Clinical Measures of Shoulder Mobility in College Water-Polo Players

2006 ◽  
Vol 15 (1) ◽  
pp. 45-57 ◽  
Author(s):  
Aaron Witwer ◽  
Eric Sauers

Context:Overhead stress from both swimming and throwing in water-polo players might lead to alterations in shoulder mobility and subsequent injury.Objective:To evaluate clinical measures of shoulder mobility in college water-polo players.Design:Repeated measures.Setting:University athletic training facility.Patients:31 Division I water-polo athletes.Main Outcome Measures:Measures were obtained for both the dominant and nondominant shoulders. Scapular upward rotation was measured using a digital inclinometer, posterior shoulder tightness was assessed by recording horizontal adduction with the scapula stabilized, and passive isolated glenohumeral-joint internal- and external-rotation range of motion were measured using goniometry.Results:No significant difference was observed between sides for scapular upward rotation (P= .68), posterior shoulder tightness (P= .25), or internal rotation (P= .41). A significant difference between sides was present for external rotation (P< .0001) and total arc of motion (P= .039).Conclusions:The dominant shoulders demonstrated significantly greater external rotation and a significantly greater total arc of motion than the nondominant shoulders did.

2019 ◽  
Vol 28 (3) ◽  
pp. 236-242 ◽  
Author(s):  
Brett S. Pexa ◽  
Eric D. Ryan ◽  
Elizabeth E. Hibberd ◽  
Elizabeth Teel ◽  
Terri Jo Rucinski ◽  
...  

Context: Following a baseball pitching bout, changes can occur to glenohumeral range of motion that could be linked to injury. These effects are in part due to the posterior shoulder’s eccentric muscle activity, which can disrupt muscle contractile elements and lead to changes in muscle cross-sectional area (CSA), as measured by ultrasound. Objective: To assess changes in muscle CSA, and range of motion immediately before and after pitching, and days 1 to 5 following pitching. Design: Repeated measures. Setting: Satellite athletic training room. Patients: Ten elite college baseball pitchers participating in the fall season (age: 18.8 [1.2] y, height: 189.2 [7.3] cm, mass: 93.1 [15.3] kg, 8 starters, 2 long relievers). Intervention: A pitching bout of at least 25 pitches (63.82 [17.42] pitches). Main Outcome Measures: Dominant and nondominant infraspinatus CSA, as measured by ultrasound, and glenohumeral range of motion including internal rotation (IRROM), external rotation (ERROM), and total rotation range of motion (TROM) before pitching, after pitching, and days 1 to 5 following the pitching bout. Results: Dominant limb CSA significantly increased day 1 after pitching, and returned to baseline on day 2 (P < .001). Dominant and nondominant TROM did not change until day 5 (4.4°, P < .001) and day 3 (4.5°, P < .001), respectively, where they increased. Dominant IRROM was significantly decreased for 3 days (day 1: 1.9°, P < .001; day 2: 3.1°, P < .001; day 3: 0.3°, P < .001) following pitching and returned to baseline on day 4, with no such changes in the nondominant limb. Dominant external rotation significantly increased immediately post pitching (4.4°, P < .001) but returned to baseline by day 1. Conclusions: The results of the study demonstrate that infraspinatus CSA does not recover until 2 days following pitching, and IRROM does not recover until 4 days following pitching. Baseball pitching elicits damage to the posterior shoulder muscle architecture, resulting in changes to physical characteristics that last up to 4 days following pitching.


2019 ◽  
Vol 54 (9) ◽  
pp. 945-952
Author(s):  
Mallory S. Faherty ◽  
Aldo Plata ◽  
Patrick Chasse ◽  
Robert Zarzour ◽  
Timothy C. Sell

