6.0 ± 3.51 months of shoulder pain) and 20 sex-, age-, and experience-matched control participants. Main Outcome Measure(s) The 3-dimensional kinematics of the shoulder joint, scapula, and trunk during spiking were assessed using an electromagnetic tracking system. Results Compared with the control group, individuals with shoulder pain demonstrated less scapular posterior tilt (P = .041) and more glenohumeral horizontal abduction (P = .008) and scapular internal rotation (P = .02) at ball contact when performing the cross-body spike. Conclusions The decrease in scapular posterior tilt, along with increased glenohumeral horizontal abduction and scapular internal rotation, was associated with shoulder pain in university volleyball players. These changes should be addressed in the training and treatment of young volleyball players.

Effect of Posterior Capsule Tightness and Humeral Retroversion on 5 Glenohumeral Joint Range of Motion Measurements: A Cadaveric Study

2019 ◽  
Vol 47 (6) ◽  
pp. 1434-1440 ◽  
Author(s):  
Dayana P. Rosa ◽  
Paula R. Camargo ◽  
John D. Borstad
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Posterior Capsule ◽  
Joint Range Of Motion ◽  
Motion Measurements ◽  
Humeral Retroversion ◽  
Clinical Measurements ◽  
Joint Range

Background: Altered glenohumeral joint range of motion can be caused by increased humeral retroversion (HR) and/or posterior capsule tightness (PCT). To make informed clinical decisions, it is vital to understand how HR and PCT alterations, individually and in combination, affect joint range of motion measurements. Purpose: To evaluate the effect of experimental tissue alterations on clinical range of motion measures. Study Design: Controlled laboratory study. Methods: Five clinical measurements were quantified in 8 fresh-frozen cadavers under 4 experimentally created conditions: baseline (no alterations), HR condition (20° increase in HR by transecting the bone), PCT condition (20% decrease in length via thermal energy), and PCT + HR combined. Clinical measurements included bicipital forearm angle, low flexion, glenohumeral internal and external rotation, and horizontal adduction. All measurements were taken by the same blinded tester. Separate 1-factor repeated measures analyses of variance were used to evaluate the effect of the alterations on each clinical measurement. Results: There was a significant main effect of condition for bicipital forearm angle ( P = .02, F = 4.03), low flexion ( P = .02, F = 3.86), internal rotation ( P = .03, F = 3.65), and external rotation ( P < .001, F = 15.15) but not for horizontal adduction ( P = .29, F = 1.33). The HR condition resulted in a decreased bicipital forearm angle of 16.1° and 15.8° as compared with the PCT and PCT + HR conditions, respectively. When compared with baseline, the PCT + HR condition decreased the low flexion test by 13.5°, and the HR condition decreased internal rotation range of motion by 14.2°. All conditions increased external rotation when compared with baseline. Conclusion: Greater measurement changes were noted in both HR conditions, suggesting that bony alterations influence motion to a greater extent than posterior capsule alterations. Clinical Relevance: Clinicians should be aware that humeral retroversion will influence the measurement of posterior shoulder tightness.

scholarly journals The Relationship between the Glenohumeral Joint Internal Rotation Deficit and the Trunk Compensation Movement in Baseball Pitchers

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 243
Author(s):  
Shih-Chung Cheng ◽  
Ting-Yu Wan ◽  
Chun-Hao Chang
Keyword(s):  
High School ◽  
Internal Rotation ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Senior High School ◽  
Control Group ◽  
Trunk Rotation ◽  
Baseball Pitchers ◽  
The Relationship ◽  
Dominant Side

Background and objectives: Glenohumeral joint internal rotation deficit (GIRD) is commonly observed in the dominant arm of baseball pitchers and is limited by horizontal adduction motions. We inferred that when pitchers’ generation of internal shoulder rotation and horizontal adduction activity is limited, they may generate compensation movements in other body parts. This study aims to investigate whether pitchers with GIRD generates trunk compensation during pitching where pitching targets were on the lower corner of their non-dominant side. Design: Case-control study. Setting: Elite senior high school baseball. Participants: Twenty-five senior high school baseball pitchers participated in this study. Twelve pitchers with GIRD were assigned to the experiment group, and the remaining 13 participants to the control group. Main outcome measures: Glenohumeral internal/external rotation of both arms and internal/external rotation of the bilateral hip joints were measured. The kinematic values of the trunk when pitching to a target were measured using high-speed infrared cameras. Results: Pitchers with GIRD exhibited significantly greater upper trunk rotation toward the non-dominant side when a baseball was released from their hand (27.39 ± 6.62 degrees), compared with non-GIRD pitchers (20.42 ± 5.97 degrees) (p < 0.05). The total rotation of the pivot leg of pitchers with GIRD (67.54 ± 7.84 degrees) was significantly smaller than that of pitchers without GIRD (74.00 ± 7.07 degrees) (p < 0.05). Conclusions: GIRD in the dominant arm affected upper trunk rotation during pitching and was associated with the hip range of motion. Future studies could conduct a longitudinal study regarding the relationship between GIRD and other joint injuries of the lower limbs.

