scholarly journals Posterior Glenohumeral Joint Capsule Contracture

2012 ◽  
Vol 4 (4) ◽  
pp. 230-236 ◽  
Author(s):  
Amitabh Dashottar ◽  
John Borstad
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Humeral Head ◽  
Glenohumeral Joint ◽  
Tensile Force ◽  
Joint Capsule ◽  
Posterior Capsule ◽  
Joint Mechanics ◽  
Cellular Processes ◽  
Standard Techniques

Glenohumeral joint posterior capsule contracture may cause shoulder pain by altering normal joint mechanics. Contracture is commonly noted in throwing athletes but can also be present in nonthrowers. The cause of contracture in throwing athletes is assumed to be a response to the high amount of repetitive tensile force placed on the tissue, whereas the mechanism of contracture in nonthrowers is unknown. It is likely that mechanical and cellular processes interact to increase the stiffness and decrease the compliance of the capsule, although the exact processes that cause a contracture have not been confirmed. Cadaver models have been used to study the effect of posterior capsule contracture on joint mechanics and demonstrate alterations in range of motion and in humeral head kinematics. Imaging has been used to assess posterior capsule contracture, although standard techniques and quantification methods are lacking. Clinically, contracture manifests as a reduction in glenohumeral internal rotation and/or cross body adduction range of motion. Stretching and manual techniques are used to improve range of motion and often decrease symptoms in painful shoulders.

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.

Effect of Posterior Capsule Tightness on Glenohumeral Translation in the Late-Cocking Phase of Pitching

2007 ◽  
Vol 16 (1) ◽  
pp. 41-49 ◽  
Author(s):  
Kim M. Clabbers ◽  
John D. Kelly ◽  
Dov Bader ◽  
Matthew Eager ◽  
Carl Imhauser ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Humeral Head ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Head Position ◽  
Posterior Capsule ◽  
Nonsignificant Trend ◽  
Before And After ◽  
Fresh Frozen ◽  
Head Translation

Context:Throwing injuries.Objective:To study the effects of posterior capsule tightness on humeral head position in late cocking simulation.Design:Eight fresh frozen shoulders were placed in position of “late cocking,” 90 degrees abduction, and 10 degrees adduction and maximal external rotation. 3D measurements of humeral head relationship to the glenoid were taken with an infrared motion sensor, both before and after suture plication of the posterior capsule. Plications of 20% posterior/inferior capsule and 20% entire posterior capsule were performed, followed by plications of 40% of the posterior/inferior capsule and 40% entire posterior capsule.Setting:Cadaver Lab.Intervention:Posterior capsular placation.Main Outcome Measures:Humeral head position.Results:40%, but not 20%, posterior/inferior and posterior plications demonstrated a trend to increased posterior-superior humeral head translation relative to controls.Conclusion:Surgically created posterior capsular tightness of the glenohumeral joint demonstrated a nonsignificant trend to increased posterior/superior humeral head translation in the late cocking position of throwing.

scholarly journals Four-Dimensional Computed Tomography Evaluation of Shoulder Joint Motion in Collegiate Baseball Pitchers

2021 ◽  
Author(s):  
Daisuke Momma ◽  
Alejandro A Espinoza Orías ◽  
Tohru Irie ◽  
Tomoyo Irie ◽  
Eiji Kondo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Internal Rotation ◽  
Contact Area ◽  
Humeral Head ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Ct Scanning ◽  
4D Ct ◽  
Collegiate Baseball ◽  
Baseball Pitchers

Abstract The purpose of this study is to evaluate the glenohumeral contact area, center of glenohumeral contact area, and center of humeral head during simulated pitching motion in collegiate baseball pitchers using four-dimensional computed tomography (4D CT). We obtained 4D CT data from the dominant and non-dominant shoulders of eight collegiate baseball pitchers during the cocking motion. CT image data of each joint were reconstructed using a 3D reconstruction software package. The glenohumeral contact area, center of glenohumeral contact area, center of humeral head, and oblateness of humeral head were calculated from 3D bone models using customized software. The center of glenohumeral contact area translated significantly from anterior to posterior during maximum external rotation to maximum internal rotation. The center of humeral head translated from posterior to anterior during maximum external rotation to maximum internal rotation. There was a high negative correlation between anterior translation of the center of glenohumeral contact area and center of humeral head, and a positive correlation between the translation and the oblateness. 4D CT analyses demonstrated that the center of humeral head translated in the opposite direction to that of the center of glenohumeral contact area during external rotation to internal rotation in abduction in the dominant and non-dominant shoulders. This diametric translation can be explained by the oblateness of the humeral head. 4D CT scanning and the software for bone surface modeling of the glenohumeral joint enabled quantitative assessment of glenohumeral micromotion and identified humeral head oblateness as the cause of diametric change.

Stretching Positions for the Posterior Capsule of the Glenohumeral Joint

2008 ◽  
Vol 36 (10) ◽  
pp. 2014-2022 ◽  
Author(s):  
Tomoki Izumi ◽  
Mitsuhiro Aoki ◽  
Takayuki Muraki ◽  
Egi Hidaka ◽  
Shigenori Miyamoto
Keyword(s):  
Internal Rotation ◽  
Glenohumeral Joint ◽  
Cadaver Study ◽  
Posterior Capsule ◽  
Large Strains ◽  
Reference Length ◽  
Posterior Shoulder ◽  
Fresh Frozen ◽  
Extension Strain ◽  
Scapular Plane

Background Various stretches have been introduced for the posterior shoulder; however, little quantitative analysis to measure stretching of the posterior capsule has been performed. Hypothesis The current shoulder stretching program is not sufficient to stretch the entire posterior capsule. Study Design Controlled laboratory study. Methods Using 8 fresh-frozen cadaver shoulders (average age, 82.4 years), 8 stretching positions for the posterior capsule were simulated by passive internal rotation. Stretching positions of 0°, 30°, 60°, and 90° of elevation in the scapular plane; 60° of flexion; 60° of abduction; 30° of extension; and 60° of flexion and horizontal adduction were adopted. Strain was measured in the upper, middle, and lower parts of the capsule. The measurement of strain was instituted from reference length. Results With internal rotation, mean strain on the upper capsule was 3.02% at 0° of elevation and 3.35% at 30° of extension. Strain on the middle capsule at 0° and 30° elevation was 0.78% and 4.77%, respectively; on the lower capsule, it was 5.65% and 2.24% at 30° and 60° of elevation, respectively, and 2.88% at 30° of extension. Increase in strains of the upper, middle, and lower capsule with internal rotation at 0°, 30°, and 60° of elevation were statistically significant, respectively ( P < .01). Other shoulder positions demonstrated no positive strain values. Conclusions Based on the results of this cadaver study, large strains on the posterior capsule of the shoulder were obtained at a stretching position of 30° of elevation in the scapular plane with internal rotation for the middle and lower capsule, while a stretching position of 30° of extension with internal rotation was effective for the upper and lower capsule. Clinical Relevance The current posterior capsule stretching program of the shoulder was not sufficient to stretch the entire posterior capsule.

Reliability Study of Measuring Range of Motion Glenohumeral Joint Internal Rotation With Pressure Biofeedback Stabilization

2015 ◽  
Vol 22 (4) ◽  
pp. 62-70 ◽  
Author(s):  
Ui-jae Hwang ◽  
◽  
Sung-min Ha ◽  
In-chul Jeon ◽  
Sung-hoon Jung ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Glenohumeral Joint ◽  
Reliability Study ◽  
Measuring Range ◽  
Pressure Biofeedback

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.

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