Context Upper extremity (UE) musculoskeletal injuries are common in baseball athletes due to the increased demand placed on the UE. The link between risk factors for UE musculoskeletal injuries and baseball athletes' perceived UE function and pain, as measured by the Kerlan-Jobe Orthopaedic Clinic (KJOC) questionnaire, is unclear. Objective To (1) describe the musculoskeletal characteristics of the UE (posture, range of motion, flexibility, and isometric strength) in a population of baseball athletes and (2) determine the predictive capability of UE musculoskeletal characteristics for the KJOC score in these athletes. Design Cohort study. Setting Athletic training room. Patients or Other Participants A total of 37 male National Collegiate Athletic Association Division I baseball athletes (age = 20.10 ± 1.27 years, height = 186.96 ± 7.64 cm, mass = 90.60 ± 10.69 kg). Intervention(s) Athletes self-reported all shoulder musculoskeletal injuries and completed the KJOC questionnaire. Postural assessment consisted of forward head and shoulder posture. Flexibility tests characterized glenohumeral internal and external rotation, posterior shoulder tightness, and pectoralis minor length. Strength tests involved the lower and middle trapezius, rhomboid, glenohumeral internal and external rotation, pectoralis major, serratus anterior, supraspinatus, and upper trapezius. Main Outcome Measure(s) All 10 KJOC questions were summed for an overall score out of 100. Questions 1 through 5 were summed for a pain score; questions 6 through 10 were summed for a function score. All data were assessed for normality. A stepwise multiple regression model was fit to determine if the predictor variables assessed could predict the KJOC score. We set the α level a priori at .05. Results For the KJOC total score, a 1-year history of shoulder injury accounted for 7.80% of the variance in the KJOC total score (P = .07). For KJOC questions 1 through 5, a history of UE injury in the year before testing and posterior shoulder tightness accounted for 14.40% of the variance in the KJOC total score (P = .047). Conclusions The link between a history of UE musculoskeletal injuries and the KJOC score highlights the need for continued focus on self-perceived pain and function after UE musculoskeletal injury.


Author(s):  
Pooya Nekooei ◽  
Tengku-Fadilah T.K ◽  
Saidon Amri ◽  
Roselan Bin Baki ◽  
Sara Majlesi ◽  
...  

Background: The game of water polo has become more familiar to all the athletes and coaches as the time has passed. It has been played as a sport for more than a century Although anatomical shoulder movement strength balance is a crucial factor in overhead throwers’ performance, it has not been studied extensively in the previous research. Objective: This study examined shoulder movement imbalance in bilateral and dominant anterior-posterior shoulder among 42 elite water polo players in Malaysia. Method: The t-test analyses of data obtained through several tests proved that water polo players had statistically significant difference between their right hand anatomical shoulder movement strength and their left hand anatomical shoulder movement strength in all eight shoulder movements, i.e. Flexion, Extension, Abduction, Adduction, Horizontal Adduction, Horizontal Abduction, Rotation and External Rotation. Results: The results of this study showed that there are significant differences of anatomical shoulder movement strength in both bilateral and Anterior-posterior shoulder movement among water polo players. The statistics results for bilateral shoulder movement of Flexion (t= 136.09 and p<.001), Extension (t= 110.92 and p<.001), Abduction (t= 121.89 and p<.001), Adduction (t= 101.47 and p<.001), Horizontal Adduction (t= 92.3 and p<.001), Horizontal Abduction (t= 95.6 and p<.001), Internal rotations (t= 109.6 and p<.001) and External rotations (t= 102.18 and p<.001) showed the p-value to be less than 0.05 for all variables of the test. The result of paired samples t-test showed there is a statistically significant difference between the mean of bilateral anatomical shoulder movement strength among water polo players. Conclusion: These findings suggest that coaches and players should take into account the shoulder movement strength imbalance in their trainings and design specific training programs to improve overhead throwers’ shoulder movement strength balance and hence their throwing performance in sports such as water polo.


2007 ◽  
Vol 16 (1) ◽  
pp. 28-40 ◽  
Author(s):  
Eric Sauers ◽  
Anna August ◽  
Alison Snyder

Context:Stretching prior to activity or as a rehabilitative intervention may promote increased throwing shoulder range of motion (ROM) in baseball pitchers.Objective:To evaluate the acute effects of Fauls modified passive stretching routine on throwing shoulder mobility in collegiate baseball players.Design:Repeated measures.Setting:Laboratory.Participants:Thirty collegiate baseball players with unimpaired shoulders.Interventions:Fauls modified passive stretching routine was performed on the throwing shoulder of each subject.Outcome Measures:Shoulder complex and passive isolated glenohumeral internal and external rotation ROM were measured with a goniometer, and posterior shoulder tightness was assessed with the Tyler’s test method using a carpenter’s square. Measurements were made bilaterally.Results:The dominant shoulder displayed significant increases in glenohumeral and shoulder complex internal and external rotation ROM and significantly decreased posterior shoulder tightness following the stretching routine.Conclusion:Application of the Fauls modified passive shoulder stretching routine results in acute gains in throwing shoulder mobility of collegiate baseball players.