Range of motion and muscle function on shoulder joints of young handball athletes

2021 ◽  
pp. 1-7
Author(s):  
Luis Ceballos-Laita ◽  
Alberto Pérez-Manzano ◽  
Teresa Mingo-Gómez ◽  
Ignacio Hernando-Garijo ◽  
Ricardo Medrano-De-La-Fuente ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Muscle Function ◽  
External Rotation ◽  
Posterior Part ◽  
Cross Sectional Study ◽  
Control Group ◽  
Cross Sectional ◽  
Shoulder Range Of Motion ◽  
Rotation Strength

BACKGROUND: The detection of primary risk factors through the assessment of shoulder range of motion (ROM) and muscle function could prevent injuries in the initial stages of the handball (HB) practice. OBJECTIVE: To compare shoulder ROM, muscle strength and muscle extensibility between throwing and non-throwing shoulders in young HB athletes and between non-HB athletes. METHODS: A cross-sectional study was designed. Participants aged between 14–16 years that practice physical activity regularly were included and divided in two groups. The HB group included volunteers who practiced HB, the control group included volunteers who practiced other activities. The variables measured were internal rotation and external rotation ROM, maximum isometric strength, and extensibility of the tissues of the posterior part of the throwing and non-throwing shoulder. RESULTS: Thirty-seven subjects were included. The HB group (n= 19) showed greater ROM in both shoulders compared to the control group (n= 18) (p< 0.05). The throwing shoulder of the HB group showed less internal rotation ROM, greater external rotation ROM and greater internal rotation strength when compared to the non-throwing shoulder (p< 0.05). CONCLUSIONS: The results of the study suggest that young HB athletes present differences in shoulder ROM compared to non-HB athletes. Also, HB athletes showed differences in ROM and strength between the TS and non-TS. Hence, the assessment of the shoulder ROM and muscle function should be taken into consideration to avoid injuries in this population.

scholarly journals Effectiveness of Suprascapular Nerve Block in the Treatment of Hemiplegic Shoulder Pain: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Yajing Hou ◽  
Yong Wang ◽  
Xiaojing Sun ◽  
Yake Lou ◽  
Ying Yu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Pain ◽  
Nerve Block ◽  
External Rotation ◽  
Meta Analysis ◽  
Suprascapular Nerve ◽  
Cochrane Library ◽  
Control Group ◽  
Suprascapular Nerve Block ◽  
Secondary Endpoints

Purpose: We aimed to investigate the effectiveness of suprascapular nerve block (SSNB) in patients with hemiplegic shoulder pain (HSP).Background: SSNB is widely used in various shoulder pains, but whether it is effective in HSP remains unknown.Methods: PubMed, Cochrane Library, and Embase databases were searched to identify potential citations. Randomized controlled trials meeting the eligible criteria were included in our analysis. The primary endpoint was Visual Analog Scale (VAS) with a maximum value of 100 and a minimum value of 0. Secondary endpoints were passive range of motion (PROM) that pain starts, and the PROM mainly included abduction, flexion, and external rotation. In addition, the upper extremity Fugl-Meyer assessment (FMA) was also included in our secondary endpoints.Results: Eight studies with 281 patients were included in our analysis. For VAS, there was no obvious difference between SSNB group and control group regardless of the follow-up period (&lt;4 weeks or ≥4 weeks), which were −6.62 (−15.76, 2.53; p = 0.16) and 1.78 (−16.18, 19.74; p = 0.85). For shoulder function, the PROM of abduction, flexion, and external rotation was similar between groups. However, motor function indicator FMA is lower in SSNB control than that in control group, with a mean difference (and 95% CI) of −2.59 (−4.52, −0.66; p = 0.008).Conclusion: SSNB is an effective way for HSP patients.Systematic Review Registration: Registration ID: CRD42021252429.

Shoulder Rotation Function following the Sup-ER Protocol in Children with Brachial Plexus Injuries

Hand ◽  
2020 ◽  
pp. 155894472093736
Author(s):  
Leeor S. Yefet ◽  
Doria Bellows ◽  
Marija Bucevska ◽  
Rebecca Courtemanche ◽  
Kim Durlacher ◽  
...  
Keyword(s):  
Cohort Study ◽  
Brachial Plexus ◽  
Range Of Motion ◽  
Internal Rotation ◽  
External Rotation ◽  
Cross Sectional ◽  
Elbow Function ◽  
Rotation Strength ◽  
Rotation Function

Background: Our group previously developed an upper extremity repositioning (Sup-ER) protocol for brachial plexus birth injuries (BPBIs) that may improve supination and external rotation (ER) at 2 years of age. Questions were raised about the potential for the protocol to cause internal rotation (IR) deficits. The goal of this study was to explore the longer-term outcomes of the Sup-ER protocol and investigate IR/ER function. Methods: This prospective cross-sectional cohort study examined 16 children older than 4 years of age with significant enough BPBI to be treated with the Sup-ER protocol. Total shoulder and elbow function were assessed, including passive and active ranges of motion and strength of IR and ER. Results: Range of motion (ROM) for most active movements was decreased in the affected compared to unaffected arm. Notably, IR passive ROM was similar in the affected (78.7°) and unaffected arm (82.8°). External rotation strength of the affected arm was weaker (42.8 N) compared to the unaffected arm (57.9 N). IR strength had a greater deficit in the affected (43.2 N) arm compared to the unaffected arm (72.2 N), but both ER and IR showed less deficit than described in the literature. Conclusions: Despite differences in ranges of motion between the affected and unaffected arms, ROMs for the affected arm were comparable to the functional limits as reported in the literature. The Sup-ER protocol shows potential to optimize long-term shoulder rotation function in children with BPBI without compromising IR.

EFFECT OF MULLIGAN’S POSTEROLATERAL GLIDE ON SHOULDER ROTATOR STRENGTH, SCAPULAR UPWARD ROTATION IN SHOULDER PAIN SUBJECTS – A RANDOMIZED CONTROLLED TRIAL

2016 ◽  
Vol 19 (03) ◽  
pp. 1650014 ◽  
Author(s):  
Y. V. Raghava Neelapala ◽  
Y Ravi Shankar Reddy ◽  
Roopa Danait
Keyword(s):  
Shoulder Pain ◽  
External Rotation ◽  
Controlled Trial ◽  
Acute Effect ◽  
Exercise Group ◽  
Before And After ◽  
Strength Formula ◽  
Improved Function ◽  
Rotation Strength ◽  
External Rotator

Background and objectives: Joints may have an effect on the function of the surrounding muscles through nociceptors and mechanoreceptors. Pain reduction in the shoulder might lead to improved function of the muscles surrounding the shoulder in individuals with shoulder pain. The aim of our work was to determine the acute effect of Mulligan’s posterolateral glide on shoulder rotator strength, scapular motor control, and pain in painful shoulders. Methodology: Individuals with shoulder pain were randomly assigned to a control active exercise group and an experimental Mulligan’s posterolateral glide group. VAS, scapular upward rotation and shoulder rotator strength were the outcomes measured before and after three sessions of intervention. Multivariate analysis of variance (MANOVA) was used to analyze the differences between the groups after the intervention. Results: A total of 31 subjects with shoulder pain participated in the study. After the intervention, VAS scores ([Formula: see text] (1, 29) [Formula: see text] 27, [Formula: see text]) and Shoulder external rotator strength ([Formula: see text] (1, 29) [Formula: see text] 4.6, [Formula: see text]) were statistically significantly different between both the groups as revealed by one-way MANOVA. There were no significant differences found between the groups in scapular upward rotation ([Formula: see text] (1, 29) [Formula: see text] 0.09, [Formula: see text]) and internal rotator strength ([Formula: see text] (1, 29) [Formula: see text] 0.03, [Formula: see text]) post treatment. Pain scores were lesser and the external rotation strength was higher after Mulligans’ mobilization when compared to active exercise. Conclusion: Mulligan’s mobilization with posterolateral glide was effective in reducing pain and improving external rotator strength in individuals with painful shoulders when compare to active exercise. There were no significant differences noted in shoulder internal rotator strength and scapular upward rotation.