2012 ◽  
Vol 21 (1) ◽  
pp. 12-17 ◽  
Author(s):  
Kevin G. Laudner ◽  
Mike Moline ◽  
Keith Meister

Context:Posterior shoulder tightness has been associated with altered shoulder range of motion (ROM) and several pathologic entities in baseball players. This tightness is hypothesized to be the result of the cumulative stress placed on the posterior shoulder during the deceleration phase of the throwing motion. The role of the posterior shoulder static restraints is to absorb this load while the glenohumeral (GH) external rotators eccentrically decelerate the arm after ball release and therefore also help dissipate this force. As such, the authors hypothesized that if the GH external rotators are weak, an excessive amount of this deceleration force is placed on the static restraints, which may lead to subsequent tightness.Objective:To compare the relationship between GH external-rotation strength and posterior shoulder tightness as measured by GH horizontal-adduction and internal-rotation ROM.Design:Descriptive study.Setting:Laboratory.Participants:45 professional baseball players.Main Outcome Measures:GH external-rotation strength and GH horizontal-adduction and internalrotation ROM.Results:GH external-rotation strength showed no relationship with either GH horizontal-adduction ROM (r2 = .02, P = .40) or GH internal-rotation ROM (r2 = .002, P = .77).Conclusion:There is little to no relationship between GH external-rotation strength and posterior shoulder tightness in professional baseball players. The posterior static restraints of the shoulder may absorb a large majority of the deceleration forces during the throwing motion. Although strengthening of the posterior shoulder dynamic restraints should not be overlooked, routine stretching of the static restraints may be more beneficial for decreasing posterior shoulder tightness and the subsequent risks associated with this tightness, although future research is warranted.


2011 ◽  
Vol 20 (3) ◽  
pp. 345-354 ◽  
Author(s):  
Peter Brubaker ◽  
Cemal Ozemek ◽  
Alimer Gonzalez ◽  
Stephen Wiley ◽  
Gregory Collins

Context:Underwater treadmill (UTM) exercise is being used with increased frequency for rehabilitation of injured athletes, yet there has been little research conducted on this modality.Objective:To determine the cardiorespiratory responses of UTM vs land treadmill (LTM) exercise, particularly with respect to the relationship between heart rate (HR) and oxygen consumption (VO2).Design and Setting:This quantitative original research took place in sports medicine and athletic training facilities at Wake Forest University.Participants:11 Wake Forest University student athletes (20.8 ± 0.6 y, 6 women and 5 men).Intervention:All participants completed the UTM and LTM exercise-testing protocols in random order. After 5 min of standing rest, both UTM and LTM protocols had 4 stages of increasing belt speed (2.3, 4.9, 7.3, and 9.6 km/h) followed by 3 exercise stages at 9.6 km/h with increasing water-jet resistance (30%, 40%, and 50% of jet capacity) or inclines (1%, 2%, and 4% grade).Main Outcome Measures:A Cosmed K4b2 device with Polar monitor was used to collect HR, ventilation (Ve), tidal volume (TV), breathing frequency (Bf), and VO2 every minute. Ratings of perceived exertion (RPE) were also obtained each minute.Results:There was no significant difference between UTM and LTM for VO2 at rest or during any stage of exercise except stage 3. Furthermore, there were no significant differences between UTM and LTM for HR, Ve, Bf, and RPE on any exercise stage. Linear regression of HR vs VO2, across all stages of exercise, indicates a similar relationship in these variables during UTM (r = .94, y = .269x − 10.86) and LTM (r = .95, y = .291x − 12.98).Conclusions:These data indicate that UTM and LTM exercise elicits similar cardiorespiratory responses and that HR can be used to guide appropriate exercise intensity for college athletes during UTM.


2022 ◽  
Vol 8 (1) ◽  
Author(s):  
Joanne DiFrancisco-Donoghue ◽  
Thomas Chan ◽  
Alexandra S. Jensen ◽  
James E. B. Docherty ◽  
Rebecca Grohman ◽  
...  

Abstract Context Muscle damage and delayed onset muscle soreness (DOMS) can occur following intense exercise. Various modalities have been studied to improve blood lactate accumulation, which is a primary reason for DOMS. It has been well established that active recovery facilitates blood lactate removal more rapidly that passive recovery due to the pumping action of the muscle. The pedal pump is a manual lymphatic technique used in osteopathic manipulative medicine to increase lymphatic drainage throughout the body. Pedal pump has been shown to increase lymphatic flow and improve immunity. This may improve circulation and improve clearance of metabolites post-exercise. Objective This study compared the use of pedal pump lymphatic technique to passive supine recovery following maximal exercise. Methods 17 subjects (male n = 10, age 23 ± 3.01; female n = 7, age 24 ± 1.8), performed a maximal volume O2 test (VO2 max) using a Bruce protocol, followed by a recovery protocol using either pedal pump technique or supine passive rest for 10 min, followed by sitting for 10 min. Outcome measures included blood lactate concentration (BL), heart rate (HR), systolic blood pressure (SBP) and VO2. Subjects returned on another day to repeat the VO2 max test to perform the other recovery protocol. All outcomes were measured at rest, within 1- minute post-peak exercise, and at minutes 4, 7, 10 and 20 of the recovery protocols. A 2 × 6 repeated measures ANOVA was used to compare outcome measures (p ≤ 0.05). Results No significant differences were found in VO2, HR, or SBP between any of the recovery protocols. There was no significant difference in BL concentrations for recovery at minutes 4, 7, or 10 (p > 0.05). However, the pedal pump recovery displayed significantly lower BL concentrations at minute 20 of recovery (p = 0.04). Conclusion The pedal pump significantly decreased blood lactate concentrations following intense exercise at recovery minute 20. The use of manual lymphatic techniques in exercise recovery should be investigated further.