Biomechanical Analysis of Glenohumeral Internal Rotation Deficit in a Cadaveric Model

2010 ◽  
Author(s):  
Akash Gupta ◽  
Jeffrey Gates ◽  
Michelle H. McGarry ◽  
James E. Tibone ◽  
Thay Q. Lee
Keyword(s):  
Internal Rotation ◽  
Clinical Decision Making ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Clinical Decision ◽  
Biomechanical Analysis ◽  
Glenohumeral Internal Rotation Deficit ◽  
Posterior Translation ◽  
Throwers Shoulder ◽  
Cadaveric Model

Overhead throwing athletes have been shown to develop adaptive changes in humeral rotation to allow for higher throwing velocities. This manifests as an increase in humeral external rotation and a decrease in internal rotation, which is called glenohumeral internal rotation deficit (GIRD). The percentage of GIRD that significantly affects glenohumeral joint kinematics is not known. The objective of the study was to create a throwers shoulder model with fixed percentages of GIRD to determine at which point kinematic changes start occurring. The results showed that there was a significant decrease in posterior translation starting at 10% GIRD. With inferior translational loads, significantly less inferior translation starts occurring at 20% GIRD. The humeral head apex position at maximum external rotation moves superiorly, posteriorly and laterally, with significant changes in the superior direction occurring with 10% GIRD onwards. Overall, significant kinematic changes begin at 10% GIRD and this should be taken into account for clinical decision-making as to when intervention is necessary.

Measurement of Glenohumeral Internal Rotation in Asymptomatic Tennis Players and Swimmers

2009 ◽  
Vol 37 (5) ◽  
pp. 1017-1023 ◽  
Author(s):  
Renato Rangel Torres ◽  
João Luiz Ellera Gomes
Keyword(s):  
Internal Rotation ◽  
External Rotation ◽  
Control Group ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Tennis Players ◽  
Glenohumeral Internal Rotation Deficit ◽  
Significant Difference ◽  
Overhead Sports ◽  
The Difference

Background Glenohumeral internal rotation deficit, often diagnosed in players of overhead sports, has been associated with the development of secondary shoulder lesions. Hypothesis Asymptomatic players of different overhead sports will exhibit variable degrees of glenohumeral internal rotation deficit. Study Design Cross-sectional study; Level of evidence, 3. Methods Fifty-four asymptomatic male volunteers (108 shoulders) divided into 3 groups (tennis players, swimmers, control group) underwent measurements of glenohumeral internal and external rotation using clinical examination with scapular stabilization. Measurements of dominant and nondominant shoulders were compared within and between groups. Glenohumeral internal rotation deficit (GIRD) was defined as the difference in internal rotation between the nondominant and dominant shoulders. Results In tennis players, mean GIRD was 23.9° ± 8.4° (P < .001); in swimmers, 12° ± 6.8° (P < .001); and in the control group, 4.9° ± 7.4° (P = .035). Dominant shoulders showed significant difference between all groups, and the difference in internal rotation of the dominant shoulder between the group of tennis players in comparison with the control group (27.6°, P < .001) was greater than the difference in internal rotation of the dominant shoulder found in the group of swimmers compared with the control group (17.9°, P < .001). Between tennis players and swimmers, the difference in internal rotation of the dominant shoulder was 9.7° (P = .002). Conclusion Dominant limbs showed less glenohumeral internal rotation than the nondominant limbs in all groups, with the deficit in the group of tennis players about twice the deficit found for swimmers. Mean difference between limbs in the control group was less than 5°, which is within normal parameters according to most studies. There were statistically significant differences between all groups when dominant shoulders were compared with each other, differences that were not compensated by external rotation gain. Tennis players had the least range of motion, followed by swimmers.

Three-Dimensional Scapular Kinematics during the Throwing Motion

2008 ◽  
Vol 24 (1) ◽  
pp. 24-34 ◽  
Author(s):  
Kristin E. Meyer ◽  
Erin E. Saether ◽  
Emily K. Soiney ◽  
Meegan S. Shebeck ◽  
Keith L. Paddock ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Angular Position ◽  
Three Dimensional ◽  
Low Velocity ◽  
Dynamic Activity ◽  
Motion Data ◽  
Asymptomatic Subjects ◽  
Scapular Motion

Proper scapular motion is crucial for normal shoulder mechanics. Scapular motion affects glenohumeral joint function during throwing, yet little is known about this dynamic activity. Asymptomatic subjects (10 male and 10 female), ages 21 to 45, were analyzed. Electromagnetic surface sensors on the sternum, acromion, and humerus were used to collect 3-D motion data during three trials of low-velocity throwing. Scapular angular position data were described for five predetermined events throughout the throw corresponding with classic descriptions of throwing phases, and trial-to-trial reliability was determined. ANOVA compared scapular angles across events. Subjects demonstrated good to excellent reliability between trials of the throw (ICC 0.74–0.98). The scapula demonstrated a pattern of external rotation, upward rotation (peak of approx. 40°), and posterior tilting during the initial phases of the throw, progressing into internal rotation after maximum humeral horizontal abduction. During the arm acceleration phase, the scapula moved toward greater internal rotation and began anteriorly tilting. At maximum humeral internal rotation, the scapula ended in internal rotation (55°), upward rotation (20°), and anterior tilting (3°).

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