2018 ◽  
Vol 47 (2) ◽  
pp. 165
Author(s):  
Lana Hirai Gimber ◽  
Mihra S. Taljanovic ◽  
Zachary A. Rockov ◽  
Elizabeth A. Krupinski ◽  
Tyson S. Chadaz ◽  
...  

<p><strong>Objective.</strong> To describe a new radiographic sign, “veil of obscuration”, associated with posterior glenohumeral joint (shoulder) dislocations and determine its incidence and validity compared to other known classic radiographic signs.</p><p><strong>Methods.</strong> Four-year retrospective study identified 30 acute posterior shoulder dislocation patients. Radiographs reviewed in consensus by 2 musculoskeletal radiologists for the “veil of obscuration”, seen on AP shoulder radiographs and representing a comminuted fracture of the lesser tuberosity projecting over the humeral head or glenohumeral joint. Incidence of this radiographic sign of posterior glenohumeral joint dislocation in addition to other previously described classic radiographic signs, and association with other fractures, surgery, and mechanism of injury were evaluated. Continuous data was analysed with student t-test and categorical data with Chi-Square test.</p><p><strong>Results. </strong>There were 20 right and 10 left posterior shoulder dislocations. Majority of injuries resulted from vehicle crash (44%). In most cases, reverse Hill-Sachs lesion (83%) and fixed internal rotation of the humeral head (76%) were present, followed by trough line (43%) and “veil of obscuration” (40%). Trough line was seen in significantly more major trauma and vehicle crashes (78% and 46%; P=0.015), while “veil of obscuration” was seen in more seizures (86%; P=0.037) and in all surgical patients.  No significant difference in presence of other classic radiographic signs in regards to surgery.</p><p><strong>Conclusion. </strong>The newly described radiographic sign of posterior shoulder dislocations named the “veil of obscuration” has comparable incidence as other classic radiographic signs and may be useful in the recognition and diagnosis of these injuries.</p>


2007 ◽  
Vol 16 (1) ◽  
pp. 41-49 ◽  
Author(s):  
Kim M. Clabbers ◽  
John D. Kelly ◽  
Dov Bader ◽  
Matthew Eager ◽  
Carl Imhauser ◽  
...  

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.


2015 ◽  
Vol 24 (3) ◽  
pp. 293-299 ◽  
Author(s):  
Kazem Malmir ◽  
Gholam Reza Olyaei ◽  
Saeed Talebian ◽  
Ali Ashraf Jamshidi

Context:Cyclic movements and muscle fatigue may result in musculoskeletal injuries by inducing changes in neuromuscular control. Ankle frontal-plane neuromuscular control has rarely been studied in spite of its importance.Objective:To compare the effects of peroneal muscle fatigue and a cyclic passive-inversion (CPI) protocol on ankle neuromuscular control during a lateral hop.Design:Quasi-experimental, repeated measures.Setting:University laboratory.Participants:22 recreationally active, healthy men with no history of ankle sprain or giving way.Interventions:Participants performed a lateral hop before and after 2 interventions on a Biodex dynamometer. They were randomly assigned to intervention order and interventions were 1 wk apart. A passive intervention included 40 CPIs at 5°/s through 80% of maximum range of motion, and a fatigue intervention involved an isometric eversion at 40% of the maximal voluntary isometric contraction until the torque decreased to 50% of its initial value.Main Outcome Measures:Median frequency of the peroneus longus during the fatigue protocol, energy absorption by the viscoelastic tissues during the CPI protocol, and feedforward onset and reaction time of the peroneus longus during landing.Results:A significant fall in median frequency (P < .05) and a significant decrease in energy absorption (P < .05) confirmed fatigue and a change in viscoelastic behavior, respectively. There was a significant main effect of condition on feedforward onset and reaction time (P < .05). No significant main effect of intervention or intervention × condition interaction was noted (P > .05). There was a significant difference between pre- and postintervention measures (P < .0125), but no significant difference was found between postintervention measures (P > .0125).Conclusions:Both fatigue and the CPI may similarly impair ankle neuromuscular control. Thus, in prolonged sports competitions and exercises, the ankle may be injured due to either fatigue or changes in the biomechanical properties of the viscoelastic tissues.


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